Predisposition Not a Basis for Denying WCB Claims
In late 1999 AWCC (HAWC consulting at that time) was involved in a dispute with the WCB in relation to an injured worker that had been denied bilateral carpal tunnel syndrome on the basis of a pre-disposition.
A predisposition, in this context, is a medical condition or disease that increases the likelihood someone will develop a work related injury.
The WCB had taken the position that AWCC’s client was predisposed to developing carpal tunnel syndrome at work due to their diabetes and denied the claim.
AWCC argued that there was no basis within the Workers’ Compensation Act, policy and/or procedure to deny entitlement on the basis of a predisposition.
Mr. Becker successfully argued this before the Alberta Appeals Commission.
The Appeals Commission ruled in the fall of 1999 that the Alberta WCB had made an error in denying bilateral carpal tunnel syndrome on the basis of predisposition.
Moreover, simply having a pre-existing condition that is aggravated by a workplace injury or accident does not, and should not, result in the automatic denial of a WCB claim.
The WCB’s own policy, Policy 03 – 02 Part II, advises that a pre-existing condition can be accepted as noted:
“For a claim to be considered under this policy there must be a confirmed presence of a pre-existing condition and evidence it was aggravated by a compensable accident.”
Far too often it has been AWCC’s experience that when the WCB is adjudicating on claims with an aggravational component the adjudicators have a strong tendency to look for factors to mitigate liability and deny the claim, as opposed to neutral based fact finding, review, and evidence-based decision-making.
The mandate of an adjudicator to apply a reasonableness test on the balance of probabilities remains, regardless of the nature of the claim, be it for full responsibility or permanent aggravational responsibility.
If you have a claim that has been denied due to a pre-existing condition please don’t hesitate to contact AWCC for a free consultation 780-440-6047.
AWCC has not seen the Board attempt to deny other claims on on the basis of a pre-disposition since the decision by the Appeals Commission striking down the denial of said claim .
Note: AWCC apologizes for the poor scan of the article which makes it very difficult to read. This was the best we could do from the only copy of the article we have in our possession presently.