Ontario Workplace Safety and Insurance Board

The worker suffered a compensable psychological injury after speaking with a suicidal caller.

The case manager determined that the worker had achieved maximum medical recovery by September 2020 with no permanent impairment.

The worker objected, arguing they still required accommodations and suffered from ongoing impairment.

The Appeals Resolution Officer allowed the appeal, finding that the treating psychologist's reports indicated the worker remained at risk for relapses, had ongoing functional impairments, and required further support.

The matter was remitted to the operating area to determine if maximum medical recovery had yet been achieved.

The worker, a nurse, appealed a Case Manager's decision denying entitlement to benefits for a mental stress injury.

The worker attributed their psychological condition to cumulative traumatic events experienced during their employment, including witnessing a patient stab themselves and dealing with fatal drug overdoses.

The Appeals Resolution Officer found that while the worker did not meet the criteria for the statutory PTSD presumption due to conflicting diagnoses, the worker was entitled to benefits under the Traumatic Mental Stress policy.

The reported incidents were clearly identifiable, objectively traumatic, arose out of the course of employment, and significantly contributed to the worker's diagnosed trauma and stressor-related disorder.

The appeal was allowed.

The worker suffered a compensable lower back injury and was prescribed muscle relaxants that caused dizziness.

The employer refused to allow the worker to return to modified duties while experiencing these side effects.

The Case Manager denied loss of earnings (LOE) benefits from October 27, 2021, arguing the medication was not in accordance with a specialty program's recommendations.

The Appeals Resolution Officer allowed the worker's objection, finding the dizziness was a compensable side effect of treatment for the work-related injury and that no modified work was available.

LOE benefits were granted from October 27, 2021, to November 17, 2021, when the side effects resolved.

The worker appealed a Case Manager's decision denying entitlement to benefits for chronic mental stress (CMS) following the implementation of the employer's COVID-19 vaccination policy.

The worker alleged harassment and discrimination by the employer after declining to be vaccinated.

The Appeals Resolution Officer denied the appeal, finding no medical evidence of a DSM diagnosis and concluding that the employer's actions were part of the normal employment function rather than a substantial work-related stressor or workplace harassment.

The worker appealed a Case Manager's decision denying loss of earnings (LOE) benefits from July 19, 2020 onward.

The worker had an accepted low back injury but stopped working in July 2020.

The Appeals Resolution Officer found that the medical evidence demonstrated the worker's absence from work was due to non-compensable psychological issues, not the compensable low back injury.

The employer had been willing and able to accommodate the low back restrictions.

The appeal was dismissed.

The worker appealed a Case Manager's decision denying entitlement to psychotraumatic disability following a workplace accident where a forklift struck a table, causing a bar to hit the worker's right knee.

The worker claimed the accident and resulting pain caused depression and anxiety.

The Appeals Resolution Officer denied the appeal, finding the worker did not meet the criteria under the psychotraumatic disability policy.

The accident was minor, the psychological symptoms arose only after loss of earnings benefits were terminated, and the worker's ongoing psychological issues were primarily related to a pre-existing trauma and a non-compensable back condition.

The worker objected to a decision denying initial entitlement to benefits for injuries sustained when they were pushed to the ground by a lead hand during a dispute over work quality.

The initial decision found the worker was the aggressor because they threw their gloves on the ground.

The Appeals Resolution Officer allowed the objection, finding that throwing gloves to the ground in frustration was not an act of physical aggression that a reasonable person would interpret as a threat.

Therefore, the worker was not the aggressor, did not remove themselves from the course of employment, and is entitled to health care benefits for their injuries.

The worker appealed a case manager's decision finding that the suitable occupation of Sales and Account Representative was suitable and denying loss of earnings benefits following a permanent work disruption.

The Appeals Resolution Officer found that the suitable occupation was appropriate given the worker's extensive employment history and transferable skills.

However, the Officer determined that the worker was only capable of earning entry-level wages, rather than median-level wages, in that occupation.

The appeal was allowed in part, granting the worker entitlement to partial loss of earnings benefits based on entry-level wages at full-time hours.

The employer objected to an adjudicator's decisions finding that the worker met the six-month deadline to claim for benefits and granting initial entitlement for bilateral hand irritant contact dermatitis.

The Appeals Resolution Officer denied the employer's objection.

The Officer found that for a disablement claim, the six-month time limit begins when the worker learns the condition is work-related, which occurred in March 2019, making the May 2019 claim timely.

Furthermore, relying on specialist medical opinions, the Officer concluded that the worker's occupational exposures to grease, oil, and rosewater significantly contributed to the development of the dermatitis.

The worker, a roofer, suffered a heart attack at work and claimed it was caused by unusual physical exertion and acute emotional stress from dealing with inexperienced trainees.

The WSIB denied initial entitlement.

The Appeals Resolution Officer upheld the denial, finding that the worker's physical exertion and emotional reaction were consistent with their usual job duties and did not constitute unusual physical exertion or acute emotional stress under WSIB policy.

The worker also had pre-existing risk factors for heart disease.

The heart condition was found not to have arisen out of employment.

The worker suffered a concussion and other injuries after a workplace fall and was granted full loss of earnings benefits.

They subsequently developed explosive diarrhea and vomiting, which prevented them from attending a neurology treatment program.

The worker sought secondary entitlement for irritable bowel syndrome with diarrhea (IBS-D) and full loss of earnings benefits for the period they could not attend treatment.

The Appeals Resolution Officer found that the post-concussion syndrome and resulting use of Cymbalta were significant contributing factors to the onset of IBS-D, granting secondary entitlement and the requested loss of earnings benefits.

The worker appealed the WSIB Case Manager's decisions denying entitlement for secondary organic conditions and a psychotraumatic disability, and reducing their benefits to partial loss of earnings (LOE).

The worker suffered a compensable right ankle fracture and claimed that compensating for the injury caused widespread secondary pain and psychological distress.

The Appeals Resolution Officer denied the appeal, finding no clear organic diagnoses to support the secondary conditions and insufficient evidence of a psychotraumatic diagnosis.

The reduction to partial LOE benefits was upheld, as the identified suitable occupation of Administrative Clerk was consistent with the worker's permanent restrictions and transferable skills.

The worker appealed decisions denying secondary entitlement for left ear, neck, and right shoulder conditions, denying an increase in the dose and THC concentration of medical cannabis, and denying an increase in the frequency of maintenance massage therapy.

The Appeals Resolution Officer found no causal relationship between the accepted workplace injuries and the left ear, neck, or right shoulder conditions.

The requested increase in medical cannabis exceeded the maximum allowable dose under WSIB policy, and the worker's condition was not palliative.

Finally, the approved twice-monthly massage therapy was deemed necessary, appropriate, and sufficient.

The worker's appeals were dismissed.

The worker appealed several decisions of the Case Manager and Nurse Consultant regarding their workplace injury claim.

The worker sought secondary entitlement for a left ear condition allegedly caused by acupuncture, and for neck and right shoulder conditions.

The worker also requested an increase in their medical cannabis dose and THC concentration, as well as an increase in the frequency of maintenance massage therapy to weekly sessions.

The Appeals Resolution Officer dismissed the appeals, finding no causal relationship between the accepted workplace injuries and the left ear, neck, or right shoulder conditions.

The requested increase in medical cannabis exceeded policy limits and the worker's condition was not palliative.

Finally, the approved twice-monthly massage therapy was deemed necessary, appropriate, and sufficient.

The worker appealed a Case Manager's decision reducing their loss of earnings (LOE) benefits from full to partial as of April 1, 2022.

The worker had sustained a right knee injury requiring surgery and subsequently developed a psychotraumatic disability.

The Appeals Resolution Officer found that although the worker was not totally disabled, they had made reasonable efforts to secure suitable employment and engaged in health care measures aimed at improving their employability.

As suitable work was not available from the employer, the worker met the criteria for full LOE benefits.

The appeal was allowed, granting full LOE benefits from April 1, 2022 to March 10, 2023.

The worker, a mechanic, was injured when a seal exploded and struck them in the chest and left shoulder.

The WSIB allowed entitlement for the left shoulder but denied entitlement for a claimed neck injury.

The worker appealed, arguing the neck injury was a whiplash-type injury with delayed onset of pain.

The Appeals Resolution Officer dismissed the appeal, finding no evidence of a neck injury being reported until six weeks after the accident, and concluding that the mechanism of injury was not compatible with the claimed neck condition.

The worker, an Educational Assistant, suffered physical injuries after being assaulted by a student.

She later sought entitlement for psychotraumatic disability, alleging her psychological symptoms were an indirect result of the workplace injury.

The Appeals Resolution Officer denied the appeal, finding that the worker's psychological deterioration was primarily triggered by a non-compensable event—specifically, learning she had been subjected to video surveillance and subsequently having her benefits terminated for misrepresenting her level of impairment.

The criteria for psychotraumatic disability under operational policy 15-04-02 were not met.

The worker, a child welfare support services worker, appealed a Case Manager's decision denying entitlement for Traumatic Mental Stress and Chronic Mental Stress.

The worker experienced multiple traumatic events during their employment, including being threatened with a knife by a youth in May 2021 and encountering another severely unwell youth in May 2022.

The Appeals Resolution Officer found that the May 2021 incident was objectively traumatic and significantly contributed to the worker's diagnosed PTSD.

The appeal was allowed for Traumatic Mental Stress, with the date of injury established as June 3, 2022, when the worker first sought medical attention.

The employer appealed a decision granting the worker partial loss of earnings (LOE) benefits.

The worker sustained a lower back injury and returned to modified work.

Prior to the injury, the worker regularly worked voluntary overtime, which was included in their short-term average earnings.

The employer's policy did not allow overtime for employees on modified work, resulting in a wage loss for the worker.

The Appeals Resolution Officer found that under WSIB policy, the worker's pre-injury overtime was correctly included in their earnings profile, and the inability to work overtime while on modified work constituted a compensable wage loss.

The employer's appeal was denied.

The worker, a personal support worker, appealed two Case Manager decisions regarding their workplace injury claim: the denial of full loss of earnings (LOE) benefits beyond November 2, 2020, and the determination that they had reached maximum psychological recovery (MPR) without a permanent impairment.

The Appeals Resolution Officer found that the worker was capable of participating in a graduated return to work plan and was therefore entitled to partial LOE benefits for a limited period, but not full LOE benefits.

Regarding the psychological claim, the Officer found that the worker had not reached MPR, as their condition was still improving with treatment and a recommended psychiatric assessment had not occurred.

The worker's appeal was allowed in part.