OWSIB 2024

The employer objected to the allowance of initial entitlement for a mental stress injury (PTSD) for a police communications operator.

The worker objected to the determined date of injury and the denial of loss of earnings (LOE) benefits from May 16, 2021.

The Appeals Resolution Officer upheld the initial entitlement, finding the worker met the criteria under the First Responders policy and the presumption was not rebutted.

The date of injury was confirmed as June 9, 2021, the date the worker was first diagnosed with work-related PTSD.

LOE benefits were denied for the period prior to the diagnosis but allowed from June 9, 2021, to October 19, 2023, as the worker was totally and then partially impaired due to the work-related injury.

The worker, a volunteer firefighter for over 30 years, appealed a decision denying entitlement for colorectal cancer as an occupational disease.

The worker sought presumptive entitlement under Policy 23-02-01, but was diagnosed at age 65, failing to meet the requirement that diagnosis occur prior to age 61.

The worker also sought entitlement under Policy 16-02-11 for asbestos exposure, but the Appeals Resolution Officer found the exposure was not continuous, repetitive, or a major component of the worker's occupational activity.

Finally, considering the merits and justice of the case, the Officer relied on IARC findings to conclude that compatibility between the worker's occupational exposures and colorectal cancer was not established.

The appeal was denied.

The worker appealed a case manager's decision to adjust their loss of earnings (LOE) benefits based on updated entry-level wages for the suitable occupation of Customer Service Representative.

The Appeals Resolution Officer found that the updated entry-level wage of $16.55 per hour represented a material change of more than 10% from the previous $14.00 per hour rate.

The worker's objection was denied, and the adjustment of LOE benefits was confirmed.

The worker appealed several decisions made by a Case Manager regarding entitlement to benefits following a workplace slip and fall.

The Appeals Resolution Officer denied initial entitlement for injuries to the worker's back, neck, shoulders, and head due to a significant delay in reporting and lack of contemporaneous medical evidence linking them to the accident.

However, the Officer found that the worker's left knee strain had reached maximum medical recovery with a permanent impairment, reversing the Case Manager's decision on that issue.

The Officer also upheld the permanent restrictions for the left ankle and knee, and confirmed that a 2% Non-Economic Loss benefit was appropriate for the left ankle impairment based on the AMA Guides.

The appeal was allowed in part.

The worker objected to WSIB decisions denying loss of earnings (LOE) benefits for a specific period and denying entitlement to psychotraumatic disability benefits following a workplace accident involving a tow motor and a forklift.

The Appeals Resolution Officer found that the worker was completely disabled from working due to the physical injury from May 31, 2021, to June 23, 2021, and granted full LOE benefits for that period.

However, the claim for psychotraumatic disability was denied because the worker's psychological symptoms were found to be an emotional reaction to a dispute with the employer over the accident details and return-to-work process, rather than an indirect result of the physical injury itself.

The worker, a police officer, appealed a Case Manager's decision denying entitlement for posttraumatic stress disorder (PTSD), traumatic mental stress, and chronic mental stress.

The worker had responded to a fatal motor vehicle incident involving a child in 2011, but did not seek psychological treatment until 2021, shortly after their own child suffered a severe medical emergency.

The employer argued the personal stressor rebutted the presumption of work-relatedness for first responders.

The Appeals Resolution Officer found that the work-related incident remained a significant contributing factor to the PTSD diagnosis, despite the co-existing personal stressor and the delay in seeking treatment.

The appeal was allowed, granting entitlement for PTSD as a first responder.

The worker appealed a decision denying entitlement for bladder cancer and loss of earnings (LOE) benefits.

The worker argued the bladder cancer was caused by occupational exposures in the petrochemical industry or by radiation treatment for a previously accepted follicular lymphoma claim.

The Appeals Resolution Officer dismissed the appeal, finding insufficient evidence that occupational exposures or the limited radiation treatment significantly contributed to the bladder cancer, noting the worker's smoking history as a major risk factor.

The claim for LOE benefits was also denied as the worker retired without functional limitations from the accepted lymphoma, and the bladder cancer was deemed non-compensable.

The worker, an educational assistant, was head-butted by a special needs student, sustaining a concussion and psychological injuries.

The worker appealed the Case Manager's decisions denying entitlement for post-traumatic stress disorder (PTSD) and post-traumatic vision syndrome.

The Appeals Resolution Officer allowed the appeal in part, granting entitlement for PTSD based on the WSIB Mental Health Specialty Clinic's assessment, finding the accident was objectively traumatic.

However, the claim for post-traumatic vision syndrome was denied, as multiple neurological assessments found no organic basis for a visual system impairment.

The worker, a firefighter, appealed a decision denying entitlement for left foot and ankle injuries.

The worker developed left foot pain after working four 11-hour shifts at a mass vaccination clinic, which required prolonged standing and walking on concrete floors in safety boots.

The Appeals Resolution Officer found that the work at the vaccination clinic represented a significant change in physical demands compared to regular firefighting duties.

The Officer concluded that the excessive prolonged walking caused a repetitive overload of the Achilles tendon, resulting in Achilles tendinosis.

The appeal was allowed in part, granting initial entitlement for the left Achilles tendon injury, and the matter was remitted to determine loss of earnings benefits.

The worker appealed the denial of initial entitlement for a left finger injury sustained while opening dirty boxes at work.

The Appeals Resolution Officer found that the worker suffered a disablement injury when a foreign object lodged under their fingernail, leading to an infection, osteomyelitis, and eventual amputation of the fingertip.

The delay in reporting was deemed reasonable given the initially minor nature of the injury.

The appeal was allowed, granting initial entitlement to the infection and secondary entitlement to the amputation and permanent impairment, with loss of earnings benefits referred back for further investigation.

The worker, a frame assembler for a window and door manufacturer, appealed the denial of initial entitlement for bilateral carpal tunnel syndrome (CTS).

The worker claimed the condition developed gradually over five to six years due to repetitive and forceful use of clamps and vibratory tools.

The employer argued the job duties were routine and did not involve awkward postures.

The Appeals Resolution Officer found the worker's testimony credible and detailed, concluding that the repetitive and forceful hand movements required to assemble windows were a significant contributing factor to the development of CTS.

The worker's objection was allowed and initial entitlement to bilateral CTS was granted.

The worker appealed a decision denying entitlement to WSIB benefits for a mental health injury allegedly caused by occupational chemical exposures.

The worker experienced a mental breakdown and was diagnosed with a 'chemical concussion' by a naturopathic doctor.

The Appeals Resolution Officer denied the appeal, finding that 'chemical concussion' is not a recognized medical diagnosis and that the worker's confirmed diagnoses of Adjustment Disorder and Generalized Anxiety Disorder were not compatible with chemical workplace exposures.

The decision relied heavily on the opinion of a WSIB Occupational Medical Consultant who found no toxicological link between the exposures and the worker's mental health conditions.

The worker objected to the recalculation of their long-term loss of earnings (LOE) benefit rate following a workplace injury.

The worker argued that the recalculation was unfair because it did not adequately consider overtime earnings and caused financial hardship.

The Appeals Resolution Officer found that the recalculation correctly applied WSIB policy regarding long-term average earnings for workers in permanent employment, and that there are no exceptions permitting adjustments based on compassionate grounds or financial need.

The worker's objection was denied.

The worker objected to a Case Manager's decision denying loss of earnings (LOE) benefits after July 7, 2023.

The worker had sustained soft tissue injuries and was offered a graduated return to work plan with sedentary administrative duties.

After working for one hour, the worker left claiming pain and did not return.

The Appeals Resolution Officer found that the medical evidence did not support total disability and that the offered work was suitable and within the worker's functional abilities.

The objection was denied as the worker failed to fully participate in the return to work process.

The worker objected to a decision denying initial entitlement for a slip and fall injury that occurred in a parking lot prior to the start of their shift.

The worker argued they were employed by the City, which owned the parking lot.

The Appeals Resolution Officer determined that the worker's employer was the Police Services Board (the employer of record), not the City, despite sharing a WSIB firm number.

Furthermore, the worker was not in the course of employment at the time of the injury because they had not yet entered the employer's premises, and the employer did not own or control the parking lot.

The worker's objection was denied.

The worker, a corrections officer, appealed the denial of presumptive entitlement to PTSD and Chronic Mental Stress (CMS).

The worker alleged that a lack of workplace support and a supervisor's aggressive behaviour during a meeting triggered their PTSD symptoms.

The Appeals Resolution Officer found that the worker's PTSD was a pre-existing condition and that employment was not a significant contributing factor.

Furthermore, the officer concluded that the workplace events did not constitute a substantial work-related stressor or egregious behaviour, but rather fell under typical interpersonal conflict and management's employment functions.

The appeal was dismissed.

The worker objected to a decision granting a 10% non-economic loss (NEL) permanent impairment rating for sleep apnea resulting from a workplace injury.

The worker sought an increase to 20%, arguing that severe sleep apnea significantly impacted their daily functioning and cognitive abilities.

The Appeals Resolution Officer denied the objection, finding that the worker's limitations were already captured in their psychological impairment rating and there was no clinical evidence requiring supervision for activities of daily living, as required for a 20% rating under the AMA Guides.

The employer objected to a Case Manager's decision allowing the worker entitlement for a low back sprain/strain as a secondary condition to a compensable right shoulder injury.

The worker developed low back pain while performing modified duties that required increased twisting and turning to accommodate the shoulder injury.

The Appeals Resolution Officer found a causal link between the altered movements and the low back strain, concluding that secondary entitlement remained in order.

The employer's objection was denied.

The employer objected to the WSIB's decision classifying its operations under NAICS Code 237210 (Land subdivision), arguing it should be classified under engineering or architectural services due to its purely administrative and consulting nature.

The Appeals Resolution Officer found that the employer's primary business activity was real estate development, which includes acquiring and developing land for subsequent sale or construction.

Because the employer had an aggregated payroll and was considered a small employer, it was correctly classified according to the activity accounting for the largest share of its insurable earnings.

The objection was denied and the classification was upheld.

The employer appealed a $250 fine levied by the Eligibility Adjudicator for late reporting of a workplace accident.

The worker suffered an eye injury and sought medical treatment on the day of the injury, triggering the employer's reporting obligation.

The employer submitted the Form 7 over seven business days later.

The Appeals Resolution Officer denied the employer's objection, finding that administrative delays do not excuse late reporting under WSIB policy, and upheld the $250 fine.