Former machine operator not able to work full-time as social worker

Complainant: Spouse of injured worker

Problem: Dispute over whether worker is completely disabled or can go back to work.

Resolution: WSIB overturned earlier decision and reinstated full benefits.

The WSIB called it one way. The injured worker and spouse disagreed. And there was a lot at stake.

The WSIB said the woman was able to work 40 hours a week as a social worker. She was receiving benefits for a back injury when she worked as a machine operator. Her benefits were reduced for not cooperating in her work transition plan. The benefits were locked in at that lower rate.

The spouse contacted the Commission on his wife’s behalf. He said his wife was totally disabled and unable to work at all, never mind full-time or in a job she had never done.
The Commission reviewed the case and asked a WSIB manager to clarify the process used to make the decision. The manager said the worker was partially disabled, but the Commission questioned whether WSIB’s position was at odds with documented medical information, which showed that the worker’s abilities were highly impaired.

The Commission pursued the case with a WSIB director, who reviewed the case and advised the lock-in decision would be reconsidered. The director determined that the case manager had given too much weight to medical information that did not reference the injured worker’s psychiatric restrictions and too little weight to the information that did.

The woman’s physical and psychological condition meant she was not able to participate in training and the work reintegration program, the WSIB decided. The WSIB discontinued the work transition services (WTS) and reinstated full benefits to cover the woman’s lost earnings. The benefits were paid retroactive to the date the WTS was closed.