L. Mansueti

The worker, a tractor trailer driver, suffered bilateral hand injuries in a motor vehicle accident.

The WSIB recalculated her long-term loss of earnings (LOE) rate, determined she was capable of sedentary work including driving, identified Customer Service Representative as a suitable occupation (SO), and subsequently reduced her LOE benefits for non-cooperation when she refused to participate in a Work Transition (WT) plan.

On appeal, the Appeals Resolution Officer upheld the long-term recalculation but found the SO was not suitable because the worker's compensable hand impairments prevented her from safely driving the long distance required to attend the WT program.

The finding of non-cooperation was rescinded, and full LOE benefits were restored.

The worker appealed a decision denying entitlement to benefits for chronic lymphocytic leukemia (CLL).

The worker, a carpenter and maintenance worker, claimed the disease was caused by workplace exposure to benzene and other solvents.

The Appeals Resolution Officer reviewed conflicting medical and occupational hygiene evidence regarding the link between benzene exposure and CLL.

Preferring the medical opinion that the worker was at an elevated risk due to workplace exposures, and noting the worker's lack of non-occupational risk factors, the Officer concluded that the employment exposures likely made a significant contribution to the development of CLL.

The appeal was allowed.

The worker's Estate objected to a decision denying WSIB benefits for multiple myeloma, arguing the disease was caused by the worker's occupational exposure to ionizing radiation while employed as a draftsman at a nuclear power station.

The Appeals Resolution Officer weighed competing medical and occupational hygiene opinions.

Relying on WSIB Occupational Medical Consultants, the Officer found that the worker's exposure to ionizing radiation was low-dose and, combined with a long latency period and non-modifiable risk factors, did not significantly contribute to the development of multiple myeloma.

The objection was denied.

The worker suffered a severe traumatic brain injury, facial fractures, and lacerations after being struck by a falling object at work.

The WSIB initially granted a 14% Non-Economic Loss (NEL) benefit for the brain injury, facial disfigurement, and loss of smell and taste.

The worker objected, seeking a higher NEL quantum.

The Appeals Resolution Officer reviewed the medical evidence and the AMA Guides, determining that the worker's impairments warranted a 1% rating for facial disfigurement, 20% for the traumatic brain injury, and 3% for loss of smell and taste.

Applying the Combined Values Chart, the worker's total whole person impairment was calculated at 23%.

The appeal was allowed.

The worker objected to several Case Manager decisions regarding their entitlement to loss of earnings (LOE) benefits, Non-Economic Loss (NEL) quantum, right knee diagnosis, and psychological treatment following a motor vehicle accident.

The Appeals Resolution Officer allowed the appeal in part.

The worker was granted full LOE benefits for a disputed period in early 2021, as their physical and psychological injuries completely prevented a return to work at that time.

The officer also removed a reduction to the worker's NEL quantum, finding the pre-existing right knee condition was asymptomatic prior to the accident.

Additional psychological treatment was approved to assist with the worker's transition to employment.

However, the officer upheld the expanded right knee diagnosis and confirmed the closure of LOE benefits in October 2021, as the worker had completed a return-to-work plan and was capable of restoring their pre-injury earnings.

The worker objected to a decision denying ongoing entitlement to benefits for a left hand injury sustained at work.

The worker originally suffered a left 4th digit injury but later developed left wrist symptoms, including a TFCC tear, after returning to full duties following a period of off-work recovery for an unrelated toe fracture.

The Appeals Resolution Officer found that the worker experienced a significant deterioration that was clinically compatible with the original injury and did not result from a new incident.

The objection was allowed, granting entitlement for a recurrence including the left TFCC tear and joint effusion.

The worker suffered an electric shock at work and subsequently developed severe anxiety and depression.

The WSIB initially denied entitlement for psychotraumatic disability and terminated loss of earnings (LOE) benefits.

On appeal, the Appeals Resolution Officer found that the workplace accident was a significant intervening event that exacerbated the worker's pre-existing psychological conditions.

Applying the thin skull doctrine, the Officer allowed the appeal, granting entitlement for Major Depressive Disorder and Generalized Anxiety Disorder, and reinstating LOE benefits from September 2, 2017.

The worker objected to a Case Manager's decision granting retroactive partial loss of earnings (LOE) benefits based on a determined suitable occupation.

The worker sought full LOE benefits from the date of injury until he returned to work with a different employer.

The Appeals Resolution Officer found that the worker was initially totally disabled and later partially disabled, but the employer did not offer suitable modified work.

Because the worker made reasonable efforts to mitigate his wage loss by seeking employment and engaging in health care treatment, he was entitled to full LOE benefits.

However, benefits were limited to January 14, 2014, as there was no medical evidence of ongoing impairment beyond that date.

The objection was allowed in part.

The worker appealed a decision denying initial entitlement for a right foot/ankle injury.

The worker claimed he fell from a trailer while chaining down a load, fracturing his calcaneus.

The employer argued the worker injured his foot at home and pointed to medical records where the worker reported falling off a ladder.

The worker testified the employer pressured him not to file a WSIB claim and promised to pay his wages, leading him to provide a false history to medical professionals.

The Appeals Resolution Officer accepted the worker's testimony, corroborated by a later letter from his family doctor confirming the worker had initially reported a work accident but asked to record it as a home injury.

The appeal was allowed and initial entitlement granted.

The worker appealed a decision denying initial entitlement to benefits for a syncope episode that occurred during a training session.

The worker fainted and struck her head, attributing the episode to excessive heat in the training room.

The Appeals Resolution Officer found that the accident occurred in the course of employment and applied the statutory presumption under s. 13(2) of the Workplace Safety and Insurance Act.

The evidence, including witness statements corroborating the hot temperature and medical evidence confirming no prior history of fainting, supported that the accident arose out of employment.

The appeal was allowed.

The worker appealed decisions denying entitlement for complex regional pain syndrome (CRPS), finding her non-cooperative in her Work Transition (WT) plan, and adjusting her loss of earnings (LOE) benefits following the closure of WT services.

The Appeals Resolution Officer found that the CRPS was not causally linked to the original workplace injury due to the significant delay in symptom onset.

However, the Officer determined that the worker was not non-cooperative in her WT plan, as her inability to participate was due to non-compensable health factors rather than a willful refusal.

Finally, the Officer upheld the LOE benefit adjustment based on the suitable occupation earnings, as the worker's work-related impairment was partial.

The objection was allowed in part.

The worker, a transport driver, suffered diesel exhaust inhalation at work due to a manifold leak.

He subsequently developed persistent headaches, dizziness, and involuntary muscle movements, later diagnosed as post-anoxic cortical myoclonus.

The WSIB initially denied further benefits, but the Appeals Resolution Officer allowed the worker's objection.

Relying on neurological evidence, the Officer found a causal link between the carbon monoxide exposure and the delayed-onset myoclonus.

The worker was granted entitlement for the condition, a non-economic loss assessment, and reinstatement of loss of earnings benefits.