- Permanent impairment {NEL}
- Significant contribution (of employment to ongoing condition)
The Board granted the worker entitlement for repetitive strain injury in February 2011, consisting of multifocal peripheral neuropathy and carpal tunnel syndrome. The worker appealed a decision of the Appeals Resolution Officer denying entitlement for permanent impairment.
The repetitive strain injury was a significant contributing factor to the onset of the worker's arm and wrist condition in February 2011.The worker had pre-existing conditions. However, before the repetitive strain injury, the worker was not symptomatic. After the repetitive strain injury, there was some improvement following ulnar nerve surgery, but the worker was left with ongoing symptoms and functional restrictions.The worker had longstanding underlying type 1 diabetes, as well as pre-existing carpal tunnel syndrome for which he underwent surgery six years prior to the compensable injury. This raised the question of whether the permanent impairment resulted from the pre-existing conditions or from the repetitive strain injury. Specifically, the Vice-Chair had to determine whether the significance of the injury was rendered insignificant by the underlying diabetes or pre-existing carpal tunnel syndrome.The underlying diabetes was not of such significance as to outweigh the significant contribution made by the repetitive strain injury to the permanent impairment. It was noted as a risk factor for the recurrence of neuropathic problems but was not a significant contributing factor to the ongoing symptoms.The pre-existing carpal tunnel syndrome did not outweigh the repetitive strain injury as a contributing factor to the permanent impairment. The condition appeared to resolve after the prior surgery. The repetitive strain injury resulted in a recurrence of the carpal tunnel symptoms notwithstanding that the prior carpal tunnel syndrome was a predisposing factor. The repetitive strain injury was a significant contributing factor without which the worker would not have suffered the onset of symptoms in February 2011, which have now persisted and become permanent.The worker had entitlement for permanent impairment. The appeal was allowed.