Getting the process moving, without the personal info

Mr. S sustained a back injury in 2006 while performing heavy lifting. The WSIB allowed his claim for lumbar strain and subsequently awarded a 25 per cent non-economic loss (NEL) benefit. He returned to work on modified duties but was unable to continue. He began receiving Canada Pension Plan disability benefits.

On his behalf, a legal clinic requested entitlement for Mr. S’s psycho-traumatic disability, which arose from his back injury. In response, the WSIB made repeated requests for medical information the clinic said was already on file. The clinic contacted the Commission saying that the delay in making the decision was unreasonable.

The Commission found the case manager had recently written Mr. S requesting medical and mental health records from 2001–2006, even though the file already included extensive medical reports. The letter included details about Mr. S’s personal and medical history, totally unrelated to his workplace injury.

The Commission contacted a WSIB manager about the delay and the personal history in the letter. The manager directed a case manager to review the claim and make a decision on psycho-traumatic entitlement. The manager said that including the personal information was inappropriate. The subsequent review determined that Mr. S did have a psycho-traumatic disability arising from the workplace injury and allowed entitlement. WSIB recognized his permanent psychological impairment and referred his file for a NEL rating, which resulted in his total NEL award being increased retroactively to 40 per cent.