Workers' Compensation

The worker, a firefighter, appealed a decision denying entitlement for left foot and ankle injuries.

The worker developed left foot pain after working four 11-hour shifts at a mass vaccination clinic, which required prolonged standing and walking on concrete floors in safety boots.

The Appeals Resolution Officer found that the work at the vaccination clinic represented a significant change in physical demands compared to regular firefighting duties.

The Officer concluded that the excessive prolonged walking caused a repetitive overload of the Achilles tendon, resulting in Achilles tendinosis.

The appeal was allowed in part, granting initial entitlement for the left Achilles tendon injury, and the matter was remitted to determine loss of earnings benefits.

The worker appealed a decision denying entitlement for bladder cancer and loss of earnings (LOE) benefits.

The worker argued the bladder cancer was caused by occupational exposures in the petrochemical industry or by radiation treatment for a previously accepted follicular lymphoma claim.

The Appeals Resolution Officer dismissed the appeal, finding insufficient evidence that occupational exposures or the limited radiation treatment significantly contributed to the bladder cancer, noting the worker's smoking history as a major risk factor.

The claim for LOE benefits was also denied as the worker retired without functional limitations from the accepted lymphoma, and the bladder cancer was deemed non-compensable.

The worker, an educational assistant, was head-butted by a special needs student, sustaining a concussion and psychological injuries.

The worker appealed the Case Manager's decisions denying entitlement for post-traumatic stress disorder (PTSD) and post-traumatic vision syndrome.

The Appeals Resolution Officer allowed the appeal in part, granting entitlement for PTSD based on the WSIB Mental Health Specialty Clinic's assessment, finding the accident was objectively traumatic.

However, the claim for post-traumatic vision syndrome was denied, as multiple neurological assessments found no organic basis for a visual system impairment.

The worker appealed the denial of initial entitlement for a left finger injury sustained while opening dirty boxes at work.

The Appeals Resolution Officer found that the worker suffered a disablement injury when a foreign object lodged under their fingernail, leading to an infection, osteomyelitis, and eventual amputation of the fingertip.

The delay in reporting was deemed reasonable given the initially minor nature of the injury.

The appeal was allowed, granting initial entitlement to the infection and secondary entitlement to the amputation and permanent impairment, with loss of earnings benefits referred back for further investigation.

The worker, a corrections officer, appealed the denial of presumptive entitlement to PTSD and Chronic Mental Stress (CMS).

The worker alleged that a lack of workplace support and a supervisor's aggressive behaviour during a meeting triggered their PTSD symptoms.

The Appeals Resolution Officer found that the worker's PTSD was a pre-existing condition and that employment was not a significant contributing factor.

Furthermore, the officer concluded that the workplace events did not constitute a substantial work-related stressor or egregious behaviour, but rather fell under typical interpersonal conflict and management's employment functions.

The appeal was dismissed.

The worker objected to the recalculation of their long-term loss of earnings (LOE) benefit rate following a workplace injury.

The worker argued that the recalculation was unfair because it did not adequately consider overtime earnings and caused financial hardship.

The Appeals Resolution Officer found that the recalculation correctly applied WSIB policy regarding long-term average earnings for workers in permanent employment, and that there are no exceptions permitting adjustments based on compassionate grounds or financial need.

The worker's objection was denied.

The worker suffered a severe left hand and wrist injury in a 2003 workplace motor vehicle accident, reaching maximum medical recovery in 2005 with a 25% Non-economic Loss award.

In 2021, the worker experienced worsening symptoms and sought entitlement for secondary conditions and a left wrist fusion surgery.

The case manager denied the requests, finding the new diagnoses were not causally related to the index injury.

On appeal, the Appeals Resolution Officer weighed competing medical opinions and preferred the treating orthopaedic surgeon's opinion over the WSIB medical consultant's, finding the worker suffered a compensable recurrence.

The appeal was allowed, granting entitlement to the secondary conditions and the wrist fusion surgery.

The worker objected to a decision denying initial entitlement for a slip and fall injury that occurred in a parking lot prior to the start of their shift.

The worker argued they were employed by the City, which owned the parking lot.

The Appeals Resolution Officer determined that the worker's employer was the Police Services Board (the employer of record), not the City, despite sharing a WSIB firm number.

Furthermore, the worker was not in the course of employment at the time of the injury because they had not yet entered the employer's premises, and the employer did not own or control the parking lot.

The worker's objection was denied.

The worker objected to a Case Manager's decision denying loss of earnings (LOE) benefits after July 7, 2023.

The worker had sustained soft tissue injuries and was offered a graduated return to work plan with sedentary administrative duties.

After working for one hour, the worker left claiming pain and did not return.

The Appeals Resolution Officer found that the medical evidence did not support total disability and that the offered work was suitable and within the worker's functional abilities.

The objection was denied as the worker failed to fully participate in the return to work process.

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 employer objected to a Case Manager's decision allowing the worker entitlement for a low back sprain/strain as a secondary condition to a compensable right shoulder injury.

The worker developed low back pain while performing modified duties that required increased twisting and turning to accommodate the shoulder injury.

The Appeals Resolution Officer found a causal link between the altered movements and the low back strain, concluding that secondary entitlement remained in order.

The employer's objection was denied.

The worker appealed a case manager's decision that their work-related left ankle sprain had fully resolved without permanent impairment and denied loss of earnings (LOE) benefits from May 9, 2023.

The Appeals Resolution Officer found that maximum medical recovery was achieved by April 12, 2023, but that the clinical evidence supported a permanent impairment with permanent restrictions.

As there was no suitable work available within the worker's restrictions, entitlement to LOE benefits from May 9, 2023 was allowed, and the matter was remitted to the operating area to determine the nature and duration of benefits.

The worker objected to a 2007 decision by a claims adjudicator that determined the suitable employment or business categories for their labour market re-entry (LMR) plan were Customer Service in Retail Establishment and Administrative Support Clerk.

The worker argued that non-occupational injuries and conditions were not considered when they were referred for the LMR plan.

The Appeals Resolution Officer denied the objection, finding that the contemporaneous evidence from 2007 did not support that the worker required limitations for their non-occupational conditions or that these conditions rendered them incapable of participating in LMR services.

The LMR plan was deemed suitable and appropriate based on the worker's functional abilities known at the time.

The worker, a communications operator, suffered a work-related mental stress injury (PTSD) in August 2019 and received loss of earnings (LOE) benefits.

After participating in a graduated return to work plan, the worker stopped working in October 2022 due to a deterioration in psychological symptoms.

The Case Manager denied entitlement to a recurrence of the work-related PTSD and LOE benefits, finding the deterioration was caused by significant non-work-related life stressors.

The worker objected to this decision and a subsequent decision denying partial LOE benefits during a March 2023 return to work plan.

The Appeals Resolution Officer dismissed the appeal, concluding that the worker's significant deterioration was due to a confluence of non-work-related life stressors, which equated to a significant new incident, and therefore the worker was not entitled to LOE benefits for a recurrence or partial LOE benefits during the subsequent return to work plan.

The worker appealed a case manager's decision denying entitlement to traumatic mental stress and chronic mental stress benefits because the claim was filed outside the time limit.

The worker experienced a traumatic workplace incident in March 2016 but did not file a claim until October 2021.

The Appeals Resolution Officer found that the transitional provisions for mental stress policies required claims to be filed on or before July 1, 2018, and unlike general time limit policies, these transitional provisions do not contain discretionary authority to extend the deadline.

The appeal was denied.

The estate of a deceased worker appealed a decision denying entitlement for colon cancer allegedly caused by workplace exposures to methyl ethyl ketone (MEK), creosote (PCBs), and ammonia.

The Appeals Resolution Officer found that, based on the Occupational Medical Consultant's review and the International Agency for Research on Cancer (IARC) classifications, there was no epidemiological link between the claimed agents and the development of colon cancer.

The appeal was dismissed.

The worker, a front-line police officer, appealed a decision denying entitlement for an adverse reaction (EGPA) stemming from an employer-arranged COVID-19 vaccination.

The Appeals Resolution Officer found that although the vaccine was not strictly mandatory at the time, the employer strongly encouraged it, arranged the clinic during work hours, and imposed negative consequences for non-compliance.

The tribunal concluded the vaccination was an activity incidental to employment and granted initial entitlement for the adverse reaction.

The worker appealed an adjudicator's decision denying initial entitlement for lung cancer claimed to be related to occupational exposures in the manufacturing industry and as a volunteer firefighter.

The Appeals Resolution Officer found that while the worker did not meet the presumptive criteria for firefighters due to their smoking history, the claim succeeded on its individual merits.

The evidence established that the worker's routine exposure to various known carcinogens, including asbestos, silica, and heavy metals, over a 40-year period was a significant contributing factor to the development of their lung cancer, alongside their smoking history.

The appeal was allowed.

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.