Pre-existing carpal tunnel syndrome was aggravated and knees were permanently injured in office worker’s tumble
A retired Ontario office worker has won her appeal for ongoing benefits for wrist, hand, and knee impairments that were aggravated by or stemmed from a workplace fall.
The worker was employed as a primary adjudicator, a position that involved a significant amount of typing. In June 1997, the worker began experiencing pain in both hands and applied for workers’ compensation benefits. Her application was granted and she received full wage loss benefits for repetitive strain injuries to both hands for a one-month period in July 1997 and a two-month period from September to November of the same year when she was unable to work due to her injuries.
The worker’s injuries flared up again in January 1998 and she received full wage loss benefits again for three weeks she was unable to work in late January and early February.
The Ontario Workplace Safety and Insurance Board (WSIB) determined that the injury to the worker’s right hand — which had been diagnosed as flexor tenosynovitis — was a permanent impairment. In February 2000 she was granted entitlement for bilateral carpal tunnel syndrome from September 1998.
The worker’s injuries improved to the point where she could work. While she reported swelling and a “warm sensation” in her hands every day, she was able to type and answer the phone without using splints or any other assistance.
On Jan. 20, 2012, the worker slipped and fell to all fours while at work. She landed on both knees and braced herself with both hands on the ground. She suffered from contusions and strain injuries on both knees and strain injuries to both hands, requiring medication. She had to stop working and the WSIB granted her entitlement to workers’ compensation benefits for these injuries. A short time later, a WSIB case manager granted her additional benefits because the work accident had aggravated her pre-existing carpal tunnel syndrome.
The worker remained off work for 16 days, during which she received full loss-of-earning benefits from the WSIB. She returned to work on Feb. 6, with modified duties and was provided with a stool to prop up her legs. She wore a knee brace and splints at times. Her employer developed a graduated plan, where she started with very little typing at first and shorter hours, gradually increasing both until she was performing her normal duties. The worker lasted three months until May, when she was diagnosed with trigger thumb. However, the WSIB denied her entitlement for the condition.
On June 11, the worker was laid off after suffering from a psychological condition that was not work-related. However, the worker claimed the condition was triggered by her being unable to sleep and it led to two weeks in the hospital.
In March 2014, the worker’s position was made redundant and she opted to take an early retirement package with a reduced pension. She also collected Canada Pension Plan disability benefits for the psychological condition and the pain in her hands and wrists.
The worker applied once again for permanent impairment benefits — claiming she required a knee brace and couldn’t walk very well — but an appeals resolution officer determined her carpal tunnel syndrome had not significantly deteriorated after the January 2012 accident. In addition, her knees hadn’t worsened and the worker wasn’t entitled to additional benefits beyond a few months after the accident.
The worker had decompression surgery of her right wrist in 2013 that reduced the numbness in that hand by about half, but there was still pain.
The worker appealed to the Workplace Safety and Insurance Appeals Tribunal, claiming her knee injuries and carpal tunnel syndrome were keeping her from being able to work and they should be deemed a permanent impairment. She said her hands were never the same after the slip and fall and the swelling had gotten worse, making it difficult to grip things.
The tribunal noted that it had already been established that the worker’s carpal tunnel syndrome in both hands was a pre-existing condition at the time of the January 2012 workplace accident. The question of whether the worker deserved additional entitlement for it depended on whether the slip and fall aggravated it to the point where it never returned to its pre-accident state.
The tribunal found that the worker’s condition didn’t resolve after her 1998 injury, but she was able to work without treatment for more than a decade before the accident. She had mild symptoms, but it didn’t prevent her from performing her job duties with some restrictions such as limited keyboarding each day. The symptoms were manageable, said the tribunal.
The tribunal also found that following the accident, the worker’s symptoms became more acute and she required more treatment. She needed modified duties and wore braces, and her pain wasn’t as manageable, to the point where she had surgery to help relieve the pain in her right hand.
The tribunal found that the worker’s bilateral wrist and hand symptoms worsened after the accident and needed more treatment. As a result, her carpal tunnel syndrome was permanently aggravated in the work accident and warranted a non-economic loss assessment for benefits.
As for the worker’s knees, it was clear their injuries stemmed from the workplace accident, said the tribunal. She continued to have restrictions months later and her medical reports indicated abnormalities. The worker still experienced pain in both knees and had difficulty with her mobility — and she had no history of knee problems before the work accident.
The tribunal noted that “ongoing entitlement is established where the accident continues to be a significant contributing factor in the worker’s ongoing complaints even if other factors may have also contributed.” Since there was no evidence of a pre-existing condition in the worker’s knees and medical reports attributed the abnormalities in her knees to the accident, the tribunal found the worker had entitlement for a bilateral knee impairment.
The tribunal remitted the matter back to the WSIB for assessment of non-economic loss benefits for both her carpal tunnel syndrome and knee impairment.
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