The case manager found the
worker suffered "from a variety
of additional conditions that are
major contributors to her pain."
The worker appealed the de-
cision and in April 2013 an ap-
peals resolution officer upheld
the decision, finding the worker
was capable of full-time work
as a retail salesperson or sales
clerk. The worker continued to
receive partial benefits based
on the difference between pro-
jected SEB earnings and her
pre-injury earnings, while she
appealed again. Her second ap-
peal was also rejected by the ap-
peals resolution officer.
The worker appealed once
again, this time to the appeals
tribunal. A doctor's report stated
that the worker "insisted" she
couldn't do any of her old jobs or
even household chores do to her
pain and depression. The doc-
tor found her "persistent severe
symptoms, consistent abnormal
physical examinations" and di-
agnosis of chronic pain disorder
made her eligible for the Canada
Pension Plan disability pension,
which the worker was granted in
April 2015. The doctor conclud-
ed that the worker wasn't expect-
ed to be able to return to gainful
employment and should be con-
sidered "totally and permanently
disabled" from the workforce.
In October 2015, another psy-
chiatrist reported that the work-
er's pain developed because of
repetitive work and her condition
was "chronic and prolonged." He
determined that she had "chronic
disabling illness" that was a "ma-
jor psychiatric disorder."
The tribunal noted that the
WSIB operational policy manu-
al set out five criteria for entitle-
ment for chronic pain disability.
They are:
• A work-related injury occurred.
• Chronic pain is caused by the
injury.
• The pain persists for six or
more months beyond the usual
healing time of the injury.
• The degree of pain is inconsistent
with organic findings.
• The pain impairs earning
capacity.
The manual also defines
chronic pain disability as when
pain results in "marked life dis-
ruption."
The appeals resolution officer
had found the worker met all of
the criteria in the policy manual
except for that the degree of her
pain was inconsistent with or-
ganic findings and therefore had
other causes. However, the tri-
bunal disagreed.
The tribunal found the worker
had medical reports that indicat-
ed her work-related injury began
the pain cycle and her chronic
pain disorder sprung out of her
diagnosed repetitive strain inju-
ry to her neck, jaw, shoulder, and
arm. In addition, assessments
ruled out any neurological basis
for her chronic pain.
The tribunal also noted the
worker's 2009 functional rehabil-
itation assessment diagnosed her
with permanent limitations from
her chronic pain and all reports
indicated the pain continued for
much longer than six months
— the normal healing time for a
repetitive strain injury. In addi-
tion, it clearly limited her earning
capacity, said the tribunal.
The tribunal also found that
the SEB of retail salesperson or
clerk was suitable for her only as
long as the work conformed to
her restrictions. However, based
on the medical reports and labour
market re-entry assessments, the
worker wasn't capable of per-
forming SEB duties full-time.
The tribunal found the work-
er was entitled to partial loss-
of-earnings benefits based on
part-time hours at the minimum
wage in her SEB.
For more information see:
• Decision No. 2506/15, 2016
CarswellOnt 9221 (Ont.
Workplace Safety & Appeals
Trib.).
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Injured < pg. 5
Work-related injury was start of pain cycle
