Decision #151/11 - Type: Workers Compensation
Preamble
This appeal deals with a decision made by the Workers Compensation Board ("WCB") that the worker was entitled to wage loss benefits to May 2, 2011 inclusive based on subsection 39(3) of The Workers Compensation Act (the "Act"). The worker disagreed and an appeal was filed with the Appeal Commission. A hearing was held on October 31, 2011 to consider the matter.Issue
Whether or not the worker is entitled to wage loss benefits after May 2, 2011.Decision
That the worker is not entitled to wage loss benefits after May 2, 2011.Decision: Unanimous
Background
The worker filed a claim with the WCB for mid low back and leg difficulties that he related to his work activities on May 3, 2007 as an equipment operator. His claim for compensation was accepted by the WCB and various types of benefits were paid to the worker.
On June 29, 2009, the WCB advised the worker as follows:
"…we have now concluded your Vocational Rehabilitation (VR) assessment. Based on this assessment, including a review of the labour market, your transferable skills, education, restrictions and number of years to anticipated retirement, we are unable to identify a viable occupational goal and earning capacity…Wage loss benefits will continue until May 2, 2011, (4 years post-injury) unless your earning capacity changes."
On March 10, 2011, it was confirmed to the worker that his wage loss benefits would end on May 3, 2011 in accordance with subsection 39(3) of the Act.
On September 12, 2011, the worker wrote to Review Office and appealed the March 10, 2011 decision. The worker requested further compensation benefits due to his financial situation and his inability to work due to his compensable back injury.
In a decision dated September 15, 2011, Review Office determined that the worker was not entitled to wage loss benefits after May 2, 2011. Review Office indicated that it was bound by the Act and based on subsection 39(3), the worker was entitled to wage loss benefits for a maximum of four years from the date of his accident or up to May 2, 2011. The worker appealed the decision to the Appeal Commission and a hearing was arranged.
Reasons
Applicable Legislation
In considering appeals, the Appeal Commission and its panels are bound by the Act, regulations and policies of the Board of Directors.
The worker is seeking continuation of his wage loss benefits after May 2, 2011. Subsections 39 (2) and (3) of the Act deal with the duration of wage loss benefits. These subsections provide:
Duration of wage loss benefits
39(2) Subject to subsection (3), wage loss benefits are payable until
(a) the loss of earning capacity ends, as determined by the board; or
(b) the worker attains the age of 65 years.
Exception re workers 61 years of age or older
39(3) Where a worker is 61 years of age or older at the commencement of his or her loss of earning capacity, the board may pay the wage loss benefits for a period of not more than 48 months following the date of the accident.
As the worker was 61 years of age at the time of the workplace injury, his wage loss benefits are subject to subsection 39(3) of the Act.
Worker's Position
The worker attended the hearing. He told the panel about his injury and his current financial status. He answered questions posed by the panel.
The worker described his accident and resulting back injury. He said that his physician and the WCB medical advisor have said that he is unemployable. He advised that he has not worked since he was injured in 2007 and that he has permanent restrictions. He advised he is receiving a permanent disability pension from CPP.
Since his WCB wage loss benefits ended in May 2011, he and his wife have tried to get by on their CPP disability pensions and his OAS pension. This has created financial difficulties for them. He believes that they will not be able to stay in their home given their modest income and their household expenses.
The worker confirmed that he was over 61 years of age at the time of the accident. He provided the panel with a copy of his driver's license which showed that he was born in June 1945 and that he is currently 66 years old.
The worker advised that had he not been injured he would have continued working until he was 70 or older. He feels it is wrong that he cannot be paid when he is clearly injured and cannot work. In answer to questions the worker provided details of his past employment which was all physical in nature.
Employer's Position
The employer sent in a submission in support of the worker's appeal.
Analysis
The worker is appealing the termination of his wage loss benefits effective May 2, 2011. The date May 2, 2011 is important because this is the conclusion of 48 months after the date of his accident which occurred on May 3, 2007. In order for the worker's appeal to succeed, the panel must find authority in the Act or WCB policies which would entitle the worker to further benefits beyond that date. Unfortunately, we were unable to so find.
We find that subsection 39(3) of the Act applies. This subsection of the Act limits the payment of wage loss benefits to workers who are 61 years of age or older to a maximum of 48 months following the accident, regardless of whether the worker's loss of earning capacity resulting from the accident continues.
The evidence on file clearly establishes that the claimant was 61 years of age at the time of the accident. Therefore, in accordance with the Act, we find that the claimant is not entitled to wage loss benefits beyond May 2, 2011. While the panel is sympathetic to the worker in the circumstances, we are bound by the clear wording of subsection 39(3) of the Act. It does not allow for any discretionary wage loss benefits beyond the 48 month period that is mandated in the legislation.
The appeal is therefore denied.
Panel Members
A. Scramstad, Presiding OfficerR. Koslowsky, Commissioner
P. Walker, Commissioner
Recording Secretary, B. Kosc
A. Scramstad - Presiding Officer
Signed at Winnipeg this 17th day of November, 2011