The Ontario Workplace Safety and Insurance Appeals Tribunal (WSIAT) has denied a worker’s appeal for extended loss of earnings (LOE) benefits and a psychiatric assessment, citing a lack of causal relationship between the worker’s compensable right knee injury and the ongoing loss of income and psychological difficulties.
The case centred on a 62-year-old former dietary aide who sustained a significant right knee injury after slipping in her employer’s parking lot in January 2019. This initial injury, compounded by pre-existing osteoarthritis, led to a total knee replacement surgery in January 2020. Despite returning to work later that year under a modified job plan, the worker claimed that she was unable to perform her duties and subsequently appealed decisions that denied her additional LOE benefits and a psychiatric assessment.
Ruling highlights
The Tribunal’s decision addressed multiple points of contention, including the suitability of the worker’s modified job role, her eligibility for additional LOE benefits, and the necessity of a psychiatric assessment.
The Tribunal upheld that the worker’s modified job as a dietary aide in the “Transitions Area” was suitable given her physical restrictions post-surgery. Despite the worker’s testimony that she struggled with the physical demands of the job, the Tribunal found that the position was “largely sedentary in nature” and that the worker had been provided with adequate accommodations, including opportunities to take microbreaks.
The Tribunal noted, “The duties were largely sedentary in nature and dovetail with the worker’s demonstrated ability as reflected in the findings of the Lower Extremity Specialty Program.”
Loss of earnings (LOE) benefits denied
Part of the appeal revolved around the worker’s entitlement to LOE benefits for periods between October 2020 and January 2021 and beyond her termination in January 2021. The Tribunal ruled that the worker was not entitled to these benefits, as her loss of earnings was not directly related to her knee injury but rather to non-compensable factors, including her failure to complete the Food Service Worker Certificate, a mandatory requirement for her role.
The ruling emphasized that the worker had three years to complete the certification and that her failure to do so, despite reminders and support from her employer, was the primary reason for her termination.
“The worker’s termination in January 2021 was likely unrelated to the workplace injury and consequently, the worker’s loss of earnings beyond January 2021 is unrelated to the workplace injury but arises from the worker’s decision not to fulfill her obligations as set out in her employment contract,” the Tribunal concluded.
Psychiatric assessment request denied
The worker’s request for a psychiatric assessment was also denied. The Tribunal found that the worker’s psychological issues, which included symptoms of depression and anxiety, were not significantly connected to her compensable injury.
Instead, these symptoms were attributed to a range of non-work-related stressors, such as financial difficulties, family health issues, and personal relationship problems. The Tribunal noted that the worker had already been referred for psychiatric evaluation by her family physician and that an additional assessment would be “a duplication of services and a waste of medical resources.”
In its analysis, the Tribunal acknowledged the worker’s emotional difficulties but found that these were not substantially linked to her knee injury. The ruling highlighted that the worker reported significant improvements in her knee condition by late 2020, only to see a decline in her physical and mental health after a non-compensable slip and fall in December 2020, followed by personal issues in early 2021.
The Tribunal stated, “The evidence before us does not establish, on a balance of probabilities, that a psychological assessment is necessary, sufficient, and appropriate in relation to the compensable knee injury.”
Final ruling
The Tribunal’s final decision was to deny the worker’s appeal on all issues. The ruling emphasized that while the worker had experienced significant challenges, both physically and emotionally, these were not found to be sufficiently connected to her workplace injury to warrant the additional benefits and assessments she sought.
For more information, see Decision No. 266/24, 2024 ONWSIAT 926 (CanLII).
