Workers' Compensation

The employer appealed an Eligibility Adjudicator's decision granting the worker initial entitlement for Welder's Flash and one day of loss of earnings (LOE) benefits.

The employer argued the worker reported the incident late, preventing the employer from offering modified duties to mitigate lost time.

The Appeals Resolution Officer found the reporting was prompt, as the worker reported the incident and sought medical attention the day after the injury.

The diagnosis was compatible with the accident history, and the worker had clinical authorization to be off work for the missed shift.

The employer's appeal was denied.

The respondent Workplace Safety and Insurance Appeals Tribunal brought a motion to dismiss the applicant's application for judicial review for delay.

The applicant commenced the application 10 months after the final reconsideration decision, arguing that the COVID-19 suspension of limitation periods under O. Reg 73/20 applied.

The court found that even if the suspension did not apply, the four-month delay beyond the common law six-month timeline was not inordinate.

The court held that the delay was reasonably explained by the pandemic context and caused no actual prejudice to the respondent.

The motion to dismiss was dismissed.

The worker, an electrician, suffered a fatal cardiac arrest shortly after arriving at a job site during an extreme cold weather alert.

The worker's estate sought initial entitlement, arguing the cardiac event was caused by work duties and the extreme cold, and relied on the statutory presumption under s. 13(2) of the WSIA.

The Appeals Resolution Officer denied the appeal, finding no evidence of unusual physical exertion or acute emotional stress.

The medical evidence indicated the worker had significant pre-existing coronary artery disease and had been experiencing symptoms prior to the incident.

The Officer concluded the heart condition did not arise out of employment.

The worker appealed an adjudicator's decision denying initial entitlement for a vertebral artery dissection leading to a stroke, which the worker alleged was caused by bumping their head and neck while repairing a radiator in a tight workspace.

The Appeals Resolution Officer found that while the worker likely experienced minor bumps, the medical evidence and the delay in symptom onset did not support that the workplace activities were a significant contributing factor to the dissection.

Given the worker's significant pre-existing risk factors for stroke, the appeal was dismissed.

The worker appealed a Case Manager's decision terminating re-employment payments effective June 13, 2022, the date the worker secured alternate employment after being terminated by the accident employer.

The Appeals Resolution Officer found that securing alternate employment to mitigate wage loss did not sever the employment relationship.

However, the worker explicitly stated on August 8, 2022, that they did not intend to return to the accident employer, which severed the relationship.

The appeal was allowed in part, granting re-employment payments less actual earnings from June 13 to August 8, 2022.

The employer objected to a Case Manager's decision denying entitlement to cost relief under the Second Injury and Enhancement Fund (SIEF) following a worker's trip and fall injury.

The employer argued that the worker's pre-existing conditions, including diabetes and lumbar degeneration, prolonged recovery.

The Appeals Resolution Officer found the accident severity was moderate and that the pre-existing conditions did not cause the accident or prolong the recovery period within the meaning of the policy.

The employer's objection was denied.

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 worker objected to a decision rating their asbestosis permanent impairment at the 15% non-economic loss (NEL) award level.

The worker argued that the predicted baseline value for their diffusing capacity for carbon monoxide (DCO) should be based on the AMA Guides' table for a 74-year-old, as the table does not provide values for individuals over 74, which would result in a 25% impairment rating.

The Appeals Resolution Officer found that the 15% rating was correct, as the respirologist had established a specific predicted DCO value for the 84-year-old worker, and the AMA Guides permit the use of accepted and verified equations outside the scope of the tables.

The worker's objection was denied.

The worker suffered a compensable left ankle fracture in 1989 and received a 9% permanent disability pension.

Over 30 years later, the worker's wage rate was reduced following a corporate reconfiguration.

The worker sought a section 147(4) supplement, arguing the wage reduction was due to their compensable injury and restrictions.

The Appeals Resolution Officer denied the appeal, finding no evidence connecting the temporary reduction in earnings to the 1989 ankle injury, as the job change was based on seniority during a corporate reconfiguration affecting multiple employees.

The worker objected to a Claims Adjudicator's decision finding that the employer had offered suitable permanently modified duties following a compensable left shoulder injury.

The worker argued that the Environmental Assistant position offered was not suitable because he lacked the necessary computer skills and training.

The Appeals Resolution Officer found that the position was physically suitable and within the worker's permanent restrictions.

Furthermore, the evidence demonstrated that the worker had the cognitive aptitude for the role and received adequate on-the-job training.

The worker's objection was denied.

The employer objected to a Case Manager's decision granting a police officer initial entitlement to post-traumatic stress disorder (PTSD) and loss of earnings (LOE) benefits.

The worker had been exposed to multiple traumatic events during their employment.

The Appeals Resolution Officer found that the worker met the criteria for the first responder PTSD presumption under Policy 15-03-13.

The employer failed to rebut the presumption, as the evidence showed the worker's employment as a police officer significantly contributed to the PTSD diagnosis.

The worker was also found entitled to full LOE benefits because the psychological injury prevented a return to any type of work.

The employer's objection was denied.

The employer objected to a decision granting the worker initial entitlement for a left shoulder dislocation and loss of earnings (LOE) benefits.

The worker tripped and fell at work, initially receiving a diagnosis of a shoulder sprain.

A week later, the worker woke up in severe pain and was diagnosed with a shoulder dislocation.

The employer argued the dislocation occurred at home and was not work-related.

The Appeals Resolution Officer found it more likely than not that the dislocation occurred during the workplace fall but self-corrected before the initial medical assessment, leaving the shoulder vulnerable.

The ARO denied the employer's objection, confirming entitlement to healthcare and LOE benefits.

The worker, a counsellor at a long-term care home, appealed the denial of initial entitlement for COVID-19.

The worker claimed they contracted the virus at work during an outbreak in April 2020, despite testing negative on two PCR tests.

The Appeals Resolution Officer found that while the worker's employment created an elevated risk of exposure, there was no medical evidence confirming a COVID-19 diagnosis.

The worker's symptoms and negative tests did not satisfy the adjudicative criteria for a confirmed condition.

The appeal was dismissed.

The worker objected to decisions finding that their work-related right shoulder sprain/strain had fully resolved with no permanent impairment, and denying entitlement to a recurrence.

The Appeals Resolution Officer reviewed the medical evidence and found that the worker had reached maximum medical recovery by January 10, 2020, with no restrictions and a significant gap in subsequent medical treatment.

The Officer also found that the worker's ongoing shoulder pain lacked a formal diagnosis establishing clinical compatibility with the original injury, and that a subsequent deterioration was the result of a new workplace incident.

The worker's objections were denied.

The worker, a Trackman Journeyman, suffered a work-related left knee injury and returned to modified duties.

The employer subsequently laid off the worker due to a shortage of work, which constituted a permanent work disruption.

The Case Manager initially denied Loss of Earnings (LOE) benefits following the layoff.

On appeal, the Appeals Resolution Officer found that the worker's ongoing knee impairment and need for active treatment precluded them from performing their pre-injury duties or securing alternative employment.

The worker's objection was allowed, granting full LOE benefits from the date of the layoff.

The worker, an Educational Assistant, appealed the denial of entitlement to Traumatic Mental Stress and Chronic Mental Stress for events occurring prior to September 2018.

The worker alleged workplace harassment and bullying by co-workers, which they claimed caused a mental stress injury.

The Appeals Resolution Officer found that the alleged incidents of harassment were not confirmed by co-workers or the employer, and appeared to be interpersonal conflicts rather than substantial work-related stressors.

The medical evidence also suggested the worker's stress was related to personal life events.

The appeal was denied, as the criteria for both Traumatic and Chronic Mental Stress were not met.

The worker appealed a Case Manager's decisions denying initial entitlement to various physical and psychological conditions, denying ongoing loss of earnings benefits, and denying entitlement for a mental stress injury following a slip and fall on a wet escalator at work.

The Appeals Resolution Officer found that the worker's additional claimed physical conditions were either pre-existing or not compatible with the mechanism of injury.

The Officer also determined that the worker had reached maximum medical recovery for their accepted contusions with no ongoing work-related impairment.

Finally, the Officer concluded that the worker was not entitled to benefits for a mental stress injury, as the incident was not objectively traumatic and the worker's psychological condition pre-dated the workplace accident.

The worker's objection was denied.

The worker, a food services cashier, appealed a Case Manager's decision denying entitlement to benefits for a psychological condition following a workplace altercation.

The worker was verbally threatened and physically assaulted by a customer who threw a cup of pop in their face, prompting the worker to strike back in self-defense.

The Appeals Resolution Officer found that the worker did not provoke the fight and was acting in the course of employment.

The appeal was allowed, granting the worker entitlement to benefits for Post-Traumatic Stress Disorder (PTSD) under the Traumatic Mental Stress policy.

The worker appealed a Case Manager's decision denying a Permanent Disability (PD) reassessment for a lower back injury sustained in 1978.

The worker had previously been awarded a 25% PD.

Following a 2021 surgery to excise a work-related hematoma, the worker argued their condition had significantly deteriorated, citing post-surgical complications and decreased functional abilities.

The Appeals Resolution Officer denied the appeal, finding that medical reporting indicated the surgical site had healed well and that ongoing back pain was related to underlying arthritic changes rather than a permanent deterioration of the accepted work-related condition.

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.