Workplace Safety and Insurance Board
Appeals Resolution Officer Decision
Decision Number: 20090012
Objection By: Worker
Employer: Not Participating
Hearing Date: N/A
Issue
The worker objects to the February 14, 2008 decision that denied entitlement to loss of earnings (LOE) benefits.
How the Issue Arises
On January 10, 2008 this then 43 year old auto mechanic sustained an injury to his right wrist as he twisted it while attempting to remove an oil filter from a tight spot. The worker sought medical attention on January 12, 2008 and was diagnosed with a right wrist sprain. Entitlement was accepted for the work injury.
The worker continued to work up to January 18, 2008 but indicated that he had ongoing problems. The worker was off work from January 21, 2008 and returned to his regular job duties on January 29, 2008.
The adjudicator reviewed entitlement to LOE benefits and found that the medical evidence did not support an impairment that prevented the worker from working. As such, entitlement to LOE benefits was denied. This decision was outlined in a letter dated February 14, 2008.
An Objection Form was received by the Workplace Safety and Insurance Board (WSIB), indicating that the worker objected to the above decision, and the file was referred to the Appeals Branch for further review and consideration.
Authority
Operational Policy Documents
18-03-02 Payment of LOE Benefits
Resolution Method and Process
The worker opted for a decision without a hearing, based on a review of the information on file. The employer was advised of the objection but chose not to participate.
Assessment of the Evidence
The worker was initially seen for a right wrist sprain on January 12, 2008. The emergency physician noted findings of pain, weakness and tenderness. As indicated on the Health Professional’s Report (Form 8), the doctor indicated that there were no task limitations in regards to the injury.
A subsequent Form 8 was received from the worker’s GP, dated January 28, 2008 and was based on an assessment on that date. The doctor indicated on the form that he had not previously treated the worker for this injury and noted that a prior assessment was performed at the emergency department of a hospital on January 12, 2008. The doctor indicated complaints of pain and stiffness with a finding of reduced strength. The doctor noted that he worker was to return to work January 28, 2008.
The Employer’s Report of Injury / Disease, dated January 22, 2008 indicated that the worker reported that he had received medical treatment with his GP on January 21, 2008. The form confirmed that the employer had been provided with work limitations for the worker’s injury but modified work was not available.
A letter from the worker’s GP, dated February 9, 2009, indicated that the worker was assessed by him on January 21, 28 and February 22, 2008, for a wrist injury. The GP indicated that the worker was advised to be off work from January 21, 2008 up to and including January 28, 2008.
The worker was sent a letter from the adjudicator dated March 3, 2009 advising that objective medical evidence was required to support the worker’s inability to work. To date this information has not been received.
If the nature or seriousness of the injury completely prevents a worker from returning to any type of work, the worker is entitled to full LOE benefits, providing the worker co-operates in health care measures as recommended by the attending health care practitioner and approved by the WSIB. If the worker does not co-operate, the WSIB may reduce or suspend the worker’s LOE benefits.
The employer indicated that they had been provided with work limitations for the worker but they were not able to accommodate the restrictions. The source of the physical limitations is unclear as the medical report of January 12, 2008 indicated that the worker was able to return to work without limitations. Although the worker’s GP had indicated that the worker was authorized off work from January 21, 2008 to January 28, 2008 it is not sufficient to base payment of LOE benefits on the doctor’s recommendation of time off from work. The medical evidence must substantiate that the worker was unable to perform his job duties.
The worker’s GP confirmed that the worker was assessed on January 21, 2008 however he did not provide any objective medical evidence to support an impairment that prevented the worker from working. The worker was specifically invited to provide medical evidence to support the period of lost time but he did not produce such evidence. In the absence of medical evidence to support deterioration from the assessment of January 12, 2008, I accept that those findings remained the same and the worker was able to work without limitations as determined by the medical professional.
Noting the above, I find that there is insufficient evidence to support that the worker was unable to perform his job duties from January 21, 2008 to January 28, 2008 and entitlement to LOE benefits remains denied.
Conclusion
There is no entitlement in this claim for the payment of LOE benefits from January 21, 2008 up to and including January 28, 2008.
The objection is denied.
DATED August 17, 2009
K. Hille
Appeals Resolution Officer