Case Summary : Delay

Delayed decisions

An injured worker and his representative contacted the Commission to complain about the delay in adjudicating the worker’s psychological entitlement for Loss of Earnings (LOE) and his return to a labour market (LMR) re-entry program. The worker was experiencing severe financial hardship since his benefits were terminated in June and he had been living in Toronto on $88 per week.

The Commission’s review of the worker’s file indicated that adjudication of the worker’s benefits was delayed for two reasons:

• the worker’s treating psychiatrist had not responded to numerous requests from the WSIB to provide information on the worker’s current medical condition; and
• a WSIB medical consultant who reviewed the file recommended that the WSIB obtain an independent psychological assessment of the worker, and that review had not been scheduled.

The Commissioner reviewed the worker’s circumstances with the Director of Clinical Services, as part of their ongoing discussion on the issue of psychological consultations. The Director was able to assist by obtaining expedited appointment dates for the worker’s independent assessment through the Psychological Trauma Program.

The Director also confirmed that an expedited review of the treating psychiatrist’s report had been undertaken. As a result, a decision was made to extend full LOE benefits retroactively to the worker.

(2005)