- Aggravation (preexisting condition) (tendonitis)
- Disablement (repetitive work)
- Medical report (opinion of medical assessor)
- Tendonitis (shoulder) (calcific)
- Medical report (Tribunal medical discussion paper)
The Board granted the worker entitlement for tendonitis of her left shoulder in April 2011. The worker appealed a decision of the Appeals Resolution Officer denying ongoing entitlement for the tendonitis or for calcific tendonitis.There were medical opinions supporting entitlement for calcific tendonitis as a result of the worker's repetitive work duties. However, a Tribunal medical discussion paper specifically states that calcific tendonitis is neither caused by nor aggravated by any particular work activity. Considering the inconsistency between the medical reporting and the discussion paper, the Vice-Chair obtained a report from a Tribunal medical assessor.The assessor agreed with the discussion paper that the cause of calcific tendonitis is unknown and that calcific tendonitis is not caused by repetitive work. However, the assessor disagreed with the statement in the discussion paper that repetitive work cannot aggravate the effects of calcific tendonitis, at least in some circumstances, including the medical facts of this case.The assessor explained that thickening of a tendon by calcification can lead to impingement syndrome. If work processes also cause tendonitis, leading to impingement, then the symptoms of the calcific tendonitis and/or the prognosis can be worsened by the work-induced impingement.The Vice-Chair accepted the opinion of the assessor and found that, while the repetitive work did not cause the calcific tendonitis, which was pre-existing, it did aggravate and worsen the impingement syndrome due to the development of the compensable overuse tendonitis. The aggravation of the effects of the pre-existing calcific tendonitis was, therefore, compensable.The Vice-Chair concluded that the worker was not entitled to additional ongoing benefits for overuse-related tendonitis, for which entitlement was granted by the Board, but the worker was entitled to ongoing benefits for aggravation of her pre-existing calcific tendonitis and the resultant left shoulder impairment.The appeal was allowed in part.