Ontario Workplace Safety and Insurance Board

The worker objected to a decision denying initial entitlement to benefits for a low back injury allegedly sustained while changing a snowplow blade.

The Appeals Resolution Officer found that while an incident occurred at work, there was no clinical evidence demonstrating a new injury or an aggravation of the worker's pre-existing spinal pathology.

The appeal was denied.

The worker, a truck driver injured in a 2012 motor vehicle accident, appealed the WSIB's decisions regarding their suitable occupation (SO) and the adjustment of their loss of earnings (LOE) benefits.

The worker argued they were totally disabled and unable to work in any capacity.

The Appeals Resolution Officer found that medical evidence, including a multidisciplinary assessment, did not support total disability and that the worker was fit to work full-time as an Administrative Assistant.

The WSIB's decision to lock in partial LOE benefits based on the starting wage of the SO was upheld, and the worker's objection was denied.

The employer objected to a decision granting the worker initial entitlement for a left shoulder dislocation and loss of earnings (LOE) benefits.

The worker tripped and fell at work, initially receiving a diagnosis of a shoulder sprain.

A week later, the worker woke up in severe pain and was diagnosed with a shoulder dislocation.

The employer argued the dislocation occurred at home and was not work-related.

The Appeals Resolution Officer found it more likely than not that the dislocation occurred during the workplace fall but self-corrected before the initial medical assessment, leaving the shoulder vulnerable.

The ARO denied the employer's objection, confirming entitlement to healthcare and LOE benefits.

The employer, a municipality, objected to a decision finding it associated with three affiliated municipal service corporations for the purposes of classification and premium rate setting under the rate framework.

The Appeals Resolution Officer found that while the employers did not meet the test of cooperation through primarily ancillary operations, they did meet the test through integrated operations, as they shared a substantial amount of staff, equipment, and processes to carry out their business activities.

The objection was denied, and the effective date of the association was confirmed as January 1, 2020.

The worker, a counsellor at a long-term care home, appealed the denial of initial entitlement for COVID-19.

The worker claimed they contracted the virus at work during an outbreak in April 2020, despite testing negative on two PCR tests.

The Appeals Resolution Officer found that while the worker's employment created an elevated risk of exposure, there was no medical evidence confirming a COVID-19 diagnosis.

The worker's symptoms and negative tests did not satisfy the adjudicative criteria for a confirmed condition.

The appeal was dismissed.

The worker objected to decisions finding that their work-related right shoulder sprain/strain had fully resolved with no permanent impairment, and denying entitlement to a recurrence.

The Appeals Resolution Officer reviewed the medical evidence and found that the worker had reached maximum medical recovery by January 10, 2020, with no restrictions and a significant gap in subsequent medical treatment.

The Officer also found that the worker's ongoing shoulder pain lacked a formal diagnosis establishing clinical compatibility with the original injury, and that a subsequent deterioration was the result of a new workplace incident.

The worker's objections were denied.

The worker, a Trackman Journeyman, suffered a work-related left knee injury and returned to modified duties.

The employer subsequently laid off the worker due to a shortage of work, which constituted a permanent work disruption.

The Case Manager initially denied Loss of Earnings (LOE) benefits following the layoff.

On appeal, the Appeals Resolution Officer found that the worker's ongoing knee impairment and need for active treatment precluded them from performing their pre-injury duties or securing alternative employment.

The worker's objection was allowed, granting full LOE benefits from the date of the layoff.

The worker appealed a Case Manager's decision limiting entitlement to a right shoulder contusion following a workplace slip and fall.

The worker argued the accident exacerbated a pre-existing condition, leading to two shoulder surgeries.

The Appeals Resolution Officer reviewed the medical evidence, noting the worker had a significant pre-existing condition from prior non-work-related accidents and had already been recommended for surgery before the workplace incident.

Finding no evidence that the workplace accident caused a deterioration of the pre-existing condition, the Officer concluded the surgeries were not work-related.

The appeal was dismissed.

The worker objected to the Case Manager's decision determining their Suitable Occupation (SO) as Other Services Support Occupations following a bilateral wrist injury.

The worker argued they were competitively unemployable due to lack of transferrable skills, experience, and a language barrier.

The Appeals Resolution Officer confirmed the SO, finding it was within the worker's physical restrictions, education level, and basic English language skills, and that prior decisions had already established the worker was capable of performing suitable work without training.

The worker, an Educational Assistant, appealed the denial of entitlement to Traumatic Mental Stress and Chronic Mental Stress for events occurring prior to September 2018.

The worker alleged workplace harassment and bullying by co-workers, which they claimed caused a mental stress injury.

The Appeals Resolution Officer found that the alleged incidents of harassment were not confirmed by co-workers or the employer, and appeared to be interpersonal conflicts rather than substantial work-related stressors.

The medical evidence also suggested the worker's stress was related to personal life events.

The appeal was denied, as the criteria for both Traumatic and Chronic Mental Stress were not met.

The worker appealed a Case Manager's decisions denying initial entitlement to various physical and psychological conditions, denying ongoing loss of earnings benefits, and denying entitlement for a mental stress injury following a slip and fall on a wet escalator at work.

The Appeals Resolution Officer found that the worker's additional claimed physical conditions were either pre-existing or not compatible with the mechanism of injury.

The Officer also determined that the worker had reached maximum medical recovery for their accepted contusions with no ongoing work-related impairment.

Finally, the Officer concluded that the worker was not entitled to benefits for a mental stress injury, as the incident was not objectively traumatic and the worker's psychological condition pre-dated the workplace accident.

The worker's objection was denied.

The worker appealed a Case Manager's decision denying a Permanent Disability (PD) reassessment for a lower back injury sustained in 1978.

The worker had previously been awarded a 25% PD.

Following a 2021 surgery to excise a work-related hematoma, the worker argued their condition had significantly deteriorated, citing post-surgical complications and decreased functional abilities.

The Appeals Resolution Officer denied the appeal, finding that medical reporting indicated the surgical site had healed well and that ongoing back pain was related to underlying arthritic changes rather than a permanent deterioration of the accepted work-related condition.

The employer objected to a Case Manager's decision to apply a re-employment penalty for breaching its re-employment obligation.

The worker had suffered a right arm injury and returned to modified duties before being laid off due to the pandemic, and subsequently terminated without cause.

The employer argued the termination was due to performance issues and lack of skills, not the workplace injury.

The Appeals Resolution Officer found insufficient contemporaneous evidence to support the employer's claim of pre-existing performance issues.

The termination was deemed a breach of the re-employment obligation, and the penalty was upheld.

The worker objected to a Return-to-Work Specialist's decision authorizing the suitable occupation of Customer Service and an associated Work Transition plan.

The worker argued they lacked the transferrable skills and education for the role and requested full loss of earnings benefits to age 65.

The Appeals Resolution Officer found that the worker's extensive experience as a business owner provided relevant customer service skills, and that the physical demands of the role were within the worker's permanent restrictions.

The suitable occupation and Work Transition plan were confirmed, and the worker's objection was denied.

The worker, a garden centre manager, claimed initial entitlement for a right eye retinal detachment after a bag of mulch tore and soil fell into their eye.

The worker later amended the accident history to claim the 40-pound bag also struck their face.

The Appeals Resolution Officer rejected the revised history as inconsistent with contemporaneous reporting.

Relying on a medical consultant's opinion that soil entering the eye is not a compatible mechanism for retinal detachment, the ARO found the injury was not work-related.

The appeal was denied.

The worker, a food services cashier, appealed a Case Manager's decision denying entitlement to benefits for a psychological condition following a workplace altercation.

The worker was verbally threatened and physically assaulted by a customer who threw a cup of pop in their face, prompting the worker to strike back in self-defense.

The Appeals Resolution Officer found that the worker did not provoke the fight and was acting in the course of employment.

The appeal was allowed, granting the worker entitlement to benefits for Post-Traumatic Stress Disorder (PTSD) under the Traumatic Mental Stress policy.

The worker, a personal support worker, experienced a severe muscular inflammatory response after receiving a mandatory work-related Covid-19 booster vaccination.

The initial adjudicator denied entitlement based on a medical consultant's opinion that the reaction was normal.

On appeal, the Appeals Resolution Officer allowed the objection, finding that under operational policy 15-04-10, the determination of an 'adverse reaction' is an adjudicative question.

Given the worker's need for emergency medical attention and temporary inability to work, the reaction was deemed adverse, and initial entitlement was granted.

The worker's Estate appealed a decision denying entitlement to Survivor benefits.

The worker had a combined 100% permanent disability benefit across two separate claims for workplace injuries sustained in 1970 and 1977.

The worker passed away in 2019 from causes unrelated to the compensable injuries.

The Estate argued for entitlement based on a prior WSIAT decision.

The Appeals Resolution Officer denied the appeal, finding that under the applicable Operational Policy Manual policy (20-03-16), a survivor is only entitled to benefits if the worker had a 100% permanent disability benefit in a single claim.

The employer appealed a Case Manager's decision denying Second Injury and Enhancement Fund (SIEF) cost relief following a worker's electrocution-type injury.

The worker developed complex regional pain syndrome (CRPS) after the incident.

The employer argued the accident was minor and that the worker's pre-existing Raynaud's disease and tendinosis prolonged recovery.

The Appeals Resolution Officer found the accident was of moderate severity and that the pre-existing conditions did not cause the accident or prolong the worker's recovery.

The employer's objection was denied.

The worker appealed a Case Manager's decision denying loss of earnings (LOE) benefits following his termination from the accident employer.

The worker had sustained a compensable right wrist injury and was performing modified duties at the time of his termination.

The employer terminated the worker citing multiple motor vehicle accidents and safety violations.

The Appeals Resolution Officer found that the termination was for cause and unrelated to the workplace injury, constituting an intervening event that broke the chain of causation.

The appeal was denied.