OWSIB 2009

The worker's estate appealed decisions denying entitlement for fibrosing alveolitis (idiopathic pulmonary fibrosis) and survivor benefits, and sought an increase in the pension quantum for accepted silicosis and COPD.

The Appeals Resolution Officer found insufficient evidence to establish that the idiopathic pulmonary fibrosis was caused by workplace exposures in the mining industry.

The officer also concluded that the compensable conditions were not a significant contributing factor in the worker's death, denying survivor benefits.

However, the officer allowed the appeal in part by increasing the pension award to 30% based on 1984 pulmonary function test results showing a deterioration in respiratory function.

The worker suffered a right knee and ankle injury after falling from a truck.

The employer requested cost relief under the Second Injury and Enhancement Fund (SIEF), arguing that the worker's recovery was prolonged by a pre-existing degenerative condition in the ankle.

The Appeals Resolution Officer denied the objection, finding that the medical evidence, including x-rays taken immediately after the accident, did not demonstrate a pre-existing condition.

The degenerative changes and disuse osteoporosis were found to be consistent with the injuries sustained in the work accident.

The worker objected to the quantum of her final future economic loss (FEL) benefit and the denial of entitlement for certain prescription medications.

The Appeals Resolution Officer found that the worker, who suffered from chronic pain disability and depression, was not unemployable, as she had demonstrated the ability to maintain part-time university studies.

The FEL benefit was ordered to be recalculated based on a 20-hour workweek at minimum wage.

The request for medication reimbursement was partially granted for prescriptions filled prior to a documented suicide threat in March 2008, but denied for Cyclomen, which was prescribed for a non-compensable condition.

The worker, who developed bilateral carpal tunnel syndrome from her duties as a hoist operator, sought entitlement for a psychotraumatic disability (major depression).

The Appeals Resolution Officer found that the worker's major depression developed as an indirect result of her physical work-related injuries and the resulting chronic pain and impairment.

The objection was granted, and the worker was found entitled to a non-economic loss assessment for the psychotraumatic condition.

The worker appealed a decision reducing his permanent disability (PD) award for a left knee injury from 15% to 3% due to a pre-existing condition, and denying interest on the award.

The Appeals Resolution Officer found that while a significant pre-existing condition existed, the 3% rating was inappropriately low given the standard 5% rating for a torn meniscus without pre-existing conditions.

The PD award was increased to 5%.

Interest was denied on the original 3% award as it was not granted via an appeal overturn, but interest was granted on the additional 2% awarded in this decision.

The worker suffered a lower back strain and was granted a 19% Non-Economic Loss award.

After completing Labour Market Re-entry (LMR) services and securing a job, his full loss of earnings (LOE) benefits were ceased.

He was subsequently laid off and requested reinstatement of full LOE benefits.

The Appeals Resolution Officer found that the worker's post-injury salary was less than his pre-injury escalated rate of pay, entitling him to partial LOE benefits.

Additionally, because he lost his job shortly after LMR services concluded, he was entitled to complete the Job Search Training Program portion of his LMR plan, during which he would receive full LOE benefits.

The worker, a housekeeper, suffered a neck injury while making a bed.

The WSIB initially allowed the claim but later overturned entitlement, concluding that her disc herniations were incompatible with her work duties and would have become symptomatic regardless.

The Appeals Resolution Officer allowed the worker's objection, finding that the accident history was compatible with the diagnosis and that the work incident likely worsened or ruptured the previously asymptomatic disc herniations.

The issue of ongoing loss of earnings benefits was remitted for further determination.

The employer objected to an adjudicator's decision granting initial entitlement and loss of earnings benefits for a worker's low back injury.

The worker claimed he injured his back while lifting boxes, but the employer argued the injury was not reported immediately and questioned the worker's credibility due to his subsequent termination for alleged fraudulent behaviour.

The Appeals Resolution Officer found that the worker's account of the injury was consistent and corroborated by initial statements from a co-worker and the store manager.

The brief delay in seeking medical attention was deemed reasonable.

The adjudicator's decision was upheld and the employer's objection was denied.

The worker, an industrial cleaner, suffered a back injury after slipping and falling at work.

The WSIB initially denied Loss of Earnings (LOE) benefits for the period of July 29, 2008 to August 25, 2008, concluding the worker was not totally disabled and modified duties were available.

The worker appealed.

The Appeals Resolution Officer allowed the appeal, finding that the medical evidence demonstrated the worker was in the acute phase of recovery and totally disabled during that period.

The worker was following his physician's instructions not to return to work, thereby complying with his obligations under the Workplace Safety and Insurance Act.

The worker suffered a right leg laceration at work in June 2004.

Over a year later, the worker claimed entitlement for a right knee meniscus tear, arguing it was related to the original accident or a premature return to work.

The Appeals Resolution Officer denied the objection, finding that medical evidence from the time of the original injury showed no knee joint involvement and that the subsequent meniscus tear was not causally related to the workplace accident.

The worker, a letter carrier, suffered a compensable injury in November 2004 after slipping on ice.

He returned to modified and then full duties.

In November 2005, he claimed a recurrence of his injuries after experiencing pain while delivering mail on a new route that required carrying a heavy satchel.

The WSIB initially denied the recurrence claim.

On appeal, the Appeals Resolution Officer found that continuity of medical treatment had been established and that the new job duties constituted an insignificant new accident that temporarily aggravated his compensable injuries.

The worker's objection was allowed.

The employer appealed a case manager's decision classifying an injured EMS worker as a volunteer, which had resulted in her earnings being set at the statutory maximum.

The Appeals Resolution Officer found that despite the 'volunteer' label used by the employer to comply with the Ambulance Act, the true nature of the employment relationship under the Workplace Safety and Insurance Act was that of a part-time casual on-call employee.

The worker was required to be on-site for 24-hour shifts rather than responding from home.

Consequently, the worker's loss of earnings rate was ordered to be recalculated based on actual earnings, with the resulting overpayment deemed non-recoverable.

The worker suffered a work-related right knee injury in 2006 and subsequently underwent a total knee replacement in 2008.

The WSIB initially denied entitlement for the surgery, concluding it was for a pre-existing osteoarthritic condition rather than the compensable injury.

The Appeals Resolution Officer allowed the worker's appeal, finding that the compensable injury permanently aggravated the underlying osteoarthritis, which progressed post-accident, bringing the total knee replacement within the scope of entitlement.

The worker appealed the denial of initial entitlement for a low back injury allegedly sustained while filling drill holes with emulsion at a quarry.

The worker claimed a specific accident occurred when pulling a jammed hose, but the Appeals Resolution Officer found inconsistencies in the worker's reporting and a lack of medical evidence corroborating a work-related accident history.

The worker had a pre-existing history of back pain and failed to report the injury to the employer or seek immediate medical attention.

The objection was denied, and the denial of initial entitlement was upheld.

The worker objected to the quantum of a 15% permanent impairment award for a lower back injury sustained in 1984.

The worker argued the award did not adequately recognize the level of disability.

The Appeals Resolution Officer reviewed the medical evidence, including a May 2009 reassessment and reports from the attending physician, and found the objective clinical findings were consistent with a 15% award.

The worker's objection was denied.

The worker objected to a decision setting the arrears date for his increased permanent disability award to September 12, 2007.

The worker had originally suffered a low back injury in 1970 and received a 10% permanent disability award.

Following a reassessment, his award was increased to 20%.

The Appeals Resolution Officer reviewed the medical evidence and found that a specialist report from September 18, 2006, demonstrated a significant permanent deterioration in the worker's condition.

Applying WSIB policy, the officer allowed the objection and adjusted the arrears date to June 18, 2006, three months prior to the specialist report.

The worker suffered a gradual onset of bilateral wrist tendonitis from typing and using a computer mouse at work.

She continued to work with accommodations but her condition worsened.

Her treating practitioners recommended a two-week absence from work to rest and allow the inflamed tendons to heal.

The WSIB initially denied full loss of earnings (LOE) benefits for this period, concluding she could have continued on modified duties.

On appeal, the Appeals Resolution Officer allowed the worker's objection, finding that rest was an acceptable and necessary form of treatment given the circumstances, and granted full LOE benefits for the two-week period.

The worker, a ski instructor and Alpine race coach, suffered bilateral knee injuries in a workplace accident.

The WSIB initially provided loss of earnings (LOE) benefits and labour market re-entry (LMR) services, but discontinued them after a medical report suggested the worker could return to his pre-injury employment with a knee brace.

The worker objected, arguing he could not perform the physical demands of his pre-injury jobs.

The Appeals Resolution Officer found that the worker could not return to his pre-injury employment due to the risk of further injury and inability to perform advanced ski instruction.

The worker was granted full LOE benefits from the date they were discontinued, resumption of LMR services, and continuation of his physiotherapy program.

The request for weight loss and strength training programs was denied.

The worker's widow appealed a decision denying her request for reimbursement of airfare for her daughter, son-in-law, and two grandchildren to travel from the USA to Ontario for the worker's funeral.

The worker had passed away from compensable mesothelioma.

The Appeals Resolution Officer denied the appeal, finding that the Workplace Safety and Insurance Act does not provide for the reimbursement of expenses incurred by individuals other than the worker or spouse.

The employer objected to the initial allowance of a worker's claim for a back injury sustained on April 20, 2007, arguing there was insufficient proof of accident due to delayed reporting and medical attention.

The worker, a construction worker, injured his back while lifting steel joists but did not report it until April 26, 2007, and sought medical attention on April 30, 2007.

The Appeals Resolution Officer found the worker's explanation for the delay reasonable, noting the injury was initially thought to be a minor strain that worsened with continued work.

The officer concluded that proof of accident was established and denied the employer's objection, confirming the initial allowance of the claim.