Claimant has been employed by Employer as a dock hand and working dock supervisor for approximately five years. He works eight hours a day, 40 hours per week. Claimant is 5 feet 5 inches and weighs 234 pounds. Before working for Employer, Claimant had no health problems with respect to his upper extremities, and no history of diabetes, thyroid or arthritic condition. Other than this claim, Claimant never made a claim for injuries to his upper extremities. Claimant never had any hobbies which involve using his upper extremities in a repetitive fashion.
Claimant's job duties now are the same as they were in October 2007. Claimant's job duties as dock hand and working dock supervisor involve loading and unloading freight by hand, and with the use of a forklift truck and yard dog, which is a small tractor. Claimant works the day shift from 4:00 A.M. to noon. Claimant does not take breaks, and takes approximately 15 minutes for lunch. The job is fast paced, and he continuously uses his upper extremities in a repetitive fashion throughout his shift.
Claimant operates a forklift up to 50 to 60 % of his day. When Claimant arrives at work, he loads or unloads freight from vehicles or containers. The freight varies in weight from under 50 pounds up to 100 pounds. The freight arrives throughout the day in 53 foot trailers. After unloading and separating freight onto pallets, Claimant cuts shrink wrap to wrap the pallets, and stacks them for later pick up by a forklift. He then turns the freight around until it is fully wrapped with the shrink wrap.
After unloading the freight by hand, Claimant operates a forklift or yard dog to unload the freight from trailers and other vehicles. Claimant drives the forklift by steering with his left hand and operating the controls with his right hand. The steering ball, which is operated by his left hand, vibrates continuously. His right hand operates levers that cause the forklift to move from side to side or up and down. Claimant uses both hands to operate the forklift, and it causes vibration in both hands. The vibration of the forklift makes his hands and elbows hurt, and his hands go numb. The controls on the yard dog also cause a vibration in Claimant's hands, but not as pronounced as the forklift.
Claimant sometimes uses a bolt cutter to cut open the seals on the containers. There are usually two seals per container, and it takes a few times cutting the bolt to break the seal.
Approximately a year and a half before October 2007, Claimant began having problems with his hands and elbows. In the beginning, he thought his hands were going to sleep. His symptoms became progressively worse. In approximately July 2007, his hands were going numb, and his elbows were painful. On September 20, 2007, Claimant saw Dr. Ginther, his primary care physician, for a check up. At that time he mentioned his upper extremity symptoms, and Dr. Ginther ordered a nerve conduction study which revealed bilateral carpal tunnel syndrome and left lateral epicondylitis.
As soon as he learned the result of the testing he told his supervisor, and Employer referred Claimant to Concentra, where, after hearing Claimant's complaints, physicians diagnosed carpal tunnel syndrome and lateral epicondylitis, and returned him to work. Claimant was then referred to Dr. David Brown on January 29, 2008. Dr. Brown obtained a detailed description of Claimant's job duties. During the examination, Dr. Brown noted calluses on Claimant's hands. After an examination, Dr. Brown diagnosed bilateral carpal tunnel syndrome, for which he recommended surgery. He also diagnosed bilateral lateral epicondylitis, worse on the left, for which he recommended conservative treatment. Dr. Brown considered Claimant's work a significant factor in the development of these conditions.
Following Dr. Brown's Independent Medical Examination, Employer provided Dr. Brown with a videotape of Claimant at work, and a Physical Demands Analysis, a report which classifies Claimant's job in the medium demand level. Dr. Brown stated that based upon what he saw on the videotape, there appeared to be little exposure to risk factors for carpal tunnel syndrome. Dr. Brown stated the work activities as depicted in the videotape, and as described in the Physical Demands Analysis, potentially could be a minor contributing factor for carpal tunnel syndrome. Dr. Brown indicated Claimant had risk factors of increased body mass index and the fact that he is in his mid forties.
Dr. Brown testified on behalf of Employer. Dr. Brown testified if he were to base his opinion solely on the videotape provided, and the physical demands analysis, and disregard the information he obtained from Claimant regarding his job duties, he does not think Claimant's work would be a substantial cause of Claimant's conditions. Dr. Brown testified if he were to consider Claimant's job activities as they were described to him by Claimant, his job activities were a cause or a substantial factor in the
diagnosis of bilateral carpal tunnel syndrome and bilateral lateral epicondylitis. He testified Claimant described a much more hand and arm intensive job than what he saw on the videotape. Dr. Brown testified he was presented two job descriptions, and his opinion on whether Claimant's work caused his condition, is different depending upon which job description he uses.
Claimant testified the videotape was made at approximately 8:30 A.M., when the bulk of the freight had already been unloaded. In addition, the dock was wet, so they were unable to operate at their ordinary speed. The videotape does not accurately depict Claimant's job duties. The videotape does not reflect Claimant's normal work speed. In addition, Claimant testified the Physical Demands Analysis report is not accurate. Claimant sometimes has to lift 100 pounds by himself, and he does not operate the forklift 75 % of the day.
Dr. Schlafly testified on behalf of Claimant. Claimant saw Dr. Schlafly on May 7, 2008. Dr. Schlafly secured a history from Claimant, conducted an examination, and reviewed the medical records, videotape, and Physical Demands Analysis. Dr. Schlafly diagnosed bilateral carpal tunnel syndrome and recommended surgery. Dr. Schlafly recommended Claimant obtain a further evaluation to determine how to treat his epicondylitis. Dr. Schlafly testified Claimant's work at Employer was the prevailing factor in the cause of his bilateral upper extremity pain and associated symptoms.
Claimant currently has complaints of pain and numbness in his upper extremities, and seeks additional medical treatment.
Claimant was a credible witness.