Employer sought financial relief from workers’ compensation costs due to worker’s disability, but tribunal found no medical evidence linking it to worker’s tumble
An Ontario employer has lost its attempt to gain special relief for its workers’ compensation costs stemming from an accident where a blind worker fell and injured himself in the workplace.
The 65-year-old worker was employed as a social worker, hired by his employer in 1986. He suffered from retinal detachment, glaucoma, and uveitis, which made him completely blind for 40 years. As a result, he used a visual aid stick when walking around.
On June 20, 2016, the worker was sitting in the office reception area. He stood up to leave, but realized he forgot to ask the receptionist something. He turned around, lost his balance, and reached for a chair, but he missed and fell to the ground, landing on his left hip. The worker was taken to hospital, where an orthopaedic surgeon diagnosed the worker with a left hip fracture and noticed signs of osteoarthritis and some displacement. Because of these conditions and the worker’s age, the surgeon recommended a full hip replacement.
The worker had hip replacement surgery the day after his accident, though his osteoarthritis was still present afterwards. A week later, the Ontario Workplace Safety and Insurance Board (WSIB) approved his claim for health care benefits for the hip fracture and a soft-tissue elbow injury the worker had also suffered in the fall at work.
Worker’s compensation for four months off work
The worker was off work for four months, returning to graduated duties with accommodations on Oct. 17, 2016. The worker claimed entitlement to loss of earnings benefits, saying he tripped over his own feet and there were no external trip hazards. The WSIB also granted him loss of earnings benefits for the period he was off work recovering from his surgery.
On Nov. 8, the employer contacted the WSIB requesting entitlement to 100 per cent cost relief from the board’s Second Injury and Enhancement Fund (SIEF). The SIEF is a fund that provides employers with financial relief from workers’ compensation costs when a workplace accident is caused by an employee’s prior disability, or a pre-existing condition contributes to a prolonged recovery from a workplace accident. The employer argued that the worker’s loss of balance and fall at work was caused by his blindness, and the extent of his disability was significant enough to warrant full cost relief.
A WSIB case manager found the worker’s blindness didn’t contribute to the worker’s injury or any delayed recover, so the employer’s claim was denied. The employer appealed to the Ontario Workplace Safety and Insurance Appeals Tribunal, referring to a U.S. medical article on visual impairment and measured balance that reported reduced visual inputs could weaken the body’s systems that maintain balance and “self-reported falling difficulties were significantly more common among those having (vision impairment) compared to those having normal vision.” The employer argued that there was a medical consensus that having a visual impairment was associated with poor balance and predisposed the worker to incurring an injury.
The tribunal referred to the SIEF policy document, which defines a pre-accident disability as “a condition which has produced periods of disability in the past requiring treatment and disrupting employment” and a pre-existing condition as “an underlying or asymptomatic condition which only becomes manifest post-accident.”
Turning around caused fall, not blindness: Tribunal
The tribunal disagreed that there was medical evidence indicating the worker’s fall was caused by his blindness. The article to which the employer referred was a general journal article and not specific medical evidence on the worker’s accident. There was a doctor’s report describing the worker’s fall as “likely due to a combination of factors including decreased vision, existing arthritis, peripheral neuropathy, and mechancial factors,” but this report didn’t fully explore the accident history — particularly the fact the worker fell while abruptly turning around.
The employer submitted that there were no risk factors at the workplace that contributed to the worker’s fall and the triggering factor was the worker’s blindness, but the tribunal found there was no proof of this. The tribunal found that it was the act of turning that precipitated the loss of balance and resulting injury, not the worker’s blindness. And since the worker’s blindness wasn’t the cause of the accident, the employer wasn’t entitled to full relief of its costs, said the tribunal.
The tribunal also found that the worker’s blindness wasn’t a pre-existing condition or disability as defined in the SIEF policy document for eligibility for relief. The blindness wasn’t something that was asymptomatic and manifested after the accident. In addition, though the worker may have had periods of disability requiring treatment, there was no evidence his blindness disrupted his employment — the worker had a longstanding employment relationship with the employer for 30 years, said the tribunal.
The tribunal determined that the worker’s blindness wasn’t the cause of his workplace accident and injury and it didn’t prolong or enhance the worker’s recovery. The employer’s claim for relief for its costs from the SIEF was denied.
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