Canadian Safety Reporter

2 Canadian HR Reporter, a Thomson Reuters business 2016 CSR | May 2016 | News She worked in the position for al- most a decade until 1998, when she began experiencing pain and discomfort in her wrists. The worker was assessed by a physiat- rist, who diagnosed carpal tunnel syndrome in both wrists. The worker underwent de- compression surgery on her right wrist in March 1999 and on her left wrist in July 1999. Shortly after her first sur- gery, the worker filed a claim for benefits for her carpal tunnel syndrome. The Ontario Work- ers Safety and Insurance Board found her condition was caused by the repetitive nature of her work duties and approved her claim. The board also found that the worker's carpal tunnel syn- drome was a permanent impair- ment and awarded her a non- economic loss award. Worker had other issues with chronic pain In 1997, before the worker was diagnosed with carpal tunnel syndrome, she was diagnosed with another condition — fi- bromyalgia, a condition causing fatigue and chronic pain in the muscles and tissues surrounding the joints. A physiatrist's report in April 1997 indicated the work- er had "unprovoked episodes of musculoskeletal symptoms" in her chest that were "unrelated to any injury or incident." There were some medical opinions dis- agreeing with the initial diagno- sis, but it was confirmed in 2001. Following the confirmation of fibromyalgia in 2001, the work- er filed a claim for benefits for this condition, claiming it was caused by her bilateral carpal tunnel syndrome — which was in turn caused by her job duties. The board found the worker's fibromyalgia wasn't caused by her work-related carpal tunnel syndrome and denied the claim. The board's decision was in- fluenced by a 2005 report by a rheumatologist that stated the worker had had musculoskeletal pain for 10 years, including back, shoulders, neck, arms, knees and hips. This pain made it difficult for the worker to walk and sleep. The report also mentioned her problem with chronic fatigue, ir- ritable bowel syndrome, depres- sion, and panic attacks. The board's medical consul- tant also found there were other areas of pain in the worker's body that were not attributable to her wrist condition. In addition, the worker's family physician said she had "various medical issues contributing to the worker's pain syndrome" and wouldn't defini- tively say there was a link. The worker appealed the board's decision to the tribunal. The tribunal referred to the board's policy on chronic pain disability, which is part of the operational policy manual gov- erning workers' compensation decisions in Ontario. The policy indicates that for chronic pain caused by a work-related injury to be compensable, there must be a medical opinion that the worker's pain is compatible and resulting from the work-related injury. No evidence fibromyalgia was caused by work-related injury The tribunal found the medical reports in 1997 and 2005, as well as additional medical evidence showing chest and back pain go- ing back to 1995, showing "long- standing, chronic, musculoskel- etal pain in areas of her body that were not affected by her bilateral carpal tunnel syndrome, and which pre-dated the diagnosis of carpal tunnel syndrome." The tribunal noted that it would be difficult to make a connection between pain in the worker's back that later spread to her shoulders, neck, arms, knees, and hips could be caused by her carpal tunnel syndrome. The tribunal noted that the worker had been experiencing pain in her wrists for some time — as long as five or six years ear- lier, according to her workers' compensation claim — before being diagnosed with carpal tun- nel syndrome. However, at this stage it was "a relatively mild con- dition and non-disabling condi- tion" and the worker was diag- nosed with fibromyalgia during a time there were no documented complaints of pain in the work- er's wrists — between 1993 and 1998 — said the tribunal. "During that five-year period, in which there were no docu- mented complaints of carpal tunnel syndrome, the worker was diagnosed with a chest wall pain syndrome, back pain which became diffuse and affected her walking, and with fibromyalgia," said the tribunal. "It is difficult to attribute the worker's fibro- myalgia to her bilateral carpal tunnel syndrome, when the for- mer condition was diagnosed during a period in which there was a lengthy absence of any documented complaints of wrist pain," said the tribunal. In addition, the tribunal point- ed to medical reports stating no link between the worker's mus- culoskeletal pain and her carpal tunnel syndrome. Considering all of the medical evidence couldn't show a link be- tween the worker's carpal tunnel syndrome and her fibromyalgia, the tribunal found no reason to overturn the board's denial of workers' compensation benefits to the worker for her fibromyal- gia. The appeal was denied. For more information see: • Decision No. 668/16, 2016 CarswellOnt 4537 (Ont. W.S.I.A. Trib.). Two claims < pg. 1 Fibromyalgia came before carpal tunnel diagnosis Credit: jcjgphotography (Shutterstock)

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