Thomas Brown
1114 – C Blackwood St. N.
Regina, Sask.
S4X 3E5
August 24th,
2006
Members of the Board
Saskatchewan Workers’
Compensation Board
200 – 1881 Scarth
Street
Regina, Sask. S4P 4L1
Re: Thomas Brown
– WCB Claim #1007 0989 21D
Members of the Board:
The following is to appeal
the Board’s non-acceptance of my work injury claim, and is further to the appeal documentation I submitted on June 3, 2005. Initially I had intended to supplement that appeal with additional medical information, and had requested that the Board
Members hold their decision for this reason. However, I have since decided to replace that appeal documentation altogether.
While the issues raised in it are well founded, and the Members of the Board are certainly welcome to review it; the following
will focus more on the central issues of my claim.
On September 7th,
1997 while employed with Regional Tree Service in Regina, a very significant change occurred to my 16-year tree trimming duties.
Instead of performing my regular duties of trimming trees with a chainsaw from a man lift basket (cherry picker), I was required
to trim them manually with a 30 foot tall ‘Pole Saw’ while standing on the ground. Although I awoke the following
morning with mild pain in my neck, shoulder, and right arm, I performed pole saw duties on 3 other occasions by which time
my symptoms had significantly worsened to a point where medical attention was sought.
After learning I had
a herniated disc in my neck I continued to perform my managerial duties for Regional Tree Service, and whatever lighter duties
I was capable of. Considering my employer had started his business in light of my Arborist (tree trimmer) and EUSA (power
line) certification, and this certification was a prerequisite for the SaskPower contracts his business depended upon; I remained
on his job site for these reasons.
These are the facts of my work
injury claim and they have been substantiated ad nauseam by my now former employer, my physicians, and myself. While further
clarification has been offered over the years, in no way has this information changed as implied in the Board Member’s
September 29, 2004 decision.
As the Members of the Board
will know, it is my contention that my injury occurred as a result of the significant change in my work duties. In other words
my injury arose out of, and in the course of my employment (Section 29 of The Workers’ Compensation Act, 1979).
Further, it is the contention of my physicians that my pre-existing condition (degenerative arthritis) was both aggravated
and accelerated by this injury (Section 50 of The Workers’ Compensation Act, 1979).
________________________
By decision dated April 21,
1999, the Members of the Board denied my claim consideration under Section 29 of the legislation stating:
“The Board
next considered whether the duties of a tree trimmer could account for a posterior cervical disc protrusion. While Mr. Brown
has medical support through Dr. Ekong’s report and Dr. Katz’s submission, the factual review of the possibility
concerning disc protrusion occurring as a result of flexing one’s neck backward to perform the duties of pole sawing,
could not physically result in a posterior disc protrusion. Therefore, the Board find that the medical opinions presented
must be discounted as incomplete.”
While I will eventually be
addressing this issue further in this appeal, I will however take this opportunity to point out that “the possibility
concerning disc protrusion occurring as a result of flexing one’s neck backward”, is not an issue for factual
review by the Board. It is in fact a medical issue and despite the November 7, 2003 request of advocate Marilyn Bird; the
Board has refused to provide medical evidence that substantiates this statement, let alone any factual evidence.
By the same decision (April
21, 1999) the Members of the Board also denied my claim consideration under Section 50 of the legislation, stating:
“The Board
do not believe the work duties materially aggravated or accelerated Mr. Brown’s underlying condition as he did not stop
working at the time he claimed to have experienced difficulties but rather continued to complete the contract and, in fact,
increased the number of hours that he worked.”
The Members of the Board argued
this point further in their January 15, 2004 decision stating:
“He began
a new contract in October commencing on October 16, 1997 working full eight to nine hour days. It was also this contract that
he presented as requiring 90% pole sawing in his work duties.”
The Members of the Board again
argued this point in their September 29, 2004 decision stating:
“He began
a new contract in October commencing on October 16, 1997 and it was with this contract that he reported requiring 90% pole
sawing duties. This statement is contained in his letter of June 28, 1998.”
With these statements the Board
has repeatedly implied that I continued to pole saw after learning of my disc herniation. This was not the case and the Members
of the Board have been made aware of this fact. The purpose of my June 28, 1998 statement was to stress how the demand for
pole sawing had significantly increased over a short period of time. Any reference made to the October pole-sawing duties
being my own was due to the fact that as manager, and the only certified Utility Arborist on staff; these duties were in fact
mine as was every aspect of this line-clearing operation. In his letter of June 2, 2003 (submitted with my Nov. 7/03 appeal)
my former employer reaffirmed his position regarding these issues, stating:
“Tom and
I worked together on every job sight of every SaskPower contract awarded to my company in 1997. Without his qualifications
and contacts within SaskPower such contracts would not have been obtainable by me. As the only qualified person on staff Tom
was required to be present during all line clearing operations.
The large majority of SaskPower line clearing (prior to Sept/97) was performed by aerial lift
of which Tom was the sole operator. In early September some areas became inaccessible by aerial lift and had to be cleared
manually by pole saw. It was at this time that I first became aware Tom had injured his neck. It also became apparent that
the more he pole sawed the worse his symptoms became.
When an additional
contract (requiring mostly pole sawing) was awarded to me I insisted that Tom see his doctor about his neck. After learning
the extent of his injury additional personnel were hired to relieve him of pole sawing. Tom performed much lighter duties
from that point on.
Where it is
true there was an increase in the amount of hours Tom worked, he worked them performing lighter/managerial duties. These hours
were also worked in an effort to meet the requirements of the new contract. This contract would have extended into 1998 (until
the next tendering) and I had renewed Tom’s tree pruner license for that purpose. Unfortunately he was unable to continue
working.”
Further to this issue it should be noted that my former employer’s payroll
statement to WCB confirms that additional personnel were hired when his October 16, 1997 contract commenced.
Regardless that my former employer’s submission corroborates my report
of light duties, and refutes the reason used to deny my claim consideration under Section 29; for reasons unstated the Board
Members remain adamant that I continued to pole saw after learning of my disc herniation. It is my contention that this contravenes
Section 25(1)
of The Workers’ Compensation
Act, 1979.
________________________
As acknowledged in the Board
Members April 21, 1999 decision, my work injury is supported with medical reports from neurosurgeon Dr. Ekong, and my primary
physician Dr. Katz. The only other medical opinion available to the Board is that of its own medical advisor Dr. Cadman, who
dismissed the possibility of a work injury occurring. Although the Board has never clearly indicated to what extent Dr. Cadman’s
opinion was used in arriving at their decision, there are numerous inconsistencies with the information on which his reports
were based.
As evidenced by the WCB file
documentation concerning my claim, the medical information provided to Dr. Cadman did not include the abovementioned reports
of my physicians. In fact, the file documentation shows that the medical evidence available at the time of Dr. Cadman’s
assessment was for the most part preliminary. More importantly this documentation shows that when updated medical evidence
was received by the Board, Dr. Cadman was not consulted with this information, nor were any other WCB medical personnel. Bearing
in mind that the last consultation from Dr. Cadman was on September 2, 1998; the following is a list of medical reports that
have neither been received nor reviewed by Board medical personnel:
1. The December 16, 1998 medical report of my primary physician Dr. Ronald Katz
2. The January 4, 1999 medical report of attending Neurosurgeon Dr. Chris Ekong
3. The February 5, 1999 consultation report (Dr. Ekong/Dr. Katz)
4. The February 19, 1999 radiology report of Dr. E.C. Lembke
5. The March 12, 1999 MRI report of Dr. C. Wallace
6. The March 23, 1999 consultation report (Dr. Ekong/Dr. Katz)
7.
The October 9, 2003 medical report
of attending Neurosurgeon Dr. Chris Ekong
As also evidenced by the file
documentation, as well as his February 16, 1998 report, Dr. Cadman was provided 2 WCB reports that clearly contained false
and misleading information. The first report dated November 3, 1997 was from CSR Kathy Basnicki in which she reported my neck
injury occurring as a result of “lifting portions of logs”. Regardless that this was established as being
Ms. Basnicki’s misinterpretation of the information provided to her by telephone (see March 19/99 memorandum to file
– Pg. 4 Para. 1); at no time was Dr. Cadman advised of this significant fact. While pole sawing was mentioned in his
report, Dr. Cadman did not comment on whether or not this activity could account for my injury. He instead determined:
“There was no injury to this man’s neck. His description of injury of
lifting portions of logs should not cause his present status.”
By memorandum dated February
16, 1998, Dr. Cadman was specifically directed to a second report containing false and misleading information. This report
was entered into my file by Client Services Manager Ernie Hinck on February 2, 1998, and is also in regards to a telephone
discussion. One area of concern is Mr. Hinck’s apparent recollection of me stating, “he always did have a
pronounced right-sided weakness, notably the right arm”. Under no circumstances have I ever made such a comment
regarding the injury I sustained 22 years earlier. To date, the only comment I’ve made with respects to this was in
my letter of June 28, 1998 where I stated, “the only lingering affect from this 22 year old injury had been a slight
decrease in range of motion in my right arm.”
While it is true Dr. Cadman
made no direct reference to Mr. Hinck’s comment, this unquestionably contributed to his medical theory that “Obviously,
this man has had a lot of longstanding problems with his neck and right arm”. Unbeknown to Dr. Cadman however,
this theory is thoroughly disproved in medical reports that were not provided to his office. One such report is from my family
physician dated December 16, 1998 in which Dr. Katz stated:
“Mr. Brown has
been a patient of our clinic since 24 June 1990, however it was only on 6 October 1997 that Mr. Brown presented for the first
time with complaints of right shoulder and right arm pain. At that point the complaints had been present for about 3 weeks.”
Another concern I have with
Mr. Hinck’s report is with respects to his comment regarding my employment, specifically:
“More
recently, he has been on social assistance and only just got into a work situation with the tree trimming business.”
While I am not ashamed
to have had my family’s income subsidised between contracts, my concern is that Mr. Hinck clearly implied that I had
only just started in the tree-trimming business. To add to my concern, the file documentation available at the time of Dr.
Cadman’s assessment shows there are no reports indicating my 16 years in the tree-trimming trade. More importantly there
are no reports indicating the significant change that occurred to my 16-yr. work duties (from man lift to pole saw), let alone
that the onset of my symptoms had coincided with this change.
Knowing the aforementioned
information would have a profound impact on Dr. Cadman’s position, I presented this evidence to his office by correspondence
dated September 6, 2005 (attached). The response I received however was not from Dr. Cadman but rather the Assistant to the
Board who by letter dated October 6, 2005 stated, “Dr. Cadman is an internal Medical Officer and I suspect he will
not be responding to your correspondence”. By letter dated October 11, 2005 (attached) I attempted to obtain Dr.
Cadman’s response through the College of Physicians and Surgeons, however the Board prohibited any involvement by the
College. Finally, as a last resort, I wrote Case Manager Janice Offet on February 3, 2006 (attached) requesting that all omitted
medical reports be submitted to WCB Medical Services for consideration. In Ms. Offet’s response dated February 8, 2006,
this request was also denied.
Clearly
Dr. Cadman was not apprised of the actual circumstances of my injury, nor did he review all medical evidence pertaining to
my case. It is my contention that such consultations are needed in order for the Board Members
to reach a decision
that is based on the real merits and justice of my claim. Without them, compliance with Section 25(1) of the legislation
is in every practical sense, unachievable.
________________________
Returning to the issue
of my C5-6 disc protrusion, and to reiterate, by decision dated April 21, 1999 the Members of the Board stated:
“The
possibility concerning disc protrusion occurring as a result of flexing one’s neck backward to perform
the duties of pole sawing, could not physically result in a posterior disc protrusion.”
To date, the only medical opinion
on file with respects to this statement is that of neurosurgeon Dr. Ekong, who of significance is also an Associated Professor
of Neurosurgery at the University of Saskatchewan. In his October 9, 2003 report Dr. Ekong refuted the above claim, stating:
“I would
like to see the evidence for such a statement. I am of the opinion that any significant injury to the neck be it in extension
or in flexion could cause enough damage to the disc material to a point that it may ultimately crack and result in
a protrusion.”
In the same report Dr. Ekong provided an abundance of medical information pertaining to my injury,
and also made the following observation regarding pole sawing:
“I
have no doubt in my mind that such a repetitive action could result in a neck injury that
might ultimately precipitate a disc protrusion.”
By decision dated January 15, 2004 the Members of the Board dismissed Dr. Ekong’s
report, stating:
“The
Board does not believe this provides sufficient explanation of the actual mechanics of the injury to justify changing their
opinion.”
Please find enclosed with this appeal one of two “Peer-reviewed” medical journal
articles entitled ‘Intervertebral Disc Herniation’, which fully supports Dr. Ekong’s position regarding
this issue. (Note: for easy referencing I have numbered each medical journal article, and placed an alphabetical letter aside
each paragraph referenced.)
In the following article (document #1) medical researchers at the University of Waterloo set out:
“To
determine whether repeated motion with low magnitude joint forces, and flexion/extension
moments consistently produce herniation in a non-degenerated, controlled porcine spine motion segment.” (Paragraph 1a)
The following determinations were made from this study:
“Herniation
occurred with modest levels of compression and flexion/extension moments but with a high number of motion
cycles. All herniations that were created during testing occurred in the posterior or posterior-lateral
areas of the annulus.” (Paragraph 1b)
“These
data suggest that highly repetitive flexion/extension motions and modest flexion/extension
even with relatively low magnitude compressive joint forces, consistently resulted in intervertebral disc herniations. Given
the radiological documentation of progressive tracking of the nucleus, there is no doubt that disc herniation is a cumulative
process that can result with modest forces if sufficient flexion/extension cycles are applied.”
(Paragraph 1c)
“The testing
conditions were limited to flexion extension motions of the motion segments. While the spine moves with six
degrees of freedom the largest motion present is in the sagittal plane (flexion/extension) which will provide
the greatest strain to the intervertebral discs and other passive structures.” (Paragraph 1d)
“The
specimens used in this study (Class 1) were more representative of the adolescent human spine, which has a much lower occurrence
of intervertebral disc herniations. This study has demonstrated that in healthy un-degenerated discs mechanical loading can
initiate, and propagate, an injury to the annulus that results in herniation if sufficient motion cycles are applied.”
(Paragraph 1e)
“This
study has shown that disc injuries and herniations can be developed during highly repetitive flexion/extension
motions with modest moments and low magnitude compression. Given our years of work loading spines in compression and shearing
modes, with only the very rare observation of herniation, we have formed the opinion that numbers of cyclic flexion
extension produce cumulative damage and lead to progressive herniation. While there may be a tendency to identify an event
that “caused” an intervertebral disc herniation, this work together with our other experiments have led us to
form the opinion that this is only a culminating event and that the real cause had already occurred.”
(Paragraph 1f)
While the specimens used in
this study represented that of an un-degenerated adolescent spine that was subjected to high numbers of motion cycles; consideration
must be given to the following:
1.
In addition to confirming a moderately large posterior disc protrusion
(herniation) at C5-6, the radiology information provided to the Board (Jan. 5/98, Feb. 19/99, Mar. 12/99) also confirmed disc
degeneration at the C5-6 and C6-7 levels of my spine. Taking this degeneration and the physically demanding nature of pole
sawing into account, it would be reasonable to conclude that high numbers of cyclic flexion/extension motions were not needed
to produce the disc protrusion in my case. In his January 4, 1999 report Dr. Ekong commented on this, stating:
“There
is no question that such strenuous activities could result in a cervical disc protrusion, especially in a cervical
spine that was not perfectly normal to begin with.”
2. Taking
my 16 years in the tree-trimming trade into account, and regardless that I operated a man lift equipped with a 6’ long
hydraulic chainsaw the majority of this time; it would be reasonable to conclude that a good part of my job involved looking
up into the trees I was trimming, and being mindful of the high-voltage power lines above me. This unquestionably resulted
in an infinite number of cyclic flexion/extension motions over the years, which as evidenced in this study can result in disc
herniation.
In conclusion of this issue, the preceding peer-reviewed
evidence fully supports Dr. Ekong’s position that repetitive flexion of the
spine can indeed “physically result in a posterior disc protrusion”.
Subsequently this evidence supports his position that my injury occurred out of, in the course
of my employment (Section 29 of The Workers’ Compensation Act, 1979).
________________________
Another issue regarding
my disc protrusion that has yet to be raised in this appeal, is also referenced in the Board’s decision dated
April 21, 1999. In it the Members of the Board claimed:
“The simple
facts of the matter are that the action of extending one’s neck would not result in a posterior disc protrusion. Alternatively,
Mr. Brown’s neck condition, with numerous osteophytes and degeneration could certainly result in a posterior disc protrusion.”
In his October 9, 2003 report
Dr. Ekong disagreed with this statement, arguing:
“I do
not agree. A more accurate statement would be that numerous osteophytes and evidence of degeneration (wear and tear)
could be consistent with evidence of a damaged spine and disc material, which could be more predisposed to a protruded disc
occurring when compared to a perfectly normal cervical spine with no evidence of wear and tear.
In my opinion the issue is that this man likely had degenerative arthritis
in his neck but it took some injury to result in that degenerative arthritis becoming symptomatic and resulting in pain down
the right arm.”
Please find enclosed a second
“Peer-reviewed” medical journal article entitled ‘Rheumatology’ (document #2) which supports
Dr. Ekong’s position regarding this issue, and subsequently supports his determination of my injury. In this peer-reviewed
article author Dr. Ian Tsang established:
“Cervical problems
can be divided into 2 main groups: those arising mainly from the joints and associated ligaments and muscles of the neck,
and those involving the cervical nerve roots or the spinal cord.” (Paragraph 2a)
“Patients
with nerve root involvement complain of significant root pain, which is usually sharp, intense and often
described as a burning sensation. It can radiate out to the trapezial and periscapular areas or down
the arm in a dermatomal distribution. Many patients also complain of numbness and motor weakness
in a myotomal distribution. Headache may occur if the upper cervical roots are involved. The symptoms
often correlate with specific head positions; they become more severe with neck hyperextension, particularly when the head
is tilted toward the affected extremity.” (Paragraph 2b)
“After
establishing whether the problem is neurologic or is arising from the joints, the physician must identify the cause. A history
of injury, recent weight loss and morning stiffness lasting longer than half an hour that involves areas other than
the neck should alert the clinician to the possibility of injury, infection or inflammation. A careful general physical
examination will confirm these possibilities.” (Paragraph 2c)
As indicated to the Board Members
in this and previous appeals, and as attested to by my former employer, and my now former spouse, I awoke the morning immediately
following the work duty change experiencing mild pain and stiffness in my neck. This pain radiated to my head (headache), and down my right shoulder and right arm. In addition to this I also experienced mild numbness
in the fingers of my right hand. When these symptoms persisted, and then significantly worsened from the head and neck positioning
of additional pole sawing duties; medical attention was sought.
Upon review of the January
5, 1998 CT myleogram, Dr. Ekong diagnosed the cause of pain radiating down my right arm (in the C6 dermatomal distribution)
to be a right-sided C5-6 posterior disc protrusion. Taking the strenuous nature of my recent work duty change into account,
and in the absence of any symptoms prior to that change reported by either my family physician or myself, Dr. Ekong concluded
that the disc protrusion was clearly the result of a physical injury. In short, he reaffirmed what the evidence itself had
determined.
Returning to the peer-reviewed
evidence of document #2, author Dr. Ian Tsang also established that:
“Narrowing
of the disc space and the neural foramina and anterior and posterior osteophyte formation are commonly seen at levels C5-6
and C6-7. These changes take years to develop, but they occur in about 50% of patients over 50 years of age and are not
usually the cause of a patient’s current symptoms. Patients only develop symptoms when additional factors such as
soft-tissue sprain or nerve root irritation occur.” (Paragraph 2d)
At this point it should
be noted that the above findings are precisely the same as those found in my January 5, 1998 CT myleogram. Of significance,
the Board obtained an interpretation of this CT myleogram dated February 19, 1999 in which radiologist Dr. Lembke offered
an explanation quite similar to that of the above peer-reviewed evidence:
“As stated
by Dr. W.G. Brown, there is a right-sided disc herniation at the C5-6 level containing both
soft and hard components. The term “hard component” refers to bony osteophyte corresponding in location to herniated
disc material. The formation of osteophytes implies that the disc herniation is non-acute as these osteophytes
take some time to form.”
Although the Board had
specifically requested interpretation of the ‘hard component’ only, Dr. Lembke evidently felt that it
was important to include the following information concerning the ‘soft component’ of my disc herniation:
“The herniation
of soft disc material need not necessarily be stable and an initial small asymptomatic disc herniation may enlarge,
perhaps acutely, resulting in the development or worsening of symptoms.”
In his October 9, 2003 report,
and in direct reference to the board-obtained interpretation of Dr. Lembke, Dr. Ekong reaffirmed his position regarding my
injury stating:
“The issue in my opinion is the soft component.
The soft component implies that there was a relatively soft disc material that protruded
over and above the pre-existing osteophyte (hard component).
In other words, even though Mr. Brown had osteophytes of longstanding, there was still
enough room for the cervical nerve roots to pass through the foramina without being pinched and it took that extra bulge from
the soft disc component for the canal to be compromised significantly in order to produce the radiculopathy (arm pain).
In my opinion the issue is that this man likely had degenerative arthritis in his
neck (hard component) but it took some injury to result in that degenerative arthritis becoming symptomatic and resulting
in pain down the right arm. The effect of that injury likely resulted in the soft component portion of the disc material which
then converted a pre-existing degenerative arthritis into a symptomatic problem causing pinching of the nerve down the right
arm.
In
spite of the presumed degenerative changes in his neck prior to the injury, he was able to function as a tree cutter and it
apparently took the work injury for the previously asymptomatic situation to become symptomatic. My understanding is that
according to the rules of WCB, if a “situation” converts a pre-existing asymptomatic situation into a symptomatic
one, that “Situation” should be compensable”.
As evidenced in the aforementioned
reports, both Dr. Ekong and Dr. Lembke clearly identified the soft component of my herniation as being indicative of an injury,
and responsible for the onset of my symptoms. It should be noted that while the Board Members recognised this component in
their September 29, 2004 decision, at no time has a Board physician acknowledged the soft component, let alone commented on
its significance.
The preceding peer-reviewed
evidence supports Dr. Lembke’s position that “numerous osteophytes and degeneration” would not
have been responsible for the onset of my symptoms, as such findings are “non-acute”. This evidence further
supports Dr. Ekong’s diagnosis that an additional factor other than osteophytes/degeneration was responsible for the
radiculopathy in my case, and that the sudden onset of symptoms was consistent with an injury occurring.
In conclusion of these issues,
all peer-reviewed evidence presented in this appeal supports Dr. Ekong’s position that my pre-existing degenerative
arthritis (hard component) was materially aggravated and accelerated by the work duty change, resulting in a bona fide injury
(soft component). Subsequently it is my contention that these circumstances warrant consideration under Section 50 of The
Workers’ Compensation Act, 1979.
________________________
And finally, as indicated in
virtually every decision rendered, the Board has repeatedly justified its dismissal of my case stating “there was
no specific injury”. While I can only account for a sudden onset of symptoms the morning immediately following
my work duty change, and a gradual increase of symptoms the more these duties were performed; there is no legislation stating
there must be a specific incident for an injury to be compensable. This was also acknowledged in the February 27, 1998 correspondence
of CSR Craig McKenzie in which he explained:
"Before we can
accept responsibility for medical cost or time loss benefits in connection with a claim, we must be able to confirm a work
related cause. This is done by confirming a specific injury, or a sufficient change in job duties/workload sufficient
enough to explain an onset of symptoms."
In my opinion the peer-reviewed evidence presented in this appeal fully supports Dr. Ekong’s position that
there was in fact a sufficient change in my job duties/workload, sufficient enough to explain the onset of my symptoms.
Other than the erroneous and incomplete reports of its medical advisor Dr. Cadman, the Board has failed to provide medical
or factual evidence that would refute a workplace injury occurring in this manner.
The preponderance of evidence provided supports the validity of my case, however should there be any uncertainty remaining;
the “benefit of doubt” should clearly be in favour of myself in accordance
with Section
25(2) of The Workers’ Compensation Act, 1979.
Respectfully,
ORIGINAL SIGNED
_________________________
Thomas D. Brown
Cc: Lyle Canute
Former Employer
Dr. Chris E. U. Ekong
Neurosurgeon
Dr. A. Ali
Primary Physician
http://tombrownskwcb.tripod.com
Referenced sections of
The Workers’ Compensation Act, 1979:
Section 25(1): A decision
of the board shall be upon the real merits and justice of the case and it is not bound to follow any legal precedent.
(2): Where
the evidence in support of the opposite sides of an issue is approximately equal, the board shall resolve the issue in favour
of the worker.
1979, c.W-17.1, s.25; 1998, c.46,
s.8.
Section 29: Where an injury to a worker arises out of his employment, it is presumed
that it occurred in the course of his employment and, where the injury occurred in the course of his employment, it is presumed
that it arose out of his employment.
1979, c.W-17.1, s.29.
Section 50: The board shall not reject the claim of a worker or a dependant for compensation
or reduce the amount of compensation payable by reason of a pre-existing condition of the worker if the injury materially
aggravates or accelerates the pre-existing condition to produce a loss of earnings or death.
1993, c.63, s.9.
Attachments:
- My September 6, 2005 correspondence to WCB medical advisor Dr. Carl K. Cadman
- My October 11, 2005 correspondence to the College of Physicians and Surgeons of Saskatchewan (re: Dr.
Carl K. Cadman)
- My February 3, 2006 correspondence to Case Manager Janice Offet
- Peer-reviewed medical journal article: Intervertebral Disc Herniation (document #1)
- Peer-reviewed medical journal article: Rheumatology: 12. Pain in the neck (document #2)
