Ontario Workplace Safety and Insurance Board

The worker appealed the denial of loss of earnings (LOE) benefits for various periods following a workplace slip and fall that resulted in a nasal fracture, left radial head fracture, and soft tissue injuries.

The WSIB had denied full LOE benefits on the basis that the employer offered modified work.

The Appeals Resolution Officer found that the medical evidence supported the worker's inability to perform even modified work during the acute recovery phase and following nasal surgery.

The worker's appeal was allowed, granting full and partial LOE benefits for the disputed periods.

The worker, a truck driver, appealed a decision limiting her workplace injury entitlement to a right knee strain and denying ongoing benefits beyond July 21, 2016.

The worker argued that her duties, which involved rapidly pushing heavy linen carts around a tight curve, caused a right knee medial meniscal tear.

The Appeals Resolution Officer found that the diagnosed meniscal tear was clinically compatible with the disablement history, despite the presence of pre-existing degenerative conditions.

The appeal was allowed in part, granting entitlement for the meniscal tear and ongoing benefits from July 21, 2016 to September 19, 2016, with further entitlement to be determined by Operations.

The worker, a community support worker, appealed a decision denying initial entitlement for a ventral hernia allegedly sustained while using a Hoyer lift with a patient.

The Appeals Resolution Officer found that the incident did not represent a chance event and that proof of accident was not established, as the evidence did not support the worker's claim that she bore most of the patient's weight.

Furthermore, the medical evidence indicated the hernia was a recurrence of a previous condition and was not clinically compatible with the reported incident.

The worker's objection was denied.

The worker suffered a right knee injury after slipping on ice at work in March 2014.

He returned to full duties in June 2014 but stopped working in April 2015 due to a flare-up of knee pain, later diagnosed as a medial meniscal tear.

The worker sought entitlement for a recurrence of the workplace injury.

The Appeals Resolution Officer denied the appeal, finding that the meniscal tear was not clinically compatible with the original sprain/strain injury and that there was insufficient evidence to show the workplace accident accelerated the worker's pre-existing degenerative osteoarthritis.

The worker appealed a case manager's decision denying ongoing entitlement and treatment for a right knee injury beyond April 21, 2015.

The worker had suffered a work-related medial meniscal tear and subsequently developed persistent symptoms, including an exacerbated Baker's cyst, on a background of pre-existing osteoarthritis.

The Appeals Resolution Officer found that the pre-existing condition had not overwhelmed the work-related injury, which continued to be a significant contributing factor to the ongoing impairment.

The worker's appeal was allowed, granting continuing entitlement and treatment, including a Synvisc injection.

The employer objected to a decision granting the worker loss of earnings (LOE) benefits beyond February 19, 2016, following arthroscopic knee surgery.

The Appeals Resolution Officer found that the worker was only partially disabled by that date and that the employer had offered suitable modified work, which the worker failed to accept or attempt.

The employer also demonstrated a willingness to provide transportation if needed.

Consequently, the worker was not participating in the work reintegration process and was not entitled to further LOE benefits.

The employer's objection was allowed.

The worker appealed a decision denying ongoing entitlement for a right shoulder partial tear of the supraspinatus tendon and calcific tendinopathy.

The Appeals Resolution Officer found that the worker's general job duties, which involved repetitive cross-body motion and pushing/pulling with force, made a significant contribution to the development of the conditions.

The objection was allowed, and the matter was remitted to the Operating Area to determine benefits.

The worker appealed a decision denying ongoing entitlement for a right shoulder rotator cuff strain and secondary entitlement for a SLAP tear and subsequent surgery.

The Appeals Resolution Officer found that the accepted strain had fully resolved and that ongoing symptoms were related to pre-existing osteoarthritis and tendinosis.

The Officer also concluded that the SLAP tear was not causally linked to the workplace injury, as the mechanism of injury was not compatible with the diagnosis.

The appeal was dismissed.

The worker appealed a decision granting a 4% non-economic loss (NEL) award for a left hand injury, arguing the quantum should be greater due to ongoing problems with her whole hand and arm.

The Appeals Resolution Officer found that the NEL clinical specialist appropriately used the American Medical Association Guides to evaluate the permanent impairment based on range of motion and sensory loss specific to the accepted area of injury (the left small finger).

The objection was denied and the 4% NEL quantum was upheld.

The worker suffered a compensable head and neck injury in 2011 after being struck by a robotic arm.

She received loss of earnings benefits and a non-economic loss award for a permanent cervical spine impairment.

The worker subsequently sought extended entitlement for psychotraumatic disability and chronic pain disability.

The Appeals Resolution Officer denied the appeal, finding no objective medical evidence of a compensable psychological condition or chronic pain disability, noting the worker had successfully returned to full-time regular employment and her pain complaints were consistent with her accepted organic injury.

The worker, a personal support worker, suffered an ankle injury and was offered modified clerical duties by the employer.

The worker's family doctor advised against returning to work, stating the modified duties would delay recovery.

The decision maker initially denied loss of earnings (LOE) benefits, finding the modified work suitable.

On appeal, the Appeals Resolution Officer found that the worker was cooperative in the work reintegration process and appropriately followed her doctor's advice to remain off work.

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

The worker appealed the denial of initial entitlement for a right wrist injury allegedly sustained in a slip and fall at work.

The Appeals Resolution Officer confirmed the denial, finding that the worker failed to establish proof of accident.

The decision noted multiple inconsistencies in the worker's accident history, including discrepancies about the weather, the date of the injury, and the nature of the incident reported to the employer.

Additionally, the worker delayed seeking medical attention and reporting the specific wrist injury for approximately one year without a reasonable explanation.

The employer objected to the 2014 and 2015 Period Reconciliation not Reported (PRNR) charges on its Workplace Safety and Insurance Board account.

The employer argued that as a small business, it was difficult to navigate the reporting requirements and requested cancellation of the penalties.

The Appeals Resolution Officer found no justification for complete cancellation but applied the WSIB's 2008 guidelines, which allow for revision if a penalty exceeds 10% of the annual actual assessment.

The 2014 PRNR charges exceeded this threshold and were reduced to 10% of the 2014 premium.

The 2015 charges did not exceed the threshold and were confirmed.

The objection was allowed in part.

The worker appealed a decision denying entitlement to a permanent impairment for a 2002 right shoulder strain and denying entitlement for right rotator cuff tears and surgery.

The Appeals Resolution Officer allowed the appeal, finding that the worker's shoulder symptoms had never abated since the 2002 injury, entitling the worker to a Non-Economic Loss assessment.

Furthermore, the Officer found that the overhead lifting required in the worker's modified duties significantly contributed to the development of the rotator cuff tears, granting entitlement to the tears and surgery as a secondary condition.

The employer objected to a field auditor's decision denying an extension of time to appeal earlier classification decisions from 2008 and 2012.

The employer argued that it did not receive actual notice of the time limits and that the WSIB made an egregious error in classifying its business activities, resulting in significant premium overcharges.

The Appeals Resolution Officer found that the employer was provided with clear notice of the six-month appeal time limits in the original decision letters.

The Officer concluded that the circumstances were not exceptional and denied the request for an extension of time.

The employer objected to a field auditor's decision denying an extension of time to appeal earlier classification decisions from 2008 and 2012.

The employer argued that it was not properly notified of the time limits and that the WSIB made an egregious error in classifying its business activities, resulting in a significant overcharge of premiums.

The Appeals Resolution Officer found that the employer was properly notified of the time limits and that there were no exceptional circumstances to justify an extension.

The appeal was denied.

The worker appealed the denial of his claim for occupational noise induced hearing loss.

The Appeals Resolution Officer found that while the worker had a sensorineural hearing loss consistent with occupational noise exposure, his calculated noise exposure of 83 dB over 8 hours per day for 40 years did not meet the WSIB's minimum threshold of 84 dB for 40 years.

The appeal was denied.

The worker suffered a left hand injury at work, resulting in a permanent impairment.

The Workplace Safety and Insurance Board awarded a 4% non-economic loss (NEL) rating based on the American Medical Association Guides.

The worker appealed, arguing the quantum should be greater due to ongoing problems with her whole hand and arm.

The Appeals Resolution Officer dismissed the appeal, finding the 4% rating was correctly calculated based on the accepted area of injury (the left small finger) and the objective medical evidence.

The worker objected to a decision denying ongoing entitlement for Durolane injections for a work-related right knee injury.

The Appeals Resolution Officer found that the injections provided significant symptomatic relief and helped the worker remain employed.

The officer rejected the external medical consultant's opinion that the treatment was for a pre-existing condition, noting a prior WSIAT decision had accepted the pre-existing condition was rendered symptomatic by the work injury.

The objection was granted, and ongoing entitlement for injections every six months was allowed.

The objecting party, a company that hired a general contractor for a furnace rebuild, appealed a decision transferring 100% of the claim costs for a worker's injury to its account.

The worker, employed by a subcontractor, was injured when wrong-sized J-hooks caused a furnace roof to sag.

The Appeals Resolution Officer found that the objecting party and the general contractor did not owe a duty of care to the worker.

Furthermore, the subcontractor who installed the J-hooks did not breach its duty of care because the employer was contractually responsible for inspecting the equipment.

The objection was allowed, and the employer was held responsible for 100% of the claim costs.