ONA’s Workplace Safety and Insurance Board (WSIB) Appeals Team has recently achieved a significant victory for a member at the Workplace Safety and Insurance Appeals Tribunal (WSIAT).
In this case, a 58-year-old RN suffered an injury due to a workplace accident. WSIB paid full Loss of Earnings (LOE) benefits for fewer than six weeks. The member returned to modified duties for four months before being pressured to return to her pre-injury duties. The increased duties exacerbated her condition and, unfortunately, she never worked again.
WSIB denied ongoing entitlement because, among other issues, the member had severe pre-existing conditions in the same area of her body as the workplace injuries. WSIB also denied LOE benefits. The member suffered major financial losses and was supported financially by her spouse until she began collecting her pension at age 65.
“ONA argued multiple issues at WSIB’s Operations level, but WSIB adjudicators continued to deny all ongoing injury entitlements and LOE benefits, saying the ongoing issues were due to the pre-existing conditions and not caused by the accident,” says WSIB Appeals Specialist Andrew Barclay.
“We then participated in a hearing at the Appeals Services Division, and entered substantial medical evidence and testimony from the member that showed the member’s functioning and pain had deteriorated from the pre-accident condition to the post-accident condition.”
The Appeals Resolution Officer (ARO) approved Non-economic Loss (NEL) awards and partial LOE benefits at a part-time rate for one month, but decided the member could work full-time after that month.
awarded to our member
ONA appealed the ARO decision to the WSIAT and requested Alternative Dispute Resolution (ADR) to expedite the appeals process. WSIAT’s ADR staff agreed with our interpretation of the evidence. We then provided additional written submissions and a summary of the member’s oral testimony.
“WSIAT agreed to approve full LOE benefits from age 58 to 65, the maximum allowed under the Workplace Safety Insurance Act, and the member received an award of more than $460,000,” explains Barclay.
“This is a huge win that demonstrates how members can receive full compensation from WSIB even in cases where they have severe pre-existing conditions.”
Learn more about how ONA supports members with their WSIB appeals here.
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