J.L. Hughson

The worker, a Millwright who suffered severe left arm and hand injuries in a workplace accident, appealed a Return-to-Work Specialist's decision denying the occupation of Pilot as a suitable occupation (SO).

The Appeals Resolution Officer dismissed the appeal, finding that while the occupation was consistent with the worker's transferable skills and interests, it was not safe or consistent with their permanent functional restrictions, which included limited gripping, no ladder climbing, and lifting restrictions.

Furthermore, the entry-level wages for a Pilot would not restore the worker's pre-injury earnings, and the availability of the position was limited.

The employer appealed a $250 fine levied by the Eligibility Adjudicator for late reporting of a workplace accident.

The worker suffered an eye injury and sought medical treatment on the day of the injury, triggering the employer's reporting obligation.

The employer submitted the Form 7 over seven business days later.

The Appeals Resolution Officer denied the employer's objection, finding that administrative delays do not excuse late reporting under WSIB policy, and upheld the $250 fine.

The worker suffered a compensable right knee injury and was offered modified duties as a Trim (Potato Inspector).

The Return-to-Work Specialist determined the modified duties were suitable.

The worker objected, arguing the work environment was unsafe due to slippery floors and the need to use a cane.

The Appeals Resolution Officer allowed the worker's objection, finding that the modified duties posed a safety risk because the worker's permanent restriction required the use of a walking aid, which could slip on the wet and oily surfaces in the work area.

The modified duties were therefore deemed not suitable.

The worker suffered a compensable right foot sprain and was prescribed custom-made orthotics.

The Nurse Consultant denied entitlement on the basis that orthotics are only funded for specific deformities.

The Appeals Resolution Officer allowed the worker's objection, finding that the orthotics were necessary, appropriate, and sufficient for the compensable injury, even if they also addressed non-compensable conditions.

The worker was granted entitlement to a one-time purchase of custom-made orthotics, provided they were purchased prior to reaching maximum medical recovery.

The worker suffered a compensable right foot sprain (turf toe) and was prescribed custom-made orthotics by a chiropodist.

The WSIB initially denied entitlement on the basis that orthotics are only funded for specific deformities.

The Appeals Resolution Officer allowed the worker's appeal, finding that the orthotics were necessary, appropriate, and sufficient for the compensable injury, even if they also addressed non-compensable conditions like flat feet.

The worker was granted entitlement to a one-time purchase of the orthotics, provided they were purchased prior to reaching maximum medical recovery.

The worker suffered a compensable lower back injury and was prescribed muscle relaxants that caused dizziness.

The employer refused to allow the worker to return to modified duties while experiencing these side effects.

The Case Manager denied loss of earnings (LOE) benefits from October 27, 2021, arguing the medication was not in accordance with a specialty program's recommendations.

The Appeals Resolution Officer allowed the worker's objection, finding the dizziness was a compensable side effect of treatment for the work-related injury and that no modified work was available.

LOE benefits were granted from October 27, 2021, to November 17, 2021, when the side effects resolved.

The worker, a police constable, developed a psychological condition and delayed filing a WSIB claim for over two years due to severe symptoms and stigma.

The Case Manager denied a time limit extension to file the claim.

On appeal, the Appeals Resolution Officer allowed the extension, finding that the worker's severe psychological symptoms, which impaired cognitive function and decision-making, constituted exceptional circumstances under WSIB policy 15-01-03.

The worker appealed a Case Manager's decision that they were fit to perform their pre-injury job duties as a Truck Driver and denying loss of earnings (LOE) benefits from May 1, 2018.

The Appeals Resolution Officer found that the pre-injury duties were not suitable given the worker's permanent right knee impairment, which restricted sitting, climbing, and kneeling.

The worker was awarded LOE benefits from May 1, 2018, to the start of their maternity leave in July 2020, based on the difference between their actual and pre-injury earnings, and was granted return-to-work services.

The worker, an electrician, suffered a lower back injury in November 2020 and returned to modified duties.

In March 2021, the worker experienced a recurrence of lower back pain and sought further benefits, which the Case Manager initially denied.

On appeal, the Appeals Resolution Officer found that the worker experienced a significant deterioration that was clinically compatible with the original injury and not caused by a new incident.

The worker's objection was allowed, granting entitlement to health care benefits for the recurrence.

The worker, a police sergeant, objected to an 8% non-economic loss (NEL) award for a work-related bilateral shoulder impairment.

The worker argued the rating should be higher due to the significant impact the injuries had on their life, including their inability to remain on the Emergency Response Team and limitations in daily activities.

The Appeals Resolution Officer found that the NEL rating was correctly calculated using the prescribed American Medical Association's Guides to the Evaluation of Permanent Impairment, which do not account for lifestyle impacts.

The 8% NEL award was confirmed.

The worker objected to the Case Manager's final 72-month lock-in decision, which locked in their partial Loss of Earnings (LOE) benefits to age 65 based on the updated median-level wages of their suitable occupation (Legal Assistant).

The Appeals Resolution Officer found that the worker was voluntarily underemployed at the time of the final review, as they were working part-time in a job outside their identified suitable occupation.

The WSIB policy directed the use of updated wage information for an experienced worker in the suitable occupation.

The Appeals Resolution Officer concluded that the median-level wage was appropriate given the worker's lack of experience in the suitable occupation, and denied the worker's objection.