Decision Number: 20100058, 2010 CanLII 31581 (ON W.S.I.B.)

Appeals Resolution Officer Decision

OBJECTION BY: Worker
WORKER: Participating
EMPLOYER: Participating
REPRESENTATIVES: Worker, Employer
HEARING DATE: April 16, 2010

Issue:
The worker is seeking additional entitlement for a hernia. This was denied in the Eligibility Adjudicator's decision letter of May 19, 2009.

How the Issue Arose:
On January 10, 2008 this now 49 year old worker fell a short distance, was caught by his safety harness, but hit his back on a skid. Entitlement was allowed for a mid back strain, there was no medical indication for lost time, and the employer was able to provide regular work not involving heights. Further medical investigations due to a hip pain indicated mild degenerative changes bilaterally; osteoarthritis is greater in the right hip, mild sclerosis involved the acetabulum bilaterally. A CT scan of the head was normal compared to a prior scan in May of 2006. In September 2006 the worker was diagnosed with a hernia which he related to the mid back accident. Entitlement was denied. This was surgicallt corrected in December 2008. The worker had surgery on April 8, 2009 for an unspecified condition.

Assessment of the Evidence:
The employer representative was surprised that the doctor related the hernia to the January work incident. This was not diagnosed until 10 months after the work incident and there is no medical continuity about a hernia. The doctor has not accurately documented any history of hernia or its development, nor was there any mention of an accident in September. There was notification of a new work injury and there were no medical forms completed documenting any incident. There is no contemporaneous medical data to support a new accident or any aggravating incident.

I am unable to substantiate that any new work injury or aggravating incident occurred in September 2008. The worker is a poor historian and was unable to provide any accurate or convincing evidence of an event that supposedly happened in September 2008. There is no report of a new injury or a recurrence of a prior injury and the employer has no records of a new work event. There is no claim file data to support such a view.

It is also unlikely that the worker experienced a hernia on the day of accident on January 10, 2008. On that day the worker injured his mid back and he did not require time off work or medical precautions. It was a minor incident without permanent impairment. This view is supported by the objective medical observations of the rheumatologist, dated October 24, 2009.
This specialist states that the worker discovered a small soft lump over the right inguinal area at the beginning of October 2008. The hernia did not arise from the workplace incident in January, it developed in the autumn of 2008 several months later.

It was noted that this worker had a prior, non-compensable hernia in the same location
a number of years ago. Also, it is curious to note that the worker had a CT scan of his head two years prior to the work accident. There is insufficient data to medically connect the hernia to the work accident.

Conclusion:
The worker's objection is denied, there is no entitlement for a hernia.