- Carpal tunnel syndrome
- Disablement (repetitive work)
- Reconsideration (consideration of evidence)
- Repetitive movement
- Medical report (Tribunal medical discussion paper)
- Words and phrases (repetitive)
The worker sought reconsideration of Decision No. 1184/19, which denied entitlement for bilateral carpal tunnel syndrome (CTS). Decision No. 1184/19RI found that the panel in Decision No. 1184/19 erred by applying an expanded definition of the term "repetitive" as used in the Tribunal's Medical Discussion Paper, and requested the opinion of a Tribunal Medical Assessor to clarify the meaning of "repetitive" in the Medical Discussion Paper.
The reconsideration request was granted and the appeal was allowed. The Medical Assessor interpreted the term "repetitive" in the Medical Discussion Paper to mean "repetitive use," which could include different motions or a combination of motions specific to the hand and wrist, performed at a high frequency for a continuous period of time. A variation in tasks alone would not provide significant relief unless the change was substantially different and reduced in duration. The panel's approach in the prior decision precluded it from considering that the worker's doctors may have had a different view of the meaning of repetitive that might have been the correct view. It was an error for the panel to establish a criterion for entitlement based on what it considered to be an expanded definition derived from Tribunal case law prior to weighing the evidence of the treating physicians. Based on the Medical Assessor's report, a clearer understanding of the term repetitive as used in the Medical Discussion Paper would have likely changed the result of the decision. The threshold test for reconsideration was therefore met. The Medical Assessor's opinion that the worker's job duties were sufficiently repetitive and forceful to be a significant causal factor in the development of CTS was accepted. It was consistent with the opinions of the worker's treating doctors. The general wording in the Medical Discussion Paper was not sufficient to deny entitlement in the worker's case.