Highlights of Noteworthy Decisions
- Medical opinion (fibromyalgia)
The worker suffered a low back injury in 2008. The worker appealed a decision of the Appeals Resolution Officer denying entitlement for fibromyalgia. The Vice-Chair referred to the Tribunal medical discussion paper on Fibromyalgia, and noted that the causes of fibromyalgia are not generally known or agreed upon, and that the nature of the connection between trauma, disability and fibromyalgia is uncertain. None the less, Board policy allows entitlement for fibromyalgia under its chronic pain disability policy. The opinion of the worker's treating rheumatologist supported a causal relationship between the worker's accident and the onset of her fibromyalgia. That opinion appeared to be based largely on the close temporal relationship between the accident and the diagnosis. However, the Vice-Chair stated that a close temporal relationship is not, on its own, sufficient to establish causation. Contrary to the opinion of the rheumatologist, the opinion of another doctor viewed the close temporal relationship as an indication that the accident did not cause the fibromyalgia. The close temporal relationship can be seen as an indication that the process leading to the development of the fibromyalgia was already underway at the time of the accident. The worker had numerous physical difficulties prior to the accident. She also had a history of non-organic symptoms, such as headaches, dizziness, depression, fatigue, sleep difficulty and spousal abuse, that have all been correlated to the occurrence of fibromyalgia. The Vice-Chair concluded that a relationship between the accident and the worker's fibromyalgia had not been demonstrated. The appeal was dismissed.