41-11WC. Cheryl Goodwin-Abare v. State of Vermont, Agency of Human Services.

• Court: Vermont

Vermont Workers Compensation 2011. 41-11WC. Cheryl Goodwin-Abare v. State of Vermont, Agency of Human Services Cheryl Goodwin-Abare v. State of Vermont, Agency of Human Services(December 14, 2011)STATE OF VERMONT DEPARTMENT OF LABORCheryl Goodwin-Abare v. State of Vermont Agency of Human ServicesOpinion No. 41-11WCBy: Phyllis Phillips, Esq. Hearing OfficerFor: Anne M. Noonan CommissionerState File No. CC-54110OPINION AND ORDERHearing held in Montpelier on October 14, 2011 Record closed on November 14, 2011APPEARANCES:Patricia Turley, Esq., for Claimant William Blake, Esq., for DefendantISSUE PRESENTED: Are Claimant's bilateral carpal tunnel syndrome and left cubital tunnel syndrome causally related to her work for Defendant? EXHIBITS: Joint Exhibit I: Medical records Claimant's Exhibit 1: Curriculum vitae, Sikhar Banerjee, MD Claimant's Exhibit 2: Workplace Safety Ergonomic Evaluation, 10/29/2010 Claimant's Exhibit 3: Job Fit Analysis, December 17, 2010 Claimant's Exhibit 4: Rossignol M, et al., Carpal Tunnel Syndrome, What is Attributableto Work? The Montreal Study, Occupational and Environmental Medicine, 1997, 54: 519-523(fn1) Defendant's Exhibit A: Curriculum vitae, Verne Backus, MD, MPH Defendant's Exhibit B: Deposition of Richard Levy, MD, October 12, 2011 Defendant's Exhibit C: Curriculum vitae, Richard Levy, MD Defendant's Exhibit D: Deposition of Craig Uejo, MD, September 28, 2011 Defendant's Exhibit E: Melhorn JM and Ackerman WE, Guides to the Evaluation ofDisease and Injury Causation (AMA 2008), Chapter 9, pp. 169180 and 191-202 CLAIM: All workers' compensation benefits to which Claimant proves her entitlement as causally related to her bilateral carpal tunnel syndrome and left cubital tunnel syndrome Costs and attorney fees pursuant to 21 V.S.A. §678 FINDINGS OF FACT: 1. At all times relevant to these proceedings, Claimant was an employee and Defendant was her employer as those terms are defined in Vermont's Workers' Compensation Act. 2. Judicial notice is taken of all relevant forms contained in the Department's file relating to this claim. 3. Claimant has been employed in various secretarial positions for the State of Vermont for almost 25 years. Since 2006 she has worked as a medical secretary at the Vermont State Hospital. Her duties involve taking and transcribing meeting minutes, maintaining patient charts, answering the telephone and generally providing administrative support to the psychiatrists, psychologists and social workers assigned there. 4. Functionally, Claimant spends up to 80% of her day on her computer, either typing or working with a mouse. In addition, she handles patient charts up to ten times per day. These are contained in three-ring binders, which Claimant frequently opens and closes in order to insert or remove chart notes. For filing new notes, she uses a three-hole punch. 5. Claimant first experienced symptoms indicative of carpal tunnel syndrome in 2008, when she began to suffer from nocturnal tingling and numbness in the third and fourth fingers of her right hand. Over a period of months she noticed that she was dropping things easily. Thereafter her symptoms progressed to include pain, first inside her right elbow and then later radiating as well from her wrist up her forearm. This presentation - from nocturnal numbness and tingling in her fingers to weakness in her hand to pain in her wrist - is classic for carpal tunnel syndrome. 6. Carpal tunnel syndrome consists of a constellation of symptoms and signs resulting from compression of the median nerve at the wrist. It is the most commonly diagnosed peripheral nerve entrapment disorder. The gold standard for diagnosing carpal tunnel syndrome is a nerve conduction study, which measures the speed at which an electrical signal travels as it moves through the nerve from a stimulus point above the wrist to a point at the base of the thumb. The more compressed the nerve is within the carpal tunnel, the slower the signal will be. 7. In Claimant's case, nerve conduction studies confirmed bilateral carpal tunnel syndrome - mild to moderate on the right, mild on the left - in November 2010. By that time, she was describing excruciating pain in her right arm, from her hand to her elbow, with similar though less severe symptoms in her left arm. The studies also documented mild left-sided cubital tunnel syndrome, an entrapment of the ulnar nerve at the elbow. 8. As treatment for her right carpal tunnel syndrome, Claimant underwent endoscopic release surgery on December 30, 2010. She returned to modified duty work on January 10, 2011 and resumed her regular full-time duties on February 1st. 9. Both pre- and post-surgery, Claimant's symptoms have manifested themselves primarily with work activities. She feels pain in her hands while typing and using her computer mouse, and has difficulty grasping, opening and closing patient chart binders. Following ergonomic evaluations in October and December 2010 various changes were made to her work station, including a different keyboard and mouse, easier-to-grip pens, smaller binders and a lateral file storage cabinet. These modifications have been somewhat helpful, but have not completely alleviated the symptoms she experiences while working. 10. Though manageable at the beginning of her work week, Claimant's symptoms typically worsen as the week progresses. By Friday they are severe. Over the weekend, with less use of her hands they abate, but then the cycle begins anew with her return to work activities each Monday. Recently, when her Waterbury work site was flooded on account of Hurricane Irene, Claimant was off work for approximately six...