OWSIB 2014

The worker, a truck driver, suffered a workplace injury when a tire blew out, causing him to fall and sustain back injuries.

The WSIB initially allowed the claim on an aggravation basis and later terminated benefits, concluding the worker had recovered to his pre-accident state.

The worker appealed, seeking recognition of a permanent thoracolumbar impairment, loss of earnings (LOE) benefits during a seasonal layoff, and entitlement for Chronic Pain Disorder (CPD) and psychotraumatic disability.

The Appeals Resolution Officer found that the worker suffered a permanent thoracolumbar impairment and was entitled to LOE benefits during the layoff period.

The Officer denied entitlement for CPD but granted entitlement for psychotraumatic disability, finding the pre-existing psychological condition was exacerbated by the workplace injury.

The WSIB was directed to conduct a work transition assessment to determine ongoing LOE benefits.

The worker appealed the denial of benefits for a psychotraumatic disability (Major Depressive Disorder), Chronic Pain Disability (CPD), and coverage for a non-professional escort for medical appointments.

The Appeals Resolution Officer found that the worker's depression was not caused by the workplace slip and fall, given her significant pre-existing psychological history and the minor nature of the accident.

The CPD claim was denied because the worker's pain levels were consistent with her organic impairment (right hip trochanteric bursitis).

However, the appeal was allowed in part regarding the non-professional escort, which was approved for WSIB-approved medical appointments located more than 60 kilometres from the worker's home.

The worker requested reconsideration of an Appeals Resolution Officer's decision regarding the nature of her pre-existing right knee condition and the employer's entitlement to Second Injury and Enhancement Fund (SIEF) cost relief.

The Appeals Manager found that the worker had only mild pre-existing osteoarthritis at the time of her slip and fall accident, and that her subsequent severe post-traumatic osteoarthritis was directly related to the accident and a subsequent misdiagnosis.

The Appeals Manager concluded that the pre-existing condition did not contribute to the accident or prolong the disability, thereby denying the employer's request for SIEF cost relief.