L. Mansueti

The worker appealed a decision denying entitlement to benefits for Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome (ACOS).

The worker had a 28-year history of working in a plastics factory with exposure to dust, fumes, and chemicals, alongside a significant smoking history.

While initial WSIB hygiene assessments found exposures below the threshold for COPD, a subsequent Occupational Medical Consultant opinion concluded that occupational exposures could not be ruled out as a material contributor to the ACOS diagnosis.

The Appeals Resolution Officer allowed the appeal, finding that the workplace exposures made a material contribution to the development and progression of the worker's ACOS.

The worker appealed a decision denying her entitlement to benefits for occupational fumes exposure.

She alleged that she developed a sore throat, sinus issues, and headaches after being exposed to caustic fumes from a malfunctioning soaker machine at work.

The employer argued there was no evidence of exposure and relied on an air monitoring study showing normal levels.

The Appeals Resolution Officer allowed the appeal, finding that documentary evidence corroborated the worker's account of a leaking valve and an open industrial curtain.

The air monitoring study was given little weight as it was conducted after corrective actions were taken.

The worker was granted entitlement to benefits for caustic fume inhalation and loss of earnings for the time missed to seek medical attention.

The worker, a first responder, appealed a Case Manager's decision establishing January 5, 2020, as the date of injury for their posttraumatic stress disorder (PTSD) claim.

The worker argued the date of injury should be in 2018, when their symptoms first commenced and their work hours were reduced.

The Appeals Resolution Officer found insufficient contemporaneous medical evidence to support a 2018 date of injury.

However, based on an Employee and Family Assistance Program intake assessment, the Officer determined the date of first medical attention for work-related stress was January 28, 2019.

The worker's objection was allowed in part, and the date of injury was adjusted to January 28, 2019.

The worker, an Educational Assistant, appealed a Case Manager's decision denying entitlement to benefits for mental stress.

The worker developed PTSD, anxiety, and depression after being physically assaulted by a student on two consecutive days in March 2022.

The Appeals Resolution Officer found that the incidents were clearly and precisely identifiable and objectively traumatic, acting as the catalyst for the worker's psychological decompensation due to the cumulative effect of multiple traumatic workplace events throughout her career.

The worker's pre-existing mental health condition did not negate entitlement.

The appeal was allowed, and initial entitlement was granted under the Traumatic Mental Stress policy.

The worker suffered a compensable lower back injury while working as a part-time cleaner temporarily assigned to full-time hours.

After a period of graduated return to work, the employer offered a permanent full-time accommodated position.

The worker declined, stating they could only work 20 hours per week due to their compensable injury and pre-existing conditions.

The Case Manager reduced the worker's partial loss of earnings (LOE) benefits, finding them capable of full-time work.

On appeal, the Appeals Resolution Officer allowed the worker's objection, applying Board policy that part-time workers are not expected to significantly increase their hours or obtain full-time work.

The worker was granted partial LOE benefits based on a 20-hour work week.

The worker appealed decisions denying loss of earnings (LOE) benefits after May 8, 2023, limiting his low back entitlement to a strain, and finding he reached maximum medical recovery (MMR) without a permanent impairment (PI).

The Appeals Resolution Officer found the worker was totally disabled and entitled to LOE benefits from May 8 to July 5, 2023, after which he was capable of performing the suitable modified work offered by the employer.

The Officer upheld the decision limiting the low back injury to a lumbar strain, preferring the diagnosis of the back and neck specialty program over a chronic pain specialist.

Finally, the Officer concluded the worker reached MMR for his knee and head injuries with no PI, but found he had a permanent impairment for his lumbar strain, entitling him to a non-economic loss (NEL) assessment.

The worker, a firefighter with 28 years of service, was diagnosed with right vocal cord squamous cell carcinoma (laryngeal cancer) and sought benefits for an occupational disease.

The initial adjudicator denied the claim because laryngeal cancer is not a prescribed cancer for firefighters under the presumptive policy.

On appeal, the Appeals Resolution Officer weighed competing medical opinions.

The Officer preferred the opinions of the worker's treating oncologist and an occupational medicine physician, who both concluded that the cancer was likely caused by occupational exposures given the worker's lack of other risk factors, over the opinion of the Board's medical consultant.

The appeal was allowed and entitlement to benefits was granted.

The worker appealed a decision denying entitlement to WSIB benefits for a mental health injury allegedly caused by occupational chemical exposures.

The worker experienced a mental breakdown and was diagnosed with a 'chemical concussion' by a naturopathic doctor.

The Appeals Resolution Officer denied the appeal, finding that 'chemical concussion' is not a recognized medical diagnosis and that the worker's confirmed diagnoses of Adjustment Disorder and Generalized Anxiety Disorder were not compatible with chemical workplace exposures.

The decision relied heavily on the opinion of a WSIB Occupational Medical Consultant who found no toxicological link between the exposures and the worker's mental health conditions.

The worker appealed a Case Manager's decision terminating his loss of earnings (LOE) benefits on the basis that the employer had offered suitable modified work.

The worker suffered a compensable low back injury and attempted a graduated return-to-work plan, but stopped working shortly after, citing an inability to tolerate the duties due to pain.

The Appeals Resolution Officer weighed conflicting medical evidence, preferring the WSIB Specialty Clinic's opinion that the worker was partially disabled and capable of modified work over his family physician's opinion of total disability.

While the modified work offered was deemed suitable, the Officer found that the employment relationship had effectively ended and the work was no longer available as of February 9, 2022.

Consequently, the worker was granted partial LOE benefits based on a suitable occupation and entitlement to return-to-work services.

The worker, a personal support worker, appealed a decision denying entitlement to WSIB benefits for a low back injury.

The worker alleged she suffered an acute disc herniation while adjusting a mechanical lift sling on a combative resident.

The employer disputed the claim, citing delayed reporting and a pre-existing back condition from a 2017 motor vehicle accident.

The Appeals Resolution Officer allowed the appeal, finding that the worker suffered a personal work-related injury and accepting expert medical evidence that the physical demands of the incident caused an acute disc prolapse.

The worker was granted entitlement to benefits for the injury and subsequent surgical intervention.

The worker objected to a Case Manager's decision denying loss of earnings (LOE) benefits from May 7, 2019.

The worker had suffered a compensable right knee injury and returned to suitable modified work.

In April 2019, the worker took an extended unapproved vacation and failed to return to work on the agreed date, resulting in termination for job abandonment.

The Appeals Resolution Officer found that the worker's wage loss after May 7, 2019, was not the result of the work-related injury, but rather the result of employment termination unrelated to the injury.

The worker's objection was denied.

The worker, a scoop tram operator, objected to a decision denying initial entitlement to benefits for a gradual onset bilateral shoulder injury.

The worker argued the injury resulted from the poor ergonomic setup of the scoop tram, which required awkward postures and exposed him to jarring and jostling.

The Appeals Resolution Officer found that the worker's job duties significantly contributed to the bilateral shoulder tears, relying on supportive medical opinions from the worker's health care professionals.

The worker's objection was allowed, and entitlement to benefits was granted.

The worker suffered a compensable left knee injury and was receiving loss of earnings (LOE) benefits.

The Case Manager suspended the worker's LOE benefits after the worker sustained a fall resulting in a hip replacement, determining this was a non-work-related change in circumstances that prevented participation in health care measures.

The Appeals Resolution Officer allowed the worker's objection, finding that the subsequent fall and hip injury were a direct result of the compensable knee impairment, and therefore the worker was entitled to the reinstatement of LOE benefits.

The worker, an Educational Assistant, suffered physical injuries after being assaulted by a student.

She later sought entitlement for psychotraumatic disability, alleging her psychological symptoms were an indirect result of the workplace injury.

The Appeals Resolution Officer denied the appeal, finding that the worker's psychological deterioration was primarily triggered by a non-compensable event—specifically, learning she had been subjected to video surveillance and subsequently having her benefits terminated for misrepresenting her level of impairment.

The criteria for psychotraumatic disability under operational policy 15-04-02 were not met.

The worker objected to the WSIB's calculation of their long-term average earnings loss of earnings (LOE) benefit rate.

The worker, who had recently completed an apprenticeship and was working as a journeyperson millwright at the time of injury, argued that their pre-injury earnings as an apprentice did not accurately reflect their earning capacity.

The Appeals Resolution Officer found that the worker had a non-permanent employment pattern and had not been employed long enough as a journeyperson to establish an earnings pattern.

Applying section 53(4.1) of the Workplace Safety and Insurance Act, the Officer concluded that the worker's earnings basis should be calculated using the average earnings of a journeyperson in the same trade.

The worker's objection was allowed in part.

The worker, a first responder, appealed a Case Manager's decision denying entitlement to benefits for Posttraumatic Stress Disorder (PTSD).

The employer argued the worker's mental stress was caused by the employer's decision to close their work location and relocate them, thereby rebutting the statutory presumption.

The Appeals Resolution Officer found that while the relocation news prompted the worker to seek medical attention, the medical evidence established that cumulative traumatic workplace events materially contributed to the PTSD diagnosis.

The appeal was allowed and entitlement to benefits for PTSD was granted.

The worker appealed a decision denying entitlement to health care benefits for onychomycosis (fungal nail infection).

The worker alleged the condition developed after wearing employer-provided safety boots in and around water and staying in a hotel during a multi-day work trip.

The Appeals Resolution Officer found that the worker's employment and exposure history, including the hotel stay and wearing wet safety boots, significantly contributed to the development of the condition.

The worker's objection was allowed and entitlement to health care benefits was granted.

The worker objected to a Case Manager's decision discontinuing his loss of earnings (LOE) benefits after he left the country, which was deemed a material change in circumstances.

The worker, who was receiving full LOE benefits for a psychotraumatic disability, argued he attempted to notify the WSIB before leaving to visit family.

The Appeals Resolution Officer found that while the worker failed to properly report the material change, there was no evidence of willful concealment.

Because the worker was totally disabled and not participating in active treatment or return-to-work activities at the time of departure, the Officer allowed the objection in part, granting the worker three weeks of LOE benefits under the WSIB's vacation policy.

The worker suffered a compensable left knee injury and was assigned self-accommodated duties that exceeded their functional abilities.

After undergoing surgery, the worker attempted a work trial with a new employer but was unsuccessful.

The WSIB Case Manager terminated the worker's loss of earnings (LOE) benefits on the basis that the worker had resigned from their pre-injury employment.

The Appeals Resolution Officer found that the worker had not resigned, either verbally or in writing, and that the employment relationship remained intact.

The worker's attempt to mitigate their wage loss by seeking alternative employment did not sever the relationship or disentitle them to benefits.

The worker's objection was allowed, and LOE benefits and return-to-work services were reinstated.

The employer appealed a decision denying cost relief under the Second Injury and Enhancement Fund (SIEF) for a worker who developed irritant contact dermatitis from frequent hand washing and sanitizing at work.

The Appeals Resolution Officer found that the worker had a pre-existing atopic predisposition that contributed to the development of the condition.

Assessing the accident severity as minor and the medical significance of the pre-existing condition as minor, the Officer granted the employer 50 per cent SIEF cost relief.