- Aggravation (preexisting condition)
- Strains and sprains
- Disablement (nature of work)
The worker sought: a) initial entitlement to benefits for an aggravation of the pre-existing condition of Epidermolysis Bullosa (EB) in December 2018 involving the feet, ankles, and toes, claimed to have resulted from a change in footwear at work in December 2018; and, b) initial entitlement to benefits for gradual onset disablement injuries to the low back, left knee and left ankle in March 2019 claimed to have resulted from a change in footwear at work as of December 2018. The worker's representative stated that in December 2018 the worker was advised by her employer that she could no longer wear the orthopedic footwear that she had been wearing to manage her EB condition, as the employer's policy required her to wear closed-toed shoes.
The Vice-Chair allowed the appeal, in part.The Vice-Chair considered whether the change in footwear as of December 2018 was reasonably incidental (related to) her employment, and found that it was. Generally, a worker will be granted initial entitlement for a disablement arising out of and in the course of employment if there was an injuring process that was part of the employment (see Decision No. 226/94). The change in footwear constituted an injuring process which was part of her employment because the employer required the worker to change her footwear as a condition of her employment. The Vice-Chair found that the worker had initial entitlement for an aggravation of her pre-existing EB condition in December 2018 and the resulting injuries to her feet and toes. The Vice-Chair found that there was compatibility of the diagnosis to the accident history. However, the worker did not have initial entitlement for a bilateral ankle injury as there was no evidence of a personal work-related injury to the bilateral ankles. The Vice-Chair found that the worker had initial entitlement to benefits for gradual onset disablement injuries to the low back, left knee and left ankle in March 2019 as a result of the change in footwear at work as of December 2018. The worker was diagnosed with musculoskeletal injuries to her right back, left knee and left ankle. It was significant that the worker's pre-injury duties required standing and walking throughout the workday. The worker testified that in March 2019 she typically walked approximately 10,000 to 12,000 steps per day at work. In the Vice-Chair's view, the amount of walking that the worker performed at work without her custom-made orthopaedic footwear further supported a work-related injuring process, especially considering the fact that the worker had a pre-existing EB condition and required appropriate orthopaedic footwear to manage that condition. The Vice-Chair referred the issue of the worker's entitlement to LOE benefits back to the Board for adjudication.