H. Mohamed

The worker appealed a decision denying a review of their Loss of Earnings (LOE) benefits from June 6, 2016 onwards, which fell after the 72-month final review date.

The worker argued that a permanent impairment recognized by WSIAT in 2023 constituted a significant deterioration, and that they were cooperating in return-to-work activities at the 72-month mark.

The Appeals Resolution Officer found that the worker reached maximum medical recovery prior to the 72-month date, meaning there was no significant deterioration post-72 months.

Furthermore, the worker had been performing accommodated duties for years, so there were no active return-to-work activities at the time of the final review.

The appeal was denied.

The worker, a 64-year-old former crane operator, suffered a compensable left ankle fracture and dislocation.

After reaching maximum medical recovery with permanent restrictions, the WSIB identified Customer Service Representative as a Suitable Occupation (SO) and later denied secondary entitlement for a right hip condition.

The worker objected to both decisions.

The Appeals Resolution Officer allowed the appeal, finding that the worker's age, limited transferable skills, and physical impairments rendered them competitively unemployable in the general labour market, entitling them to full loss of earnings benefits to age 65.

Furthermore, the Officer granted secondary entitlement for a right hip soft tissue injury, concluding it was caused by an altered gait resulting from the compensable left ankle impairment.

The worker appealed a Case Manager's decision denying Loss of Earnings (LOE) benefits beyond October 2, 2022.

The worker had sustained a permanent low back impairment and was working reduced hours as a driving instructor.

The Appeals Resolution Officer found that the worker was underemployed and capable of working 25 hours per week in the Suitable Occupation of Accounting Technicians and Bookkeepers.

The objection was allowed in part, granting the worker partial LOE benefits based on deemed wages in the suitable occupation.

The worker appealed the Eligibility Adjudicator's decision denying initial entitlement to a low back injury on its own merits and on an aggravation basis.

The worker sustained a workplace injury while pushing a heavy crate.

The Appeals Resolution Officer found that the worker had a pre-existing low back condition and that the workplace accident caused a minor injury that exacerbated the worker's right-sided L5 radiculopathy.

The appeal was allowed in part, granting entitlement to right L5 radiculopathy on an aggravation basis until October 4, 2018, when the worker returned to their pre-accident state, along with full Loss of Earnings benefits for that period.

The worker suffered a work-related neck and shoulder injury and was accommodated with modified duties.

The employer subsequently terminated the worker's employment after the worker declined an early retirement package.

The worker appealed decisions finding no breach of re-employment obligations and terminating entitlement to the neck injury.

The Appeals Resolution Officer found no breach of re-employment obligations, as the termination was motivated by interpersonal conflict and attitude issues, not the workplace injury.

However, the Officer allowed the appeal regarding the neck injury, applying the thin skull doctrine to find that the workplace accident significantly aggravated an asymptomatic pre-existing degenerative disc disease.

The worker was granted ongoing entitlement and approval for the proposed neck surgery.

The worker, a school bus driver, appealed a decision denying entitlement for a low back and bilateral knee injury.

The worker claimed the injury was a disablement caused by prolonged sitting and excessive driving after a route change.

The Appeals Resolution Officer found that the worker's job duties significantly contributed to the low back injury with radiating symptoms down the left leg, noting the lack of prior back issues and supportive medical opinions from a chiropractor and physiotherapist.

The appeal was allowed for the low back injury.

The worker, who suffered a compensable low back injury resulting in a 61% combined Non-Economic Loss benefit, appealed decisions denying entitlement to hydrotherapy, a stationary modular home, and a hydropool.

The Appeals Resolution Officer denied the appeal, finding no objective medical evidence that hydrotherapy would provide more than transient relief or achieve the goals of maintenance treatment.

Furthermore, the requested stationary modular home and hydropool did not meet the criteria for specialized hobby equipment under the Independent Living Devices policy.

The worker, a garden centre manager, claimed initial entitlement for a right eye retinal detachment after a bag of mulch tore and soil fell into their eye.

The worker later amended the accident history to claim the 40-pound bag also struck their face.

The Appeals Resolution Officer rejected the revised history as inconsistent with contemporaneous reporting.

Relying on a medical consultant's opinion that soil entering the eye is not a compatible mechanism for retinal detachment, the ARO found the injury was not work-related.

The appeal was denied.

The worker appealed a Case Manager's decision denying entitlement for a left wrist injury and various right shoulder, knee, and hip diagnoses, and concluding the worker had fully recovered from their soft tissue injuries.

The Appeals Resolution Officer found no proof of accident for the left wrist injury due to a six-month delay in reporting.

Entitlement was granted for right shoulder bursitis and right hip greater trochanteric bursitis, but denied for right shoulder AC joint osteoarthritis, impingement, right knee osteoarthritis, and a lateral meniscus tear.

The worker was found to have fully recovered from the right knee and shoulder injuries, while the right hip injury was remitted for further adjudication.

The worker suffered a work-related low back strain and appealed the Case Manager's decisions that they had fully recovered by November 21, 2016, and denying entitlement to chronic pain disability (CPD) and psychotraumatic disability.

The Appeals Resolution Officer found that the medical evidence supported ongoing impairment beyond the recovery date, as the worker had not reached maximum medical recovery.

Furthermore, the worker met all five criteria under WSIB Policy 15-04-03 for CPD, including that the pain persisted beyond the usual healing time, was inconsistent with organic findings, and impaired earning capacity.

The worker's objection was allowed, granting ongoing entitlement and a Non-Economic Loss assessment for CPD.

The worker appealed a Case Manager's decision denying initial entitlement for dental fractures allegedly sustained during a workplace fall.

The worker had fallen and fractured their elbow, but did not report any facial or dental injuries until several weeks later, and did not seek dental treatment for over 14 months.

The Appeals Resolution Officer found insufficient evidence to establish that the broken teeth were caused by the workplace accident, noting the lack of contemporaneous medical documentation of facial injuries and the significant delay in seeking treatment.

The appeal was denied.

The worker appealed a decision denying initial entitlement for upper back, neck, and right upper extremity injuries.

The worker experienced a sudden onset of pain while stretching at home before work.

The Appeals Resolution Officer found that the injuries did not arise out of and in the course of employment, as the incident occurred at home and was not related to the worker's job duties.

The medical evidence also indicated pre-existing degenerative conditions.

The appeal was denied.

The worker suffered a compensable right ankle sprain and returned to work with minor accommodations.

Several months later, the worker's employment was terminated.

The worker alleged the termination was a reprisal for filing a WSIB claim, breaching the employer's re-employment obligations.

The Appeals Resolution Officer found that the employer successfully rebutted the presumption of a breach, as evidence demonstrated the termination was due to a significant economic downturn and the worker's unauthorized absence, rather than the work-related injury.

The worker's objection was denied.

The employer appealed a Case Manager's decision granting the worker loss of earnings (LOE) benefits from November 18, 2018, to February 1, 2019, following a low back injury.

The worker, who was pregnant, had declined an offer of modified light office duties, relying on a family physician's note advising her to remain off work.

The Appeals Resolution Officer found that the worker was capable of performing the modified duties and had failed to co-operate in her early and safe return to work as required by section 40 of the Workplace Safety and Insurance Act.

The appeal was allowed in part, restricting LOE benefits to November 20, 2018, and rescinding benefits paid beyond that date.

The worker, a housekeeper, suffered seizures and was diagnosed with a conversion disorder following a verbal and physical confrontation with her supervisor regarding room assignments.

The worker sought entitlement for Traumatic Mental Stress (TMS) and Chronic Mental Stress (CMS).

The Appeals Resolution Officer found that while the incident was not an 'objectively traumatic' event required for TMS, the supervisor's aggressive behaviour—including pulling a duvet from the worker and cornering her in a washroom—constituted workplace harassment and a substantial work-related stressor.

As the medical evidence confirmed the incident was the predominant cause of the worker's conversion disorder, initial entitlement for CMS was granted.

The worker, a truck driver, appealed a decision denying entitlement for left-sided weakness and loss of earnings (LOE) benefits following an unwitnessed workplace fall.

While initial entitlement was granted for lacerations sustained in the fall, the worker's ongoing inability to work was due to undiagnosed left-sided weakness.

Medical investigations ruled out a stroke or head injury, and no definitive diagnosis was provided to link the weakness to the workplace accident.

Applying WSIB policy, the Appeals Resolution Officer found no compatibility between the symptom and the accident history.

The appeal was denied, and LOE benefits were not granted.

The worker appealed a Case Manager's decision calculating his partial loss of earnings (LOE) benefits based on projected Suitable Employment or Business (SEB) wages rather than his actual wages from August 2005 to May 2006.

The worker argued he was performing duties within his SEB of storekeeper/parts clerk.

The Appeals Resolution Officer found that the worker's primary job duty was as a courier driver, which fell outside his identified SEB.

Consequently, the worker was not employed in his SEB, and his LOE benefits were correctly based on projected SEB wages.

The appeal was denied.

The worker suffered a left hand amputation injury at work and received loss of earnings benefits.

The worker objected to four decisions by the WSIB Operating Area: (1) that he was not a student at the time of the accident; (2) that the suitable occupation (SO) of security guard was appropriate; (3) that his benefits were correctly reduced based on the SO wages; and (4) that he was not entitled to a permanent impairment for psychotraumatic disability.

The Appeals Resolution Officer denied the worker's objections, finding that the worker had not been enrolled in an educational program for over two years and was not pursuing formal education, making him a worker rather than a student.

The Officer also found the SO of security guard was suitable and available, the wage reduction was appropriate, and the medical evidence did not support a permanent psychological impairment at the time.

The worker appealed a decision denying initial entitlement for a right wrist injury.

The worker, an assembly line worker, developed right wrist pain and swelling after being instructed to fold weather strips twice instead of once.

The employer argued the symptoms were related to pre-existing arthritis and that there was no change in job duties.

The Appeals Resolution Officer found the worker's testimony credible and concluded that the change in work method constituted an accident/disablement.

The worker's appeal was allowed, granting initial entitlement for a right wrist sprain/tendonitis.

The worker suffered a compensable right knee injury in 1989 and was granted a 5% permanent disability (PD) award in 1993.

In 2013, she requested a reassessment of her PD award, arguing her condition had worsened.

The Appeals Resolution Officer denied the request, finding that the worker's current knee symptoms, which arose after a 20-year gap in medical continuity, were the result of degenerative pathology rather than an exacerbation of her compensable work-related condition.