Workplace Safety and Insurance Law

The worker, a long-haul truck driver, appealed a decision denying initial entitlement for right wrist carpal tunnel syndrome.

The worker argued that prolonged gripping of the steering wheel and vibration exposure were significant contributing factors to the injury.

The Appeals Resolution Officer found that the worker's duties did not involve significant, repetitive, frequent, and forceful wrist movements, noting that the worker maintained a predominantly neutral posture while driving and had multiple non-driving periods.

The appeal was denied, as the evidence did not establish that the injury arose out of and in the course of employment.

The worker appealed a Case Manager's decision concluding they had reached maximum medical recovery (MMR) by July 23, 2024, with no permanent impairment resulting from a work-related left ankle/foot injury.

The Appeals Resolution Officer reviewed the medical evidence, including reports from a WSIB Lower Extremity Specialty Clinic, which indicated the fracture had fully healed with full range of motion and no residual impairment.

The appeal was denied, confirming the worker reached MMR with no permanent impairment.

The worker, a non-resident long-haul truck driver, was injured in a compensable motor vehicle accident and subsequently returned to their home country for medical care.

The worker appealed a decision denying loss of earnings (LOE) benefits beyond March 30, 2022, and a decision calculating their long-term rate without including alleged cash payments.

The Appeals Resolution Officer allowed the appeal in part, finding the worker was totally impaired and entitled to full LOE benefits until May 2022, and partially impaired and entitled to partial LOE benefits thereafter based on part-time earnings in their home country.

The appeal regarding the long-term rate calculation was dismissed due to insufficient proof of the alleged cash earnings.

The worker appealed a case manager's decision to temporarily suspend their loss of earnings (LOE) benefits.

The case manager had suspended the benefits on the basis that the worker was unable to participate in psychological treatment for their compensable PTSD due to a non-compensable concussion.

The Appeals Resolution Officer allowed the appeal, finding that the worker's concussion only prevented treatment for a brief period, and that the WSIB failed to provide the required notice of non-co-operation before suspending benefits.

The worker was entitled to full LOE for the suspended period.

The employer objected to a Case Manager's decision granting a police officer initial entitlement to post-traumatic stress disorder (PTSD) and loss of earnings (LOE) benefits.

The worker had been exposed to multiple traumatic events during their employment.

The Appeals Resolution Officer found that the worker met the criteria for the first responder PTSD presumption under Policy 15-03-13.

The employer failed to rebut the presumption, as the evidence showed the worker's employment as a police officer significantly contributed to the PTSD diagnosis.

The worker was also found entitled to full LOE benefits because the psychological injury prevented a return to any type of work.

The employer's objection was denied.

The worker objected to a decision denying initial entitlement to benefits for a low back injury allegedly sustained while changing a snowplow blade.

The Appeals Resolution Officer found that while an incident occurred at work, there was no clinical evidence demonstrating a new injury or an aggravation of the worker's pre-existing spinal pathology.

The appeal was denied.

The worker, a truck driver injured in a 2012 motor vehicle accident, appealed the WSIB's decisions regarding their suitable occupation (SO) and the adjustment of their loss of earnings (LOE) benefits.

The worker argued they were totally disabled and unable to work in any capacity.

The Appeals Resolution Officer found that medical evidence, including a multidisciplinary assessment, did not support total disability and that the worker was fit to work full-time as an Administrative Assistant.

The WSIB's decision to lock in partial LOE benefits based on the starting wage of the SO was upheld, and the worker's objection was denied.

The worker, a counsellor at a long-term care home, appealed the denial of initial entitlement for COVID-19.

The worker claimed they contracted the virus at work during an outbreak in April 2020, despite testing negative on two PCR tests.

The Appeals Resolution Officer found that while the worker's employment created an elevated risk of exposure, there was no medical evidence confirming a COVID-19 diagnosis.

The worker's symptoms and negative tests did not satisfy the adjudicative criteria for a confirmed condition.

The appeal was dismissed.

The worker objected to decisions finding that their work-related right shoulder sprain/strain had fully resolved with no permanent impairment, and denying entitlement to a recurrence.

The Appeals Resolution Officer reviewed the medical evidence and found that the worker had reached maximum medical recovery by January 10, 2020, with no restrictions and a significant gap in subsequent medical treatment.

The Officer also found that the worker's ongoing shoulder pain lacked a formal diagnosis establishing clinical compatibility with the original injury, and that a subsequent deterioration was the result of a new workplace incident.

The worker's objections were denied.

The worker, a Trackman Journeyman, suffered a work-related left knee injury and returned to modified duties.

The employer subsequently laid off the worker due to a shortage of work, which constituted a permanent work disruption.

The Case Manager initially denied Loss of Earnings (LOE) benefits following the layoff.

On appeal, the Appeals Resolution Officer found that the worker's ongoing knee impairment and need for active treatment precluded them from performing their pre-injury duties or securing alternative employment.

The worker's objection was allowed, granting full LOE benefits from the date of the layoff.

The worker appealed a Case Manager's decision limiting entitlement to a right shoulder contusion following a workplace slip and fall.

The worker argued the accident exacerbated a pre-existing condition, leading to two shoulder surgeries.

The Appeals Resolution Officer reviewed the medical evidence, noting the worker had a significant pre-existing condition from prior non-work-related accidents and had already been recommended for surgery before the workplace incident.

Finding no evidence that the workplace accident caused a deterioration of the pre-existing condition, the Officer concluded the surgeries were not work-related.

The appeal was dismissed.

The worker objected to the Case Manager's decision determining their Suitable Occupation (SO) as Other Services Support Occupations following a bilateral wrist injury.

The worker argued they were competitively unemployable due to lack of transferrable skills, experience, and a language barrier.

The Appeals Resolution Officer confirmed the SO, finding it was within the worker's physical restrictions, education level, and basic English language skills, and that prior decisions had already established the worker was capable of performing suitable work without training.

The worker appealed a Case Manager's decision denying a Permanent Disability (PD) reassessment for a lower back injury sustained in 1978.

The worker had previously been awarded a 25% PD.

Following a 2021 surgery to excise a work-related hematoma, the worker argued their condition had significantly deteriorated, citing post-surgical complications and decreased functional abilities.

The Appeals Resolution Officer denied the appeal, finding that medical reporting indicated the surgical site had healed well and that ongoing back pain was related to underlying arthritic changes rather than a permanent deterioration of the accepted work-related condition.

The worker, a garden centre manager, claimed initial entitlement for a right eye retinal detachment after a bag of mulch tore and soil fell into their eye.

The worker later amended the accident history to claim the 40-pound bag also struck their face.

The Appeals Resolution Officer rejected the revised history as inconsistent with contemporaneous reporting.

Relying on a medical consultant's opinion that soil entering the eye is not a compatible mechanism for retinal detachment, the ARO found the injury was not work-related.

The appeal was denied.

The worker's Estate appealed a decision denying entitlement to Survivor benefits.

The worker had a combined 100% permanent disability benefit across two separate claims for workplace injuries sustained in 1970 and 1977.

The worker passed away in 2019 from causes unrelated to the compensable injuries.

The Estate argued for entitlement based on a prior WSIAT decision.

The Appeals Resolution Officer denied the appeal, finding that under the applicable Operational Policy Manual policy (20-03-16), a survivor is only entitled to benefits if the worker had a 100% permanent disability benefit in a single claim.

The worker, a pipefitter, suffered injuries including hearing loss, tinnitus, and PTSD following a workplace accident where a pipe exploded.

The Case Manager determined that the worker had recovered from their work-related conditions with no ongoing or permanent impairment.

The worker objected, seeking ongoing entitlement and recognition of permanent impairment for their hearing loss, tinnitus, and PTSD.

The Appeals Resolution Officer allowed the objection, finding that the medical evidence supported that the worker had reached maximum medical recovery for both their hearing conditions and PTSD, and that these conditions resulted in permanent impairments entitling the worker to Non-economic Loss determinations.

The worker, a light-duty cleaner, appealed a decision denying initial entitlement to benefits for a low back injury.

The worker alleged experiencing immediate severe low back pain after finishing work duties but delayed reporting the injury and seeking medical attention.

The Appeals Resolution Officer applied the five-point check system and the 'four immediates' test, finding no proof of a work-related accident.

The evidence showed the worker initially claimed sick leave, had a pre-existing symptomatic low back condition, and denied a specific injury when first seeking medical care.

The worker's objection was denied.

The worker appealed a Case Manager's decision denying loss of earnings (LOE) benefits from December 9, 2021 onwards.

The worker had suffered a left ankle injury and was instructed by an orthopedic surgeon to remain off work and wear an air cast.

The employer offered modified seated duties, but the medical evidence supported a brief period of rest and time off work during the acute phase of recovery.

The Appeals Resolution Officer allowed the appeal, finding the worker was entitled to LOE benefits from December 9, 2021 through January 20, 2022.

The worker appealed two Non-Economic Loss (NEL) decisions regarding permanent impairments from a 2015 workplace injury.

The worker objected to a 24% NEL benefit for bilateral hip replacements and right thigh impairment, and a 20% NEL benefit for post-traumatic stress disorder and major depressive episode.

The Appeals Resolution Officer reviewed the medical evidence and the application of the AMA Guides and WSIB policies.

The Officer found that the clinical specialist correctly calculated the physical impairment ratings and appropriately classified the psychological impairment as a Class 3 Moderate impairment.

The appeals were dismissed and the NEL quantums were confirmed.

The worker appealed a Case Manager's decision denying ongoing entitlement to loss of earnings (LOE) benefits and a permanent impairment assessment for a right knee injury subsequent to October 19, 2018.

The Appeals Resolution Officer found that the medical evidence supported a permanent work-related impairment of the right knee, entitling the worker to a Non-Economic Loss (NEL) assessment.

However, the worker was not entitled to LOE benefits after October 19, 2018, as there was insufficient evidence that their loss of earnings resulted from the work-related injury.