Ontario Workplace Safety and Insurance Board

The worker appealed a Case Manager's decision denying entitlement to benefits for Chronic Mental Stress (CMS) related to workplace harassment.

The worker, a heavy equipment operator, alleged a toxic work environment involving racist, sexist, and homophobic comments, as well as targeted bullying by a supervisor and co-workers.

An independent employer investigation substantiated numerous incidents of harassment and discrimination.

The Appeals Resolution Officer found that the substantiated incidents collectively amounted to workplace harassment and conduct that a reasonable person would perceive as egregious or abusive.

The appeal was allowed, and the worker was granted entitlement to CMS benefits.

The worker, a sales development representative, suffered facial scarring and psychological impairments (PTSD and Major Depressive Disorder) after being bitten by a dog at work.

They returned to modified duties but were permanently laid off in February 2020.

The Case Manager denied ongoing loss of earnings (LOE) benefits, concluding the wage loss was due to the lay-off rather than the injury.

On appeal, the Appeals Resolution Officer found that the worker remained partially impaired from a psychological perspective at the time of the lay-off, which affected their ability to fully restore their pre-injury earnings.

The worker's objection was allowed in part, granting ongoing partial LOE benefits from the date of the lay-off until they secured new employment in November 2020.

The worker appealed a decision denying entitlement for colon cancer, alleging it resulted from occupational exposures to chemicals and asbestos while employed in the rubber industry from 1954 to 1989.

The Appeals Resolution Officer reviewed medical and occupational hygiene evidence, including opinions from Occupational Medical Consultants and OHCOW.

The ARO found that the epidemiological evidence did not establish a significant association between rubber industry work and colon cancer.

The appeal was dismissed, as it was not shown that the worker's occupational exposures significantly contributed to the development of the disease.

The worker, a prep cook for over 18 years, appealed the denial of initial entitlement for a left shoulder injury.

The worker claimed the injury, diagnosed as rotator cuff tendinitis, subacromial bursitis, and biceps tenosynovitis, was a gradual onset disablement caused by heavy and repetitive work duties.

The Appeals Resolution Officer reviewed the worker's extensive daily tasks, which involved significant over-shoulder reaching and lifting.

Finding the medical evidence and job duties compatible with the injury, the Officer allowed the appeal and granted entitlement to benefits, including surgery and associated loss of earnings.

The employer appealed a Case Manager's decision denying cost relief under the Second Injury and Enhancement Fund (SIEF) following a worker's left foot and ankle injury sustained while transferring a patient.

The employer argued that the worker's pre-existing hypothyroidism caused or contributed to their neuropathic pain and prolonged recovery.

The Appeals Resolution Officer found the accident was of minor severity but concluded there was no medical evidence that the pre-existing condition enhanced the injury or prolonged recovery.

The appeal was denied and SIEF cost relief was not granted.

The worker objected to a Case Manager's decision discontinuing his loss of earnings (LOE) benefits after he left the country, which was deemed a material change in circumstances.

The worker, who was receiving full LOE benefits for a psychotraumatic disability, argued he attempted to notify the WSIB before leaving to visit family.

The Appeals Resolution Officer found that while the worker failed to properly report the material change, there was no evidence of willful concealment.

Because the worker was totally disabled and not participating in active treatment or return-to-work activities at the time of departure, the Officer allowed the objection in part, granting the worker three weeks of LOE benefits under the WSIB's vacation policy.

The worker appealed the denial of benefits related to a 1999 fall at home, the denial of section 147(4) supplementary benefits, and the denial of a permanent disability reassessment.

The worker had an accepted 1989 claim for an aggravation of pre-existing fibromyalgia.

The Appeals Resolution Officer found that the 1999 fall was not caused by the compensable injury, as the worker's condition had been stable and they had been working full-time prior to the fall.

The request for supplementary benefits was denied because the worker's earning capacity had significantly increased after completing a return-to-work program.

The request for a permanent disability reassessment was also denied, as any worsening of the worker's condition was attributable to the non-work-related second accident.

The appeal was dismissed.

The employer appealed an Eligibility Adjudicator's decision granting the worker initial entitlement for Welder's Flash and one day of loss of earnings (LOE) benefits.

The employer argued the worker reported the incident late, preventing the employer from offering modified duties to mitigate lost time.

The Appeals Resolution Officer found the reporting was prompt, as the worker reported the incident and sought medical attention the day after the injury.

The diagnosis was compatible with the accident history, and the worker had clinical authorization to be off work for the missed shift.

The employer's appeal was denied.

The worker, an electrician, suffered a fatal cardiac arrest shortly after arriving at a job site during an extreme cold weather alert.

The worker's estate sought initial entitlement, arguing the cardiac event was caused by work duties and the extreme cold, and relied on the statutory presumption under s. 13(2) of the WSIA.

The Appeals Resolution Officer denied the appeal, finding no evidence of unusual physical exertion or acute emotional stress.

The medical evidence indicated the worker had significant pre-existing coronary artery disease and had been experiencing symptoms prior to the incident.

The Officer concluded the heart condition did not arise out of employment.

The worker, who suffered a compensable low back injury resulting in a 61% combined Non-Economic Loss benefit, appealed decisions denying entitlement to hydrotherapy, a stationary modular home, and a hydropool.

The Appeals Resolution Officer denied the appeal, finding no objective medical evidence that hydrotherapy would provide more than transient relief or achieve the goals of maintenance treatment.

Furthermore, the requested stationary modular home and hydropool did not meet the criteria for specialized hobby equipment under the Independent Living Devices policy.

The worker appealed an adjudicator's decision denying initial entitlement for a vertebral artery dissection leading to a stroke, which the worker alleged was caused by bumping their head and neck while repairing a radiator in a tight workspace.

The Appeals Resolution Officer found that while the worker likely experienced minor bumps, the medical evidence and the delay in symptom onset did not support that the workplace activities were a significant contributing factor to the dissection.

Given the worker's significant pre-existing risk factors for stroke, the appeal was dismissed.

The worker suffered a compensable left knee injury and was assigned self-accommodated duties that exceeded their functional abilities.

After undergoing surgery, the worker attempted a work trial with a new employer but was unsuccessful.

The WSIB Case Manager terminated the worker's loss of earnings (LOE) benefits on the basis that the worker had resigned from their pre-injury employment.

The Appeals Resolution Officer found that the worker had not resigned, either verbally or in writing, and that the employment relationship remained intact.

The worker's attempt to mitigate their wage loss by seeking alternative employment did not sever the relationship or disentitle them to benefits.

The worker's objection was allowed, and LOE benefits and return-to-work services were reinstated.

The worker appealed a Case Manager's decision terminating re-employment payments effective June 13, 2022, the date the worker secured alternate employment after being terminated by the accident employer.

The Appeals Resolution Officer found that securing alternate employment to mitigate wage loss did not sever the employment relationship.

However, the worker explicitly stated on August 8, 2022, that they did not intend to return to the accident employer, which severed the relationship.

The appeal was allowed in part, granting re-employment payments less actual earnings from June 13 to August 8, 2022.

The employer objected to a Case Manager's decision denying entitlement to cost relief under the Second Injury and Enhancement Fund (SIEF) following a worker's trip and fall injury.

The employer argued that the worker's pre-existing conditions, including diabetes and lumbar degeneration, prolonged recovery.

The Appeals Resolution Officer found the accident severity was moderate and that the pre-existing conditions did not cause the accident or prolong the recovery period within the meaning of the policy.

The employer's objection was denied.

The worker suffered a compensable left ankle fracture in 1989 and received a 9% permanent disability pension.

Over 30 years later, the worker's wage rate was reduced following a corporate reconfiguration.

The worker sought a section 147(4) supplement, arguing the wage reduction was due to their compensable injury and restrictions.

The Appeals Resolution Officer denied the appeal, finding no evidence connecting the temporary reduction in earnings to the 1989 ankle injury, as the job change was based on seniority during a corporate reconfiguration affecting multiple employees.

The worker objected to a decision rating their asbestosis permanent impairment at the 15% non-economic loss (NEL) award level.

The worker argued that the predicted baseline value for their diffusing capacity for carbon monoxide (DCO) should be based on the AMA Guides' table for a 74-year-old, as the table does not provide values for individuals over 74, which would result in a 25% impairment rating.

The Appeals Resolution Officer found that the 15% rating was correct, as the respirologist had established a specific predicted DCO value for the 84-year-old worker, and the AMA Guides permit the use of accepted and verified equations outside the scope of the tables.

The worker's objection was denied.

The worker appealed a Case Manager's decision determining they had achieved maximum medical recovery (MMR) for a compensable left elbow injury (lateral epicondylitis) without an ongoing impairment.

The Appeals Resolution Officer reviewed the medical evidence, including reports from orthopaedic surgeons, and found no objective findings to support an ongoing functional abnormality or loss.

The worker's subjective symptoms were not correlated with objective deficits.

The appeal was dismissed, confirming the worker achieved MMR without an ongoing impairment as of April 22, 2021.

The worker objected to a Claims Adjudicator's decision finding that the employer had offered suitable permanently modified duties following a compensable left shoulder injury.

The worker argued that the Environmental Assistant position offered was not suitable because he lacked the necessary computer skills and training.

The Appeals Resolution Officer found that the position was physically suitable and within the worker's permanent restrictions.

Furthermore, the evidence demonstrated that the worker had the cognitive aptitude for the role and received adequate on-the-job training.

The worker's objection was denied.

The worker appealed a case manager's decision to temporarily suspend their loss of earnings (LOE) benefits.

The case manager had suspended the benefits on the basis that the worker was unable to participate in psychological treatment for their compensable PTSD due to a non-compensable concussion.

The Appeals Resolution Officer allowed the appeal, finding that the worker's concussion only prevented treatment for a brief period, and that the WSIB failed to provide the required notice of non-co-operation before suspending benefits.

The worker was entitled to full LOE for the suspended period.

The employer objected to a Case Manager's decision granting a police officer initial entitlement to post-traumatic stress disorder (PTSD) and loss of earnings (LOE) benefits.

The worker had been exposed to multiple traumatic events during their employment.

The Appeals Resolution Officer found that the worker met the criteria for the first responder PTSD presumption under Policy 15-03-13.

The employer failed to rebut the presumption, as the evidence showed the worker's employment as a police officer significantly contributed to the PTSD diagnosis.

The worker was also found entitled to full LOE benefits because the psychological injury prevented a return to any type of work.

The employer's objection was denied.