FD: FD: DT:D DN:81/87 STY: PANEL:O'Neil; Lankin; Jago DDATE: TYPE:A ACT: DECON:81/87L CCON: SCON: BDG:Claims Adjudication Branch Procedures

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1 FD: FD: DT:D DN:81/87 STY: PANEL:O'Neil; Lankin; Jago DDATE: TYPE:A ACT: DECON:81/87L CCON: SCON: BDG:Claims Adjudication Branch Procedures Manual, document no ; Claims Services Division Manual, s.122(1), p.262, directive 15 REGS: PDCON: DIST: KEYW:arising out of and in the course of employment; vibrations; white finger disease; mining SUM: Worker entitled to benefits for vibration induced white finger disease resulting from use of jack-leg drill on almost daily basis for 34 years. PD: IDATE: HDATE: TCO: KEYPER:E. Bowman XREF: COMMENTS: TEXT:

2 WORKERS' COMPENSATION APPEALS TRIBUNAL DECISION NO. 81/87 This appeal was heard on October 28, 1987, in Sudbury by: K.G. O'Neil: Panel Chairman, W.D. Jago: Tribunal Member representative of employers, F.L. Lankin: Tribunal Member representative of workers. THE APPEAL PROCEEDINGS The worker appeals the February 18, 1983, decision of the former Appeal Board of the Workers' Compensation Board in which entitlement to benefits for white finger disease was denied. Leave to appeal from that decision was granted in Decision No. 81/87L. The worker appeared and was represented by E. Bowman of the Sudbury Office of the Worker Adviser. The employer was notified but did not attend. THE EVIDENCE The Panel heard evidence under oath from the worker and considered it together with the Case Description materials. THE NATURE OF THE CASE The issue for the Panel is whether the worker suffered from an industrial disease, white finger disease, arising out of and in the course of his employment as a driller in a Sudbury mine. THE PANEL'S REASONS The worker was a driller for the accident employer for 34 years between 1948 and 1983 when he retired. In approximately 1970, the worker began to notice a problem with his right hand. His fingers changed colour, turning either white or blue when he was exposed to cold weather. After a short time, this condition also involved his left hand and gradually worsened. The worker had various symptoms from then on, continuing up to the time of the hearing, which he attributed to vibration induced white finger disease. The worker also suffers from osteoarthritis in his hands and in 1984 underwent surgery for bilateral carpal tunnel release. WCB Benefits were paid for lost time and medical aid for the carpal tunnel release. The Appeal Board decided on February 18, 1983, that the worker had "no entitlement for the condition diagnosed as white finger disease as arising out of and in the course of his employment". The findings that proceeded this conclusion were that the worker had sufficient drilling exposure to

3 2 substantiate the presence of white finger disease and that it was not believed that the worker had a significant enough degree of the disease or sufficient disability to warrant any award. Since the time of the Appeal Board's decision, the worker testified that in general his symptoms have gotten worse. Since his retirement, the arthritic symptoms have improved but the white finger symptoms have worsened. This is corroborated by his continuing search for medical attention. On November 25, 1983, the worker was seen by Dr. E.O.W. Knight who related his complaints of numbness and excessive cold sensitivity. Dr. Knight diagnosed both bilateral carpal tunnel syndrome and a mild Raynaud's disease. Raynaud's disease is another name for vibration induced white finger disease. He indicated that the Raynaud's phenomenon affected all his fingers in both hands. He reported that the condition affected mainly his social life and that he had symptoms of numbness and tingling which tended to occur in the morning and while driving. The worker's January 1984 carpal tunnel release did not in his view substantially improve his symptoms, but made them worse. Apparently during the time he was being assessed by the WCB as to the carpal tunnel syndrome, the worker was seen in the hand clinic at the Downsview Hospital and Rehabilitation Centre. As a part of this assessment, Dr. F. Murray saw the worker on August 1, At that time, he complained of constant tingling in both hands, extending up the forearm when driving a car. He said he could not feel anything when he cut his finger. The doctor was unable to elicit two point discrimination. Dr. Murray wrote: With the history of numbness and cold on exposure to cold, I do not think there is too much doubt that this man has the so called vibration or white hand syndrome. He felt that the problem was not due to the 1983 wrist fracture but, had been coming on over the past many years. Before the Panel, the worker complained of ongoing hand symptoms creating difficulty sleeping at night, inability to raise his hands over his head, and inability to drive. The WCB's policy directive on white finger disease reads as follows: 1. That vibration induced white finger disease be accepted as an industrial disease under section 122 and section 1(1)(n) of the Act as peculiar to and characteristic of a process, trade or occupation involving exposure to high frequency, rapid acceleration in vibratory tools. 2. That based on medical advice, vibration induced white finger disease be favourably considered when the following circumstances apply:

4 3 (a) there is a clear and adequate history of two or more years continuous employment on high frequency, rapid acceleration vibratory tools immediately preceding the onset of vasospastic response, and (b) the condition has been confirmed on medical examination by a specialist consultant in vascular disease. 3. Where the Board's industrial medicine consultant recommends that the worker be removed from exposure employment, due to this specific condition, payment of disability benefits may be considered so long as this disease persists. Normally, this benefit would consist of temporary partial disability benefits and vocational rehabilitation services where this need is identified. 4. A permanent disability award may be considered for this condition two years after a definitive diagnosis has been made. 5. Claims which do not meet the criteria as set out in 2(a) should be individually judged on their own merits having regard to the nature of the occupation, the extent of the exposure, and other factors peculiar to the individual case. Consideration will be given where it seems evident that the vibration induced white finger disease resulted from occupational exposure to high frequency rapid acceleration of vibratory tools. The benefit of doubt applies. January 10, 1978, Bd M.4709 No.6. In the Claims Adjudication Branch Procedures Manual, guidelines make clear that Adjudicators normally allow a claim where there is medical compatibility between the diagnosis and the work history. After that, two years are allowed to pass before a permanent disability award is made. There is no doubt, and the Appeal Board was in agreement, that the worker had had clear and adequate history of sufficient exposure to cause white finger disease. He used the jack-leg drill on almost a daily basis for 34 years. Although the diagnosis had not been confirmed by the Board doctors at the time of the Appeal Board decision, this had been done by the time of the hearing before the Appeals Tribunal. We are therefore of the view that the worker has entitlement under the Board's guidelines and is entitled to a finding that he has vibration induced white finger disease which arises out of and in the course of his employment. We were asked to refer the nature and extent of the disability and benefits to the Workers' Compensation Board for assessment, and we do so.

5 4 THE DECISION The appeal is allowed. The worker suffers from vibration induced white finger disease which arose out of and in the course of his employment as a miner. The question of the nature and extent of benefits is referred to the Workers' Compensation Board for decision. DATED at Toronto, this 24th day of December, SIGNED: K.G. O'Neil, W.D. Jago, F.L. Lankin.

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