The claimant, Sandra Forbeck, was 54 years old as of the date of the hearing. Ms. Forbeck began working as a cashier at the Dollar Tree Stores, Inc., (Dollar Tree) in August of 2001. Ms. Forbeck last worked at Dollar Tree on December 22, 2003. When Ms. Forbeck left Dollar Tree, she had used a scanner at the cash register for approximately a year. Ms. Forbeck had other responsibilities other than her cashier work, including wrapping merchandise sold, stocking shelves and dusting or cleaning.
Ms. Forbeck began noticing complaints with her right middle, ring and small fingers approximately two weeks before she reported her complaints to her supervisor and was sent to St. Luke's Urgent Care on December 22, 2003. Ms. Forbeck's complaints were of numbness in the right thumb, middle, ring and small fingers with pain in the right wrist when she reported to St. Luke's Urgent Care. Ms. Forbeck continues to have pain, numbness and tingling in the right hand.
Ms. Forbeck's hours worked in the months prior to her injury are as follows:
| Week ending December 27, 2003 | 10.48 hours |
| Week ending December 20, 2003 | 27.82 hours |
| Week ending December 13, 2003 | 17.38 hours |
| Week ending December 06, 2003 | 21.51 hours |
| Week ending November 29, 2003 | 10.32 hours |
| Week ending November 22, 2003 | 16.38 hours |
| Week ending November 15, 2003 | 17.88 hours |
| Week ending November 01, 2003 | 9.77 hours |
Ms. Forbeck testified that most items that she handled weighed five pounds or less and that she usually worked a five-hour shift.
Dr. Henry Ollinger, M.D., testified by deposition that he is a board certified plastic surgeon specializing in hand and upper extremity work. Dr. Ollinger examined Ms. Forbeck on July 22, 2004, and found that Ms. Forbeck was a 52 -year-old female with diabetes, morbid obesity, bilateral carpal tunnel syndrome, a left trigger thumb and an early diabetic stiff hand. Dr. Ollinger opined that Ms. Forbeck's employment was not a substantial factor in her carpal tunnel syndrome.
During cross-examination, Dr. Ollinger noted that Ms. Forbeck's payroll records reflect 27.82 hours of work during the week ending December 26, 2003, 17.38 hours the previous week and 21.51 hours the week before that.
Dr. Ollinger distinguished the effects of diabetes from carpal tunnel syndrome by describing diabetes as causing symptoms of pain, numbness or a burning type feeling in the feet or hands if there
is diabetic peripheral neuropathy from the symptoms of a localized compressive neuropathy causing symptoms in primarily the thumb, index and long fingers of the hand.
Dr. Ollinger testified that Ms. Forbeck suffers from carpal tunnel syndrome, not from diabetic peripheral neuropathy.
Dr. Ollinger stated that Ms. Forbeck's work of cashiering approximately 85 percent of the time during a 20 -hour work week handling the smaller-weight purchases of about 20 people per hour by dragging the items purchased across a scanner is insufficient to cause her carpal tunnel syndrome. Dr. Ollinger stated that Ms. Forbeck's work at the Dollar Tree lacked the rate of repetitiveness and force, posture and contact to cause her carpal tunnel complaints.
Dr. James Walentynowicz, orthopaedic surgeon, testified by deposition that he saw Ms. Forbeck on May 28, 2004. Dr. Walentynowicz opined that Ms. Forbeck's work as a cashier for Dollar Tree was a substantial factor in causing Ms. Forbeck's right carpal tunnel syndrome. Dr. Walentynowicz testified during cross-examination that he had no information regarding the length of Ms. Forbeck's employment at Dollar Tree, how many days a week Ms. Forbeck worked as a cashier at Dollar Tree, what other job responsibilities Ms. Forbeck had at Dollar Tree or volume of business that she handled at Dollar Tree.
Ms. Forbeck's supervisor at Dollar Tree testified confirming Ms. Forbeck's testimony regarding hours worked and weight of items sold. The supervisor added that "drawer pulls" reflecting $\ 400.00 in sales (signifying 400 items at a $\ 1.00 apiece sold) were at least twice during one of Ms. Forbeck's shifts and could have been as many as four times a shift.