Highlights of Noteworthy Decisions

Decision 1706 16
30/04/2020
R. McCutcheon
  • Consequences of injury (iatrogenic illness) (medication) (anti-inflammatory)
  • Osteoporosis (transient)
  • Evidence (weight) (medical report)

On August 22, 2006, the worker was stung by an insect at work. The worker developed an infection as a result requiring him to take prednisone for approximately two months.

In this appeal the worker was claiming entitlement for osteoporosis/osteopenia and related vertebral fractures which occurred in 2008 as a secondary condition to his use of prednisone.
The Tribunal Chair found that the worker took 1425 mg of prednisone over the course of approximately two months in September and October 2006. The diagnosis of osteoporosis/osteopenia was made in December 2008, over two years after the worker had stopped the course of prednisone in October 2006.
The Chair requested the opinion of Tribunal medical assessor. His report noted that the medical literature suggested that following cessation of corticosteroid (prednisone) use bone density rapidly reversed and probably over a period of time would return to baseline levels.
The worker was a lifelong smoker, with a 40-pack year history, which was a risk factor for bone density loss. The medical literature supported a direct and independent link between smoking and the development of bone density loss.
The Chair gave less weight to the medical report from a radiologist submitted by the worker in reply to that of the medical assessor. In her reasons she noted among other considerations that the radiologist was retired at the time the opinion was given. In general, reports from former medical practitioners who are not licensed to practice medicine are considered less reliable. See, for example, Decision No. 1205/15I.
The Chair also considered the evidence this radiologist gave in proceedings in respect of a workers' compensation claim the worker made in another province. The Chair found however that the opinion provide there was consistent with the current view that bone density levels returned to baseline levels once prednisone treatment ceased.
The appeal was denied.