OWSIB 2010

The worker objected to the denial of a psychological assessment referral, a change in their suitable employment or business (SEB) profile, and the adjustment of loss of earnings benefits.

The Appeals Resolution Officer denied the worker's objections, finding no evidence of a psychotraumatic injury and upholding the SEB change due to the worker's limited cooperation with labour market re-entry.

Furthermore, upon reviewing newly obtained medical records showing a significant pre-existing chronic low back condition, the Officer rescinded the previous allowance for a permanent aggravation, limiting entitlement to a temporary aggravation that resolved by January 2007.

The worker objected to a decision granting a permanent disability (PD) award of 20% for residual impairment to his left knee and left ankle, arguing it did not accurately reflect his current level of permanent disability following a 1979 workplace injury.

The Appeals Resolution Officer reviewed the medical evidence, including assessments from 1991 and 2008/2009, and found no significant deterioration in the left knee condition or functional limitations to warrant an increase beyond the 15% already awarded for the knee.

The 5% award for the left ankle was also found to be accurate.

The worker's objection was denied, and the 20% PD award was confirmed.

The worker objected to the suitable employment or business (SEB) of security guard and the associated earnings used to calculate his loss of earnings (LOE) benefit following a work-related right shoulder injury.

The worker argued he was unfit for the role due to physical and psychological impairments and inadequate training.

The Appeals Resolution Officer found that the worker met the educational and physical requirements for entry-level security occupations, and there was no evidence of a psychological barrier to employment during the labour market re-entry program.

The objection was denied and the LOE benefit calculation was upheld.

The worker objected to decisions denying entitlement to loss of earnings (LOE) benefits following a permanent lay-off and denying a permanent impairment for his back condition.

The worker had suffered a back strain at work in February 2006 but had a history of multiple motor vehicle accidents causing back and neck pain.

The Appeals Resolution Officer found that the worker's work-related back impairment had resolved by August 2006, and any ongoing impairment was due to pre-existing and subsequent non-compensable injuries.

The worker was found to have reached Maximum Medical Recovery without a permanent work-related impairment, and the objection was denied.

The worker, a baker and cake decorator, developed a right shoulder injury diagnosed as a repetitive strain.

She sought Loss of Earnings (LOE) benefits for a 10-day period when her physician authorized her off work.

The WSIB denied the benefits, concluding that the employer had provided suitable modified employment that accommodated her restrictions.

The Appeals Resolution Officer upheld the denial, finding that the medical evidence did not support total disability and that the worker failed to cooperate with the early and safe return to work process by refusing the bona fide offer of suitable modified employment.

A police officer injured his hip while pursuing a suspect but delayed filing a WSIB claim for over a year because he initially believed the injury was minor and his doctor misdiagnosed it as bursitis.

The WSIB initially denied the claim for failing to meet the six-month reporting time limit.

On appeal, the Appeals Resolution Officer granted the worker's objection and extended the time limit.

The Officer found that exceptional circumstances existed under Policy 15-01-03 because the worker had reported the accident to his supervisor, co-workers, and a health care professional within the six-month period.

The worker appealed a decision denying initial entitlement for a workplace accident where she sustained an electrical shock.

She sought recognition of the injury, reimbursement for travel expenses to medical appointments, and loss of earnings benefits for personal time used to attend those appointments.

The Appeals Resolution Officer granted initial entitlement and travel expenses, finding the medical investigations were a direct necessity of the accident.

However, the request for loss of earnings benefits was denied because the worker did not actually lose any time from her scheduled working hours.

The worker and employer both objected to a claims adjudicator's decision regarding entitlement to loss of earnings (LOE) benefits for a repetitive strain injury to the neck and shoulders.

The worker claimed the injury was caused by an ergonomically incorrect workstation.

The Appeals Resolution Officer confirmed the granting of initial entitlement, finding that the worker suffered a work-related strain due to the workstation setup.

The Officer also granted LOE benefits for several periods, including a period of graduated return to work and a flare-up caused by mail duties, but denied benefits for three days in May 2008 before the worker sought medical attention.

The employer appealed a decision levying a penalty for breaching its re-employment obligations under section 41 of the Workplace Safety and Insurance Act.

The employer had terminated the worker after obtaining video surveillance of the worker shoveling snow, which the employer believed contradicted his medical restrictions for a workplace elbow injury.

The Appeals Resolution Officer found that while the employer's decision to terminate was rash and misguided, it was not done in bad faith or with malicious intent to thwart the Act.

The penalty was rescinded.

The worker objected to a decision reducing her loss of earnings (LOE) benefits by the amount of her Canada Pension Plan (CPP) disability benefits.

The worker suffered multiple soft tissue injuries and developed chronic pain disorder and psychological impairments.

She was granted CPP disability benefits.

The Appeals Resolution Officer found that all diagnoses and complaints described in the CPP application fell within the scope of the WSIB claim, with no non-work-related conditions present.

Therefore, the full amount of the CPP benefit (excluding the portion for her children) was properly offset against her LOE benefits.

The worker's objection was denied.

The worker, a letter carrier, slipped and fell on ice while delivering mail, injuring his left hip.

He was later diagnosed with advanced osteoarthritis and underwent a left total hip replacement.

The employer objected to the Adjudicator's decision allowing entitlement for the surgery, arguing the initial injury was minor and there was a lack of continuity of complaint.

The Appeals Resolution Officer denied the employer's appeal, finding that the worker was asymptomatic prior to the fall and that the medical evidence demonstrated the workplace injury significantly accelerated the pre-existing osteoarthritis, making the surgery a necessary and appropriate result of the injury.

The worker appealed a decision awarding him a zero per cent Non-Economic Loss (NEL) permanent impairment award for occupational Noise Induced Hearing Loss (NIHL).

The Appeals Resolution Officer reviewed the file and found that the initial NEL assessment incorrectly calculated the worker's age as 85 instead of 75, resulting in an excessive deduction for presbycusis (aging).

After correcting the age and applying the AMA Guides, the worker's binaural hearing impairment was calculated at 3.8%, which translates to a one per cent whole person impairment.

The appeal was allowed, and the worker was granted a one per cent NEL award.

The worker, who suffered a minor left shoulder strain in 1985 that developed into a chronic pain disability, requested reimbursement for an orthopaedic pillow.

The Appeals Resolution Officer denied the request, finding no medical evidence that the pillow was necessary for the treatment of the compensable injury.

The medical evidence indicated the worker suffered from pre-existing cervical and lumbar degenerative disc disease, which was not related to the minor work injury.

The worker, a truck driver, suffered a right knee injury in 2005 when struck by a falling load.

He did not lose time from work.

In 2008, he sought ongoing entitlement for his right knee and initial entitlement for a low back condition, claiming they were related to the 2005 accident.

The Appeals Resolution Officer denied the appeal, finding that the current right leg symptoms were likely related to the low back rather than the original knee strain, and that there was no evidence the low back was injured in the 2005 accident.

The worker objected to the WSIB's decisions changing her Suitable Employment or Business (SEB) to Customer Service Representative and closing her Labour Market Re-entry (LMR) plan for non-cooperation.

The Appeals Resolution Officer found the Customer Service Representative SEB unsuitable due to the worker's medical precaution against prolonged sitting.

Furthermore, while the worker reduced her LMR attendance hours, this non-cooperation was justified by legitimate medical reasons, specifically increased low back and neuropathic pain.

The worker's objection was allowed, full Loss of Earnings benefits were restored, and the file was returned to reconsider the original SEB of Administrative Support Worker.

The worker suffered a compensable left shoulder injury and later sought entitlement for secondary injuries to her neck and right shoulder, as well as for regional pain syndrome.

The Appeals Resolution Officer found no causal link between the secondary areas of injury and the work-related left shoulder injury.

The medical evidence did not support the diagnosis of regional pain syndrome as being compatible with the work injury.

The worker's objection was denied.

The worker objected to a decision terminating his Labour Market Re-entry (LMR) plan for non-cooperation, which reduced his Loss of Earnings (LOE) benefits from full to partial based on projected full-time earnings as a Cashier/Gas Bar Attendant.

The worker argued he was only capable of working 20 hours per week due to his low back condition.

The Appeals Resolution Officer found that while the identified Suitable Employment or Business (SEB) was suitable and available, the medical evidence supported that the worker was only capable of sustained employment on a part-time basis.

The worker's objection was allowed in part, and partial LOE benefits were adjusted to reflect a 20-hour work week.

The employer objected to a decision allowing the worker entitlement for a non-work-related second injury that occurred at home.

The worker, who had a compensable lower back condition, fell down a flight of stairs when her left leg gave out.

The Appeals Resolution Officer found that the worker's fall was caused by her ongoing compensable thoracolumbar condition, noting medical evidence of left leg weakness and decreased balance.

The employer's objection was denied and entitlement for the second injury was upheld.

The worker suffered a right elbow injury in 2000 and was later diagnosed with chronic pain disability.

The worker sought full or partial loss of earnings (LOE) benefits from July 21, 2004, arguing that the modified work provided by the employer was not suitable and that she was competitively unemployable.

The Appeals Resolution Officer found that the worker was capable of performing modified duties for 5 hours a day from June 21, 2004, to November 14, 2005, entitling her to partial LOE benefits for that period.

However, based on medical evidence showing a progression of chronic pain symptoms, the Officer concluded that the worker was unable to return to any kind of work after November 14, 2005.

The worker was granted full LOE benefits from that date pending a psycho-vocational assessment.

The worker, a Registered Practical Nurse, sustained a bilateral wrist strain at work.

She sought full loss of earnings benefits for a period when she was off work.

The case manager initially denied the benefits, concluding there was no medical evidence to support time off.

On appeal, the Appeals Resolution Officer found that the worker was willing to return to suitable modified work, but the employer did not offer any until her medical restrictions were clarified.

The worker's objection was granted, and she was awarded full loss of earnings benefits for the disputed period.