APPEALS RESOLUTION OFFICER DECISION
DECISION NUMBER:
20250019
OBJECTING PARTY:
worker
REPRESENTED by:
WORKER REPRESENTATIVE
RESPONDENT PARTY:
employer
REPRESENTED by:
EMPLOYER REPRESENTATIVE
HEARING:
VIDEOCONFERENCE – october 22, 2024
HEARD by:
L. Mansueti, appeals resolution officer
OCTOBER 29, 2024
ISSUES
The worker objects to:
- The Eligibility Adjudicator (EA) decision letter dated May 18, 2023, denying the payment of loss of earnings (LOE) benefits from May 8, 2023, onward.
The Case Manager (CM) decision dated February 26, 2024:
communicating entitlement for L4-5 disc herniation aggravation was rescinded, and low back entitlement was limited to a strain only, and
communicating he reached maximum medical recovery (MMR) for his compensable injuries (low back strain, left knee, left lower leg and head contusion) on February 20, 2024, with no evidence of a permanent impairment (PI).
BACKGROUND
On May 3, 2023, the worker attempted to move a heavy table with sheet panels on it with the assistance of his coworkers. The worker grabbed a hold of a plastic roll holder slotted into the table, when the roll holder disengaged causing him to fall backward and the holder struck his left knee. The worker was working as a Machine Operator at the time of injury, and he had worked with the employer for approximately 14 months.
The decision letter dated May 18, 2023, communicated entitlement was in order for health care benefits for injuries involving the lower back, left lower leg, left knee, and a head contusion. In addition, LOE benefits were approved from May 4 to 7, 2023, inclusive. The decision letter communicated LOE benefits were not in order effective May 8, 2023, on the basis the employer offered the worker suitable modified work.
The worker remained off work, and participated in health care treatment. In October 2023, entitlement was expanded to include L4-5 minimal disc protrusion. The worker was discharged from treatment on February 20, 2024. The decision letter dated February 26, 2024, communicated the worker’s entitlement was limited to a lumbar strain only, and it was determined he reached MMR for his low back injury, left knee, left lower leg and head contusion on February 20, 2024, with no evidence of a PI.
The worker objected to the decisions dated May 18, 2023, and February 26, 2024. It is the position of the worker the modified work was not suitable, and he is also claiming he did not recover from his workplace injuries. The worker is seeking further LOE benefits and acknowledgement of a PI for his compensable injuries. These are now the issues before the Appeals Services Division (ASD).
AUTHORITY
Workplace Safety and Insurance Act (WSIA), 1997, as amended
Operational Policy Manual
Published
11-01-01 Adjudicative Process 11-01-05 Determining Permanent Impairment 18-03-02 Payment and Reviewing LOE Benefits (Prior to Final Review) 19-02-07 RTW Overview and Key Concepts
November 3, 2008 November 3, 2014 September 1, 2021 April 9, 2021
Administrative Practice Document: Weighing of Medical Evidence February 2024
ANALYSIS
I have carefully considered all of the available information, legislation, relevant operational policies, administrative practice document and testimony in reaching this decision. For the reasons that follow, I find the worker is entitled to LOE benefits from May 8, 2023, to July 5, 2023, inclusive, and he is entitled to a non-economic loss (NEL) assessment for his lumbar strain.
It should be noted my review and assessment does not include an all-inclusive summary of all the evidence submitted to the record, and there has been no attempt to reference every document in the claim file. I have included a summary of the pertinent evidence submitted to the record in relation to the issues in dispute.
Review of the Evidence
Following the workplace accident, the worker sought medical attention on May 4, 2023, at a hospital emergency department. Dr. A. Fogel completed a Health Professional’s Report (Form 8) for this visit. The report indicated the worker’s areas of injury included his head, low back, and left lower leg. Dr. Forgel indicated the worker was experiencing musculoskeletal pain owing to a left leg contusion and sprains/strains. The treatment plan consisted of Vimovo, rest, and physiotherapy. The x-rays yielded unremarkable results. The worker was advised to follow-up with his primary care physician. Dr. Fogel indicated the worker was capable of returning to modified work on May 8, 2023, as per his tolerance level.
On May 5, 2023, the employer offered the worker modified work, which consisted of helping the Panels Supervisor with production paperwork and labels; and performing louver assembly with no lifting or pushing tasks. It was noted these jobs were sitting positions. The offer of work indicated transportation could be provided upon receipt of medical documentation indicating he was unable to drive. The record indicated the worker did not accept the offer of modified work. It was noted the worker was experiencing a lot of pain and he was unable to move. The worker endorsed he had difficulty walking and sitting.
The worker testified the employer called him to discuss returning to work on multiple occasions, and he declined their offer of work. He stated he declined the offer of modified work because he had too much pain in his legs, he could not sit or stand, and he could not perform the modified work tasks. The worker indicated the employer offered him light work; however, he indicated there was no light work available in his section. The worker testified his main issue in not accepting the work offer was his inability to drive due to his difficulty with sitting. Prior to the work accident, the worker indicated he drove to work, which was a 10 to 20 minute drive depending on traffic. He stated he was not aware the employer was offering a taxi for him. He maintained he was unable to report to work.
On May 8, 2023, Dr. A. Lam, the worker’s primary care physician, assessed the worker. The worker was diagnosed with a lumbar strain, and he was advised to participate in physiotherapy. Dr. Lam reassessed the worker on May 15, 2023. The record contains a doctor’s note wherein Dr. Lam recommended the worker remain off work and engage in physiotherapy as he was experiencing low back pain. The worker’s return to work date was not known. The chart note for this visit indicated the worker presented with low back pain radiating to the right leg. Tenderness was observed at the right lumbar paraspinal area, and range of motion (ROM) was reduced by 50 per cent.
A radiograph dated May 16, 2023, for low back pain/sciatica was compared to a previous diagnostic test dated January 18, 2018. The report indicated there was no evidence of acute fractures or spondylolisthesis and lumbar alignment is maintained.
The worker commenced a Program of Care (POC) on May 24, 2023. A. Dulloo, Physiotherapist, completed the initial assessment. The report indicated the worker saw his family doctor on May 15, 2023, and had x-rays completed. The worker had attended another physiotherapy clinic on May 8, 2023, for his low back; however, he was unable to continue his treatment at that clinic because they did not accept patients with WSIB claims. The worker endorsed having pain in his low back, right thigh, left knee, right knee, left foot, and head. He indicated he was initially experiencing pain in the low back, left knee and left lower leg; however, he was now experiencing more pain on the right side. The worker stated he was experiencing lack of concentration, frustration, and occasional blurry vision when his back pain increases. The occupational diagnoses included lower back sprain/strain, lumbar radiculopathy at right leg, right piriformis syndrome, left knee sprain/strain, left foot pain (probable plantar fasciitis with metatarsalgia). The worker advised A. Dulloo he had suffered from sciatic pain prior to the workplace incident, and he believes he may have aggravated it. A. Dulloo recommended the worker remain off work due to the severity of his pain in his low back. The worker was advised regular assessments would be completed to determine his abilities and restrictions. A. Dulloo provided restrictions for return-to-work planning, and also completed a Functional Abilities Form (FAF). A. Dulloo stated, in part:
It is recommended that a Case Manager oversees his case & interactions between the patient and his employer for return to work. It is not recommended that patient goes to work currently due to presentation of [pain] in the Rt lower limb. MRI still pending (lower back).
The employer submitted an Employer’s Progress Report (Form 42) dated May 31, 2023, indicating the worker had not returned to work. They indicated the worker declined the employer’s offer of modified work on May 8, 16 and 31, 2023. The employer indicated the modified work offered to the worker was self-paced, allowed for alternating between sitting and standing, and also included transportation accommodation via taxi.
Dr. Lam completed a Health Professional’s Report (Form 26) on June 3, 2023, indicating the worker was unable to return to work due to sciatica. It was noted a magnetic resonance imaging (MRI) scan was ordered, and the worker was still receiving physiotherapy.
The POC progress report dated June 19, 2023, indicated the worker experienced a minimal improvement with treatment to date. The worker reported having decreased pain in his low back and left knee; however, his pain was still ongoing, and it continued to prevent him from performing activities of daily living (ADLs) pain-free and with normal active ROM. He indicated he was mainly experiencing pain in his right lower back, right leg and right foot. It was noted an MRI was still pending. The worker expressed concerns in that he believed his employer will make him perform duties outside of his restrictions and/or give him fast-paced work.
On July 5, 2023, A. Dulloo completed a FAF indicating the worker was capable of returning to work, within the following restrictions:
walking – can walk up to 1 hour with frequent breaks
standing 15 to 30 minutes
sitting 30 minutes to 1 hour, needs to position change
lifting 5 to 10 kg (not on a repetitive basis)
stair climbing 5 to 10 steps
ladder climbing 4 to 6 steps
able to drive car, able to use public transit
limit repetitive bending and twisting
recommend a gradual RTW plan, starting with 2 hours per shift
The POC outcome summary report dated July 21, 2023, indicated A. Dulloo informed the worker he could commence modified duties as per the FAF restrictions. It was noted the worker did not want to perform modified duties due to concerns that his employer would not respect his restrictions. He advised A. Dulloo that his supervisor “will make him do more work and do this and that,” and he feared these working conditions would aggravate his pain. The worker testified in his experience the employer expected a lot of output and they always demanded more, and he stated he would not be able to keep up with up with their expectations. He also mentioned there was another employee who had been on modified work, and they were unable to do small tasks. The worker wondered why this employee would come to work if they could not do their job.
A. Dulloo completed an FAFs dated August 16, 2023, and August 30, 2023, reiterating the worker was capable of returning to work with restrictions.
An MRI of the lumbar spine was completed on August 27, 2023. The report showed evidence of a central disc protrusion at L4-5 minimally contacting the traversing nerve roots in the lateral recess without compression.
FAFs completed by A. Dulloo on September 15, 2023, and September 29, 2023, indicated the worker was capable of returning to work within his restrictions. A POC report dated October 20, 2023, indicated a pain specialist referral was recommended. A. Dulloo indicated the worker had not returned to work due to concerns the employer will not adhere to his restrictions.
Dr. Lam provided a doctor’s note dated October 13, 2023, indicating the worker was unable to return to work due to low back pain. The treatment plan consisted of physiotherapy and a referral to a pain clinic. The clinical note for this visit indicated the worker’s low back pain was improving with physiotherapy. It was noted the worker reported his pain was aggravated with sitting and standing, and he endorsed having a 5 to 10 minute walking tolerance. The worker’s low back pain was radiating down to the legs. Dr. Lam noted the worker was working as a window assembler, which requires heavy lifting. Dr. Lam surmised the worker was unable to return to work at this time.
The worker was referred a back and neck specialty program for a comprehensive evaluation. On October 31, 2023, Dr. E. Massicotte, Neurosurgeon, and U. Gandhi, Chiropractor, assessed the worker. The worker presented with low back pain, and he indicated he had difficulty with ADLs. The report indicated the worker remained off work. He indicated he was unable to sit, stand or walk for prolonged periods, and he reported his sleep was affected. The worker’s occupational diagnosis included lumbar strain secondary to a fall at work. A partial functional recovery was anticipated; however, it was noted it would take 12 to 14 months. The worker was recommended to participate in the Functional Treatment Program (FTP). The worker was noted to be functioning within a limited physical demands capacity (PDC), and he was determined to be capable of returning to work within his restrictions and self-paced activities. The worker was advised he would benefit from task rotation and microbreaks to allow for symptom management and fatigue recovery.
The worker was referred to a lower extremity program for a comprehensive evaluation of his left knee. On November 7, 2023, the worker was assessed by Dr. S. Desai, Orthopaedic Surgeon, and M. Kaplan, Registered Physiotherapist. The worker reported minimal improvement with physiotherapy, and he endorsed having intermittent pain over the anterior left knee aggravated by standing more than 15 minutes or squatting. He indicated he had not returned to work due to an inability to sit, stand or walk for long periods of time, as well as lack of sleep. The worker’s occupational diagnosis was left knee direct contact injury/contusion with near complete healing. The report indicated the clinical examination did not show any significant knee findings. The worker’s main limitation was in keeping with his low back and radiculopathy. The assessment team recommended the worker continue with follow-up at the back and neck specialty program. There were no limitations for the left knee. The worker was determined to be fit to perform suitable work within the PDC level. The worker commenced an active treatment program at the FTP from November 15, 2023.
Dr. Lam referred the worker to Dr. S. Sahni, Chronic Pain Specialist at a sports medicine clinic. Dr. Sahni assessed the worker on November 21, 2023, for low back pain. Dr. Sahni indicated the worker had bilateral lumbar radiculopathy secondary to L4-5 disc herniation. The differential diagnosis was bilateral facetogenic arthritic pain. Dr. Sahni encouraged the worker to continue treatment at the FTP, and they recommended medications for neuropathic symptom management. Dr. Sahni also recommended an epidural steroid injection.
The worker transitioned from the FTP to the Enhanced Functional Treatment (EFT) Program with a focus on work hardening on December 27, 2023. The worker returned to the lower extremity program on January 2, 2024, for a follow-up evaluation. The assessment team determined the worker was fully functionally recovered from the left knee injury, and they did not recommend any restrictions or limitations. The worker was advised to continue to attend the back and neck specialty program. The worker was discharged from the EFT on or about February 5, 2024. The discharge report indicated the worker demonstrated limited improvement in his functional tolerances, continued to report high levels of pain in the neck, back and lower extremity and demonstrated self-limiting behaviours due to pain. The treatment team determined the worker was approaching a functional plateau, and a discharge from treatment was recommended. The worker’s current PDC level was noted to be sedentary-light, with pacing, and microbreaks to manage symptoms. The EFT discharge report provided restrictions for waking, standing, sitting, lifting, stair climbing, pushing/pulling, ladder climbing, bending, and repetitive movements.
The worker returned to the back and neck specialty program for a reassessment on February 20, 2024, wherein he was assessed by Dr. Massicotte and K. Malakovski, Physiotherapist. Th worker reported minimal to no improvement with his lumbar symptoms. He had completed treatment with limited gains and self-limiting behaviours due to pain. It was noted the worker remained off work as he declined the employer’s offer of modified duties. The worker’s occupational diagnosis was noted to be lumbar strain. The assessment team indicated no further functional improvement was anticipated, and no further treatment was recommended. The worker was determined to be capable of returning to work within his restrictions. The assessment team identified several medical and clinical barriers, including poor sleep and driving barriers, which could impact symptom management and productivity at work. The worker was noted to exhibit tearfulness, worry, and distress during the assessment, and he endorsed feeling anxious and distress over his recovery. It was noted the worker had declined psychosocial intervention throughout his treatment program, and he was unable to provide an answer as to whether he would be open to psychosocial support for his perception of pain. The assessment team determined the worker had the following permanent low back restrictions gleaned from the EFT discharge report:
walking occasional basis, up to 15 minutes at a time with opportunity for microbreaks and pacing
standing occasional basis, up to 20 minutes with opportunity for positional changes
sitting occasional basis, up to 30 minutes with opportunity for positional changes
stair climbing occasional basis with use of handrail
lifting from floor to waist up to 15lbs occasionally with a 7.5/8” stool
lifting waist to shoulder up to 10lbs occasionally
lifting above shoulder 0 to 5kg
pushing and pulling 5 to 10kg
ladder climbing limited to a rare basis with use of bilateral hands
able to drive car and take public transit
limited repetitive forward bending/twisting of the low back, neck, and left knee to a rare basis
The worker was determined to be capable of returning to work within the sedentary-light PDC level with the opportunity for positional changes and microbreaks every 30 to 45 minutes for 5 minutes for symptom management. The worker was determined to have reached MMR.
The worker testified he has remained off work due to his compensable injuries. The worker indicated he had not worked in any capacity since his work accident. The worker stated he has not been in contact with the employer because he is not able to return to work.
1. LOE Benefit Entitlement
Operational policy 18-03-02 states, in part:
Full LOE
If the nature or seriousness of the injury/disease completely prevents a worker from returning to any type of work, or if the worker is able to return to some form of work but the WSIB determines no suitable work is available, the worker is generally entitled to full LOE benefits providing the worker co-operates in health care measures and all aspects of the return-to-work (RTW) process.
In order to render a decision in this claim, a review of the worker’s level of impairment is required to determine whether they were partially or totally disabled as a result of their compensable injures; and whether they could have reasonably returned to work in some capacity.
The worker representative submitted the workplace accident derailed the worker’s life. She submitted the worker’s ongoing pain and sleep interruptions limited his ability to perform ADLs and perform modified work. The worker representative submitted the modified work offered by the employer was not suitable given the worker’s compensable PIs, noting he was not able to sit for prolonged periods of time. She submitted the modified job demands exceeded the worker’s functional abilities. The worker representative submitted the worker has always been a hard worker, and he would have returned to work if he was capable of doing so.
It is the position of the employer representative the worker was partially disabled, and he was capable of returning to the suitable work offered by the employer. The employer representative submitted the modified duties were well within the worker’s functional abilities, as none of the tasks involved lifting, pushing, pulling, and they were all self-paced and could be performed in a seated position. The employer representative indicated the medical evidence supports he was capable of returning to work, and there is no clinical explanation as to why the worker could not perform the modified duties offered to him.
In review of the medical evidence before me, I find the nature and seriousness of the worker’s compensable injuries completely prevented him from returning to any type of work from May 8, 2023, to July 5, 2023, inclusive. A. Dulloo, who had been treating the worker since May 24, 2023, indicated the worker was capable of returning to work within his restrictions as per the FAF dated July 5, 2023. As such, I find the worker was totally disabled and unable to work from May 8, 2023, to July 5, 2023, inclusive, at which time it was confirmed he was partially disabled and capable of returning to some form of work.
The next question to be determined is whether the modified work offered by the employer was suitable. Operational policy 19-02-07 indicates suitable work means post-injury work that is safe, productive, consistent with the worker’s functional abilities, and that restores the worker’s pre-injury earnings, to the greatest extent possible.
The employer offered the worker modified work that consisted of assisting the Panels Supervisor with production paperwork and labels and louver assembly work. The offer of modified work indicated the work did not involve any lifting or pushing, and he could perform these jobs in a seated position. In review of the worker’s restrictions as per the July 5, 2023, FAF, I am in agreement the modified job demands are within his limitations.
I acknowledge the worker declined the employer’s offer of modified work. The worker testified he was physically unable to perform the modified job duties, he could not travel to work, and the job demands were not suitable. While I appreciate the worker had reservations and doubts about the employer’s commitment to offer safe and suitable work, it must be noted the worker never attempted to return to work, thus his concerns could not be substantiated. Based on the evidence before me, I find the employer offered safe and suitable work to the worker, and he could have reasonably returned to work on July 6, 2023.
In review of the subsequent medical evidence submitted to the record, the clinical reports from the worker’s treating health care professionals indicate he was partially disabled and capable of returning to work with restrictions save for Dr. Lam’s clinical note dated October 13, 2023. Dr. Lam indicated the worker had ongoing back pain, and submitted the worker was unable to return to work due to back pain. I have not placed significant weight on this medical evidence as the clinical assessment is void of any objective findings to support the worker was totally disabled and unable to return to any type of work.
In summation, I accept the worker is entitled to further LOE benefits from May 8, 2023, to July 5, 2023, inclusive. I find the worker was partially disabled and capable of returning to suitable modified work effective July 6, 2023.
2. Low Back Entitlement
In order to establish initial entitlement to benefits, operational policy 11-01-01 states in part:
Five point check system
All decision-makers use the same criteria for ruling on initial entitlement to WSIB benefits. This system is known as the "five point check system."
An allowable claim must have the following five points:
an employer
a worker
personal work-related injury
proof of accident, and
compatibility of diagnosis to accident or disablement history.
In this case, the “five point check system” was satisfied in that it was accepted the worker sustained personal work-related injuries involving a low back strain/sprain, as well as injuries involving the left knee, left lower leg and head. The worker underwent a low back MRI in August 2023, and there was evidence of a disc protrusion at L-5 minimally contacting the traversing nerve roots in the lateral recess without compression. As documented in memorandum A0024 dated October 18, 2023, the CM expanded entitlement to include a L4-5 disc protrusion as per the MRI findings, which was subsequently rescinded.
The worker was assessed by Dr. Massicotte on October 31, 2023, at the back and neck specialty program, wherein the worker’s occupational diagnosis was confirmed to be lumbar strain secondary to a fall at work. Dr. Massicotte confirmed the worker’s lumbar strain diagnosis as per the February 20, 2024, back and neck specialty program report. Conversely, Dr. Sahni diagnosed the worker with lumbar radiculopathy secondary to a L4-5 disc herniation as per the November 21, 2023, consultation report.
It is noted the record contains contrary medical opinions with respect to the worker’s low back diagnosis. As per the Administrative Practice Document, Weighing Medical Evidence, the decision-maker is expected to assess and weigh each report in order to reach a decision. Consideration is given to:
The health care professional’s access to all the relevant medical records, including diagnostic reports available to review in order to obtain a complete understanding of the person’s relevant medical history and the injury process involved
Timeliness of the medical examination in relation to the issue at hand.
Degree of the health professional’s knowledge of past and present medical history and its impact on the medical opinion.
Extent of the health professional’s knowledge and understanding of the injured or ill person’s employment environment in relation to ongoing impairment.
Expertise of those offering an opinion and relevance to the issue. Reference to relevant medical literature that supports the opinion and recommendations.
Evidence or opinion based on an examination of the injured or ill person. Evaluation of the person’s complaints and symptoms relative to the medical findings.
Well-explained and logical conclusion of opinion, including supporting medical findings.
Dr. Massicotte had access to all of the relevant medical records as these documents were provided as part of the referral to the specialty program. It is noted Dr. Sahni reviewed the worker’s August 2023 lumbar spine MRI as reference was made to it in the consultation report; however, it is not known whether they received all of the relevant medical records to fully understand the worker’s relevant medical history and injury process involved. It is noted both Dr. Massicotte and Dr. Sahni assessed the worker around the same time, several months post-accident. I find both Dr. Massicotte and Dr. Sahni are experts in their respective fields, thus both their opinions have probative value. In review of the evidence before me, I have placed more significant weight on Dr. Massicotte’s occupational diagnosis of lumbar strain. While the worker may have endorsed symptoms in keeping with radiculopathy secondary to a L4-5 disc herniation, I agree with Dr. Massicotte in that the worker’s occupational diagnosis is a lumbar strain noting the mechanism of injury and his symptomology are consistent with this diagnosis. Based on the foregoing, the worker’s low back entitlement under this claim is lumbar strain.
3. MMR/PI
Entitlement in this claim was accepted for a low back strain, as well as injuries involving the left knee, lower left leg and head.
Operational policy 11-01-05 states, in part:
A work-related impairment is considered permanent when it continues to exist after maximum medical recovery (MMR) has been reached.
A recovery from the work-related injury/disease is considered to have been made if there is no evidence of an ongoing work-related impairment at the time MMR is reached.
The policy indicates MMR means that a plateau in recovery has been reached and it is not likely that there will be any further significant improvement in the work-related injury/disease. As enumerated in the policy:
Determining MMR
In all cases, decision-makers identify when MMR is reached. Decision-makers consider whether
recent clinical evidence indicates any change in the work-related injury/disease
the worker is receiving or will receive treatment that is likely to improve the work-related injury/disease, or
the worker is receiving treatment or using medication to maintain the current level of recovery.
In review of the evidence before me, I find the worker reached MMR for his left knee contusion on January 2, 2024, when he was discharged from the lower extremity specialty program. The clinical evidence supports the worker achieved a full functional recovery of the left knee with no restrictions. As such, I find the worker reached MMR for his left knee and left lower leg on January 2, 2024, with no evidence of a PI.
There is limited medical evidence pertaining to the worker’s head contusion. The worker testified he experienced headaches and endorsed having a “vibrating feeling” in his head; however, I do not find these symptoms are in keeping with his compensable head contusion, which appears to have since resolved. I find the worker likely reached MMR for his head on October 20, 2023, the date of the POC outcome summary, with no evidence of a PI.
With respect to the low back, I find the worker reached MMR on February 20, 2024, with evidence of a PI as per the back and neck specialty program report. The assessment report indicated the worker reached MMR; however, a full recovery was not achieved. The evidence in the record supports the worker was determined to have a permanent functional impairment and permanent physical restrictions. Based on the foregoing, I find the worker is entitled to a NEL assessment for his permanent low back impairment.
CONCLUSION
I conclude:
The worker is entitled to full LOE benefits from May 8, 2023, to July 5, 2023, inclusive.
There is no entitlement to benefits for an aggravation of the worker’s L4-5 disc herniation. Entitlement remains in order for a lumbar strain.
The worker recovered from his left knee contusion and head contusion with no evidence of a PI. The worker achieved a partial recovery of his lumbar strain, with evidence of a PI. The worker is entitled to a NEL assessment for his lumbar strain.
The operating area shall determine the extent and duration of benefits flowing from this decision, subject to the usual rights of appeal.
The worker’s objection is allowed-in-part.
DATED October 29, 2024
L. Mansueti
Appeals Resolution Officer
Appeals Services Division