- Loss of earnings {LOE} (review) (extension)
- Loss of earnings {LOE} (review) (after seventy-two months) (co-operating in ESRTW)
The worker appealed an ARO decision from April 25, 2025, which upheld the deferral of the final LOE benefit review originally decided on March 14, 2024. The worker was self-represented, and the employer did not participate.
The Panel denied the appeal.The worker was injured on July 5, 2018, due to a workplace threat and received entitlement for mental stress injury benefits. Return to work (RTW) services were intermittently suspended and reinstated based on the worker's readiness and permanent restrictions. The worker engaged in psychotherapy, occupational therapy, and short-term computer training. The final LOE review may be deferred if the worker is cooperating in a return-to-work plan with training that is not completed by 72 months, is engaged in health care measures, or if the workplace parties are cooperating in RTW activities. The WSIB may review benefits up to 24 months after the 72-month period if these conditions apply. The worker argued that no formal RTW or work transition plan was in place by the 72-month lock-in date (July 5, 2024), that WSIB delays hindered progress, and that the deferral was based on speculative planning. The worker sought to have LOE benefits locked in at 100% from the lock-in date to age 65. The WSIB documented ongoing cooperation in health care and RTW activities before and after the lock-in date, including psychological treatment, occupational therapy, vocational assessments, and short-term training completed by February 2024. A formal RTW plan was established after the lock-in date but the worker was actively engaged in approved treatments and discussions about suitable occupations. The Panel found the deferral appropriate under WSIA and WSIB policy because the worker was cooperating in health care measures and RTW activities at the 72-month period. The presence of ongoing treatment and active engagement in vocational planning justified deferral, despite the formal RTW plan being finalized after the lock-in date.