Workplace Safety and Insurance Law

The worker appealed the denial of entitlement for chronic mental stress and a physical chest wall strain.

The Appeals Resolution Officer found that the workplace conflicts did not amount to harassment or a substantial work-related stressor, denying the chronic mental stress claim.

However, the Officer allowed the physical injury claim, finding that a minor workplace incident permanently aggravated the worker's pre-existing left-sided intercostal neuralgia.

The worker was granted entitlement for the permanent aggravation, with a non-economic loss determination to follow.

The worker appealed a Case Manager's decisions denying a permanent impairment for a concussion injury and denying entitlement for right optic neuropathy.

The Appeals Resolution Officer found that the worker had reached maximum medical recovery for the concussion but suffered a permanent impairment for post-concussion syndrome and posttraumatic migraines, entitling them to a Non-Economic Loss award.

However, the worker was not entitled to a permanent impairment for their right eye conditions, as the right optic neuropathy was determined to be a non-occupational condition likely due to microvascular issues rather than the workplace injury.

The appeal was allowed in part.

The worker, a personal support worker, appealed a decision denying initial entitlement for a lower back injury sustained while preventing a 280-pound patient from falling.

The eligibility adjudicator had denied the claim due to delayed reporting and medical attention.

The Appeals Resolution Officer allowed the appeal, finding that the worker's testimony regarding the incident and the delays—attributed to the COVID-19 pandemic and a belief that the pain was a flare-up of a pre-existing condition—was credible.

The Officer concluded the worker sustained a personal work-related injury that exacerbated a pre-existing lower back condition.

The worker appealed a Case Manager's decision limiting their entitlement to partial loss of earnings (LOE) benefits.

The worker had sustained physical injuries and a psychotraumatic disability after an incident with an aggressive patient.

While physical restrictions allowed for modified work, the Appeals Resolution Officer found that the worker's psychological condition completely prevented a return to work until January 2021, and suitable work was unavailable until March 2021.

The appeal was allowed, granting the worker full LOE benefits for the disputed period.

The worker appealed a Case Manager's decision that their compensable low back strain had fully resolved with no ongoing impairment as of December 14, 2021.

The Appeals Resolution Officer reviewed the medical evidence, including Functional Abilities Forms from the treating physiotherapist, which indicated ongoing physical limitations and an inability to resume pre-injury duties.

The Officer found no evidence that the worker had reached maximum medical recovery (MMR) and concluded the worker had ongoing entitlement.

The appeal was allowed and the matter remitted to the Operating Area for further adjudication regarding MMR and loss of earnings benefits.

The worker appealed a decision denying initial entitlement for Noise Induced Hearing Loss (NIHL) related to their employment as a sewing machine operator.

The worker had sufficient noise exposure, but the audiogram closest to their retirement showed hearing loss values below the required 22.5 dB threshold in each ear.

Furthermore, the WSIB Audiologist concluded the hearing loss pattern was not consistent with noise-induced sensorineural hearing loss.

The Appeals Resolution Officer found the worker did not meet the eligibility criteria and denied the appeal.

The employer and worker both appealed decisions of the Case Manager regarding the worker's shoulder conditions.

The worker claimed a left shoulder injury developed gradually from their duties as an in-house technician, leading to calcific tendonitis, adhesive capsulitis, and a secondary right shoulder condition.

The Appeals Resolution Officer found insufficient evidence of a disablement situation arising out of and in the course of employment, noting the worker's symptoms worsened during a one-month vacation and while performing modified duties without overhead activities.

Consequently, initial entitlement for the left shoulder, loss of earnings benefits, permanent impairment, secondary right shoulder entitlement, and SIEF cost relief were all denied.

The employer's objection was allowed and the worker's objection was denied.

The worker appealed a decision denying initial entitlement to WSIB benefits for a diagnosed skin condition (dyshidrotic/vesicular eczema) on their hands and wrists, which they alleged was caused by wearing gloves at work.

The Appeals Resolution Officer reviewed the medical evidence and found no indication from the treating physicians that the condition was caused by workplace exposures.

Applying the five-point check system under Operational Policy 11-01-01, the Officer concluded that the worker failed to establish compatibility between the diagnosis and their employment history.

The appeal was dismissed and entitlement was denied.

Employer One (E1) appealed a decision denying a transfer of claim costs to Employer Two (E2).

E1's worker slipped and fell on ice in E1's parking lot.

E1 argued that E2, contracted for winter maintenance, was negligent in failing to salt the lot.

The Appeals Resolution Officer found that E2 met its contractual obligations by checking the property daily and that the weather conditions did not reasonably warrant salting on the morning of the incident.

The standard of care is reasonableness, not perfection.

The appeal was dismissed and costs remained with E1.

The estate of a deceased worker appealed a decision regarding the calculation of survivor benefits for the worker's spouse.

The worker died from non-small-cell lung cancer caused by workplace asbestos exposure.

The initial decision based the benefits on the earnings of a Foundry Worker, where the most significant exposure occurred.

The Appeals Resolution Officer allowed the appeal, finding that the worker's later exposure as a Storekeeper also contributed synergistically to the disease, and therefore the benefits should be based on the earnings of a Storekeeper on the date of injury.

The worker and employer both objected to WSIB decisions regarding the worker's level of impairment, ability to participate in return-to-work services, and entitlement to secondary conditions following a compensable psychological injury (PTSD and depression).

The Appeals Resolution Officer found that the worker was capable of participating in work transition services and that there was no permanent restriction preventing a return to the injury employer in an accommodated capacity, provided the worker was not exposed to a police station or traumatic content.

The Officer denied the worker's claim of a significant deterioration in their psychological condition but granted secondary entitlement to ptosis as a physical manifestation of the work-related psychological impairment.

The worker, a truck driver, suffered a workplace injury in November 2019 and was subsequently laid off due to a seasonal work shortage, which became a permanent work disruption in June 2020.

The Case Manager denied loss of earnings (LOE) benefits, determining the worker could restore their wage loss as a Light Delivery Driver.

The Appeals Resolution Officer allowed the worker's appeal, finding that the physical restrictions and psychological barriers prevented the worker from securing employment in the suggested suitable occupation without return to work assistance.

The worker was granted full LOE benefits from June 1, 2020, and a return to work assessment.

The worker appealed the Case Manager's decisions that they had achieved maximum medical recovery (MMR) from a compensable low back injury by May 14, 2018 with no permanent impairment, and denying loss of earnings (LOE) benefits following a pandemic-related work disruption starting March 20, 2020.

The Appeals Resolution Officer found that the medical evidence supported MMR by May 2018 with no ongoing impairment, as there was a significant gap in medical records regarding low back complaints after that date.

Regarding LOE benefits, the work disruption was deemed temporary despite its length, and there was no evidence the worker sought alternative employment.

The appeal was denied.

The worker appealed a Case Manager's decision denying loss of earnings (LOE) benefits from August 15, 2015 to November 26, 2015.

The worker had sustained a workplace injury to their neck and right shoulder and later experienced an exacerbation.

The Appeals Resolution Officer found that the worker was unable to return to work for a portion of the period and, although capable of modified work later, was not provided with a graduated return to work plan by the employer.

The appeal was allowed, granting LOE benefits for the disputed periods.

The worker appealed a decision denying loss of earnings (LOE) benefits for various periods following a workplace neck injury.

The worker argued she was totally disabled and unable to perform the modified duties offered by the employer.

The Appeals Resolution Officer reviewed the medical evidence, including reports from the emergency physician and family doctor, and concluded the worker was only partially impaired.

The Officer found that the modified duties offered by the employer, which included polishing cutlery and working as a greeter, were safe, suitable, and within the worker's functional abilities.

The appeal was dismissed and the denial of LOE benefits was confirmed.

The employer appealed a decision by the Account Specialist regarding the effective date of its reclassification and the retroactive cancellation of mandatory construction coverage for its executive officers.

The employer sought to have its reclassification from Custom Welding to Other Machinery and Equipment Operation made retroactive to the account's inception in 2011, rather than January 1, 2018.

The employer also requested that mandatory coverage for executive officers be cancelled retroactively to January 2013.

The Appeals Resolution Officer dismissed the appeal, finding that under Policy 14-02-06, the notification date was July 2018, limiting retroactivity to January 1, 2018.

The Officer also found no exceptional circumstances under the Merits and Justice Policy to warrant departing from the standard rules for either the classification retroactivity or the mandatory coverage exemption.

The worker, a special needs assistant, suffered a compensable left ankle injury shortly before the annual summer school break.

She was fit for modified work, but the employer could not accommodate her, so she received full loss of earnings (LOE) benefits until the summer break began.

The Case Manager denied LOE benefits during the summer break, finding the wage loss was due to the seasonal layoff rather than the injury.

The worker appealed, arguing that under WSIB Operational Policy 15-06-02, her LOE benefits should have continued during the temporary work disruption.

The Appeals Resolution Officer dismissed the appeal, concluding that the worker did not intend to work during the summer break and historically collected employment insurance.

Paying LOE benefits during the seasonal layoff would place her in a better position than if she had not been injured.

The worker, a 16-year-old cherry processor, objected to a decision denying initial entitlement for a right eye injury sustained when a co-worker threw a piece of wood at him.

The initial decision found the worker had participated in a fight and thus removed himself from the course of employment.

The Appeals Resolution Officer allowed the appeal, finding that the worker's verbal response to the co-worker's derogatory taunts did not constitute a fight under WSIB policy.

The worker was actively performing his regular job duties when assaulted, and was therefore in the course of his employment when injured.

The worker, a personal support worker, appealed the denial of initial entitlement for a right shoulder sprain.

The injury occurred when she reached back to close a door while carrying soiled linen after performing heavy patient care.

The Appeals Resolution Officer found that while closing a door would not normally cause a sprain, the heavy nature of her duties, understaffing, and awkward posture left her susceptible to injury.

The appeal was allowed, granting initial entitlement for the right shoulder sprain.

The worker appealed a decision denying loss of earnings (LOE) benefits beyond August 17, 2015, following a compensable right eye injury.

The employer had offered modified work, which the worker declined, claiming it was unsuitable and unsafe.

The Appeals Resolution Officer found that the worker was not totally disabled and had failed to actively participate in the work reintegration process.

However, because the WSIB did not provide the required written warning before levying a non-cooperation penalty, the worker was granted full LOE benefits until September 22, 2015, and partial LOE benefits at 50 percent until October 6, 2015.

The appeal was allowed in part.