Ontario Workplace Safety and Insurance Board

The worker, a dietary aide, appealed a Case Manager's decision denying entitlement for a right shoulder partial tear and granting the employer 25% Second Injury and Enhancement Fund (SIEF) relief.

The Appeals Resolution Officer found that the worker's job duties, which involved repetitive overhead lifting of heavy trays due to a change to fine dining service, were compatible with the diagnosis of a right shoulder partial tear.

Furthermore, the medical evidence did not support the existence of a pre-existing condition that would warrant SIEF cost relief.

The worker's objection was allowed, granting entitlement for the shoulder tear and rescinding the SIEF relief.

The employer appealed a Case Manager's decision granting 50% cost relief under the Second Injury and Enhancement Fund (SIEF) for a worker's lower back injury, seeking 90% relief.

The employer argued the accident severity was minor and the pre-existing condition was major.

The Appeals Resolution Officer found the accident severity was moderate due to the awkward posture and heavy weight of the industrial curtains involved.

The pre-existing condition was also found to be moderate, as it placed the worker at a slightly higher risk of injury but did not significantly prolong the recovery period.

The 50% cost relief was confirmed and the employer's objection was denied.

The worker appealed a Case Manager's decision denying entitlement to a recurrence for a low back injury sustained on August 22, 2020, and refusing to amalgamate the new claim into the original 2017 claim.

The Appeals Resolution Officer found that the August 2020 incident, which involved lifting a patient from the floor to a chair, constituted a significant new incident rather than a recurrence.

Furthermore, the new injury was not clinically compatible with the original injury, as the symptoms and MRI findings shifted from the left side to a new right-sided disc herniation.

The appeal was dismissed.

The worker appealed a Case Manager's decision denying loss of earnings (LOE) benefits from August 15, 2015 to November 26, 2015.

The worker had sustained a workplace injury to their neck and right shoulder and later experienced an exacerbation.

The Appeals Resolution Officer found that the worker was unable to return to work for a portion of the period and, although capable of modified work later, was not provided with a graduated return to work plan by the employer.

The appeal was allowed, granting LOE benefits for the disputed periods.

The worker suffered a concussion and neck strain after a workplace accident involving a loader machine.

The worker briefly returned to work but stopped due to increased symptoms, later returning to modified duties.

The case manager denied loss of earnings (LOE) benefits for the period the worker was off work, citing a lack of medical documentation.

On appeal, the Appeals Resolution Officer found that the medical evidence, including reports from a concussion and pain clinic, supported the worker's inability to work in any capacity during that time.

The worker's objection was allowed, and full LOE benefits were granted for the disputed period.

The employer objected to an Eligibility Adjudicator's decision granting the worker initial entitlement to WSIB benefits for COVID-19.

The worker, a heavy equipment operator, tested positive for COVID-19 but had no known workplace exposure, worked primarily outdoors, and followed COVID-19 protocols including masking and social distancing.

The Appeals Resolution Officer found that the nature of the worker's employment did not create a risk of contracting COVID-19 to which the public at large was not normally exposed.

The employer's objection was allowed, and the initial entitlement for COVID-19 was rescinded.

The worker suffered a compensable crush injury to their right foot, resulting in toe amputations.

The worker subsequently developed lower back pain and sought secondary entitlement, which was initially denied by the Case Manager.

On appeal, the Appeals Resolution Officer found that medical evidence supported a causal relationship between the worker's altered gait following the foot injury and their diagnosed right sacroiliac dysfunction and facet irritation.

The worker's objection was allowed, granting secondary entitlement for the lower back.

The employer objected to a decision denying relief under the Second Injury and Enhancement Fund (SIEF) for a worker's right shoulder injury.

The worker sustained full thickness rotator cuff tears while trying to catch a 100-pound cylinder.

The employer argued that pre-existing degenerative changes in the worker's shoulder prolonged the recovery and warranted 75% SIEF relief.

The Appeals Resolution Officer found the accident was moderate in severity and that the medical evidence did not establish that the pre-existing degenerative changes prolonged or enhanced the work-related disability.

The employer's objection was denied.

The employer objected to a Case Manager's decision finding that it breached its re-employment obligation.

The worker, who was performing modified duties following a workplace injury, was terminated within six months of re-employment.

The employer argued the termination was justified due to the worker breaching its workplace violence and harassment policy by yelling at a manager.

The Appeals Resolution Officer found that the employer failed to rebut the presumption that the termination was related to the work injury, noting that the altercation stemmed from the worker's complaints about not being provided suitable duties.

The employer's objection was denied.

The worker, who sustained severe injuries including a leg amputation following a work-related motor vehicle accident, objected to a decision denying entitlement to an all-terrain vehicle (ATV).

The worker requested the ATV to safely access and care for animals on their 26-acre farm, as other mobility devices were unsuitable for the uneven and wet terrain.

The Appeals Resolution Officer allowed the objection, finding that the ATV met the criteria for an independent living device under WSIB policy, as it would restore the worker's mobility and independence, and the anticipated benefits outweighed the costs and speculative safety concerns.

The worker, a personal support worker, contracted COVID-19 due to a workplace outbreak and subsequently developed migratory musculoskeletal pain, leading to a diagnosis of seronegative rheumatoid arthritis.

The OD Adjudicator initially denied secondary entitlement for the arthritis and terminated loss of earning (LOE) benefits, relying on an OHAP physician's opinion that there was insufficient literature to establish a causal link.

On appeal, the Appeals Resolution Officer allowed the worker's objection, preferring the opinions of multiple specialists, including an infectious disease specialist and rheumatologists, who concluded the arthritis was likely triggered by the work-related COVID-19 infection.

The worker was granted secondary entitlement to seronegative rheumatoid arthritis and ongoing LOE benefits.

The worker sustained a thumb amputation when their hand was caught in a machine roller, and subsequently developed a psychotraumatic disability.

The employer appealed a Case Manager's decision denying cost relief under the Second Injury and Enhancement Fund (SIEF), arguing the worker's pre-existing anxiety enhanced their psychological reaction.

The Appeals Resolution Officer found the workplace accident was of major severity, as the machine roller weighed over a tonne and could cause serious permanent disability.

The worker's pre-existing anxiety was deemed of minor significance.

Under WSIB policy, an accident of major severity combined with a pre-existing condition of minor significance warrants zero percent SIEF relief.

The employer's appeal was dismissed.

The worker appealed a decision denying initial entitlement for a low back injury allegedly sustained while operating a jackhammer.

The worker felt a minor pinch but continued working and did not report the injury or seek medical attention for several weeks, eventually being diagnosed with a disc herniation.

The Appeals Resolution Officer dismissed the appeal, finding that the significant delay in reporting the injury and seeking medical attention broke the chain of causation, and therefore proof of accident was not established.

The worker, a paramedic with an allowed claim for posttraumatic stress disorder (PTSD), objected to a decision denying entitlement to medical cannabis.

The Appeals Resolution Officer reviewed the request under WSIB Operational Policy 17-01-10, which restricts medical cannabis entitlement to specific designated conditions.

Because PTSD is not a designated condition under the policy, the worker did not meet the mandatory criteria.

The worker's objection was denied.

The worker objected to a Case Manager's decision denying Loss of Earnings (LOE) benefits beyond August 1, 2018.

The worker suffered a left arm proximal humerus fracture and was offered modified duties by the employer.

The Appeals Resolution Officer found that the worker was capable of returning to light sedentary duties as of August 1, 2018, and that the employer's offer of modified work was safe, productive, and consistent with the worker's functional abilities.

As the suitable work was available at no wage loss, the worker was not entitled to further LOE benefits.

The objection was denied.

The worker appealed decisions regarding the non-economic loss (NEL) quantum for a psychological condition (adjustment disorder with mixed anxiety and depressed mood) and the determination that there were no formal psychological restrictions for returning to work.

The Appeals Resolution Officer reviewed the clinical evidence and WSIB policies, concluding that the worker's psychological impairment was appropriately rated at 10% under Class 2 (Mild impairment), resulting in a 6% NEL benefit when combined with prior ratings.

The Officer also found that the clinical evidence supported workplace accommodations rather than formal psychological restrictions.

The worker's objection was denied.

The employer appealed decisions granting the worker healthcare and loss of earnings (LOE) benefits for injuries sustained after falling from a scaffold, and denying the employer Second Injury and Enhancement Fund (SIEF) cost relief.

The employer argued the fall was caused by a diabetic medical episode rather than a workplace accident.

The Appeals Resolution Officer found no evidence that the worker's low blood sugar caused the fall, concluding the injuries arose out of and in the course of employment.

The worker was entitled to LOE benefits as the injuries prevented any work for a month.

SIEF cost relief was denied because the accident was of moderate severity and there was no evidence the pre-existing diabetes caused the accident or prolonged recovery.

The employer's appeal was denied.

The objecting party, NS, appealed a decision ruling them an executive officer without coverage.

NS held the title of Chief Operating Officer and owned 5% of the company.

However, examining the substance of the relationship, the Appeals Resolution Officer found that NS had no authority to act independently, was not responsible for the overall direction of the company, and could not bind the organization.

The WSIB concluded that NS was a worker, not an executive officer, and granted the objection.

The worker appealed a decision denying initial entitlement for upper back, neck, and right upper extremity injuries.

The worker experienced a sudden onset of pain while stretching at home before work.

The Appeals Resolution Officer found that the injuries did not arise out of and in the course of employment, as the incident occurred at home and was not related to the worker's job duties.

The medical evidence also indicated pre-existing degenerative conditions.

The appeal was denied.

The worker appealed the Eligibility Adjudicator's decisions denying initial entitlement for bilateral carpal tunnel syndrome and right foot plantar fasciitis/right ankle tendonitis.

The Appeals Resolution Officer allowed the appeal in part.

The officer found that the physical demands of the worker's regular duties, which involved repetitive and forceful use of the hands and wrists with vibrating tools, were a significant contributing factor to the bilateral carpal tunnel syndrome.

However, the officer denied entitlement for the foot and ankle conditions, finding they were a progression of pre-existing, non-work-related problems and not significantly contributed to by the worker's duties.