Workplace Safety and Insurance Law

The worker objected to a decision granting a permanent disability (PD) award of 20% for residual impairment to his left knee and left ankle, arguing it did not accurately reflect his current level of permanent disability following a 1979 workplace injury.

The Appeals Resolution Officer reviewed the medical evidence, including assessments from 1991 and 2008/2009, and found no significant deterioration in the left knee condition or functional limitations to warrant an increase beyond the 15% already awarded for the knee.

The 5% award for the left ankle was also found to be accurate.

The worker's objection was denied, and the 20% PD award was confirmed.

The worker objected to the denial of a psychological assessment referral, a change in their suitable employment or business (SEB) profile, and the adjustment of loss of earnings benefits.

The Appeals Resolution Officer denied the worker's objections, finding no evidence of a psychotraumatic injury and upholding the SEB change due to the worker's limited cooperation with labour market re-entry.

Furthermore, upon reviewing newly obtained medical records showing a significant pre-existing chronic low back condition, the Officer rescinded the previous allowance for a permanent aggravation, limiting entitlement to a temporary aggravation that resolved by January 2007.

The worker, a bakery employee who suffered a repetitive strain injury to his upper extremities, appealed decisions regarding his non-economic loss (NEL) award, a NEL redetermination, and his loss of earnings (LOE) benefits.

The Appeals Resolution Officer confirmed the 16 percent NEL award, finding the second NEL assessment more accurately reflected the worker's impairment.

The request for a NEL redetermination was denied as medical evidence did not show a significant deterioration in the worker's condition.

However, the objection regarding LOE benefits was allowed in part; while the worker was found to be employable, the evidence demonstrated he was only capable of working four hours per day, necessitating a recalculation of his LOE benefits from August 1, 2007.

The worker appealed a decision denying initial entitlement for a workplace accident where she sustained an electrical shock.

She sought recognition of the injury, reimbursement for travel expenses to medical appointments, and loss of earnings benefits for personal time used to attend those appointments.

The Appeals Resolution Officer granted initial entitlement and travel expenses, finding the medical investigations were a direct necessity of the accident.

However, the request for loss of earnings benefits was denied because the worker did not actually lose any time from her scheduled working hours.

The worker appealed multiple decisions denying entitlement for various conditions, including neurotoxicity from ethylene oxide exposure, TMJ impairment, Hand Arm Vibration Syndrome, blastomycosis, and bilateral hip impairment.

The Appeals Resolution Officer reviewed the medical and occupational hygiene evidence and concluded that the worker did not establish that these conditions were significantly contributed to by his employment.

The appeal was denied in its entirety.

The employer appealed a decision granting WSIB benefits to a worker who sustained injuries during an altercation with his foreman.

The employer argued the worker was the aggressor and thus removed himself from the course of employment under WSIB policy 15-03-11.

The Appeals Resolution Officer found that the initial argument and hat-tipping did not constitute a fight under the policy, as they were not likely to cause injury.

Relying on medical evidence from the day of the incident, the Officer concluded the worker was assaulted and did not retaliate.

The employer's appeal was denied and entitlement to benefits was confirmed.

The worker, a baker and cake decorator, developed a right shoulder injury diagnosed as a repetitive strain.

She sought Loss of Earnings (LOE) benefits for a 10-day period when her physician authorized her off work.

The WSIB denied the benefits, concluding that the employer had provided suitable modified employment that accommodated her restrictions.

The Appeals Resolution Officer upheld the denial, finding that the medical evidence did not support total disability and that the worker failed to cooperate with the early and safe return to work process by refusing the bona fide offer of suitable modified employment.

A police officer injured his hip while pursuing a suspect but delayed filing a WSIB claim for over a year because he initially believed the injury was minor and his doctor misdiagnosed it as bursitis.

The WSIB initially denied the claim for failing to meet the six-month reporting time limit.

On appeal, the Appeals Resolution Officer granted the worker's objection and extended the time limit.

The Officer found that exceptional circumstances existed under Policy 15-01-03 because the worker had reported the accident to his supervisor, co-workers, and a health care professional within the six-month period.

The worker, a letter carrier, slipped and fell on ice while delivering mail, injuring his left hip.

He was later diagnosed with advanced osteoarthritis and underwent a left total hip replacement.

The employer objected to the Adjudicator's decision allowing entitlement for the surgery, arguing the initial injury was minor and there was a lack of continuity of complaint.

The Appeals Resolution Officer denied the employer's appeal, finding that the worker was asymptomatic prior to the fall and that the medical evidence demonstrated the workplace injury significantly accelerated the pre-existing osteoarthritis, making the surgery a necessary and appropriate result of the injury.

The worker suffered a workplace injury resulting in the near amputation of his left index finger and subsequently developed a psychotraumatic disability.

After participating in labour market re-entry (LMR) activities, his full loss of earnings (LOE) benefits were reduced to partial LOE benefits based on deemed earnings as a parking lot attendant.

The worker objected, claiming he was unemployable at the time of the final LOE review.

The Appeals Resolution Officer allowed the objection, finding that the worker lacked the basic English language skills required for the identified suitable employment and that his psychiatric condition had deteriorated, rendering him unemployable.

The worker objected to decisions denying entitlement to loss of earnings (LOE) benefits following a permanent lay-off and denying a permanent impairment for his back condition.

The worker had suffered a back strain at work in February 2006 but had a history of multiple motor vehicle accidents causing back and neck pain.

The Appeals Resolution Officer found that the worker's work-related back impairment had resolved by August 2006, and any ongoing impairment was due to pre-existing and subsequent non-compensable injuries.

The worker was found to have reached Maximum Medical Recovery without a permanent work-related impairment, and the objection was denied.

The worker objected to a decision reducing her loss of earnings (LOE) benefits by the amount of her Canada Pension Plan (CPP) disability benefits.

The worker suffered multiple soft tissue injuries and developed chronic pain disorder and psychological impairments.

She was granted CPP disability benefits.

The Appeals Resolution Officer found that all diagnoses and complaints described in the CPP application fell within the scope of the WSIB claim, with no non-work-related conditions present.

Therefore, the full amount of the CPP benefit (excluding the portion for her children) was properly offset against her LOE benefits.

The worker's objection was denied.

The employer appealed a decision levying a penalty for breaching its re-employment obligations under section 41 of the Workplace Safety and Insurance Act.

The employer had terminated the worker after obtaining video surveillance of the worker shoveling snow, which the employer believed contradicted his medical restrictions for a workplace elbow injury.

The Appeals Resolution Officer found that while the employer's decision to terminate was rash and misguided, it was not done in bad faith or with malicious intent to thwart the Act.

The penalty was rescinded.

The worker objected to the suitable employment or business (SEB) of security guard and the associated earnings used to calculate his loss of earnings (LOE) benefit following a work-related right shoulder injury.

The worker argued he was unfit for the role due to physical and psychological impairments and inadequate training.

The Appeals Resolution Officer found that the worker met the educational and physical requirements for entry-level security occupations, and there was no evidence of a psychological barrier to employment during the labour market re-entry program.

The objection was denied and the LOE benefit calculation was upheld.

The worker and employer both objected to a claims adjudicator's decision regarding entitlement to loss of earnings (LOE) benefits for a repetitive strain injury to the neck and shoulders.

The worker claimed the injury was caused by an ergonomically incorrect workstation.

The Appeals Resolution Officer confirmed the granting of initial entitlement, finding that the worker suffered a work-related strain due to the workstation setup.

The Officer also granted LOE benefits for several periods, including a period of graduated return to work and a flare-up caused by mail duties, but denied benefits for three days in May 2008 before the worker sought medical attention.

The worker objected to a decision denying initial entitlement for a bilateral knee impairment, claiming it was aggravated by prolonged standing at work.

The Appeals Resolution Officer found no evidence of a work accident and noted a long history of non-compensable knee problems, multiple surgeries, and non-work-related accidents.

The officer concluded that the worker's duties did not cause or aggravate the degenerative condition, and denied the objection.

The worker objected to WSIB decisions reducing her loss of earnings benefits following the closure of her labour market re-entry (LMR) services and at the final review.

The worker argued she was unemployable due to a significant bilateral upper extremity impairment.

The Appeals Resolution Officer found that while the worker had a significant impairment, she had successfully completed extensive LMR training and was capable of working 30 hours per week in suitable elemental service or reception roles.

The objection was allowed in part, adjusting the loss of earnings benefits to reflect a 30-hour work week at minimum wage.

The worker appealed a decision regarding the final review of his loss of earnings (LOE) benefits.

The worker had suffered compensable bilateral epicondylitis and shoulder injuries, and also had non-compensable neck and back conditions.

The WSIB had previously determined he was unemployable but at the final review concluded he could perform part-time elemental service work.

The Appeals Resolution Officer found that the worker's primary barrier to return to work was pain, to which the compensable conditions significantly contributed.

As the worker had not been provided with a pain management program and presented with very limited use of his hands and arms, the Officer concluded he was not competitively employable.

The objection was allowed and LOE benefits were adjusted accordingly.

The worker, a resident care worker at a homeless shelter, appealed a claims adjudicator's decision denying entitlement for a Methicillin Resistant Staphylococcus Aureus (MRSA) infection.

The worker argued he contracted the infection from a client at the shelter.

The Appeals Resolution Officer found that while the worker was employed in a facility with a risk of communicable diseases and a client had been diagnosed with MRSA, there was insufficient evidence to establish on a balance of probabilities that the worker contracted the illness in the workplace, as MRSA is also prevalent in the general community.

The worker's objection was denied.

The worker requested an extension of the time limit to appeal three decisions from 1993, 1995, and 1999 denying entitlement for chronic pain, neck, and back injuries.

The worker argued that her previous representative went out of business, she had limited English skills, and she suffered from health and personal problems.

The Appeals Resolution Officer denied the extension, finding no evidence that the worker was incapacitated to the point of being unable to submit a timely appeal, and noting that the delay was significant and due to inattentiveness.