Workplace Safety and Insurance Board
Appeals Resolution Officer Decision
Decision Number: 20150085
Decision Date: February 13, 2015
Objecting Party: Worker
Represented by: Worker Representative
Respondent: Employer (not participating)
Hearing: Hearing in Writing
Heard by: D. Duguay, Appeals Resolution Officer
Issue
The worker is objecting to the Eligibility Adjudicator's decision dated July 30, 2014 which denied initial entitlement concluding there was no proof of an accident occurring at work on April 30, 2014.
Background
The worker, then 44 years old, with the employer since October 3, 1989, was working as a Personal Support Worker at the time of her injury. The worker claimed she injured her left shoulder while transferring a resident with the assistance of a co-worker on April 30, 2014.
The worker sought medical attention on July 20, 2014 for left clavicle and scapular pain.
The Eligibility Adjudicator, in her decision dated July 30, 2014, denied initial entitlement concluding there was insufficient evidence to establish proof of an accident having occurred on April 30, 2014. The worker objected to this decision.
Authority
Operational Policy Manual Documents
Policy 11-01-01 Adjudicative Process
Policy 11-01-02 Decision Making
Policy 15-02-01 Definition of an Accident
Analysis
Policy 11-01-01 states:
Proof of accident
Decision-makers may consider the following when examining proof of accident,
- Does an accident or disablement situation exist?
- Are there any witnesses?
- Are there discrepancies in the date of accident and the date the worker stopped working?
- Was there any delay in the onset of symptoms or in seeking health care attention?
Analysis
The issue before me is proof of accident occurring on April 30, 2014. I do not find in favor of the worker and have outlined my reasons below.
To establish proof of accident there must be evidence to support the incident occurred as described.
The worker, as per memo #1 dated July 29, 2014, confirmed she did not report the incident to anyone. The worker further advised she continued to have difficulty with her shoulder and arm but continued to perform her regular duties without complaint.
In this case, the worker did not report the incident. The worker continued to perform regular duties without evidence to demonstrate she was having any difficulties with her left shoulder and arm.
The worker first sought medical attention on July 24, 2014, almost 3 months after the claimed incident.
Noting the significant delays, I am unable establish the worker suffered an accident work on April 30, 2014. I find there is insufficient evidence to establish proof of accident.
Conclusion
I conclude there is insufficient evidence to demonstrate proof of an accident having occurred at work on April 30, 2014.
The worker’s objection is denied.
DATED February 13, 2015
Mr. D. Duguay Appeals Resolution Officer Appeals Services Division