C. Marr

The worker, a customer service representative at a hospital parking garage, appealed the denial of benefits for a mental stress injury.

Following a change in the employer's parking systems and staffing cuts, the worker was frequently subjected to verbal abuse, name-calling, and intimidating behaviour from frustrated customers while working alone.

The Appeals Resolution Officer allowed the appeal, finding that the abusive conduct from customers constituted a substantial work-related stressor that was the predominant cause of the worker's adjustment disorder.

The worker was granted entitlement to benefits under the chronic mental stress policy, and the date of injury was corrected to the date the worker first sought medical attention.

The worker, a carpenter, appealed the denial of initial entitlement for bilateral carpal tunnel syndrome (CTS) and the determination that they missed the time limit to claim benefits.

The Appeals Resolution Officer adjusted the date of injury to November 22, 2022, the date of the CTS diagnosis, and granted an extension to the time limit to claim due to administrative confusion involving a prior claim for hand-arm vibration syndrome.

However, initial entitlement for CTS was denied because the worker had not performed the relevant job duties for two years prior to the diagnosis, failing to establish that the condition was caused by the physical demands of their employment.

The worker objected to a Case Manager's decision denying loss of earnings (LOE) benefits after July 7, 2023.

The worker had sustained soft tissue injuries and was offered a graduated return to work plan with sedentary administrative duties.

After working for one hour, the worker left claiming pain and did not return.

The Appeals Resolution Officer found that the medical evidence did not support total disability and that the offered work was suitable and within the worker's functional abilities.

The objection was denied as the worker failed to fully participate in the return to work process.

The worker appealed the denial of loss of earnings (LOE) benefits following an accepted recurrence of a compensable low back injury.

The worker argued they experienced a significant deterioration in June 2021 that prevented them from working.

The Appeals Resolution Officer found that the medical evidence did not support a significant deterioration in June 2021, but did support a significant deterioration as of May 19, 2022, when the worker's family doctor reported moderately decreased range of motion.

The worker was found to be totally disabled from that date.

The appeal was allowed in part, granting full LOE benefits from May 19, 2022, ongoing.

The worker, a courier driver, suffered a compensable right eye and facial injury when struck by a truck door handle.

The worker objected to WSIB decisions denying entitlement for secondary eye conditions, setting the maximum medical recovery (MMR) date at October 1, 2022, and denying loss of earnings (LOE) benefits after September 13, 2022.

The Appeals Resolution Officer denied entitlement for the secondary eye conditions, finding them incompatible with the mechanism of injury.

However, the Officer varied the MMR date to February 21, 2023, based on specialist reports, and granted full or partial LOE benefits up to that date, pending confirmation of the worker's return-to-work hours and wages.

The worker appealed a Case Manager's decision denying a redetermination of their Non-economic Loss (NEL) benefit for a compensable low back injury.

The worker argued that their lumbar spine flexion had deteriorated since the last NEL redetermination in 2006.

The Appeals Resolution Officer found that the slight loss of lateral flexion and the degree of sensory deficit did not constitute a significant and permanent worsening of the work-related impairment under the AMA Guides.

The appeal was dismissed.

The worker appealed a Case Manager's decision denying loss of earnings (LOE) benefits from July 19, 2020 onward.

The worker had an accepted low back injury but stopped working in July 2020.

The Appeals Resolution Officer found that the medical evidence demonstrated the worker's absence from work was due to non-compensable psychological issues, not the compensable low back injury.

The employer had been willing and able to accommodate the low back restrictions.

The appeal was dismissed.

The worker, a mechanic, was injured when a seal exploded and struck them in the chest and left shoulder.

The WSIB allowed entitlement for the left shoulder but denied entitlement for a claimed neck injury.

The worker appealed, arguing the neck injury was a whiplash-type injury with delayed onset of pain.

The Appeals Resolution Officer dismissed the appeal, finding no evidence of a neck injury being reported until six weeks after the accident, and concluding that the mechanism of injury was not compatible with the claimed neck condition.

The worker appealed decisions denying permanent impairment for right knee and low back injuries, denying entitlement for chronic pain disability (CPD), and denying further loss of earnings (LOE) benefits.

The Appeals Resolution Officer found no permanent organic impairment for the knee or back injuries, as the clinical evidence and imaging did not support significant pathology.

However, the worker was granted entitlement for CPD, having met all five policy criteria, including pain persisting beyond usual healing time and inconsistent with organic findings.

The worker was also awarded LOE benefits for a previously denied period, with further benefits to be determined.

The worker appealed the denial of benefits related to a 1999 fall at home, the denial of section 147(4) supplementary benefits, and the denial of a permanent disability reassessment.

The worker had an accepted 1989 claim for an aggravation of pre-existing fibromyalgia.

The Appeals Resolution Officer found that the 1999 fall was not caused by the compensable injury, as the worker's condition had been stable and they had been working full-time prior to the fall.

The request for supplementary benefits was denied because the worker's earning capacity had significantly increased after completing a return-to-work program.

The request for a permanent disability reassessment was also denied, as any worsening of the worker's condition was attributable to the non-work-related second accident.

The appeal was dismissed.

The worker, a truck driver injured in a 2012 motor vehicle accident, appealed the WSIB's decisions regarding their suitable occupation (SO) and the adjustment of their loss of earnings (LOE) benefits.

The worker argued they were totally disabled and unable to work in any capacity.

The Appeals Resolution Officer found that medical evidence, including a multidisciplinary assessment, did not support total disability and that the worker was fit to work full-time as an Administrative Assistant.

The WSIB's decision to lock in partial LOE benefits based on the starting wage of the SO was upheld, and the worker's objection was denied.

The worker appealed the Case Manager's decisions that they had achieved maximum medical recovery (MMR) from a compensable low back injury by May 14, 2018 with no permanent impairment, and denying loss of earnings (LOE) benefits following a pandemic-related work disruption starting March 20, 2020.

The Appeals Resolution Officer found that the medical evidence supported MMR by May 2018 with no ongoing impairment, as there was a significant gap in medical records regarding low back complaints after that date.

Regarding LOE benefits, the work disruption was deemed temporary despite its length, and there was no evidence the worker sought alternative employment.

The appeal was denied.

The worker, a personal support worker, injured her right shoulder and elbow while transferring a resident.

The Case Manager determined that the worker's compensable right shoulder injury resolved by April 20, 2018, with no ongoing or permanent work-related impairment, and denied loss of earnings (LOE) benefits after July 30, 2018, as well as benefits related to a subsequent shoulder surgery.

The worker objected to these decisions.

The Appeals Resolution Officer found that the clinical evidence supported the conclusion that the worker achieved maximum medical recovery from her compensable strain by April 2018.

The surgery revealed a congenital absence of a biceps tendon, not a work-related injury.

Consequently, the worker was not entitled to LOE benefits after July 30, 2018, or benefits related to the surgery.

The objection was denied.

The worker, a special needs assistant, suffered a compensable left ankle injury shortly before the annual summer school break.

She was fit for modified work, but the employer could not accommodate her, so she received full loss of earnings (LOE) benefits until the summer break began.

The Case Manager denied LOE benefits during the summer break, finding the wage loss was due to the seasonal layoff rather than the injury.

The worker appealed, arguing that under WSIB Operational Policy 15-06-02, her LOE benefits should have continued during the temporary work disruption.

The Appeals Resolution Officer dismissed the appeal, concluding that the worker did not intend to work during the summer break and historically collected employment insurance.

Paying LOE benefits during the seasonal layoff would place her in a better position than if she had not been injured.

The worker appealed decisions denying entitlement to benefits for chronic pain disability (CPD), psychotraumatic disability, and loss of earnings (LOE) benefits beyond December 7, 2015, following a work-related head injury.

The Appeals Resolution Officer found that the worker met the criteria for CPD and granted a Non-economic Loss determination for this condition.

The worker was not entitled to benefits for a psychotraumatic disability or permanent organic impairment.

Full LOE benefits were granted from December 8, 2015, to January 26, 2017, with further entitlement to be determined by the Operating Area following a work transition assessment.

The worker, a unionized labourer, suffered a compensable right inguinal hernia while shovelling snow at work.

Two days later, he was laid off due to a shortage of work.

The Case Manager initially denied loss of earnings (LOE) benefits for the period following the layoff and the period following his hernia repair surgery.

On appeal, the Appeals Resolution Officer allowed the worker's objection, finding that the work-related injury prevented him from seeking new employment through the union hall and that he was entitled to LOE benefits during his recovery from surgery.

The worker was awarded full LOE benefits from the date of layoff until his return to work.

The worker appealed a decision denying loss of earnings (LOE) benefits beyond August 17, 2015, following a compensable right eye injury.

The employer had offered modified work, which the worker declined, claiming it was unsuitable and unsafe.

The Appeals Resolution Officer found that the worker was not totally disabled and had failed to actively participate in the work reintegration process.

However, because the WSIB did not provide the required written warning before levying a non-cooperation penalty, the worker was granted full LOE benefits until September 22, 2015, and partial LOE benefits at 50 percent until October 6, 2015.

The appeal was allowed in part.

The worker appealed decisions denying entitlement to benefits for a psychotraumatic disability and Chronic Pain Disability, as well as the quantum of her 10% Non-economic Loss (NEL) award and the suitability of her work transition plan.

The Appeals Resolution Officer found that the worker's severe depression and pain symptoms were not directly caused by her compensable bilateral shoulder and elbow repetitive strain injuries, noting the presence of concurrent non-compensable medical issues.

The 10% NEL award was confirmed as accurately reflecting the worker's organic impairment based on clinical findings.

The work transition plan and suitable occupation of customer service and information clerks were also confirmed as reasonable and suitable for the worker's physical restrictions.

The appeal was denied.