Workers' Compensation

The employer appealed a decision granting the worker secondary entitlement for an infected burn on the left upper thigh and loss of earnings benefits.

The worker sustained a work-related thermal burn which subsequently became infected, causing the worker to miss work.

The employer argued the infection developed outside of work hours and was not work-related.

The Appeals Resolution Officer denied the employer's appeal, finding that the infection was causally linked to the work-related burn injury, as the worker would not have been subject to the risk of infection but for the initial work-related wound.

The worker appealed the denial of loss of earnings (LOE) benefits following an accepted recurrence of a compensable low back injury.

The worker argued they experienced a significant deterioration in June 2021 that prevented them from working.

The Appeals Resolution Officer found that the medical evidence did not support a significant deterioration in June 2021, but did support a significant deterioration as of May 19, 2022, when the worker's family doctor reported moderately decreased range of motion.

The worker was found to be totally disabled from that date.

The appeal was allowed in part, granting full LOE benefits from May 19, 2022, ongoing.

The worker appealed a Case Manager's decision that concluded they had reached maximum medical recovery for a right elbow biceps tendon insertion strain with no evidence of a permanent impairment.

The Appeals Resolution Officer found that the worker did have a permanent impairment, relying on a discharge report that documented permanent functional restrictions despite normal ranges of motion.

The matter was remitted to determine the degree of impairment using the RSI Rating Schedule.

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 appealed a Case Manager's decision offsetting 100% of their CPP disability benefits from their loss of earnings (LOE) benefits, and a NEL Clinical Specialist's decision rating their non-economic loss (NEL) benefit for psychotraumatic disability at 25%.

The Appeals Resolution Officer allowed the appeal in part.

The officer found that the CPP disability benefits were granted for both work-related and non-work-related injuries, and reduced the offset to 67% to account for the non-compensable injuries.

The officer confirmed the 25% NEL rating for psychotraumatic disability, finding that the worker's impairment fell within the lower range of a Class 3 impairment under the AMA Guides and WSIB policy.

A municipality contracted with a constructor to repair a water main and dispatched quality control inspectors to the project site.

A pedestrian was fatally struck by construction equipment at an intersection where required safety measures — a fence and signallers — were absent.

The municipality was charged as an employer under the Occupational Health and Safety Act for failing to ensure that prescribed regulatory measures were carried out in the workplace.

On equal division, the Supreme Court of Canada dismissed the appeal, with the majority holding that proof of control over workers or the workplace is not required to establish the actus reus of the employer's duty under s. 25(1)(c); control is relevant only to the due diligence defence.

The dissent would have either remitted the matter or restored the acquittals on the basis that regulatory measures apply only to work within the employer's sphere of control.

The worker, a personal support worker, appealed a case manager's decision denying entitlement for a right shoulder rotator cuff tear and finding that multiple injuries had fully resolved by January 14, 2022.

The Appeals Resolution Officer allowed the appeal in part, finding that the rotator cuff tear was compatible with the workplace accident where a 200-lb resident fell on the worker.

The Officer also found that while the worker's bruises had resolved by December 2, 2021, maximum medical recovery had not been reached for the right shoulder injury.

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 employer objected to a Case Manager's decision that the worker reached maximum medical recovery (MMR) by December 16, 2022, with a permanent low back impairment.

The worker, a personal support worker, suffered a low back strain and exacerbation of pre-existing spondylolisthesis after assisting a patient.

The Appeals Resolution Officer reviewed the medical evidence, including reports from a specialty clinic, and found that the worker had reached a plateau in recovery with no further significant improvement likely.

The Officer concluded that the worker continued to have an ongoing work-related impairment at the time of MMR, confirming the permanent impairment.

The employer's objection was denied.

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, a courier driver, suffered a compensable right eye and facial injury when struck by a truck door handle.

The worker objected to WSIB decisions denying entitlement for secondary eye conditions, setting the maximum medical recovery (MMR) date at October 1, 2022, and denying loss of earnings (LOE) benefits after September 13, 2022.

The Appeals Resolution Officer denied entitlement for the secondary eye conditions, finding them incompatible with the mechanism of injury.

However, the Officer varied the MMR date to February 21, 2023, based on specialist reports, and granted full or partial LOE benefits up to that date, pending confirmation of the worker's return-to-work hours and wages.

The worker, a personal support worker, appealed the denial of initial entitlement for a low back injury after slipping and falling on hand sanitizer at work.

The eligibility adjudicator had denied the claim, finding the injury was not compatible with the mechanism of injury due to a pre-existing condition.

The Appeals Resolution Officer allowed the appeal, finding that the fall was a significant contributing factor to the exacerbation of the worker's pre-existing severe L4-L5 focal stenosis and cauda equina.

Initial entitlement, entitlement to surgery, entitlement for a secondary CSF leak, and loss of earnings benefits were granted.

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 appealed a Case Manager's decision denying loss of earnings (LOE) benefits from November 15, 2019, to February 8, 2022.

The worker had suffered a compensable left elbow injury and was unable to return to his pre-injury heavy manual labour duties.

The Appeals Resolution Officer found that the worker made reasonable efforts to mitigate his wage loss by seeking retraining, attending school for Business Finance, and securing suitable employment that accommodated his permanent restrictions.

The appeal was allowed in part, granting the worker full LOE benefits for the period in question, less actual earnings received from three new jobs during that time.

The worker appealed a decision denying secondary entitlement to post-traumatic stress disorder (PTSD) and a recurrence of a work-related psychotraumatic disability following a severe allergic reaction to epoxy at work.

The Appeals Resolution Officer reviewed medical evidence, including a WSIB-sponsored comprehensive assessment from CAMH, which confirmed the PTSD diagnosis and its causal link to the workplace incident.

The appeal was allowed, granting secondary entitlement to PTSD, a recurrence of the mental health condition, and funding for recommended psychological treatment.

A non-economic loss redetermination was deemed premature as the worker had not yet reached maximum medical recovery.

The worker appealed the Eligibility Adjudicator's decision denying initial entitlement for an umbilical hernia.

The worker alleged the hernia was caused by pushing and pulling heavy skids with a manual hand jack at work.

The employer argued the hernia may have been caused by recent weight gain and noted a delay in reporting.

The Appeals Resolution Officer found that the worker met the five-point check system for an allowable claim, noting the diagnosed hernia was compatible with the reported mechanism of injury and there were no non-work activities identified that could have caused it.

The worker's objection was allowed and initial entitlement to an umbilical hernia was granted.

The worker appealed a Case Manager's decision denying a redetermination of their Non-economic Loss (NEL) benefit for a compensable low back injury.

The worker argued that their lumbar spine flexion had deteriorated since the last NEL redetermination in 2006.

The Appeals Resolution Officer found that the slight loss of lateral flexion and the degree of sensory deficit did not constitute a significant and permanent worsening of the work-related impairment under the AMA Guides.

The appeal was dismissed.

The worker appealed several WSIB decisions regarding his compensable right shoulder injury.

The Appeals Resolution Officer found that the modified duties offered by the employer were not suitable, as they exceeded the worker's restrictions and required him to overcompensate with his left arm.

The worker was granted secondary entitlement for a left shoulder injury and entitlement to a chronic pain disability (CPD).

The officer also restored full loss of earnings (LOE) benefits, finding the worker totally impaired and incapable of participating in the proposed suitable occupation.

Entitlement to a psychotraumatic disability was denied as CPD was granted.

The worker suffered a compensable right foot sprain (turf toe) and was prescribed custom-made orthotics by a chiropodist.

The WSIB initially denied entitlement on the basis that orthotics are only funded for specific deformities.

The Appeals Resolution Officer allowed the worker's appeal, finding that the orthotics were necessary, appropriate, and sufficient for the compensable injury, even if they also addressed non-compensable conditions like flat feet.

The worker was granted entitlement to a one-time purchase of the orthotics, provided they were purchased prior to reaching maximum medical recovery.