Workplace Safety and Insurance Law

The worker suffered a low back strain while spotting a client in a weight room.

The WSIB terminated benefits effective October 1, 2007, finding no ongoing objective physical impairment.

The worker objected, arguing he had ongoing symptoms and permanent restrictions.

The Appeals Resolution Officer upheld the termination, noting that medical evidence, including an MRI and functional abilities evaluation, showed no structural or neurological impairment, and that the worker's ongoing restrictions were based on subjective pain complaints rather than objective physical findings.

The worker objected to an adjudicator's decision denying a non-economic loss (NEL) redetermination for various upper extremity impairments.

The Appeals Resolution Officer reviewed medical evidence, including reports from a physiotherapist and an orthopaedic surgeon.

The Officer found that the worker developed right Guyon's canal syndrome secondary to his compensable right carpal tunnel syndrome and lateral epicondylitis, entitling him to a redetermination.

Furthermore, the Officer found objective evidence of significant deterioration in both the right and left elbows, warranting a NEL redetermination for those areas as well.

The worker's objection was allowed in part.

The employer objected to the denial of cost relief under the Second Injury and Enhancement Fund (SIEF) and the denial of a transfer of costs regarding a worker's motor vehicle accident claim.

The Appeals Resolution Officer found no evidence of a pre-existing condition to warrant SIEF relief.

The officer also found that the worker was entirely at fault for the accident, having failed to stop at a stop sign due to inclement weather, and that his actions did not constitute serious and wilful misconduct.

As the other driver was an innocent party, there was no basis to transfer costs to another Schedule 1 employer.

The employer's objection was denied.

The worker objected to the denial of a Non-Economic Loss (NEL) re-determination for her left carpal tunnel syndrome.

She argued that her condition had significantly deteriorated since her initial 5% NEL award in 2003, citing increased pain, weakness, and trigger finger symptoms.

The Appeals Resolution Officer reviewed the medical evidence and found no objective clinical findings to support a significant deterioration in the worker's condition.

The worker's objection was denied.

The worker, who injured her back in a 1983 slip and fall, sought a time limit extension to appeal a 1988 decision that denied her entitlement for Chronic Pain Disability and psychotraumatic disability.

The Appeals Resolution Officer reviewed the claim history and noted that the worker had been represented by various advocates over the years and had been advised multiple times that she could appeal the 1988 decision.

Finding no valid reason for the extended delay and noting the worker's prior representation and notice of time limits, the Officer denied the request for a time limit extension.

The worker, an auto mechanic, suffered a right wrist sprain at work and sought loss of earnings (LOE) benefits for a period off work.

The adjudicator denied the benefits, finding insufficient medical evidence of an impairment preventing work.

The worker objected.

The Appeals Resolution Officer found that the initial medical report indicated no task limitations, and subsequent reports from the worker's GP did not provide objective medical evidence to support an inability to work.

The objection was denied.

The employer objected to a WSIB audit decision finding that amounts paid to the employer's spouse in 2006 and 2007 were insurable earnings.

The employer argued the spouse was a partner, not a worker, as she had no employment contract, received no T4, and her drawings depended on business profitability.

The Appeals Resolution Officer dismissed the objection, finding insufficient evidence of a partnership under the Partnerships Act or WSIB policy.

The business was registered as a sole proprietorship, and the spouse herself stated her husband owned the company.

Consequently, the spouse was deemed a worker and her remuneration was insurable.

The employer objected to a decision denying entitlement to cost relief under the Second Injury and Enhancement Fund (SIEF) for a worker's compensable left knee injury.

The employer argued that the worker's weight and pre-existing degenerative knee condition contributed to the accident and prolonged recovery.

The Appeals Resolution Officer found that the worker recovered within the expected timeframe following surgery, and that the acute meniscus tear was caused by a twisting incident at work, not the worker's weight or pre-existing degenerative changes.

The objection was denied.

The employer objected to retroactive premium charges and interest for 2006 and 2007 after being identified through a joint WSIB-CRA program as an unregistered business.

The employer argued they were unaware of the requirement to register and could not afford the retroactive amounts.

The Appeals Resolution Officer denied the objection, finding that the business was compulsorily covered and that ignorance of the law did not exempt the employer from their obligations.

The WSIB's policy of limiting retroactive charges to two years under the joint program was applied correctly, and financial hardship was deemed a matter for the collections department, not a basis for waiving premiums.

The worker objected to a decision denying an increase in his permanent disability award for a 1980 bilateral lower leg injury.

The worker argued his left ankle had deteriorated, causing discomfort and instability.

The Appeals Resolution Officer reviewed the medical evidence, including a recent orthopaedic assessment, and found that the worker's left ankle was not completely immobile, which would be required for a maximum 12 percent award under the Ontario Ratings Schedule.

The officer concluded there was no evidence of additional assessable permanent disability and confirmed the existing 17.5 percent award.

The employer appealed a Case Manager's decision granting the worker initial entitlement for a bilateral upper arm condition.

The worker, a letter carrier, developed tendinopathy and osteoarthritis after repetitive sorting duties.

The Appeals Resolution Officer found that the repetitive nature of the duties likely caused the onset of the condition, aggravating a pre-existing condition.

The employer's appeal was denied, and initial entitlement was upheld on an aggravation basis.

The worker appealed a decision denying entitlement for a low back injury allegedly sustained while shovelling snow at work.

The Appeals Resolution Officer found significant inconsistencies in the worker's evidence regarding the date of injury and the incident history.

Medical records showed a history of degenerative disc disease and spinal stenosis but did not corroborate the worker's account of an acute workplace trauma.

The objection was denied due to insufficient evidence to establish proof of accident.

The worker objected to a decision limiting his loss of earnings benefits to September 6, 2007, for a right arm strain sustained in August 2006.

The worker argued that his ongoing repetitive employment aggravated his condition and that his impairment continued.

The Appeals Resolution Officer found that the medical evidence supported the conclusion that the right arm strain had resolved by September 2007, and that the worker's ongoing complaints were related to an unassociated carpal tunnel syndrome condition.

The worker's objection was denied.

The worker, a delivery driver, appealed a decision denying entitlement for a right knee injury.

He claimed the injury developed gradually after returning to work following a prolonged absence for a non-compensable condition.

The Appeals Resolution Officer found insufficient evidence that the impairment arose out of and in the course of employment, noting the worker's delay in reporting, the light workload at the time, and the lack of a specific incident.

The worker's objection was denied.

The worker appealed a claims adjudicator's decision denying initial entitlement for a left hip and lower back condition, diagnosed as avascular necrosis.

The worker alleged the condition was caused or aggravated by repetitive twisting and turning on an assembly line.

The Appeals Resolution Officer found insufficient evidence to relate the condition to the worker's employment duties, noting the ergonomic assessment did not identify significant risk factors and the onset of pain could have occurred outside of employment.

The appeal was denied.

The worker, a rock truck driver, suffered a compensable right knee injury (traumatic tendonitis) after striking his knee on the steering column.

Ten months later, he requested entitlement to the medications Celebrex and Synvisc.

The Appeals Resolution Officer found that the compensable tendonitis had resolved and that the requested medications were prescribed for bilateral osteoarthritis, a non-compensable degenerative condition.

The worker's objection was denied and entitlement to the medications was refused.

The employer objected to the initial allowance of the worker's claim for a back injury sustained after falling from a truck, as well as the worker's entitlement to Loss of Earning (LOE) benefits.

The Appeals Resolution Officer upheld the initial entitlement and LOE benefits, finding that the worker met the criteria for proof of accident despite a slight delay in reporting.

The Officer also increased the employer's Second Injury Enhancement Fund (SIEF) relief from 25% to 50% due to the moderate nature of the worker's pre-existing condition.

The worker appealed a decision denying his request for recurrent benefits and an expansion of entitlement to include a neck impairment.

The worker claimed he was injured when a co-worker jumped on his back, which he characterized as an assault.

The Appeals Resolution Officer found that the worker had initiated the interaction by kicking the co-worker and was engaged in horseplay, thereby removing himself from the course of his employment.

The ARO also found insufficient evidence of a serious impairment that would excuse the horseplay.

The appeal was denied.

The worker appealed the closure of his labour market re-entry (LMR) services and associated loss of earnings benefits.

The WSIB had terminated the services after the worker stopped attending his academic upgrading classes and failed to maintain contact.

The worker argued that his transportation difficulties and lack of a driver's licence prevented his attendance.

The Appeals Resolution Officer found that the worker had agreed to the LMR plan despite knowing his transportation limitations and had failed to fulfill his commitments or maintain contact.

The appeal was dismissed, and the closure of LMR services was upheld.

The worker, a restaurant server, slipped on water in the kitchen and injured his right knee five minutes after signing out from his shift.

Initial entitlement was denied on the basis that he was not in the course of his employment.

The Appeals Resolution Officer allowed the worker's objection, finding that the brief interlude of personal conversation on the employer's premises shortly after the shift ended did not take the worker out of the course of employment.