The employee was born in 1955, and graduated from Charleston High School. He has no further formal education but has had training and experience as a meat cutter. After high school, he worked as a butcher for about 16 years. He started working at Gates in July of 1988. He worked at Gates until his dismissal in 2002 or 2003.
He worked at Gates as a spiral line operator, which involved several different jobs. The first job was as a line yarn tech. He used an air ratchet gun. Each time he used the gun it would ratchet his wrist and had a lot of torque, which put pressure on wrist supination and pronation. On the average he used the air ratchet gun 5-6 hours a day. The second job was stripping the cover off hoses to salvage tubing to be fed back in the machine. He would use his wrists, elbows, and shoulder and his upper body to pull the coverings off of hoses. This was difficult to do because the hoses were vacuumed and pulled on tight. The third job was to relieve other employees performing the pan hose job, which was using his arms and hands in a pivot motion while the hose was moving at 140 feet per minute. The fourth job was to feed rubber into the extruders. A lot of the time the rubber was defective and would get hung in the extruders. He would then have to yank, tug and pull the rubber with his hands to get them out. Every time he pulled, the motion would separate the wrist from his arm. Most of the time he was operating the air ratchet, which is more twisting of the hands and arms, and would also affect his shoulders. It is more hand intensive than the stripping hose and panning hose. The last job, feeding rubber into the extruder, is more hand intensive than the air ratchet but he did that job the least. All of the different jobs were all repetitive use of hands and shoulders.
Most of time he would work 12-hour days, and averaged about 44 hours per week in work. Every 2 hours he would have a 15 -minute break, would have a 20 -minute break for lunch. He did not work for anyone else other than Gates Rubber. He did mow a few yards with a full size tractor, which was owned by the KC Hall. It was not hand intensive and did not cause any problems with his upper extremities.
The employee reported the injuries on March 10, 2000, because the plant manager had therapists from Restart at the plant. There had been a lot of injuries in the plant and they had come to observe the jobs. He had been having problems with his hands, arms and wrists for about three months before. The employee was swollen and hurting a lot that day and reported it to his supervisor, Marty Vied. Marty said that since the therapist was there for him to go see her. The therapist was out on the floor to watch his job, and saw the air ratchet gun twisting. He was using constantly using his hands and arms during a shift. Prior to that day, he did not know what was causing the problems. The employer had filled out a report of injury.
Prior to March of 2000, he had no other treatment for his upper extremity. Outside of Gates Rubber, he had no other hand or arm intensive work, hobbies, or anything else. On March 10, 2000, his symptoms included swelling of his fingers, wrists, and the elbows to the point of discolorment.
The company sent him to Dr. Tobin, Dr. Lents, and Dr. Brown for treatment. Dr. Brown performed surgery
on his right wrist on July 18, 2000. Employee Exhibits C, D, E and F, are pictures of a burn to his arm that resulted from surgery when his arm was placed in a stainless steel trough. Dr. Thornton debrided the burn and did a skin graft from right upper thigh. The burn was observed during the hearing. The burn was on the upper part of forearm to lower part of his arm at the elbow, and was about $3 \times 4$ inches. He did not continue under the care of Dr. Brown and went back to Dr. Lents. In 2001, Dr. Lents performed surgery on his right and left wrists. The employer sent the employee to Dr. Kapp for impingement of his shoulders. Dr. Kapp performed surgery on his right shoulder. The symptoms with right hand and shoulder improved somewhat but as not much as he though they would. He did not have surgery on his left shoulder.
Dr. Lents performed surgery on his left wrist on June 11, 2001. Between June 11, 2001 and June 25, 2001, he was outside of his house and fell over garden hose. He was walking on an embankment and caught his right toe under garden hose and tripped. On the way down he twisted his body and landed on his left shoulder blade and back. His arm was up in the air. It did not affect his wrist. When he went back on June 25, had had no swelling that he knew of and no increase in symptoms.
He was sent to Dr. Chiu for pain management and for RSD. He continued to have problems and was sent to Dr. Strecker who performed surgery on his left hand and wrist where he shortened a bone and repaired cartilage. The surgery did not solve the problems and he had a fusion to his left wrist on December 20, 2002. After the surgery, the RSD got worse and he had a wound infection that required hospitalization. He saw Dr. Graham for pain management. The company sent him to Dr. Lehman who examined him but did not tre