A COVID-19 screener who claimed that repetitive use of industrial hand sanitizer pumps — as many as 600 times daily — contributed to the onset of a finger injury has won her case before the Nova Scotia Workers’ Compensation Appeals Tribunal.
The Tribunal’s decision, delivered by Appeal Commissioner Richard Dipo P. Ola, overturned a prior ruling by the Workers’ Compensation Board that had denied her claim, stating the injury did not arise from her job.
The worker, identified here as W., contended that extensive use of the sanitizer pumps, along with other job-related activities, caused her symptoms, which included painful locking of the fingers and difficulties performing everyday tasks. She testified that her condition became so severe that she often needed assistance with household activities and was unable to open containers, fasten buttons, or even hold a toothbrush comfortably.
W. worked as a COVID-19 screener from early 2021, a role that involved “up to 600 daily uses of industrial sanitizer pumps,” she testified. W. reported that this repetitive strain began to worsen over the year, ultimately leading her to file a claim in December 2021. Although initially trying to manage the pain herself, she described the symptoms as unbearable, explaining that they frequently woke her at night, and required her to use hot water to release her locked fingers.
Diverging medical opinions
The Tribunal reviewed assessments by two physicians with differing views on W.’s condition and its cause. A report from Dr. K. Boehm suggested a potential link between her symptoms and job-related repetitive motions, noting that while repetitive tasks do not universally result in trigger finger, W.’s work activities “could be related to the development and worsening of her symptoms.” This opinion supported W.’s claim that her employment duties likely contributed to her condition.
Conversely, Dr. J. Veasey disputed the likelihood of a causal link between W.’s job and her injury, noting that “trigger finger is a common affliction in the general population and is not generally regarded as a disease of occupations.” Dr. Veasey argued that W.’s duties lacked the force component typically associated with occupational injuries involving tendon inflammation. He cited studies indicating that both high repetition and high force are generally necessary for such conditions to be work-related, but provided no specific studies to support his position.
The Tribunal noted gaps in Dr. Veasey’s assessment, including his reliance on generalized conclusions rather than addressing the specifics of W.’s job duties. Commissioner Ola questioned the applicability of Dr. Veasey’s findings, particularly as he had not personally examined W. or assessed the cumulative effects of her daily tasks. Ola found Veasey’s analysis “less than thorough,” ultimately attributing greater weight to W.’s firsthand testimony and Dr. Boehm’s more balanced medical opinion.
Weighing evidence and applying common sense
In his analysis, Ola referenced Section 186 of the Workers’ Compensation Act, which mandates that cases be decided on “real merits and justice.” Ola also applied Section 187, which requires that doubts be resolved in favor of the worker when the evidence is evenly balanced. He concluded that W.’s credible, detailed testimony filled in the gaps left by inconclusive medical evidence and provided a solid foundation for granting her appeal.
Ola’s decision was guided by several factors: W.’s prior history without finger issues, the noticeable improvement in her symptoms after leaving her screening role, and the absence of any non-work-related activities that could have caused her condition. “The only evidence that points unequivocally in the Worker’s favour is the Worker’s oral testimony,” Ola wrote, adding that her testimony was “clear, candid, and forthcoming.”
Ola also cited case law from Cape Breton Development Corporation v. Nova Scotia Workers’ Compensation Appeals Tribunal, which advises decision-makers to use common sense in cases lacking definitive medical evidence. He emphasized that the Tribunal could reasonably infer a work-related cause from W.’s description of her job duties and the consistency of her symptoms with those tasks.
For more information, see 2023-106-AD (Re), 2024 CanLII 103619 (NS WCAT).
