Highlights of Noteworthy Decisions

Decision 2206 19
20/01/2020
D. Revington
  • Board Directives and Guidelines (recurrences)
  • Recurrences (compensable injury)
  • Significant contribution (of compensable accident to subsequent disability)

The worker suffered a head injury in August 2009. The worker appealed a decision of the Appeals Resolution Officer denying entitlement for a recurrence in May 2013.

Tribunal decisions have found that the applicable Board policy is the policy that was in effect at the time of the initial Board decision. There was some uncertainty as to the date of the initial Board decision in this case. Board Operational Policy Manual, Document No. 15-02-05, on recurrences, was published on February 1, 2018, whereas Document No. 15-03-01, on recurrences, was published on February 18, 2009.
Document No. 15-03-01 states that a recurrence may result from an insignificant new accident or even from no new accident. To determine if there has been a recurrence, it must be established that there is clinical compatibility or a combination of clinical compatibility and continuity between the original injury and the current condition. Clinical compatibility involves comparing the worker's current clinical condition with the worker's clinical condition after the initial accident; the comparison is made by considering whether parts and functions of the body that are currently affected are the same as those affected by the initial accident.
Document No. 15-02-05 explicitly requires that the second incident result in a significant deterioration in order for there to be entitlement for a recurrence. It retains the criterion of clinical compatibility. The body parts or functions affected now must be the same as, or related to, those affected by the original injury. A causal link must be established between the original injury and the deterioration arising from the second incident. Continuity is not a criterion but it may be an indicator of a causal link.
The Vice-Chair found that, regardless of which policy applies, the worker did not have entitlement for a recurrence. The compensable injury was not a significant causal factor of the worker's condition in May 2013. The initial accident was a cut on the top of the worker's head. It did not require stitches. The worker was off work for only two days. The current condition consisted of headaches, neck pain, right shoulder pain, depression and many somatic complaints. There was no convincing medical evidence to explain how the current complaints could be related to the minor initial injury. The worker has suffered from many non-work-related conditions since the compensable accident. There was also little evidence of continuity between the compensable injury and the condition in May 2013. The worker suffered a significant deterioration in May 2013, but it was not compatible with the original injury. A causal link between the significant deterioration and the original injury was not established.
The appeal was dismissed.