Highlights of Noteworthy Decisions

Decision 2238 18
08/08/2019
R. Horne - K. Soden - M. Ferrari
  • Disablement (strenuous work)
  • Disc, degeneration (lumbosacral)
  • Evidence (epidemiological)
  • Medical report (Tribunal medical discussion paper)

The worker appealed a decision of the Appeals Resolution Officer denying entitlement for degenerative disc disease and a herniated disc, which the worker related to strenuous work as a roofer.

The Tribunal medical discussion paper on low back pain essentially takes the position that degenerative disc disease is caused by genetics and natural ageing, and that heavy work does not make a significant contribution. It cites a lack of high level scientific evidence on the topic.
The worker submitted a paper from OHCOW. That paper takes the position that scientific evidence does support a connection between heavy work and the development of degenerative disc disease, sufficient to cause disc herniation, and disputes the conclusion of the Tribunal medical discussion paper that there is insufficient evidence to make such a connection.
The Panel reviewed Tribunal decisions, and found that no consensus has yet been established. Some decisions have allowed entitlement for degenerative disc disease on a disablement basis while others have not.
The Panel reviewed the scientific papers referred to in the OHCOW report. The Tribunal medical discussion paper and the majority of scientific papers reviewed by the Panel acknowledge that degenerative disc disease is part of the ageing process. The Panel found a lack of consistency in the findings in the scientific papers referred to in the OHCOW report. Some show an association between heavy lifting and degenerative disc disease but some do not. This is exactly what the Tribunal medical discussion paper found when it stated that there is a lack of consistent high level scientific evidence on the topic.
It makes intuitive sense that heavy lifting over time would lead to a bad back. However, establishing work-relatedness requires more than a possibility; it requires a probability. Establishing a nexus to work becomes exceptionally difficult when the condition is prevalent in the general population, working and non-working, blue collar and sedentary workers. It is even more difficult when the condition is progressive and age-related.
The Panel was unable to conclude that the worker's exposure to heavy lifting in this case was a significant contributing factor to his degenerative disc disease and subsequent disc herniation.
The appeal was dismissed.