A Case Study in Workers’ Compensation Advocacy
I. Introduction
At Blue Collar Consulting, we believe that no denial should go unchallenged when the evidence supports the worker. This is the story of a health care worker who developed debilitating plantar fasciitis after an extended shift on hard institutional flooring. She had no prior history of foot problems, no known risk factors, and no explanation for her symptoms other than the work she had performed. The WCB denied her claim anyway. We appealed, and the Appeals Commission reversed the denial, directing the matter back to WCB for full adjudication and entitlement. This case illustrates a recurring problem in WCB adjudication: conditions that can have both occupational and non-occupational origins are sometimes denied reflexively, without a genuine examination of the specific worker’s circumstances. When the evidence is examined carefully and the worker’s situation is properly understood, the result can and should be different. That is what happened here.
II. Background of the Worker’s Case
Our client worked in a health care setting that required her to spend extended hours on her feet on hard institutional flooring. This was not occasional or incidental standing — it was the sustained, daily physical demand of her job. She had no prior foot conditions, no history of plantar fasciitis, and none of the lifestyle or health risk factors that WCB might otherwise point to as alternative explanations.
Shortly after an extended shift, she developed acute plantar fasciitis — a painful and often disabling inflammation of the connective tissue running along the bottom of the foot. The onset was rapid and the timing was direct. Her symptoms impaired her ability to work and carry out ordinary daily activities. She sought medical treatment and filed a WCB claim.
WCB denied the claim. The Board declined to accept that her plantar fasciitis arose out of and occurred in the course of her employment. No alternative cause was identified. The denial appeared to rest on the general proposition that plantar fasciitis is a condition with possible non-occupational origins — without examining whether any such origin actually applied to this worker. The denial of a claim with no competing explanation and a clear occupational timeline highlighted the gap between policy intent and WCB’s rigid application. It was here that Blue Collar Consulting stepped in, determined to bridge that gap and fight for fairness.
III. The Plantar Fasciitis Dispute
- WCB’s Position
- Blue Collar’s Advocacy
We appealed the denial to the Appeals Commission and built our case around three central arguments.
First, the timeline was direct and the onset was sudden. Our client had no prior foot history and no predisposing risk factors. The rapid development of symptoms following the extended shift was the predictable consequence of prolonged mechanical stress on the plantar fascia. Where a worker with no prior history develops an injury immediately following a specific work exposure, that temporal connection carries significant evidentiary weight.
Second, there was no identified alternative cause. WCB had not pointed to any non-occupational factor that could explain the injury. Under WCB’s own benefit-of-the-doubt policy, where the evidence does not clearly favour one explanation over another, the worker is entitled to the benefit of the doubt. Here, there was nothing on the other side of the scale. The absence of any competing explanation strengthened the occupational causal argument.
Third, the medical evidence was clinically consistent with work-related causation. The clinical presentation matched what would be expected from the type and duration of occupational exposure involved. Extended standing on hard surfaces is a recognized mechanism for the development of plantar fasciitis, and our client’s presentation was consistent with that mechanism.
- Evidence Considered
- Medical records documented the diagnosis and the rapid onset of symptoms immediately following the extended work shift, with a clinical presentation consistent with mechanically induced plantar fasciitis from prolonged occupational standing on hard flooring.
- The worker’s own account established the sustained demands of her role on the day in question and in the period leading up to the onset of symptoms. Her testimony was consistent and uncontradicted.
- There was no medical or other evidence before the Commission identifying any non-occupational factor capable of explaining the injury. The absence of predisposing risk factors was itself part of the evidentiary picture, and it pointed squarely toward work.
- The Decision
The Appeals Commission agreed with our position. It found that the worker’s plantar fasciitis arose out of and occurred in the course of her employment. The denial was reversed, and the matter was directed back to the WCB for full adjudication and entitlement. The claim was accepted.
The Commission’s finding affirmed that causation does not require a single traumatic incident. A condition that develops as a result of sustained occupational exposure — particularly in a worker with no predisposing risk factors and no alternative explanation — is compensable. This reversal confirmed that the evidence, not the form of the injury, must drive the decision.
IV. Policy and Legal Context
- Requires an assessment of whether the work was a contributing cause of the injury. It does not require that work be the only possible cause in the general population — only that it was a cause in this worker’s case. The combination of occupational exposure, timing, and the absence of any identified alternative cause satisfied that standard.WCB Policy 03-01 (Arising Out of and Occurring in the Course of Employment):
- Where the evidence is reasonably balanced, the worker’s claim must be accepted. Here the scales did not merely tip toward the worker — there was nothing credible on the other side. The policy protects workers in ambiguous cases; it should not be required to carry the entire weight of a case that is not ambiguous at all.Benefit of the Doubt Policy:
- The absence of prior foot history, the absence of non-occupational risk factors, and the absence of any competing diagnosis were all relevant and properly considered by the Commission. What is not present in the record is often as important as what is.The significance of absence:
V. The Broader Implications
- 01. Plantar fasciitis and similar overuse conditions do not require a discrete traumatic event. Sustained occupational exposure on hard surfaces is a recognized mechanism, and WCB must account for it.Onset without incident is still compensable.
- 02. A worker who has none of the predisposing factors that would support non-occupational causation is in a stronger position than WCB’s initial denial suggested. Advocates must build that affirmative case from the absence of competing explanations.Risk factor absence matters.
- 03. For workers in health care, retail, manufacturing, and similar industries, this decision confirms that the physical demands of their jobs can and do cause compensable injuries — even when those injuries develop gradually rather than suddenly.Occupational standing is a real mechanism of injury.
- 04. When the evidence points to work and nothing points away from it, WCB is not entitled to a denial. The Appeals Commission’s decision reinforced that this protection has real meaning and must be applied.The benefit of the doubt is a real protection.
VI. Advocacy Lessons
- In conditions with mixed occupational and non-occupational origins, building the negative case — demonstrating what is not present — is as important as establishing the occupational exposure. Both sides of the ledger matter.The absence of risk factors is itself evidence.
- A rapid and specific onset of symptoms following a defined work exposure, in a worker with no prior history, is among the clearest factual patterns available in occupational injury claims. Where that pattern is present, it should be front and centre in the submissions.Timing is a powerful tool.
- WCB’s benefit-of-the-doubt policy exists for situations exactly like this one. Advocates should not leave it to the adjudicator to apply it — it should be identified, cited, and argued as part of every case where the evidence is unbalanced in the worker’s favour.The benefit of the doubt must be actively claimed.
- WCB’s initial denial did not reflect a careful reading of the evidence. The Appeals Commission’s decision did. The difference was the appeal — and the difference the appeal made to our client’s life was significant.Persistence matters.
VII. Conclusion
This was a straightforward case made complicated by WCB’s unwillingness to examine the evidence on its own terms. Our client had no prior foot problems, no risk factors, and a clear and direct timeline connecting her injury to her work. The denial was not grounded in the evidence — it was grounded in a categorical resistance to accepting overuse conditions without a discrete incident.
The Appeals Commission corrected that. Its decision confirmed what the evidence had always shown: this worker’s injury arose from her work, she was entitled to compensation, and WCB’s denial was wrong.
At Blue Collar Consulting, we are committed to ensuring that decisions like WCB’s initial denial do not stand when the evidence says otherwise. Workers deserve to have their claims decided on the facts. When they are not, we appeal. This case is proof that with careful preparation, the right arguments, and persistence, even denials that seem categorical can be overturned. The result here restored our client’s entitlement and reinforced a principle that protects every worker whose overuse injury is dismissed without a genuine look at the evidence.