- Aggravation (preexisting condition) (asthma)
- Permanent impairment {NEL}
The issues under appeal were whether the worker was entitled to an aggravation of her underlying asthma, and whether the worker's aggravation of underlying asthma ceased as of July 30, 2018.
The Panel allowed the appeal.The Panel found that the worker's asthma, on a balance of probabilities, developed as a result of workplace exposures. The Panel placed significant weight on the medical opinions of the physicians in this appeal, who each determined that the worker's asthma likely resulted from workplace exposures. The worker was appropriately granted entitlement for exacerbation of her subclinical asthma. The worker was entitled to ongoing benefits for asthma including a NEL determination. As per Policy 16-01-01, the Panel first considered whether the worker had an ongoing diagnosis of asthma. The Panel found that the worker had reached a plateau in her recovery, and it was not likely that there would be significant improvement. Next, the Panel considered whether the worker's ongoing asthma was work-related. The Panel found no evidence of significance that the worker's pre-existing subclinical asthma was so significant that it overwhelmed the worker's ongoing work-related asthma. The Panel determined that the workplace exposures accelerated the worker's development of asthma and permanently changed the long-term course of the worker's asthmatic condition.Policy 16-01-01 advises that a worker's permanent impairment due to asthma is rated in two areas. The first is respiratory impairment. One of the considerations is whether they have been prescribed medications related to the asthma. The worker had been prescribed inhaled corticosteroids as well as salbutamol (a bronchodilator) on an ongoing basis. As a result, the worker had a ratable permanent impairment. Further, Policy 16-01-01 states that a worker's immunological impairment will be considered when rating a permanent impairment for asthma. The policy states that if a worker has a clinically significant sensitization to a workplace substance, the worker is considered to have a permanent impairment of the immune system. A sensitization is considered to be clinically significant if the worker is sensitized, and upon exposure to the workplace substance, the worker experiences asthmatic symptoms. The level of exposure need not be excessive. In this appeal, the Panel determined that the workplace exposures that led to the development of the worker's asthmatic condition included packaging exotic mushrooms. As a result, the worker had developed an immunological impairment (sensitization) as a result of her workplace exposure to exotic mushrooms. The worker's now sensitized immune system represented a ratable permanent impairment.