The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker is appealing the decisions made by the Workers Compensation Board ("WCB") that:

1. Accident of March 1, 2013: The claim is not acceptable; 

2. Accident of June 11, 2013: The claim is not acceptable; 

3. Accident of August 1, 2013: The claim is not acceptable; 

4. Accident of August 20, 2013: The claim is not acceptable; 

5. Accident of July 9, 2013: The worker is not entitled to further benefits after July 26, 2013; 

6. Accident of September 11, 2013: The worker is not entitled to further benefits after February 17, 2014.

A file review was held on March 24, 2020 to consider the worker's appeals.

Issue

1. Accident of March 1, 2013: Whether or not the claim is acceptable; 

2. Accident of June 11, 2013: Whether or not the claim is acceptable; 

3. Accident of August 1, 2013: Whether or not the claim is acceptable; 

4. Accident of August 20, 2013: Whether or not the claim is acceptable; 

5. Accident of July 9, 2013: Whether or not the worker is entitled to further benefits after July 26, 2013; 

6. Accident of September 11, 2013: Whether or not the worker is entitled to further benefits after February 17, 2014.

Decision

1. Accident of March 1, 2013: The claim is not acceptable; 

2. Accident of June 11, 2013: The claim is not acceptable; 

3. Accident of August 1, 2013: The claim is not acceptable; 

4. Accident of August 20, 2013: The claim is not acceptable; 

5. Accident of July 9, 2013: The worker is not entitled to further benefits after July 26, 2013; 

6. Accident of September 11, 2013: The worker is not entitled to further benefits after February 17, 2014.

Background

Accident of March 1, 2013

The worker filed a Worker Incident Report with the WCB on January 12, 2015, indicating she injured both arms and shoulders at work. She reported that her injuries occurred as a result of work she did between March and September 2013, including duties such as pushing and pulling a floor scrubber, using a mop and pail to clean large hallways, lifting and moving heavy tables and carrying large bags of recycling material. The worker noted that she noticed a loss of muscle strength in her arms in August 2013.

The employer filed an Employer’s Incident Report on January 14, 2015 indicating that the worker had not advised that she sustained an injury until January 8, 2015. The employer further noted that the worker had not worked since September 2013 due to compensable and non-compensable injuries.

In discussion with the WCB on January 16, 2015, the worker confirmed her report of injuries from her job duties between March and September 2013. She further confirmed that she had been off work from September 11, 2013 to February 14, 2014 due to symptoms she was experiencing from another WCB claim. When asked by the WCB how her arms and shoulders were during that time, the worker indicated that “…she had lots of pain to her arms” and sought treatment from her family physician, who referred her for an MRI study in December 2014. The worker further advised that her WCB case manager recommended she open a new WCB claim as she was reporting injuries to her arms and shoulders on a different claim with WCB.

On January 16, 2015, the WCB advised the worker that her claim was not acceptable. It was noted that the worker did not report her claim until approximately a year and a half after onset of her symptoms and that there had been no improvement in her symptoms despite not working since September 2013. On January 22, 2015, the worker provided the WCB with a copy of her December 2, 2014 MRI study results along with information from an online medical website.

The WCB advised the worker on January 22, 2015 that the information received had been reviewed but there would be no change to the earlier decision. On January 25, 2015, the worker provided the WCB with further medical information and on January 27, 2015, the WCB again advised the decision remained unchanged.

On January 27, 2015, the worker submitted further medical information and requested reconsideration of the WCB’s decision to Review Office. Review Office determined on February 25, 2015 that due to the significant delay in reporting her injuries, a causal relationship between the worker’s job duties in 2013 and her ongoing difficulties could not be established and her claim was not acceptable.

The worker continued to submit further medical information to Review Office from April 2019 to September 2019 and was advised by Review Office on April 26, 2019, April 30, 2019 and September 13, 2019 that there would be no reconsideration of the February 25, 2015 decision.

Accident of June 11, 2013

The worker filed a Worker Incident Report with the WCB on March 29, 2019 reporting injury to her neck and legs that occurred on January 1, 2013 and which she attributed to her job duties. The worker contacted the WCB on March 29, 2019 to add to her Report that the issues with her legs “…started in May 2013 when pushing floor machine that kept breaking down & then given a machine that didn’t have a wheel drive.”

On April 15, 2019, the employer filed an Employer’s Incident Report with the WCB indicating that the worker had not reported sustaining an injury on January 1, 2013 and had not completed an incident report until March 29, 2019. Further, the employer advised that the worker had remained off work since September 2013.

Between April 2019 and May 2019, the worker provided the WCB with copies of various diagnostic imaging testing and medical reports completed by her healthcare providers. On July 24, 2019, the WCB advised the worker that her claim was not acceptable as the worker’s ongoing symptoms and diagnoses could not be related to her job duties in 2013 or to any workplace incident or incidents that may have occurred.

On July 29, 2019, the worker submitted further information and requested reconsideration of the WCB’s decision to Review Office. The worker provided further information to Review Office on August 6, 2019.

Review Office determined on August 12, 2019 that the worker’s claim was not acceptable. Review Office was unable to establish a relationship between the worker’s difficulties and her job duties as the worker significantly delayed reporting her difficulties and seeking medical attention for the difficulties. Further, Review Office noted the employer’s report that they were unaware the worker had sustained an injury and that the worker had not been at work since September 2013. Review Office also noted that medical evidence from the worker’s treating sports medicine physician dated August 13, 2014 indicated the worker reported bilateral leg pain dating back to 2009, which resulted in testing in 2010.

The worker submitted further information to Review Office in support of her claim and requesting further reconsideration on August 15, 2019, August 23, 2019, August 26, 2019 and August 29, 2019. Review Office determined on September 4, 2019 that as the evidence supported the worker had bilateral leg difficulties in 2009 and the worker delayed in reporting and seeking treatment for her difficulties, her claim was not acceptable. The worker again submitted further information to Review Office on September 6, 2019, September 10, 2019, September 15, 2019, September 19, 2019 and September 23, 2019 and was advised on September 24, 2019 there would be no change to Review Office’s earlier decisions.

Accident of August 1, 2013

On March 27, 2019, the worker submitted a Worker Incident Report to the WCB indicating she injured both her wrists and fingers at work on August 1, 2013. In the Report, the worker advised that she was not sure of the exact date of her injury but related it to job duties involving screwing and unscrewing boards multiple times while cleaning during the summer of 2013. She also noted carrying heavy tables “several days after” the duties involving the boards.

On the same date, a report dated March 9, 2018 from the worker’s treating plastic surgeon to the worker’s treating family physician was provided to the WCB noting that the worker had previously undergone carpal tunnel decompression surgery on her left hand and recommending the surgery for her right hand despite normal nerve conduction studies for that hand.

The worker provided the WCB with copies of medical information, including nerve conduction studies, pre and post-surgery reports and notes of her medications on April 2, 2019. Further information was provided by the worker on April 8, 2019, April 14, 2019 and April 15, 2019.

The employer submitted the Employer’s Incident Report on April 15, 2019. The employer advised that they were not aware the worker sustained an injury on August 1, 2013 as it had not been reported to them until April 9, 2019. The employer further noted that the worker had not worked since September 11, 2013.

The worker submitted further information in support of her claim on May 2, 2019 and May 3, 2019.

On July 22, 2019, the WCB advised that worker that her claim was not acceptable. While acknowledging the job duties the worker reported she was performing when she developed the symptoms did require a level of force and repetition, the WCB found the worker’s job duties to be varied and noted she was not required to consistently perform forceful and/or repetitive duties. Accordingly, the WCB could not relate her wrist difficulties with the job duties performed in 2013.

The worker submitted further information on July 29, 2019 and requested reconsideration of the WCB’s decision to Review Office. The worker provided additional information on August 6, 2019, August 7, 2019, August 15, 2019, August 16, 2019 and September 6, 2019.

On September 19, 2019, Review Office determined the worker’s claim was not acceptable. Review Office found that due to the six year delay in reporting her injuries and the minimal medical evidence that documented the worker’s bilateral wrist difficulties, it was unable to establish a relationship between the worker’s wrist difficulties and her job duties performed in 2013. The worker submitted further information on September 23, 2019 and on September 24, 2019, Review Office advised the worker there would be no change to the earlier decision.

Accident of August 20, 2013

On July 22, 2019, the worker filed a Worker Incident Report with the WCB reporting that she injured her buttocks, back and right leg in a slip and fall incident at work on August 20, 2013. In her report, the worker noted that the incident was witnessed by a co-worker. When she sought treatment on August 26, 2013 for an unrelated issue, she mentioned the incident and again mentioned it to her doctor on September 9, 2013, when she was referred for x-rays.

The worker also provided WCB with a copy of the Employee Accident Report dated August 20, 2013 that was provided to her employer, a copy of the September 9, 2013 chart note from her treating family physician and a copy of the September 10, 2013 x-ray results. The Employee Accident Report confirmed the worker’s description of the incident. The September 9, 2013 chart note indicated the worker reported “lots of pain in R (right) leg now from hip and into foot, especially R (right) leg” after the incident, and the x-ray report indicated normal findings.

In a discussion with the employer on July 22, 2019, the employer confirmed the worker did complete an incident report however, the employer advised the worker was contacted on August 30, 2013 and she advised she did not miss any time from work and did not seek treatment. The Employer submitted their Employer’s Incident Report to the WCB on July 23, 2019 and confirmed the information provided on July 22, 2019.

The WCB advised the worker on July 24, 2019 that her claim was not acceptable. The WCB noted that the worker reported her slip and fall incident to her employer; however, she advised her employer on August 30, 2013 that she did not miss time or seek treatment related to the incident. The complaints reported to the treating physician on September 9, 2013 were not consistent with the areas of injury report to the employer. It was also noted that the medical evidence did not support an injury or injuries sustained from the incident. Further, as the worker did not report her difficulties to the WCB until July 22, 2019, the WCB was unable to relate her ongoing difficulties to an incident on August 20, 2013.

The worker requested reconsideration of the WCB’s decision to Review Office on July 29, 2019 and submitted further information in support of her request. Additional information was provided by the worker on August 8, 2019, August 15, 2019 and August 16, 2019. On August 20, 2019, a report dated August 12, 2019 was received from the worker’s treating family physician. The August 12, 2019 report outlined a diagnosis of “soft tissue trauma” after the worker reported her slip and fall accident on August 20, 2013. It further noted continued upper and lower back pain and multiple musculoskeletal complaints from the 2013 incident. The WCB advised the worker on August 21, 2019 that this new medical information was reviewed but there was no change to the earlier decision. The worker re-submitted her request for reconsideration to Review Office on September 6, 2019. Further information was provided by the worker on September 10, 2019 and September 12, 2019.

Review Office determined on September 13, 2019 that the worker’s claim was not acceptable. Review Office relied and placed weight on the information provided closest to the August 20, 2013 incident indicating the worker did have a slip and fall incident but did not sustain an injury. As such, Review Office found the worker’s claim was not acceptable.

Accident of July 9, 2013

The worker filed a Worker Incident Report with the WCB on July 9, 2013. She reported an injury to her stomach that occurred when she was struck by the handle of a floor scrubber. The worker sought treatment for her injury on July 10, 2013 and was diagnosed with a “traumatic abdominal injury”; however, no visible bruising was noted by her family physician. The physician recommended the worker remain off work for five to seven days.

The employer filed an Employer’s Incident Report on July 11, 2013 and sent the WCB an email on July 12, 2013 noting their concerns with the worker’s claim.

At a follow-up appointment with her treating physician on July 15, 2013, the physician recommended the worker remain off work until July 21, 2013. The worker’s claim was accepted by the WCB on July 23, 2013. In a discussion about her claim with her WCB adjudicator on July 24, 2013, the worker confirmed the mechanism of injury and advised at her doctor’s appointment on July 19, 2013, the physician recommended that she could return to work, on modified duties, on July 29, 2013.

The WCB discussed the worker’s claim with her family physician on July 26, 2013. The physician advised the WCB that the worker’s injury had resolved and she could return to work on July 29, 2013. The physician’s report of the same date confirmed this information and set out restrictions of no lifting greater than 10 pounds and for the worker not to use a specific floor scrubbing machine. The worker’s entitlement to benefits ended when she returned to her full regular duties, with restrictions, on July 29, 2013.

On April 20, 2019, the worker provided the WCB with copies of medical information related to her non-compensable health condition and requested the WCB reinstate her benefits as she suffered injuries to her upper and lower back in addition to her stomach from the July 9, 2013 incident. On July 24, 2019, the WCB advised the worker she was not entitled to benefits after July 26, 2013 as the medical evidence she provided did not support her current ongoing difficulties were related to her July 9, 2013 claim. Further, the WCB advised that the worker’s injury from the July 9, 2013 incident had resolved and she was not entitled to benefits after July 26, 2013.

The worker requested reconsideration of the WCB’s decision to Review Office on August 26, 2019 and provided further information in support of her request on August 31, 2019 and September 6, 2019.

On September 23, 2019, Review Office found that the worker was not entitled to further benefits after July 26, 2013. Review Office found, upon reviewing the worker’s various claim files, that she did not report a back injury to her employer, the WCB or her treating healthcare providers while this claim was active. As such, Review Office determined that the worker did not sustain injury to her back as a result of the July 9, 2013 incident and the medical evidence on file supported that she recovered from the abdominal injury by July 26, 2013.

The worker submitted further medical information to Review Office on September 23, 2019 and on September 24, 2019, Review Office advised the worker there was no change to the earlier decision.

Accident of September 11, 2013

The worker reported to the WCB on September 13, 2013 that she injured her neck in an incident at work on September 11, 2013. She described the incident as:

The elevator was out of order which I needed to take the garbage out. So I pushed my white wagon of garbage down the stairs. After 2 steps I decided to pull it. So I went in front of it, the weight of the wagon with the garbage when it landed down to the step it pulled me down unexpectedly, took me by surprise. This is when I heard my neck cracking, snapping sound, and my neck pulled apart hard. Was very painful. Right after I felt a very painful headache on the left side of my head. When I would move my neck side to side it makes a cracking sound. It is my neck at the back that I feel the severe pain.

The worker also provided the WCB with photo images of the worksite where the incident occurred.

The employer filed an Employer’s Incident Report on September 13, 2013 confirming the incident and advising that the worker had not yet returned to work.

In a discussion with her WCB adjudicator on September 16, 2013, the worker confirmed the mechanism of injury and advised that she was seen by her family physician that day. The WCB received a copy of the September 16, 2013 x-ray report indicating no fractures in the cervical spine. At an initial physiotherapy assessment on September 23, 2013, the worker reported neck pain when lifting or carrying, and frontal headaches. The physiotherapist diagnosed the worker with a cervical sprain/strain and recommended that the worker could return to modified duties in one to two weeks once her pain and inflammation had decreased. The worker continued to receive physiotherapy treatment and remained off work. At a physiotherapy appointment on December 6, 2013, the worker reported neck pain and cracking, headaches and difficulty sleeping. The physiotherapist noted that the worker was not progressing as expected with treatment.

Due to her ongoing issues, a call-in examination with a WCB medical advisor was arranged. On February 5, 2014, the worker attended at the WCB for a call-in examination with a WCB medical advisor. After the examination, the WCB medical advisor opined that the worker’s probable diagnosis from the workplace accident on September 11, 2013 was a cervical muscle strain. Further, the WCB medical advisor opined that due to the length of time since the injury and lack of medical evidence of any “…radiculopathic process that might explain prolonged recovery”, the worker’s current presentation could not be causally related to the September 11, 2013 workplace accident. The WCB medical advisor went on to note that the worker could return to work without restrictions.

The WCB advised the worker on February 7, 2014, that based on the WCB medical advisor’s examination and a review of her file, it determined she no longer had a loss of earning capacity and as of February 17, 2014, she would not be entitled to further benefits.

On October 22, 2014, the worker submitted further medical information and requested the WCB reinstate her benefits. On October 24, 2014, the WCB advised the information was reviewed, but there would be no change to the February 7, 2014 decision.

On October 29, 2014, the worker requested reconsideration of the WCB’s decision to Review Office. The worker requested Review Office to review the information she previously submitted in support of her request. Review Office determined on December 18, 2014 that the worker was not entitled to benefits after February 17, 2014, relying upon the WCB medical advisor’s opinion that the worker’s compensable injury was a cervical muscle strain which would have recovered in a short duration and that her ongoing difficulties were not related to the workplace accident of September 11, 2013.

The worker filed an appeal to the Appeal Commission on March 13, 2015, but requested on September 5, 2015 that her appeal be cancelled.

On April 2, 2019, the worker submitted additional information, including diagnostic imaging reports, medical reports and portions of information from her other WCB claims, requesting that the WCB review her entitlement to further benefits. The worker submitted further information to the WCB on April 4, 2019, April 5, 2019, April 12, 2019, May 2, 2019 and May 3, 2019. The WCB advised the worker on May 3, 2019 that the information was reviewed but it was determined the information did not establish a causal effect between her current difficulties and the workplace accident of September 11, 2013 and there would be no change to the February 7, 2014 decision.

The worker again submitted further information and on May 14, 2019, requested reconsideration of the WCB’s decision to Review Office. Review Office advised the worker on May 16, 2019 that there would be no change to the December 18, 2014 decision that she was not entitled to benefits after February 17, 2014. The worker provided further information to Review Office on May 23, 2019 and was again advised on May 30, 2019 by Review Office the decision remained unchanged.

On July 29, 2019, August 6, 2019, August 15, 2019, August 16, 2019, September 6, 2019 and September 10, 2019, additional information was provided to Review Office and the worker again requested reconsideration of the previous WCB and Review Office decisions. Review Office considered all the material submitted by the worker in support of her reconsideration request and found that the worker had been diagnosed with “widespread chronic symptoms” including fibromyalgia and myofascial neck complaints that could not be related to the compensable neck injury that occurred many years previous to these diagnoses. Accordingly, on September 13, 2019, Review Office upheld the previous decision that the worker was not entitled to benefits after February 17, 2014.

All Claims

The worker filed an appeal with the Appeal Commission for all of her claims on September 30, 2019. File reviews were arranged.

Reasons

Applicable Legislation

The Appeal Commission and its panels are bound by The Workers Compensation Act (the "Act"), regulations under that Act and the policies established by the WCB's Board of Directors.

The Act sets out the definition of an accident in s 1(1) as a chance event occasioned by a physical or natural cause, as a result of which a worker is injured. The definition includes events arising out of and in the course of employment as well as occupational disease.

When it is established that a worker has been injured as a result of an accident at work, the worker is entitled to benefits under s 4(1) of the Act. Those benefits may include wage loss benefits where there is a loss of income earning capacity arising out of the injury, as set out in s 39 of the Act, or medical aid as required to cure and provide relief from injury arising out of a compensable accident, provided under s 27 of the Act.

The Act requires in s 17(1) that an injured worker report an accident to their employer within 30 days after the injury occurs. Further, the Act requires in s 19(2) that an application for compensation be filed with the WCB within one year after the date of injury, subject to s 109 which allows the WCB to enlarge the time period for application where an injustice would result as a result of failing to do so.

Worker’s Position

The worker’s position is outlined in the numerous written submissions to the Appeal Commission, received on November 26, 2019, December 2, 2019, December 6, 2019, December 10, 2019, December 11, 2019, December 17, 2019, February 27, 2020, March 3, 2020, March 18, 2020 and March 23, 2020. The worker’s submissions included photographs and medical reports annotated by the worker, print-outs of web-based medical materials as well as various handwritten correspondence from the worker to the Appeal Commission.

The worker explained that sometimes she has difficulty in making herself clear in response to questions, whether from her doctor or WCB or even in the previous hearing before the Appeal Commission.

The worker’s position is that her current physical complaints relating to her wrists, shoulders, fingers, arms and neck as outlined in the various medical reports she provided, on file, all relate to the workplace injuries that occurred from March through September 2013. She stated in her submissions that her current diagnoses of fibromyalgia and carpal tunnel syndrome are related to and the result of the September 11, 2013 neck injury.

The worker stated that her prior diagnoses related to her knees and carpal tunnel syndrome should not be considered in addressing the claims arising from the injuries she reported in 2013. She noted as well that she first sustained a neck injury in 1999 which arose out of a motor vehicle accident.

The worker stated that the claims related to the accident of March 1, 2013, the accident of June 11, 2013 and the accident of September 11, 2013 are all linked together and relate to a single incident. She stated that the arm weakness she experienced in 2013 led to the injury to her neck on September 11, 2013, but that the WCB required these injuries to be addressed in multiple claims. She stated her belief that the WCB’s acceptance of her neck injury arising out of the accident of September 11, 2013 should therefore lead to acceptance of the injuries she reported as arising out of those claims as well.

The worker disputed the employer’s claim that there was a working elevator she could have used so as to avoid having to transport the wagon with recycling and garbage down stairs. She provided photographs of the equipment she used in her work and the work environment to illustrate how far she had to carry heavy loads in carrying out her work duties, resulting in overuse injuries. The worker provided additional detail on the nature of the high force repetitive tasks undertaken at work in summer 2013, resulting in her wrist and hand injuries. The worker explained that it took her until 2018 or 2019 to understand that her injuries and physical complaints all arose out of the reported workplace restrictions incidents of 2013.

In sum, the worker urged the appeal panel to view the various claim files as an inter-connected series of events that resulted in multiple injuries to the worker and continue to contribute or to cause her ongoing physical complaints.

Employer’s Position

The employer did not participate in the appeals.

Analysis

This appeal deals with six different accident claims filed by the appellant worker, all arising during 2013. The panel considered the totality of evidence presented by the worker as well as the contents of each of these claim files in determining the issues before us. For the reasons outlined below, with respect to each claim in turn, the panel dismissed the worker’s appeals on all claims.

Accident of March 1, 2013

The issue for determination on this claim is whether the claim is acceptable. In order to find that it is, the panel would have to determine that the worker was injured as a result of an accident that occurred arising out of and in the course of her employment. The panel was not able to make such a finding.

The worker made a claim on January 12, 2015 arising out of her reported injury to both shoulders and arms, including her wrists and hands that occurred, according to information on file over the course of March through September 2013 in the course of the worker’s employment.

According to the worker’s reports, she injured her shoulders and arms in the course of completing her work duties, including pushing and pulling a heavy floor scrubber, moving heavy tables and carrying heavy recycling bags. She reported that she first became aware of the injury during July and August of 2013 when she noticed muscle weakness in her arms.

The panel noted that the worker did not report injury to her arms and shoulders to her employer during this time period, although she did report other injuries during this time period, relating to the accidents of July 9, 2013 and September 11, 2013. With the exception of a period of medical leave related to the accident of July 9, 2013, the worker continued in her employment until the injury of September 11, 2013. The employer first learned of this reported injury in January 2015.

The panel reviewed the medical reports for 2013 in particular and noted that objective findings do not support that the worker injured her arms and shoulders as described, during this period of time, neither as a traumatic nor cumulative injury. Further, the panel noted that the most recent medical findings with respect to the worker’s shoulders and arms also do not support a finding that the ongoing difficulties are related to the reported mechanism of injury.

There is a significant delay in reporting of this injury, both to the employer and to the WCB. Such a delay adds to the challenges the panel finds here in establishing a causal link between the worker’s job duties and her reported injury. While the worker explained that she became aware of this injury in summer of 2013, she has not provided a satisfactory explanation for the delay in reporting.

The panel finds that the evidence does not support, on a balance of probabilities that the worker’s reported injury arose out of and in the course of her employment. Furthermore, the panel finds that the worker’s delay of some 17 months in reporting the injury to the WCB is significant and that the evidence does not support, on a balance of probabilities that an injustice would result if the time period for reporting were not enlarged.

The claim is therefore not acceptable. The appeal is dismissed.

Accident of June 11, 2013

The issue for determination on this claim is whether the claim is acceptable. In order to find that it is, the panel would have to determine that the worker was injured as a result of an accident that occurred arising out of and in the course of her employment. The panel was not able to make such a finding.

The worker made a claim to the WCB on March 29, 2019 for injury arising out of and in the course of her employment. Initially, the claim indicated an incident date of January 1, 2013 but the worker subsequently clarified that the incident occurred on June 11, 2013 and was reported to her supervisor the same date. The worker claimed injury to her neck and legs related to her employment duties. The employer stated it was not aware of the injury until hearing from the WCB on March 29, 2019.

The worker indicated that as a result of repetitive overhead work she injured her neck. Further, as a result of pushing the floor cleaning machine and other duties, including lifting desks and tables, summer cleanup and carrying recycling bags, she also injured her legs. She reported that as a result, on June 11, 2013 she paid another employee to finish her floor cleaning duties for that shift.

The panel noted that the worker’s report of mechanism of injury relates to many of the same job-related tasks that were reported to be the cause of the injury sustained in relation to the accident of March 1, 2013.

The panel reviewed the medical reporting with respect to the worker’s neck condition and finds that there is evidence of degenerative changes in the worker’s cervical spine, but there is no evidence to support a repetitive strain injury as might be expected given the reported mechanism of injury. Further, the medical reporting with respect to the worker’s leg complaints does not support a finding that the issues arose out of the worker’s job duties in 2013. In fact, there is evidence that the worker had pre-existing knee and leg problems dating back to 2009 at least. There are not medical findings to support any aggravation or enhancement of a pre-existing condition, however.

There is a significant delay in reporting of this injury, both to the employer and to the WCB. Such a delay adds to the challenges the panel finds here in establishing a causal link between the worker’s job duties and her reported injury. While the worker explained that she became aware of these injuries in the spring of 2013, she has not provided a satisfactory explanation for the delay in reporting.

The panel finds that the evidence does not support, on a balance of probabilities that the worker’s reported injury arose out of and in the course of her employment. Furthermore, the panel finds that the worker’s delay of some six years in reporting the injury to the WCB is significant and that the evidence does not support, on a balance of probabilities that an injustice would result if the time period for reporting were not enlarged.

The claim is therefore not acceptable. The appeal is dismissed.

Accident of July 9, 2013

The issue for the panel to determine is whether the worker is entitled to further benefits after July 26, 2013. In order to find that she is, the panel would have to determine that the worker continued to suffer a loss of earning capacity or required additional medical aid to address the injury sustained in the accident of July 9, 2013. The panel was not able to make such findings.

The worker’s claim arose out of an incident at work in which she sustained a trauma injury to her abdomen. The worker reported the injury to her employer and to the WCB on the date it occurred. She saw her family physician on July 10, 2013 who advised that she remain off work through July 22, 2013.

The panel noted that the treating physician initially reported to the WCB on July 15, 2013 noting that the worker complained of abdominal pain due to trauma, but that there were no objective findings noted. An x-ray was ordered and the worker was advised to rest and take mild analgesic medication. A July 24, 2013 note from the treating physician stated the worker could return to regular duties on July 29, 2013 with some restrictions noted. The WCB spoke with the physician on July 26, 2013 and he advised that there was a psychological aspect to the injury such that the worker did not want to use the machine that caused her injury. The physician reported that the injury itself had resolved.

On the basis of the physician’s statement that the worker’s injury was resolved, the WCB determined that the worker could return to regular duties after July 26, 2013.

The worker has noted ongoing abdominal issues but the medical reporting indicates that she was diagnosed with a non-compensable abdominal illness as early as 2009 and the subsequent medical reporting does not indicate that this condition was impacted in any way by the July 9, 2013 traumatic injury.

On the basis of the medical findings with respect to this injury, and on the standard of a balance of probabilities, the panel concludes that the worker recovered from the compensable injury by July 26, 2013.

The worker is therefore not entitled to further benefits after July 26, 2013. The appeal is dismissed.

Accident of August 1, 2013

The issue for determination on this claim is whether the claim is acceptable. In order to find that it is, the panel would have to determine that the worker was injured as a result of an accident that occurred arising out of and in the course of her employment. The panel was not able to make such a finding.

The worker made a claim to the WCB on March 27, 2019 for injury arising out of and in the course of her employment. In her report the worker noted that she injured her wrists and hands during the summer of 2013 as a result of job duties that included removing and re-installing a number of boards, that had to be unfastened and refastened by hand. She stated that she was injured as a result of undertaking the repetitive task of removing and re-inserting the screws that fastened these boards, using both her hands.

The panel noted that the WCB file documents that the worker had evidence of bilateral carpal tunnel syndrome as early as April 2010.

The panel noted that the worker had just returned to work with restrictions on July 29, 2013 from the July 9 injury. She next saw her treating family physician on August 12, 2013 with respect to problems related to her knees. Although unclear from the documentation on file when and why an x-ray was ordered, the worker had an x-ray of both hands taken on August 12, 2013. The results indicate some minimal joint space narrowing in the 1st and 2nd fingers of both hands with normal mineralization, and no other “significant bony, soft tissue or joint abnormalities” indicated.

While the evidence suggests that the worker had pre-existing bilateral wrist complaints, there is no evidence of any specific injury or trauma to her wrists occurring in August 2013, nor are there any medical findings to support that her pre-existing condition was aggravated or exacerbated by the work duties undertaken at that time.

There is a significant delay in reporting of this injury, both to the employer and to the WCB. Such a delay adds to the challenges the panel finds here in establishing a causal link between the worker’s job duties and her reported injury. While the worker explained that she became aware of these injuries in the summer of 2013, she has not provided a satisfactory explanation for her delay in reporting.

The panel finds that the evidence does not support, on a balance of probabilities that the worker’s reported injury arose out of and in the course of her employment. Furthermore, the panel finds that the worker’s delay of nearly six years in reporting the injury to the WCB is significant and that the evidence does not support, on a balance of probabilities that an injustice would result if the time period for reporting were not enlarged.

The claim is therefore not acceptable. The appeal is dismissed.

Accident of August 20, 2013

The issue for determination on this claim is whether the claim is acceptable. In order to find that it is, the panel would have to determine that the worker was injured as a result of an accident that occurred arising out of and in the course of her employment. The panel was not able to make such a finding.

The worker made a claim to the WCB on July 22, 2019 for injury arising out of and in the course of her employment. In her report the worker noted that she injured her buttocks and right leg on August 20, 2013 when she slipped and fell on a wet floor while mopping. The worker completed an Employee Accident Report for her employer on August 20, 2013 describing a slip and fall with landing on her buttocks and left hand. A note on that report, submitted by the employer, indicates that as of August 30, 2013, there was no related time loss and the worker had not seen a doctor. Consistent with that note, the employer advised the WCB on July 23, 2019 the worker advised the employer “…that she did not miss any time from work nor had she sought medical attention. She also indicated that she was alright.”

The worker advised the WCB that she saw her treating family physician on August 26, 2013 but notes that his report does not mention the slip and fall. She saw another physician on September 9, 2013. The chart note from that appointment confirms that the worker reported that she fell at work on August 20, 2013, slipping on a freshly washed floor. The chart note indicates that the worker “landed right on her behind” and reported “lots of pain in [right] leg now from hip and into foot.” Objective findings from that visit note a normal hip exam, but an x-ray was ordered. The x-ray results of September 10, 2013 are normal and indicate no changes have occurred since the previous study of September 25, 2012. No “acute process” is identified.

The worker’s treating family physician did submit a Doctor First Report to the WCB with respect to this incident on August 20, 2019, indicating injury to the worker’s right leg and hip as a result of the slip and fall six years earlier. The physician indicates a diagnosis of soft tissue trauma in 2013, and reports current findings of continued upper and lower back pain, multiple musculoskeletal complaints and muscular pain.

On the basis of the evidence reviewed, the panel is satisfied that the worker did fall at work on August 20, 2013, but in order to find that the claim is acceptable, the panel must find that not only did the fall occur, but also the worker was injured as a result. The evidence here does not support that conclusion. There are no medical findings from around the time of the reported injury to support that the worker was injured as a result of the fall. Further the panel notes the employer’s evidence that the worker reported on August 30, 2013 that she was all right. Further, the worker continued to work at her regular duties until she was injured on September 11, 2013 and then left work thereafter related to that injury.

Again, there is a significant delay in reporting of this injury to the WCB. As noted above, such a delay adds to the challenges the panel finds here in establishing a causal link between the worker’s job duties and her reported injury.

The panel finds that the evidence does not support, on a balance of probabilities that the worker’s reported injury arose out of and in the course of her employment. Furthermore, the panel finds that the worker’s delay of nearly six years in reporting the injury to the WCB is significant and that the evidence does not support, on a balance of probabilities that an injustice would result if the time period for reporting were not enlarged.

The claim is therefore not acceptable. The appeal is dismissed.

Accident of September 11, 2013

The issue for the panel to determine is whether the worker is entitled to further benefits after February 17, 2014. In order to find that she is, the panel would have to determine that the worker continued to suffer a loss of earning capacity or required additional medical aid to address the injury sustained in the accident of September 11, 2013. The panel was not able to make such findings.

The worker reported to the WCB on September 13, 2013 that she injured her neck at work in the course of completing work duties on September 11, 2013. She reported the incident to her employer on the day that it happened. The WCB accepted the worker’s claim and benefits were provided until February 17, 2014. On February 7, 2014 the WCB advised the worker that it was unable to accept further responsibility for the worker’s injury as it could no longer confirm that there was a loss of earning capacity or requirement for medical aid related to the September 11, 2013 compensable workplace injury.

In considering whether the worker is entitled to further benefits beyond February 17, 2014, the panel reviewed the medical findings, summarized as follows:

• On September 16, 2013, the worker reported a neck injury to her primary care physician, complaining that after her neck “snapped” at work, she was experiencing pain and headaches. The physician reported findings of restricted range of motion and recommended physiotherapy and use of hot/cold compresses. 

• A cervical spine x-ray taken September 18, 2013 revealed loss of normal cervical lordosis, no pre-vertebral swelling and no evidence of fracture or dislocation. The x-ray also revealed some narrowing at both the C5-C6 and C6-C7 level, as well as degenerative changes. 

• At a follow up assessment on September 20, 2013, the treating physician noted objective findings of severe restriction in range of motion, most severe in lateral rotation in both directions. 

• On September 23, 2013 the worker was assessed for physiotherapy. That report notes impairment of mobility in the worker’s cervical spine and reduced strength in her neck. The diagnosis provided is of cervical sprain/strain. 

• Physiotherapy reports dated October 28 and November 8, 2013 indicate ongoing painful range of motion in the worker’s cervical spine and continued subjective complaints of neck pain and headaches. 

• On December 6, 2013, the physiotherapist noted that the worker was not progressing as elected and continued to present with neck pain and headaches. 

• A WCB physiotherapist advisor reviewed the file on December 30, 2013 and concluded there was no evidence of “sustained benefit with treatment on review of the physiotherapy and/or medical reports.” 

• At a WCB call in examination on February 5, 2014, the worker complained of intermittent sharp pain in the mid-neck, worsened by heavy pushing and pulling as well as turning her head suddenly. She noted that the headaches initially experienced after the injury had resolved, as had associated difficulty with sleeping. She reported she had completed physiotherapy and was not doing any home exercises. On examination, the WCB physician noted significant emotional distress, mildly restricted range of motion of the cervical spine in forward flexion and extension that appeared to be related to left-sided neck pain. The medical advisor confirms the initial diagnosis of cervical strain and noted that based upon the current examination, “…it appears unlikely that the current presentation relates causally to the effects of the September 2013 injury.” The examination revealed “…evidence of nonspecific pain without evidence of a neurologic nerve root impingement” that might explain the prolonged recovery. The medical advisor concluded that it was probable the worker could return to work and that restrictions were not warranted. 

• A May 17, 2015 cervical spine MRI study revealed multilevel degenerative changes “not significantly changed compared to the previous MRI study from January 2011.”

Based upon the medical reporting, the mechanism of injury and the accepted compensable diagnosis of a cervical strain injury, the panel accepts the conclusions reached by the WCB medical advisor on February 5, 2014. The evidence does not support an ongoing causal link between the worker’s ongoing complaints and the cervical strain injury sustained on September 11, 2013, nor does it support that there was any aggravation or enhancement of the worker’s pre-existing degenerative cervical spine issues.

The panel finds, on a balance of probabilities, that the worker’s compensable injury was resolved by February 17, 2014 and that any requirement for medical aid or loss of earning capacity beyond that date was not related to the compensable workplace injury of September 11, 2013.

Therefore there is no entitlement to benefits after February 17, 2014. The appeal is dismissed.

Panel Members

K. Dyck, Presiding Officer
P. Challoner, Commissioner
M. Kernaghan, Commissioner

Recording Secretary, J. Lee

K. Dyck - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 12th day of May, 2020