- Disablement (nature of work)
- Evidence (weight)
- Postal workers (letter carrier)
- Tarsal tunnel syndrome
A letter carrier appealed a decision of the Appeals Resolution Officer denying entitlement for tarsal tunnel syndrome.The worker related the condition to a change in his route in 1998, which required him to walk longer distances with heavier mail. The worker relied on a medical opinion from a community medicine specialist at the Occupational Health Clinics for Ontario Workers (OHCOW).The Tribunal considers a number of factors in determining the weight to be given to medical and other expert evidence. The factors include: credentials of the practitioner, quality of the report, knowledge of the facts, responsiveness to the issues, objectivity of the report, opportunity to observe, contemporaneity, consistency with other evidence and neutrality.The Panel placed little weight on the report of the doctor from OHCOW. The doctor was not a neurologist or nerve specialist. He saw the worker on only one occasion and that was more than six years after the onset of the injury in 2001. The report was based on the misapprehension that there was a close temporal relationship between the change in duties and the onset of symptoms. Many assertions in the report were unsupported and the conclusions were not well explained.Medical literature did not support a causal link between the increased work duties and tarsal tunnel syndrome. Extensive walking or increase in carried weight are not identified as causal or contributing factors to development of tarsal tunnel syndrome. The literature suggests that a specific cause of tarsal tunnel syndrome is unknown in 20% to 40% of patients, implying that idiopathic or spontaneous onset is plausible. In this case, there was no reasonable temporal connection between the change in duties in 1998 and the onset of symptoms in 2001.The worker did not have entitlement for tarsal tunnel syndrome. The appeal was dismissed.