C. da Cunha

The worker appealed the Case Manager's decision that he had reached maximum medical recovery for a work-related adjustment disorder with no permanent impairment evident.

The Appeals Resolution Officer found that the worker's psychological condition had remained symptomatic for nearly three years since its manifestation.

Relying on the psychological evidence, the Officer concluded that the failure to adjust over such a prolonged period constituted a permanent impairment.

The appeal was allowed, and the worker was found entitled to a non-economic loss award determination.

The worker appealed the denial of initial entitlement for non-ischemic dilated cardiomyopathy (NIDC), which he alleged was caused by myocarditis arising from an occupationally compulsory COVID-19 vaccination.

The Appeals Resolution Officer reviewed conflicting medical opinions, including those from treating cardiologists, a general practitioner, and an occupational medicine consultant.

The Officer found that while there was a temporal relationship between the vaccination and the onset of symptoms, the objective medical evidence did not confirm a diagnosis of myocarditis according to CDC criteria.

As the diagnosis of myocarditis was not objectively confirmed, the appeal was dismissed and initial entitlement was denied.

The worker appealed the Case Managers' decisions denying entitlement for left elbow lateral epicondylitis and a common extensor partial tear, and finding that he had reached maximum medical recovery (MMR) with no permanent impairment.

The Appeals Resolution Officer allowed the appeal in part, finding that the initial diagnosis of lateral epicondylitis was compatible with the workplace accident.

Relying on the WSIB Medical Consultant's opinion, the Officer also granted secondary entitlement for the partial tear, concluding it was a progression of the work-related injury.

The Officer determined the worker had not reached MMR as of April 26, 2023, and remitted the issue of permanent impairment to the Operating Area.

The worker appealed the denial of initial entitlement for sarcoidosis, arguing the condition arose from environmental workplace exposures to chemicals, dust, bacteria, viruses, spores, and mold during her 13 years as a Medical Instrument Technician.

The Appeals Resolution Officer reviewed the medical and scientific evidence, including an Occupational Policy Branch scientific review, which concluded that the etiology of sarcoidosis remains unknown and there is inadequate evidence linking it to the worker's specific occupational exposures.

Finding that the workplace exposures were not a significant contributing factor to the development of the disease, the appeal was dismissed.

The worker appealed a decision denying secondary entitlement to post-traumatic stress disorder (PTSD) and a recurrence of a work-related psychotraumatic disability following a severe allergic reaction to epoxy at work.

The Appeals Resolution Officer reviewed medical evidence, including a WSIB-sponsored comprehensive assessment from CAMH, which confirmed the PTSD diagnosis and its causal link to the workplace incident.

The appeal was allowed, granting secondary entitlement to PTSD, a recurrence of the mental health condition, and funding for recommended psychological treatment.

A non-economic loss redetermination was deemed premature as the worker had not yet reached maximum medical recovery.

The late worker contracted COVID-19 during a workplace outbreak and passed away approximately three weeks later.

The WSIB granted survivor benefits but denied a non-economic loss (NEL) award determination.

The worker's estate appealed, arguing the worker reached maximum medical recovery (MMR) on the date of death.

The Appeals Resolution Officer denied the appeal, finding that the worker's condition deteriorated precipitously without ever reaching a plateau or recovery.

Because the worker did not reach MMR, they did not suffer a permanent impairment under the operational policies, and therefore no NEL award determination was payable.

The worker suffered a concussion and other injuries after a workplace fall and was granted full loss of earnings benefits.

They subsequently developed explosive diarrhea and vomiting, which prevented them from attending a neurology treatment program.

The worker sought secondary entitlement for irritable bowel syndrome with diarrhea (IBS-D) and full loss of earnings benefits for the period they could not attend treatment.

The Appeals Resolution Officer found that the post-concussion syndrome and resulting use of Cymbalta were significant contributing factors to the onset of IBS-D, granting secondary entitlement and the requested loss of earnings benefits.

The worker appealed Case Manager decisions regarding his apprentice status, secondary entitlement for psychotraumatic disability, and ongoing loss of earnings benefits following a right ring finger injury and subsequent surgeries.

The Appeals Resolution Officer found that the worker was not an apprentice on the date of injury, denying an adjustment to his pre-accident earnings basis.

However, the Officer granted secondary entitlement for adjustment disorder, PTSD, major depressive disorder, and generalized anxiety disorder, finding them compatible with the work-related injury and treatment process.

The worker was also granted ongoing loss of earnings benefits and funding for mental health treatment.

The worker, a police officer, appealed the Case Manager's decisions regarding the date of injury and entitlement to loss of earnings (LOE) benefits for a work-related post-traumatic stress disorder (PTSD).

The Case Manager had established the date of injury as November 28, 2022, the date of the formal PTSD diagnosis, and granted LOE benefits from November 29, 2022.

The Appeals Resolution Officer allowed the worker's appeal, finding that the date of injury should be February 4, 2022, the date the worker first sought medical attention for their mental health crisis, which eventually led to the PTSD diagnosis.

The Officer also found that the work-related PTSD was a significant contributing factor to the worker's inability to return to work from February 5, 2022, and granted LOE benefits for the period of February 5, 2022 to November 29, 2022.

The worker, a police officer, appealed a decision denying initial entitlement for a low back injury sustained during a voluntary annual fitness (PIN) test on their day off.

The employer argued the injury did not arise out of employment and cited delayed reporting.

The Appeals Resolution Officer allowed the appeal, finding the fitness test was authorized, supervised, and incidental to employment, thus occurring in the course of employment.

The delay in reporting was deemed reasonable given the worker's attempts to self-accommodate, establishing proof of accident.

The worker objected to a decision rating their asbestosis permanent impairment at the 15% non-economic loss (NEL) award level.

The worker argued that the predicted baseline value for their diffusing capacity for carbon monoxide (DCO) should be based on the AMA Guides' table for a 74-year-old, as the table does not provide values for individuals over 74, which would result in a 25% impairment rating.

The Appeals Resolution Officer found that the 15% rating was correct, as the respirologist had established a specific predicted DCO value for the 84-year-old worker, and the AMA Guides permit the use of accepted and verified equations outside the scope of the tables.

The worker's objection was denied.

The worker, a personal support worker, experienced a severe muscular inflammatory response after receiving a mandatory work-related Covid-19 booster vaccination.

The initial adjudicator denied entitlement based on a medical consultant's opinion that the reaction was normal.

On appeal, the Appeals Resolution Officer allowed the objection, finding that under operational policy 15-04-10, the determination of an 'adverse reaction' is an adjudicative question.

Given the worker's need for emergency medical attention and temporary inability to work, the reaction was deemed adverse, and initial entitlement was granted.

The estate of a deceased worker appealed a decision regarding the calculation of survivor benefits for the worker's spouse.

The worker died from non-small-cell lung cancer caused by workplace asbestos exposure.

The initial decision based the benefits on the earnings of a Foundry Worker, where the most significant exposure occurred.

The Appeals Resolution Officer allowed the appeal, finding that the worker's later exposure as a Storekeeper also contributed synergistically to the disease, and therefore the benefits should be based on the earnings of a Storekeeper on the date of injury.

The worker appealed a Case Manager's decision denying full loss of earnings (LOE) benefits following four right shoulder surgeries.

The worker had previously completed a return-to-work plan but expressed an intention not to return to work until they felt ready, effectively removing themselves from the workforce.

The Appeals Resolution Officer found that the worker's inability to earn was caused by non-work-related factors, specifically their self-perceived total disability and decision not to engage in job search activities.

The appeal was denied, and no full LOE benefits were awarded for the post-surgical recovery periods.

The employer objected to a decision granting the worker ongoing full loss of earnings (LOE) benefits from December 18, 2020 to February 5, 2021, following a work-related Covid-19 infection.

The employer argued that Public Health had cleared the worker to return to work and that modified duties were available.

The Appeals Resolution Officer found that despite the Public Health clearance, two physicians had assessed the worker and concluded they were medically unable to return to any work until February 1, 2021, due to ongoing symptoms.

As the medical evidence supported total disability during the period, the worker was entitled to full LOE benefits.

The employer's objection was denied.

The worker appealed the Eligibility Adjudicator's decisions denying initial entitlement for bilateral carpal tunnel syndrome and right foot plantar fasciitis/right ankle tendonitis.

The Appeals Resolution Officer allowed the appeal in part.

The officer found that the physical demands of the worker's regular duties, which involved repetitive and forceful use of the hands and wrists with vibrating tools, were a significant contributing factor to the bilateral carpal tunnel syndrome.

However, the officer denied entitlement for the foot and ankle conditions, finding they were a progression of pre-existing, non-work-related problems and not significantly contributed to by the worker's duties.

The employer appealed a decision denying Second Injury and Enhancement Fund (SIEF) cost relief for a worker's carpal tunnel syndrome claim.

The employer argued that the worker's pre-existing obesity contributed to the injury and prolonged recovery.

The Appeals Resolution Officer denied the appeal, finding that the accident was of moderate severity and that obesity is not considered a pre-accident disability or pre-existing condition under the SIEF policy.

Furthermore, there was no medical evidence indicating that the worker's obesity affected the post-accident recovery period.

The worker, who had a recognized permanent impairment for reactive airways dysfunction syndrome (RADS), removed himself from his modified hospital housekeeping duties in March 2020 due to fears of contracting COVID-19.

He sought full loss of earnings (LOE) benefits for the period he was off work.

The Appeals Resolution Officer denied the appeal, finding that the hospital remained a safe workplace under the Occupational Health and Safety Act and had implemented appropriate COVID-19 protocols.

Because a suitable occupation remained available to the worker at a wage loss, his full wage loss was not solely caused by his work-related impairment, precluding entitlement to full LOE benefits.

The worker suffered multiple injuries while working on a ship and received loss of earnings (LOE) benefits.

The employer laid off workers for the winter on December 31, 2020.

The WSIB initially denied LOE benefits from January 1, 2021 to March 15, 2021, classifying the layoff as a temporary work disruption (TWD).

The Appeals Resolution Officer found that the layoff was a permanent work disruption (PWD) for the worker, as the employer had already replaced the worker and had no intention of recalling them.

The worker's appeal was allowed, and full LOE benefits were granted for the disputed period.

Employer 1 objected to a decision transferring 100% of the costs of a worker's claim to its accident cost record.

The worker was injured after falling through an uncovered floor vent on a construction site.

The Appeals Resolution Officer found that Respondent 1, the worker's employer, was 100% responsible for the accident because it allowed the worker to enter an area known to be unsafe and cordoned off by the general contractor (Respondent 2).

Employer 1's objection was allowed, and no costs were transferred to Employer 1 or Respondent 2.