F. Broad

The Director of Service Delivery requested a reconsideration of an Appeals Resolution Officer (ARO) decision that granted the worker partial Loss of Earnings (LOE) benefits from September 17, 2007.

The Director argued that the ARO failed to properly apply the Workplace Safety and Insurance Act and WSIB policy regarding the 72-month final LOE benefit review.

The Appeals Manager agreed with the Director, finding that under section 44 of the Act, LOE benefits could only be reviewed and paid from December 14, 2011, the date the worker was granted entitlement for a Non-Economic Loss (NEL) assessment.

The ARO's reliance on the Merits and Justice policy to bypass the statutory timeframes was incorrect.

The reconsideration request was allowed, and benefits were ordered payable from December 14, 2011.

The worker requested reconsideration of an Appeals Resolution Officer's decision regarding the nature of her pre-existing right knee condition and the employer's entitlement to Second Injury and Enhancement Fund (SIEF) cost relief.

The Appeals Manager found that the worker had only mild pre-existing osteoarthritis at the time of her slip and fall accident, and that her subsequent severe post-traumatic osteoarthritis was directly related to the accident and a subsequent misdiagnosis.

The Appeals Manager concluded that the pre-existing condition did not contribute to the accident or prolong the disability, thereby denying the employer's request for SIEF cost relief.