Ontario Workplace Safety and Insurance Board

The worker, a car salesman, suffered a stroke (intracranial hemorrhage) at work after experiencing unexpected and unaccustomed stress when two finalized vehicle sales were cancelled on the same day and a customer confronted them at their workstation.

The WSIB initially denied entitlement, finding the workplace exposures were not a significant contributing factor.

On appeal, the Appeals Resolution Officer found that the extraordinary workplace stress precipitated a hypertensive crisis, which led to the stroke.

The worker's objection was allowed, and initial entitlement to benefits was granted.

The worker, a Millwright who suffered severe left arm and hand injuries in a workplace accident, appealed a Return-to-Work Specialist's decision denying the occupation of Pilot as a suitable occupation (SO).

The Appeals Resolution Officer dismissed the appeal, finding that while the occupation was consistent with the worker's transferable skills and interests, it was not safe or consistent with their permanent functional restrictions, which included limited gripping, no ladder climbing, and lifting restrictions.

Furthermore, the entry-level wages for a Pilot would not restore the worker's pre-injury earnings, and the availability of the position was limited.

The worker appealed the denial of initial entitlement for non-ischemic dilated cardiomyopathy (NIDC), which he alleged was caused by myocarditis arising from an occupationally compulsory COVID-19 vaccination.

The Appeals Resolution Officer reviewed conflicting medical opinions, including those from treating cardiologists, a general practitioner, and an occupational medicine consultant.

The Officer found that while there was a temporal relationship between the vaccination and the onset of symptoms, the objective medical evidence did not confirm a diagnosis of myocarditis according to CDC criteria.

As the diagnosis of myocarditis was not objectively confirmed, the appeal was dismissed and initial entitlement was denied.

The worker appealed a Case Manager's decision that determined they were partially impaired, capable of working as a telephone solicitor, and entitled only to partial loss of earnings (LOE) benefits.

The Appeals Resolution Officer found that the occupation of telephone solicitor was not suitable given the worker's age, lack of transferable skills, need for extensive training, and the limited employment outlook for the position.

The Officer concluded the worker was unemployable due to their compensable injuries and awarded full LOE benefits effective January 31, 2025, locked in to age 65.

The worker, a painter, suffered a lower back injury at work and was denied loss of earnings benefits by a Case Manager who determined that modified duties offered by the employer were suitable.

The worker objected, arguing that medical evidence supported total disability.

The Appeals Resolution Officer allowed the objection, finding that unrebutted medical opinions from the worker's family doctor and physiotherapist confirmed the worker was completely prevented from returning to any type of work.

The worker was granted full loss of earnings benefits for the period in question.

The worker appealed an Adjudicator's decision denying initial entitlement to WSIB benefits for an allergic reaction allegedly caused by exposure to nitrile gloves at work.

The Appeals Resolution Officer reviewed the medical evidence, placing significant weight on the opinion of an occupational allergist who concluded the worker's symptoms were not compatible with a typical allergic reaction to gloves.

The Appeals Resolution Officer found no evidence that workplace exposure significantly contributed to the worker's symptoms and denied the appeal.

The employer objected to a case manager's decision allowing the worker loss of earnings benefits during a temporary work disruption caused by a plant re-tooling.

The worker had previously been performing suitable work at no wage loss following a compensable bilateral knee injury.

The Appeals Resolution Officer found that the worker met the criteria under WSIB Operational Policy 15-06-02, as their work history demonstrated they would normally seek new employment during a layoff, and their significant medical restrictions impacted their ability to earn income through new employment.

The employer's objection was denied and the benefits were maintained.

The worker appealed decisions regarding their maximum medical recovery (MMR) date, the 35% non-economic loss (NEL) quantum for their chronic pain disability (CPD), and the denial of loss of earnings (LOE) benefits from January 7, 2016.

The Appeals Resolution Officer upheld the MMR date of January 7, 2016, and confirmed the 35% NEL rating accurately reflected the worker's moderate impairment.

However, the Officer found that while the modified duties offered were suitable, the worker's CPD and ongoing pain rendered them capable of only part-time work (20 hours per week).

Consequently, the worker was granted partial LOE benefits retroactive to May 4, 2015.

The worker appealed a decision denying an extension of time to file a claim for a mental stress injury allegedly arising from a work incident in March 2001.

The worker filed the claim 23 years later, in January 2024, alleging paranoia caused by workplace video monitoring.

The Appeals Resolution Officer denied the appeal, finding that the 23-year delay prejudiced the employer and rendered the evidence too stale to adjudicate the claim on its merits.

Furthermore, the contemporaneous medical evidence did not support a work-related cause for the worker's hospitalization, and no exceptional circumstances justified the delay.

The worker's estate appealed a decision determining the quantum of the worker's Non-Economic Loss (NEL) benefit for mixed dementia, Alzheimer's disease, and vascular type dementia at 45%.

The worker had been exposed to McIntyre Powder and suffered multiple head injuries during their employment as an underground miner.

The central issue was whether the worker's impairment required 'some supervision and/or direction' (warranting a 20-45% rating) or 'directed care under confinement' (warranting a 50-90% rating) under the AMA Guides.

The Appeals Resolution Officer found that the extensive family and community support required to sustain the worker's independent living amounted to directed care.

The appeal was allowed, and the NEL benefit quantum was increased to 50%.

The worker appealed decisions determining they had reached maximum medical recovery (MMR) without a permanent impairment and denying entitlement for psychotraumatic and chronic pain disabilities following a workplace slip and fall.

The Appeals Resolution Officer found that while the worker reached MMR, they sustained a permanent exacerbation of a pre-existing degenerative low back condition.

Furthermore, the evidence supported that the worker's psychological conditions (MDD, GAD, and PTSD) were directly related to the workplace accident and extended disablement.

The appeal was allowed in part, granting entitlement for psychotraumatic disability and recognizing a permanent impairment.

The worker appealed a Case Manager decision regarding loss of earnings (LOE) benefits following a 2015 motor vehicle accident that resulted in permanent physical and psychotraumatic impairments.

The Appeals Resolution Officer found that the worker was completely unable to work due to the combined effects of his physical and psychological impairments, and that the identified suitable occupation of Cashier was not suitable.

The Officer upheld the decision to treat taxable dividends received in 2016 and 2017 as post-injury earnings, resulting in no LOE benefits for late 2016 and partial LOE benefits for 2017.

However, the worker was granted full LOE benefits from January 1, 2018 to the 72-month review date, and continuing to age 65.

The worker appealed a Nurse Consultant's decision denying entitlement for Botox injections.

The worker sustained a workplace injury in 2016, for which they received entitlement for a neck strain, cervicogenic headaches, and chronic pain disability.

The worker's representative argued Botox was prescribed to treat chronic migraines and persistent headaches related to the compensable condition.

The Appeals Resolution Officer denied the appeal, finding that the worker's ongoing headaches were not caused by the accepted physical conditions, and that chronic migraines were not an accepted compensable condition.

Furthermore, WSIB policy and Drug Advisory Committee recommendations did not support Botox for neck pain, myofascial pain, or headache disorders.

The worker appealed decisions denying ongoing entitlement for bilateral shoulder and lower back injuries stemming from two separate workplace accidents in 2008 and 2009.

The Appeals Resolution Officer found that the worker's degenerative changes and subsequent MRI findings were not causally related to the initial strain injuries.

The Officer upheld the determinations that maximum medical recovery was reached for all injuries by 2009 and 2010, with no permanent impairment.

The appeals were denied.

The worker appealed case manager decisions denying entitlement to a recurrence of a right leg injury, denying entitlement for a secondary left leg condition, and adjusting loss of earnings (LOE) benefits based on a determined capacity to earn minimum wage in a suitable occupation.

The Appeals Resolution Officer found no clinical evidence of a significant deterioration of the original injury or a causally linked secondary condition.

The LOE adjustment was confirmed as the worker had completed a return to work plan with training and was capable of earning entry-level wages in the suitable occupation.

The appeal was denied.

The worker appealed a Case Manager's decision that found them partially impaired, identified Customer and Information Service Representative as a suitable occupation (SO), and awarded partial loss of earnings (LOE) benefits.

The Appeals Resolution Officer found that while the worker was partially impaired and the SO was physically safe, the worker lacked the transferrable skills and cognitive abilities for the role.

Given the worker's age, lack of skills, and complex non-compensable medical issues, the worker was deemed competitively unemployable.

The appeal was allowed, and the worker was granted full LOE benefits from June 3, 2020, until they turned 65 on January 24, 2022.

The worker, an educational assistant, appealed a Case Manager's decision denying initial entitlement for traumatic mental stress (TMS) and chronic mental stress (CMS).

The worker had been subjected to multiple incidents of physical violence by special needs students over her career, culminating in a May 2022 incident where she was punched in the face by a 14-year-old student.

The Appeals Resolution Officer found that being the object of physical violence constituted an objectively traumatic event under WSIB Policy 15-03-02, regardless of the worker's occupation or training.

Relying on psychiatric evidence, the Officer concluded that the cumulative traumatic exposures significantly contributed to the worker's diagnosis of post-traumatic stress disorder (PTSD).

The worker's objection was allowed, and initial entitlement for PTSD was granted.

The worker, a housekeeping aide, appealed a decision denying initial entitlement for bilateral hand conditions (palmar psoriasis, contact dermatitis, and allergic contact dermatitis) claimed to result from workplace exposure to cleaning chemicals and gloves.

The Appeals Resolution Officer reviewed medical evidence, including a dermatologist's opinion and patch testing results, which ruled out palmar psoriasis and allergic contact dermatitis but confirmed a diagnosis of irritant contact dermatitis.

Finding a temporal relationship and significant contribution from occupational exposure to cleaning chemicals, the Officer granted initial entitlement for irritant contact dermatitis.

The worker was also granted loss of earning (LOE) benefits for lost time from work, as the employer could not accommodate the worker's restrictions.

The worker and employer both objected to a Case Manager's decision regarding loss of earnings (LOE) benefits following a workplace injury to the worker's right finger.

The worker appealed the denial of LOE benefits from April 10, 2024 to May 6, 2024, arguing they were following medical advice to remain off work post-surgery.

The employer appealed the allowance of LOE benefits for April 8 and 9, 2024, arguing suitable modified duties were available.

The Appeals Resolution Officer denied the worker's appeal, finding that safe and suitable modified duties were available that accommodated the worker's functional limitations.

The employer's appeal was allowed in part; LOE benefits were denied for April 8 as the surgery occurred on April 9, but entitlement was confirmed for the actual surgery date of April 9.

The worker appealed a decision denying WSIB entitlement for pulmonary fibrosis and emphysema allegedly caused by occupational asbestos exposure while working as an HVAC technician.

The Appeals Resolution Officer reviewed the medical evidence, including opinions from a respirologist and an occupational medical consultant, both of whom concluded the lung disease was secondary to an underlying connective tissue disease rather than asbestos exposure.

The appeal was denied, as the worker's employment exposure was found not to be a significant contributing factor to the development of the conditions.