OWSIB 2011

The worker objected to the denial of a non-economic loss (NEL) award for her left knee following a slip and fall at work.

The WSIB had allowed the claim for an aggravation of pre-existing osteoarthritis but concluded the aggravation ceased by 2001.

The Appeals Resolution Officer reviewed the medical evidence and agreed that the worker had returned to her pre-accident state by November 2001, and that later symptoms were due to the natural progression of her underlying osteoarthritis.

The worker's objection was denied.

The worker appealed the closure of Loss of Earnings (LOE) benefits, the denial of additional treatment, the denial of left shoulder entitlement, and the denial of Chronic Pain Disability following a workplace head injury.

The Appeals Resolution Officer found that the worker was entitled to partial LOE benefits until her actual return to full-time hours and granted entitlement for the left shoulder injury as a recurrence.

However, the denial of additional treatment was confirmed due to a lack of recent medical evidence, and Chronic Pain Disability was denied because the worker did not meet all five required criteria, specifically lacking an extended healing time and impaired earnings capacity.

The worker objected to a decision denying entitlement for a low back injury sustained at work on January 28, 2010, and sought loss of earnings benefits for time off work starting February 21, 2010.

The initial denial was based on a three-week delay in seeking medical attention.

The Appeals Resolution Officer found that the worker had self-treated the injury and continued working in pain.

Applying WSIB policies on initial entitlement and recurrences, the Officer concluded there was clinical compatibility between the original injury and the condition that caused the lost time, with no evidence of an intervening event.

The objection was granted, and loss of earnings benefits were awarded.

The worker, a body shop repairman for 25 years, appealed a decision denying entitlement for bilateral carpal tunnel syndrome.

The Appeals Resolution Officer found that the worker's heavy use of vibratory tools and repetitive wrist movements were a significant contributing factor to the development of the condition.

The appeal was allowed, establishing a causal relationship between the employment and the disablement, with the accident date amended to March 25, 1998.

The worker objected to a decision basing her partial loss of earnings (LOE) benefits on deemed suitable employment or business (SEB) earnings of $13.00 per hour at 40 hours per week, rather than her actual part-time earnings as a law clerk.

The worker argued she was unable to work full-time due to her compensable shoulder and neck injuries.

The Appeals Resolution Officer denied the objection, finding that the approved labour market re-entry plan indicated the worker was capable of a 40-hour work week.

Because the worker was not working full-time, she was considered underemployed under Board policy, and deemed earnings were correctly applied.

The employer objected to a Case Manager's decision denying claim cost relief under the Second Injury and Enhancement Fund (SIEF) Policy.

The worker sustained a left knee strain at work while pulling shopping carts.

The employer argued that the worker's pre-existing osteoarthritis and possible meniscus tear caused or contributed to the injury and prolonged recovery.

The Appeals Resolution Officer found that the accident was of moderate severity and that the worker's recovery was not prolonged by the minor pre-existing condition.

The employer's objection was denied.

The worker appealed the WSIB's decisions regarding his earnings basis and Labour Market Re-entry (LMR) plan following a workplace injury.

The worker argued his earnings basis should reflect an apprentice journeyman's wages and requested a change in his training venue from a 51-week program at Everest College to a three-year program at Cambrian College.

The Appeals Resolution Officer denied the appeal, finding no evidence the worker was hired as an apprentice, and upholding the current Suitable Employment or Business (SEB) and training venue as suitable, reasonable, and cost-effective.

The worker appealed a decision denying full loss of earnings (LOE) benefits from July 8, 2010, arguing that the identified suitable employment or business (SEB) objective of cashier was not suitable due to his limited education and compensable chronic pain disability.

The Appeals Resolution Officer found that despite the worker's limited education and impairment, he had successfully completed a labour market re-entry program and work placements as a cashier.

The worker had also demonstrated a willingness to secure employment.

The appeal was dismissed, and the SEB of cashier was deemed suitable.

The worker suffered a right elbow fracture after slipping and falling at work in 2003.

After years of modified duties, the employer could no longer accommodate her restrictions.

The WSIB operating area denied a permanent impairment due to the lack of a confirmed organic diagnosis for her ongoing pain.

On appeal, the Appeals Resolution Officer found that the worker's ongoing symptoms were causally linked to the workplace accident.

Applying the WSIB's Chronic Pain Disability policy, the Officer concluded the worker met all five criteria for entitlement, recognizing a permanent impairment and directing a Non-Economic Loss assessment.

The worker objected to the WSIB's decision to discontinue his loss of earnings (LOE) benefits effective May 18, 2009.

The WSIB had terminated benefits based on video surveillance submitted by the employer, concluding the worker was fit to drive and perform modified duties.

The Appeals Resolution Officer found that the brief video surveillance of the worker assisting with a canopy did not demonstrate he was capable of the 125-kilometre drive required to attend modified duties.

The medical evidence supported that the worker remained partially impaired and unfit to drive until July 14, 2009.

The objection was granted, and the worker was awarded full LOE benefits from May 18, 2009, to July 14, 2009.

The worker objected to a case manager's decision denying full loss of earnings (LOE) benefits beyond November 16, 2009, after he refused modified work following a right thumb fracture.

The Appeals Resolution Officer found that the modified work offered by the employer was suitable and within the worker's functional abilities.

However, because the case manager did not provide written notice of the decision until December 9, 2009, the worker was entitled to full LOE benefits up to that date.

The objection was allowed in part.

The worker sustained a crush injury and fracture to his left thumb at work and was placed on modified duties.

He was subsequently permanently laid off.

The WSIB awarded Loss of Earnings (LOE) benefits from the date of layoff until he found alternative employment.

The employer objected to the payment of LOE benefits.

The Appeals Resolution Officer denied the employer's objection, finding that the worker's employability was clearly affected by the work-related impairment and associated restrictions at the time of the layoff, entitling him to LOE benefits under WSIB policy.

The worker objected to a Case Manager's decision denying ongoing entitlement for a left shoulder injury sustained in October 2007.

Initially diagnosed as a sprain, an ultrasound and MRI a year later revealed a full-thickness supraspinatus tendon tear.

The employer argued there was a lack of medical continuity during the intervening year.

The Appeals Resolution Officer allowed the objection, finding clinical compatibility between the original injury and the tendon tear, and noting the worker's stoic effort to continue working despite progressive deterioration.

Ongoing entitlement was granted.