WSIAT 487/20

Abstract: 487/20 focused on two key points:

(1) The Adjudicator misclassified the severity of the workplace accident, thereby limiting the quantum of cost relief available. Changing the accident severity from Moderate to Minor increased the Quantum of SIEF from 50% to 75%

(2) The appeals process and lengthy and by the time this decision was reached by the Tribunal the claim was outside of the four-year NEER window. Due Diligence by the company’s representative resulted in MANUAL ADJUSTMENT of the 2015 NEER year.

Nature of the Workplace Accident: The worker hit her head on a storage rack while adjusting storage totes in the racking. When she stood up she struck the back of her head.

She suffered a head injury with a mild concussion, a chipped tooth, and a neck strain.

Prior Decisions on this file: 50% cost relief granted, at the OPERATIONS Level, on the basis that the worker had a MODERATE pre-existing condition and this was a Moderate Workplace Accident.

This decision was supported at the APPEALS BRANCH and the level of cost relief remained at 50%

The decision by the Appeal Resolution Officer was appealed to the Tribunal on the grounds that the while the worker did have a MODERATE pre-existing condition this accident should be considered MINOR, and cost relief should be increased.

SE-GA argued that the force involved was minor in nature as the storage area was very small and the worker could not stand up in the area. The Vice-Chair agreed and increased the award to 75% cost relief. (Moderate pre-existing condition with a Minor accident). They concluded the worker’s head could not have traveled a great distance before it made contact with a solid object.

The Vice-Chair based this decision on “relevant consideration as to the extent of the disability the mechanics of the accident would reasonably be expected to cause.”

It is important to note that this was a 2015 accident, and the decision by the Tribunal was not granted until 2020 when the claim was outside of the 4-year experience window for 2015 claims.

The WSIB manually adjusted the client’s September 2019 NEER statement and issued a cheque to the client so they actually benefitted from this decision.

There are two key points here:

1. The due diligence by the client/SE-GA to pursue cost relief through the entire appeals process.
2. That SE-GA asked for the manual adjustment very early in the appeal in the event the conclusion of the appeal occurred after September 20, 2019.

Date of the Decision: March 27, 2020