WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFICER DECISION
Decision number: 20100037
OBJECTION BY: Worker
WORKER: Participating
EMPLOYER: Not Participating
ISSUE
The worker is requesting entitlement to a new wheelchair.
HOW THE ISSUE ARISES
On September 28, 2008 this worker sustained an injury to his shoulders and neck as a result of a workplace accident. At the time of the accident, the worker was wheelchair bound due to a non-compensable condition. As a result, of the injuries, the worker required permanent precautions. The accident employer could not accommodate him with modified employment, as a result, he was referred for Labour Market Re-entry Services. Based on the various tests, Community Social Services Worker was identified as the suitable employment/business.
The service provider raised concerns over wheelchair accessibility and safety and thought that the worker’s wheelchair was not suitable for classroom training. It was not considered ergonomically correct for him as it did not have side arms or proper back support. The service provider recommended an ergonomically correct wheelchair and one that was lighter in weight. The case manager with the assistance of the WSIB Nurse Case Manager reviewed the request for an ergonomic new wheelchair and determined that the need for a wheelchair was not related to the compensable shoulder and neck injury. As a result, the request for funding a wheelchair was denied. The case manager outlined the full particulars of the decision in the correspondence dated November 16, 2009. The worker objected to this decision, as a result, the worker’s file was referred to the Appeals Branch for further consideration.
AUTHORITY
WSIB Operational Policy Document:
19-03-06 – Labour market re-entry expenses
RESOLUTION METHOD AND PROCESS
The worker requested an expedited decision within 60 days based on the information on record. The employer did not participate in the appeal.
ASSESSMENT OF THE EVIDENCE
It is the worker’s position that prior to his workplace accident, he had no difficulty using his wheelchair. He had no difficulty lifting it to put it in his car. However, subsequent to the injury to his shoulders and neck he started to have problems lifting the wheelchair in and out of his car. He also had difficulty sitting for six hours per day in the classroom. He requested a lighter wheelchair recommended by his physiotherapist and family doctor to take the strain off both his shoulders and that was ergonomically correct to support his back and shoulder while in the classroom.
According to WSIB Operational Policy Document 19-03-06 it states in part:
The WSIB pays the necessary expenses related to labour market re-entry assessment and plan.
The typical expenses paid during the LMR plan include
Registration fees
Tuition
Examination fees
Text books
Course material (items or supplies especially required for a course or project
Tutor assistance, and or
Transcript fees
Exceptional expenses
The WSIB pays the following expenses if the circumstances require
Workplace modification and assistive devices
The WSIB pays for all modifications and assistive devices that
Are necessary for the worker to re-enter the labour market in the suitable and available employer or business (SEB) or
Will allow the worker to return to suitable and available employment with the accident employer, as long as the employer is not required to accommodate the worker under the re-employment obligations.
Tools, equipment or protective clothing
The WSIB does not purchase tools, equipment or protective clothing required to perform the SEB, except when
The school or program agency does not provide or make available to the worker the necessary tools, equipment or protective clothing, and
The tools, equipment or protective clothing are specifically required to complete the program or course, and the worker provides the decision-maker with information indicating that requirement or
Because of the work-related impairment, the worker requires special tools, equipment, or protective clothing that would not normally be required for a person in the SEB.
I have reviewed all of the evidence on record and written submissions made. I also considered the applicable WSIB Operational Policy Documents and relevant legislation. In assessing all of the evidence, I am satisfied that the worker is entitled to the allowance of an ergonomically correct wheelchair. In reaching this decision, I noted and accepted the following:
At the time of the accident, the worker was wheelchair bound as a result of a non-compensable condition diagnosed as polio at the age of 2. Prior to the accident, there is no evidence he was having any problems using his wheelchair.
As a result, of the workplace injury, the worker developed problems with his bilateral shoulder and neck. He has been left with a residual impairment and granted a 23 per cent NEL award and requires permanent restrictions of avoiding work at or avoid shoulder level, limited modified heavy lifting and carrying and avoid long reaching.
From the time that LMR services commenced, the service provider recommended a lighter and more ergonomically correct wheelchair. This is outlined on page 32 of the LMR report under subheading potential barriers with solutions – wheelchair. In the report he stated the following:
“The worker did not report any other medical conditions which potentially could impact LMR services, however, he did report a concern with his current wheelchair.
Mr xxxxxx’s current wheelchair is more of racer type device. Meaning it has a very low back, no arm or foot rests and the seat pan droops therefore ergonomic support is a concern. Although an ergonomic assessment and devices are inclusive of this plan consideration for sponsoring a wheelchair is also requested. By sponsoring this unique device it will ensure Mr xxxxxx has the necessary ergonomic support as LMR training consists of 4-6 hours and to transfer from a wheelchair to an ergonomic chair within the facility is not realistic. Mr xxxxxx has no lower body strength. .. The LMR provider is aware that this device is not directly related to Mr xxxxxx’s bilateral shoulder injury; however, without sponsorship as indicated above there are concerns with proper ergonomics for Mr xxxxxx which could potentially put him at further risk of injury.”
According to the Cascade Disability Management Ergonomic Office Computer Workstation Evaluation dated November 19, 2009, it stated the following:
“Mr xxxxxx utilises a wheelchair as a result of his pre-injury medical. He has limited to no muscle tone in his legs. He reports pain from base of skull across top of shoulder and into top of shoulder joint area; pain from base of skull across top of shoulders and into top of shoulder joint area’ pain from mid to upper back, as result of school work - sitting in wheelchair, looking down at work.”
According to the report, it also indicated that the worker used the ergo chair however he had difficulty transferring as the ergo chair had wheels and pivots freely. Worker would have to transfer to use the washroom and to take breaks, thereby requiring he lift his body mass each time, potentially against his physical limitations.
The service provider asked the worker whether there were funds available from alternate sources to replace the wheelchair. The worker noted that it was a challenge with utilizing other funders as there is typically a significant delay in processing such that he would not get the chair in time to use for school. The worker anticipated the cost of the wheelchair would be approximately $7,000.00
The physiotherapist in the report dated February 25, 2009 outlined that a barrier in recovery was the heavy wheelchair for the shoulders lifting in and out of his vehicle.
According to the Regional Evaluation Specialty health care assessment dated August 10, 2009 commented on the need for a new wheelchair and stated the following:
“I also agree with Dr Bates that a new wheelchair prescription may be necessary. “
This worker’s current LMR plan consists of the following:
Alpha Logic and computer training from November 16, 2009 to May 28, 2010;
SSW Certificate program from June 3, 2010 to June 2011 and
Job search training program from June 20, 2011 to July 15, 2011.
While I recognize that the wheelchair is not directly related to his non-compensable condition, however without an ergonomically correct wheelchair as recommended by the worker’s treating physician and examining physician and the service provider, there are concerns about the proper ergonomics, potential risk of further injury and his success in the LMR program.
I therefore find it reasonable to allow for the new wheelchair on a once only basis.
CONCLUSION
The worker’s objection is granted.
The worker is entitled to a new wheelchair recommended by his treating physician on a once only basis.
DATED March 12, 2010
T. Cerone
Appeals Resolution Officer
Appeals Branch