Workers' Compensation

The worker sustained a thumb amputation when their hand was caught in a machine roller, and subsequently developed a psychotraumatic disability.

The employer appealed a Case Manager's decision denying cost relief under the Second Injury and Enhancement Fund (SIEF), arguing the worker's pre-existing anxiety enhanced their psychological reaction.

The Appeals Resolution Officer found the workplace accident was of major severity, as the machine roller weighed over a tonne and could cause serious permanent disability.

The worker's pre-existing anxiety was deemed of minor significance.

Under WSIB policy, an accident of major severity combined with a pre-existing condition of minor significance warrants zero percent SIEF relief.

The employer's appeal was dismissed.

The worker, a dietary aide, appealed a Case Manager's decision denying entitlement for a right shoulder partial tear and granting the employer 25% Second Injury and Enhancement Fund (SIEF) relief.

The Appeals Resolution Officer found that the worker's job duties, which involved repetitive overhead lifting of heavy trays due to a change to fine dining service, were compatible with the diagnosis of a right shoulder partial tear.

Furthermore, the medical evidence did not support the existence of a pre-existing condition that would warrant SIEF cost relief.

The worker's objection was allowed, granting entitlement for the shoulder tear and rescinding the SIEF relief.

The worker appealed a decision denying initial entitlement for a low back injury allegedly sustained while operating a jackhammer.

The worker felt a minor pinch but continued working and did not report the injury or seek medical attention for several weeks, eventually being diagnosed with a disc herniation.

The Appeals Resolution Officer dismissed the appeal, finding that the significant delay in reporting the injury and seeking medical attention broke the chain of causation, and therefore proof of accident was not established.

The worker, a paramedic with an allowed claim for posttraumatic stress disorder (PTSD), objected to a decision denying entitlement to medical cannabis.

The Appeals Resolution Officer reviewed the request under WSIB Operational Policy 17-01-10, which restricts medical cannabis entitlement to specific designated conditions.

Because PTSD is not a designated condition under the policy, the worker did not meet the mandatory criteria.

The worker's objection was denied.

The worker appealed decisions regarding the non-economic loss (NEL) quantum for a psychological condition (adjustment disorder with mixed anxiety and depressed mood) and the determination that there were no formal psychological restrictions for returning to work.

The Appeals Resolution Officer reviewed the clinical evidence and WSIB policies, concluding that the worker's psychological impairment was appropriately rated at 10% under Class 2 (Mild impairment), resulting in a 6% NEL benefit when combined with prior ratings.

The Officer also found that the clinical evidence supported workplace accommodations rather than formal psychological restrictions.

The worker's objection was denied.

The worker objected to a Case Manager's decision denying Loss of Earnings (LOE) benefits beyond August 1, 2018.

The worker suffered a left arm proximal humerus fracture and was offered modified duties by the employer.

The Appeals Resolution Officer found that the worker was capable of returning to light sedentary duties as of August 1, 2018, and that the employer's offer of modified work was safe, productive, and consistent with the worker's functional abilities.

As the suitable work was available at no wage loss, the worker was not entitled to further LOE benefits.

The objection was denied.

The employer appealed decisions granting the worker healthcare and loss of earnings (LOE) benefits for injuries sustained after falling from a scaffold, and denying the employer Second Injury and Enhancement Fund (SIEF) cost relief.

The employer argued the fall was caused by a diabetic medical episode rather than a workplace accident.

The Appeals Resolution Officer found no evidence that the worker's low blood sugar caused the fall, concluding the injuries arose out of and in the course of employment.

The worker was entitled to LOE benefits as the injuries prevented any work for a month.

SIEF cost relief was denied because the accident was of moderate severity and there was no evidence the pre-existing diabetes caused the accident or prolonged recovery.

The employer's 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 employer objected to a decision denying a transfer of costs for a worker's slip and fall claim to the respondent, a snow removal contractor.

The worker slipped on ice and snow on a sidewalk outside a building where they provided janitorial services.

The Appeals Resolution Officer found that the respondent had a reasonable system of maintenance in place and had cleared the sidewalk prior to the accident.

The employer failed to prove on a balance of probabilities that the respondent was negligent.

The objection was denied and the costs remained on the employer's accident record.

The worker appealed the Eligibility Adjudicator's decisions denying initial entitlement for bilateral carpal tunnel syndrome and right foot plantar fasciitis/right ankle tendonitis.

The Appeals Resolution Officer allowed the appeal in part.

The officer found that the physical demands of the worker's regular duties, which involved repetitive and forceful use of the hands and wrists with vibrating tools, were a significant contributing factor to the bilateral carpal tunnel syndrome.

However, the officer denied entitlement for the foot and ankle conditions, finding they were a progression of pre-existing, non-work-related problems and not significantly contributed to by the worker's duties.

The employer appealed a decision denying Second Injury and Enhancement Fund (SIEF) cost relief for a worker's carpal tunnel syndrome claim.

The employer argued that the worker's pre-existing obesity contributed to the injury and prolonged recovery.

The Appeals Resolution Officer denied the appeal, finding that the accident was of moderate severity and that obesity is not considered a pre-accident disability or pre-existing condition under the SIEF policy.

Furthermore, there was no medical evidence indicating that the worker's obesity affected the post-accident recovery period.

The estate of a deceased worker appealed a decision denying WSIB entitlement for the worker's colon cancer, alleging it was caused by occupational exposure to various chemicals during their 42-year employment in the rubber manufacturing industry.

The Appeals Resolution Officer reviewed the medical and scientific evidence, including IARC monographs and internal medical consultant opinions.

The Officer found no compelling evidence that the worker was exposed to the claimed chemicals or that such exposures are causally linked to colon cancer.

The appeal was denied.

The employer appealed a Case Manager's decision granting the worker entitlement to Traumatic Mental Stress (TMS) benefits.

The worker, a driver, was verbally assaulted and threatened by a temporary co-worker while on a paid coffee break outside the employer's premises.

The employer argued the worker had removed themselves from the course of employment.

The Appeals Resolution Officer denied the appeal, finding that the worker was required to leave the premises for their duties and was on a paid break, thus remaining in the course of employment.

The event was objectively traumatic, satisfying the criteria for TMS.

The worker, a police officer with a previously established claim for post-traumatic stress disorder (PTSD), appealed a case manager's decision denying entitlement to a recurrence of PTSD.

The worker had returned to work in a courthouse screening role but stopped working in May 2019 after experiencing suicidal thoughts and a deterioration in mental health, which coincided with the death of their father and ongoing workplace stressors.

The Appeals Resolution Officer allowed the appeal, finding that the worker experienced a significant deterioration in their compensable psychological condition that did not result from a significant new incident and was clinically compatible with the original injury.

The worker was granted full loss of earnings (LOE) benefits from May 21, 2019 onward.

The worker, a drywall installer who suffered a workplace injury resulting in severed fingers, objected to the Case Manager's decision to adjust their Loss of Earnings (LOE) benefits to partial LOE benefits based on the expected wages of a Suitable Occupation (SO) in retail sales.

The worker had completed a return to work plan but remained unemployed.

The Appeals Resolution Officer upheld the decision, finding that under the Operational Policy Manual, the adjustment to partial LOE benefits using the identified SO entry-level wage of $14.25 per hour was appropriate at the closure of the return to work plan.

The worker, a registered nurse, lost her balance while descending stairs at work and landed heavily on her left leg.

She was initially diagnosed with a hip strain, but a subsequent x-ray revealed a subcapital fracture of the left hip.

The Eligibility Adjudicator denied entitlement to the fracture because it was not evident on the initial x-ray.

The Appeals Resolution Officer allowed the worker's appeal, finding that the accident contributed significantly to the fracture, which was likely an 'occult' fracture not visible on the initial x-ray.

The worker was granted entitlement for the fracture and full loss of earnings benefits from the date of her hip surgery until her return to modified duties.

The employer objected to an Eligibility Adjudicator's decision granting the worker entitlement for a COVID-19 infection.

The worker, a senior electrician, tested positive for COVID-19 following an outbreak among maintenance staff at the workplace.

The Appeals Resolution Officer found that the nature of the worker's employment created a greater risk of contracting the illness compared to the general community, and that the infection was more likely than not acquired at work.

The employer's objection was denied and the worker's entitlement to benefits was upheld.

The estate of a deceased firefighter appealed the denial of initial entitlement for Chronic Myelomonocytic Leukemia (CMML), arguing the disease was caused by cumulative workplace exposures to carcinogens over a 32-year career.

The Appeals Resolution Officer found that CMML is not a prescribed cancer under the presumptive legislation for firefighters.

Relying on the WSIB Occupational Medical Consultant's review of peer-reviewed literature, the Officer concluded that CMML is not recognized as an occupational cancer and is not associated with firefighting exposures.

The appeal was denied.

The self-represented applicant moved under s. 21(5) of the Courts of Justice Act to set aside a single judge's orders adding the Workplace Safety and Insurance Appeals Tribunal as a party to his judicial review application and dismissing the application for extreme delay.

The applicant argued that s. 9(2) of the Judicial Review Procedure Act and the Divisional Court's test for delay violated the Charter and the Constitution Act, 1867.

The Divisional Court dismissed the motion, finding no constitutional violations, no error in adding the Tribunal as a party, and no error in dismissing the application due to an extraordinary and unexplained 12-year delay.

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.