The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

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

Date of Accident - March 2, 2020:

1. There is no entitlement to further benefits.

Date of Accident - November 21, 2020:

2. The worker's right shoulder surgery is not accepted in relation to the claim; and 3. There is no entitlement to benefits beyond April 2, 2021.

A hearing was held on December 13, 2022 to consider the worker's appeal.

Issue

Date of Accident - March 2, 2020:

1. Whether or not the worker is entitled to further benefits in relation to the March 2, 2020 accident.

Date of Accident - November 21, 2020:

2. Whether or not responsibility should be accepted for the worker's right shoulder surgery in relation to the November 21, 2020 accident; and 3. Whether or not the worker is entitled to benefits after April 2, 2021.

Decision

Date of Accident - March 2, 2020:

1. The worker is not entitled to further benefits in relation to the March 2, 2020 accident.

Date of Accident - November 21, 2020:

2. Responsibility should be accepted for the worker's right shoulder surgery in relation to the November 21, 2020 accident; and 

3. The worker is entitled to benefits after April 2, 2021.

Background

Date of Accident - March 2, 2020

On March 4, 2020, the worker reported injuring his lower back and right shoulder on March 2, 2020 when he slipped and fell down approximately four steps as he was escorting someone down the stairs. The worker noted he had symptoms of a sore lower back and soreness in his shoulder but had not sought medical treatment and was self-treating the symptoms. In a conversation with the WCB on April 7, 2020, the worker confirmed he had not missed time from work, had not sought medical treatment and had no medical expenses.

The worker contacted the WCB on March 31, 2021 to discuss a recurrence of his injury. The WCB spoke with the worker on April 7, 2021, and again on April 28, 2021, when the worker advised he would like to have his claim re-opened to investigate a recurrence as he believed a more serious injury occurred. It was noted the worker had further WCB claims and was gathering medical information which he believed would support a recurrence. The worker also requested a statement be taken from a co-worker to provide additional information on his claim.

On May 14, 2021, the worker's representative requested reconsideration of the WCB's decision on another of the worker's claims which made note of the March 2, 2020 workplace accident, described as "…a fall onto an outstretched hand from which [the worker] reported he felt a tear in his right shoulder" and submitted that mechanism of injury accounted for a labral tear and there was a causal relationship between the March 2, 2020 accident and the worker's ongoing symptoms and his other WCB claims. On May 14, 2021, the worker's representative was advised that a further investigation would take place.

On May 27, 2021, the WCB contacted the worker for a status update. The worker advised he felt 50% stronger since his last accident but was still struggling. He indicated that a further MRI study was scheduled for October 2021 to determine if the tear in his shoulder was bigger than shown in a previous MRI performed in December 2020. The worker also provided the WCB with the contact information for his co-worker who he believed could provide further information.

The WCB spoke with the worker's former co-worker on May 27, 2021. The co-worker advised he stopped working with the worker in April 2020, but had been working with the worker for two years prior to that. The co-worker further advised he was behind the worker when he fell and that it was a pretty significant fall. The co-worker noticed that the worker displayed signs he was in discomfort and pain after the incident, and would often stretch his arm out or do something to keep his arm moving due to pain. The co-worker could not identify specific complaints, but could tell the worker continued to have pain in his shoulder. The co-worker noted they were involved in a motor vehicle accident a few weeks after the March 2, 2020 incident, and they stopped working together after that.

On May 28, 2021, the WCB received a copy of the December 29, 2020 MRI of the worker's right shoulder. The MRI indicated mild-moderate glenohumeral osteoarthritis and degenerative tearing posterior labrum with paralabral cyst.

On June 3, 2021, the WCB advised the worker that they had determined he had recovered from the workplace accident and his current symptoms were more likely related to a pre-existing degenerative condition. On August 3, 2021, the worker's representative requested that Review Office reconsider the WCB's decision. The representative argued that the March 2, 2020 incident and subsequent incidents had all contributed to the worker's current right shoulder difficulties and need for surgery. On October 4, 2021, the employer provided a submission in support of the WCB's decision the worker was not entitled to further benefits, noting that in their opinion, the worker only sustained a strain to his right shoulder as a result of the March 2, 2020 incident, and the worker's ongoing issues were the result of pre-existing issues. On October 12, 2021, the worker's representative provided a response to that submission.

On October 19, 2021, Review Office determined that the worker was not entitled to further benefits in relation to the March 2, 2020 incident. Review Office acknowledged the information gathered from the worker's co-worker who noted the worker had difficulties after the incident was helpful to establish the incident caused the worker problems. However, Review Office found that as there was no further contact with the worker after April 7, 2020 and no medical treatment sought, they were unable to establish the worker continued to experience difficulties after that date or suffered a recurrence of this injury.

Date of Accident - November 21, 2020

On November 24, 2020, the worker reported to the WCB he again injured his right shoulder in an incident at work on November 21, 2020. The worker described having to use a rope to slide down quickly using both hands and feeling immediate pain and tearing in his right shoulder. The worker finished his shift and continued to work, noting severe pain at night and an inability to sleep on his right shoulder, as well as pain when raising his right arm above his head. The employer provided an Employer's Incident Report on November 25, 2020 and noted a similar mechanism of injury.

On November 26, 2020, the worker attended for medical treatment, reporting a painful shoulder after climbing down a rope at work on November 21, 2020 and feeling a tear in his shoulder. The treating physician recorded the worker had full range of motion, with slight tenderness over the lateral aspect of the right pectoral muscle, and provided a diagnosis of "likely tear on right pectoral muscle." The physician referred the worker for physiotherapy.

On December 2, 2020, the worker attended an initial physiotherapy assessment. The worker reported pain centered over the anterior and lateral shoulder region, decreased strength at shoulder level and above, and increased pain with all activities above shoulder height. Tenderness was also noted over the supraspinatus tendon insertion point. The treating physiotherapist queried a right shoulder rotator cuff partial tear vs acute tendonitis.

At a follow-up appointment with the treating physician on December 15, 2020, the physician referred the worker for an MRI. The MRI, performed December 29, 2020, indicated mild to moderate glenohumeral osteoarthritis and degenerative tearing posterior labrum with paralabral cyst.

On January 25, 2021, a WCB medical advisor reviewed the worker's file and opined that the compensable diagnosis with respect to the November 21, 2020 workplace accident was a shoulder strain as set out on the December 12, 2020 physiotherapy report and the MRI requisition completed by the worker's treating physician. The medical advisor opined that "Strain injuries typically resolve over a period of a few days to a few (4-6) weeks." The medical advisor further noted there was evidence of pre-existing conditions, with the December 29, 2020 MRI indicating "…pre-existing labral tearing (evidence by the presence of a labral cyst) and mild-moderate associated glenohumeral joint osteoarthritis." The medical advisor also noted the worker was working his regular duties, and it was anticipated that with participation in physiotherapy, there would be continued improvements in the worker's symptoms.

The worker was referred to an orthopedic surgeon. At an appointment on February 23, 2021, the orthopedic surgeon noted the worker's complaints of ongoing right shoulder pain after being injured at work on November 2020. On examination, the surgeon found the worker had no visible wasting or deformity, full range of motion with a painful arc, and mild tenderness over the posterior joint line. The surgeon noted the worker had a positive empty can test, O'Brien's test, and posterior labral grind test. The surgeon recommended arthroscopic assessment with a view to a posterior labral tear repair, a check of the subacromial space and possible decompression.

On March 26, 2021, the WCB medical advisor completed a further review of the worker's file. The medical advisor reviewed the information from the orthopedic surgeon and spoke with the surgeon to clarify some of the information on March 25, 2021. The medical advisor also discussed the proposed surgery with two other WCB medical advisors and opined that the surgery was appropriate, but appeared to be related to the pre-existing condition rather than any material effects of the compensable injury. On March 26, 2021, the WCB advised the worker that they had determined he had recovered from the November 21, 2020 workplace accident and his entitlement to benefits would end on April 2, 2021.

On April 6, 2021, the treating physiotherapist provided the WCB with a discharge report indicating the worker reported a further incident at work that resulted in significantly increased shoulder pain, and the worker had started a new WCB claim. The treating orthopedic surgeon also provided a letter dated April 6, 2021 in support of the request for approval for the arthroscopic surgery. The surgeon noted there was a "…definite temporal relation to work related injuries…" and that the worker "…likely had enhancement of work related injury with worsening pre-existing condition." On April 20, 2021, the WCB provided the worker with a letter advising there would be no change to the earlier decision. On April 29, 2021, the WCB received a copy of a report by the treating physiotherapist dated April 6, 2021, in support of the worker's request for further benefits. The physiotherapist noted the worker's progress had slowed and plateaued, which led to an MRI being ordered. The physiotherapist advised the MRI showed a worsening or aggravation of the damage noted on the previous MRI and explained the worker's slower than expected recovery. On May 3, 2021, the WCB requested a further opinion from the WCB medical advisor, and on May 12, 2021, the medical advisor opined that the additional medical evidence did not support a change to the earlier opinion. On May 13, 2021, the WCB advised the worker that following a review of his file by the WCB medical advisor, there was no change to the decision that he had recovered from the compensable injury and his entitlement to benefits ended on April 2, 2021.

On August 3, 2021, the worker's representative requested that Review Office reconsider the WCB's decision. The representative submitted the worker continued to experience symptoms in his right shoulder as a result of the November 21, 2020 accident and required surgery for treatment of the injury, and as such, should be entitled to further benefits, including coverage for the proposed surgery. On October 4, 2021, the employer provided a submission in support of the WCB's decision, and the worker's representative provided a response to that submission on October 12, 2021.

On October 19, 2021, Review Office determined there was no entitlement to benefits beyond April 2, 2021, and the right shoulder surgery was not accepted. Review Office accepted and agreed with the opinions of the WCB medical advisors that the worker's compensable injury was a right shoulder strain injury in the environment of pre-existing factors, and found that there was no indication the worker had any additional injury to the right shoulder as the diagnostic test results showed only pre-existing factors. Review Office further noted the worker's treating healthcare providers did not provide any work restrictions for the worker, with the worker self-limiting his activities.

With respect to the proposed right shoulder surgery, Review Office accepted the opinion of the WCB medical advisor who, after speaking with the treating orthopedic surgeon, opined that the surgery was directed at the worker's pre-existing condition of labral tearing and associated glenohumeral joint osteoarthritis, with there being no clinical evidence of material change in the pre-existing conditions noted on the December 29, 2020 MRI which could be attributed to the effects of the compensable injury. Review Office concluded that there was no relationship between the worker's compensable strain injury as a result of the November 21, 2020 workplace accident and the need for the worker's right shoulder surgery.

Both Claims

On May 13, 2022, the worker's representative filed an appeal from the decisions on both claims with the Appeal Commission and an oral hearing was arranged.

Following the hearing, the appeal panel requested additional medical information prior to discussing the case further. The requested information was later received and was forwarded to the interested parties for comment. On February 21, 2023, the appeal panel met further to discuss the case and render its decision on the issues under appeal.

Reasons

Applicable Legislation and Policy

The Appeal Commission and its panels are bound by The Workers Compensation Act (the "Act"), regulations made under the Act and policies established by the WCB's Board of Directors. The provisions of the Act which were in effect as at the date of the worker's accidents are applicable.

Subsection 4(1) of the Act provides that where a worker suffers personal injury by accident arising out of and in the course of employment, compensation shall be paid.

Subsection 4(2) provides that a worker who is injured in an accident is entitled to wage loss benefits for the loss of earning capacity resulting from the accident, but no wage loss benefits are payable where the injury does not result in a loss of earning capacity during any period after the day on which the accident happens.

Subsection 27(1) of the Act states that the WCB "…may provide a worker with such medical aid as the board considers necessary to cure and provide relief from an injury resulting from an accident."

Subsection 39(2) of the Act provides that the WCB will pay wage loss benefits until such time as the worker's loss of earning capacity ends, or the worker attains the age of 65 years.

WCB Policy 44.10.20.10, Pre-existing Conditions (the "Policy"), addresses eligibility for compensation in circumstances where a worker has a pre-existing condition. The purpose of the Policy is stated, in part, as follows:

The Workers Compensation Board (WCB) will not provide benefits for disablement resulting solely from the effects of a worker's pre-existing condition as a pre-existing condition is not "personal injury by accident arising out of and in the course of the employment." The WCB is only responsible for personal injury as a result of accidents that are determined to be arising out of and in the course of employment.

With respect to wage loss eligibility, the Policy states, in part, that:

When a worker has:

1) recovered from the workplace accident to the point that it is no longer contributing, to a material degree, to a loss of earning capacity, and

2) the pre-existing condition has not been enhanced as a result of compensable injury arising out of and in the course of the employment, and

3) the pre-existing condition is not a compensable condition, the loss of earning capacity is not the responsibility of the WCB and benefits will not be paid.

The following definitions are set out in the Policy:

Pre-existing condition: A pre-existing condition is a medical condition that existed prior to the compensable injury.

Aggravation: The temporary clinical effect of a compensable injury on a pre-existing condition such that the pre-existing condition will eventually return to its pre-accident state unaffected by the compensable injury.

Enhancement: When a compensable injury permanently adversely affects a pre-existing condition.

Worker's Position

The worker was represented by a worker advisor, who filed a written submission in advance of the hearing and made an oral submission at the hearing, a copy of which was also provided to the panel. The worker responded to questions from his representative, and the worker and the representative responded to questions from the panel.

The worker's position was that both the March 2 and November 21, 2020 accidents caused more significant injuries than the WCB recognized, which conservative efforts could not resolve, necessitating surgical intervention, and the worker's appeals for further benefits and with respect to the performed surgical procedures should be granted.

With respect to the March 2, 2020 claim, the worker's representative submitted that the WCB did virtually no investigation on this claim, such that the file notes are incomplete and contain little or no insight into the worker's status. It was submitted that such omissions are significant.

The worker's representative acknowledged that the worker reported his symptoms had resolved within one or two months of the accident, but submitted that this did not rule out the worker having sustained a significant injury or injuries. The representative submitted that the mechanism of injury, combined with the worker's age and absence of prior right shoulder difficulties, was capable of causing a significant structural injury.

The worker's representative encouraged the panel to consider that the worker's concerns at the time with respect to being exposed to COVID and his evidence that the adjudicator had told him he was waiving the need for medical reporting as a mitigating factor.

The worker's representative asked that the panel accept the opinions of the worker's treating and consulting healthcare providers, noting in particular the September 30, 2022 report of the physician with an interest in occupational health medicine.

With respect to the second and third issues, relating to the November 21, 2020 accident, the worker's representative indicated that they were again relying on the opinions of the treating healthcare providers which had been provided in advance of the hearing, in terms of that accident having caused and/or enhanced the worker's right shoulder conditions and led to a need for surgery.

The worker's representative noted that the mechanism of injury in this case was consistent with the types of traumatic mechanism which are accepted as causing a shoulder labrum injury, and submitted that based on the documented examination findings, the full extent of the worker's injury was missed or misdiagnosed during the initial medical appointments. It was submitted that the treating orthopedic surgeon's diagnoses were likely present and symptomatic from the start of the claim. The representative submitted that the initial assessments do not support the worker sustained only a shoulder strain or disprove the worker suffered more significant injuries.

The worker's representative asked that the panel attach no weight to the WCB medical consultant's comments that there was no evidence of a diagnosis beyond a degree of shoulder strain and that shoulder surgery was not related to the accepted compensable injury of a shoulder strain. The representative noted, in part, that the initial healthcare providers did not diagnose a shoulder strain, and the consultant's diagnosis of a strain was therefore made in default.

The worker's representative submitted that while the WCB medical advisor opined that it was speculative to conclude that the November 2020 accident caused an enhancement, this would apply both ways, such that it was similarly speculative for the WCB medical advisor to conclude that the December 2020 MRI results would have been the same before the worker's injuries, without medical evidence of that. The worker's representative further submitted that while the WCB medical consultant had stated that the treating orthopedic surgeon agreed that it was speculative to conclude the compensable injury had caused further injury to the labrum or an enhancement, it was clear from the March 15, 2022 letter from the treating orthopedic surgeon, provided in advance of the hearing, that the surgeon did not agree on that point.

In conclusion, it was submitted that but for the November 2020 workplace accident, the worker would not have needed the surgery which was proposed in February 2021 and performed in May 2022, and asked that the panel grant the worker's appeals for further benefits and with respect to the performed surgical procedures.

Employer's Position

The employer was represented by its Workers Compensation Coordinator, who made a submission at the hearing, and responded to questions from members of the panel.

The employer's position was that the worker sustained nothing more than a shoulder strain at the time of the March 2, 2020 and November 21, 2020 incidents, and the need for the worker's right shoulder surgery was solely due to the worker's pre-existing conditions.

With respect to the March 2, 2020 accident, the employer's representative submitted that there is no evidence to support that the worker sustained anything more than possibly a minor strain at that time. The representative submitted that file information confirms that the worker did not seek medical attention at that time or at any time following the injury, and the worker did not miss time from work following the injury.

The employer's representative noted that the worker did not have further contact with the WCB concerning the claim over a period of approximately one year, until he contacted the WCB in March 2021 with respect to a recurrence. In the employer's view, no recurrence occurred in this case. The representative noted that in several instances the worker advised the WCB that he had fully recovered, that his symptoms had completely resolved in one to three months, that he had no ongoing difficulties, and that he was able to resume 100% of his duties without experiencing difficulties with his right shoulder. Accordingly, it was submitted that the appeal with respect to this claim should be dismissed.

With respect to the November 21, 2020 accident, the employer's representative submitted that no responsibility should be accepted for the worker's right shoulder surgery in relation to that incident. The representative stated that in the employer's view, the need for this surgery was the result of the worker's pre-existing osteoarthritic issues and degenerative changes in his right shoulder and these were not enhanced by the November 2020 incident.

The employer's representative noted that the treating orthopedic surgeon's report and request for approval of that surgery were considered by three WCB medical advisors internally, who also contacted the treating surgeon to discuss this matter. The representative submitted that the medical advisor's subsequent report provided a reasonable synopsis of what was discussed, including that the December 2020 MRI did not provide objective evidence of a material change in the pre-existing conditions which could be attributed to the effects of the compensable injury, and that it was agreed the proposed surgery was appropriate, but the need for it appeared to be in relation to the pre-existing condition rather than any material effect of the compensable injury.

The employer's representative submitted that while the treating orthopedic surgeon has opined that the worker likely had an enhancement of the work-related injury with a worsening pre-existing condition, this is speculative, and without compelling or supporting evidence. The representative stated that in their view, it is clear that the proposed surgery, which was performed in May 2022, was to remedy the degenerative changes in the worker's right shoulder and was not related to the November 21, 2020 accident. The representative therefore submitted that no responsibility should be accepted for the worker's right shoulder surgery in relation to that accident, and the appeal on this issue should be dismissed.

With respect to the third issue, being entitlement to ongoing benefits after April 2, 2021, the employer's representative noted that the claim was accepted for a sprain/strain injury to the right shoulder, medical aid benefits were payable, and it did not appear that the worker missed any time from work at the beginning of November or the following months. On March 26, 2021, the WCB determined that the worker had recovered from the effects of the compensable injury and that any ongoing issues were solely related to his pre-existing shoulder issues.

The employer's representative stated that they believed the information supported the determination that the worker had recovered from the compensable injury, and the pre-existing condition was not enhanced and was not related to that injury. The representative therefore submitted that the worker had recovered from the effects of that compensable injury and was not entitled to any further benefits beyond April 2, 2021, and the appeal on that issue should also be dismissed.

Analysis

Date of Accident – March 2, 2020

Issue 1: Whether or not the worker is entitled to further benefits in relation to the March 2, 2020 accident.

For the worker's appeal on this issue to be successful, the panel must find, on a balance of probabilities, that the worker has suffered a further loss of earning capacity and/or requires further medical aid in relation to the March 2, 2020 workplace accident or injury. The panel is unable to make that finding for the reasons that follow.

The panel finds that there is a lack of medical evidence to indicate that the worker sustained anything more than a sprain/strain injury. The panel acknowledges the worker's reference to the adjudicator having indicated he would waive the requirement for medical reporting. In the absence of sufficient evidence, however, the panel is unable to find that the worker has continued to suffer from his compensable injury.

Information on file indicates that the worker advised on several occasions that he had recovered from the effects of his March 2, 2020 workplace accident within approximately one month after that accident. In his evidence at the hearing, the worker confirmed that by April or May 2020 his symptoms had resolved to the point that he did not notice any pain in his shoulder, and he did not recall having any difficulties or symptoms leading up to the November 21, 2020 workplace accident. The worker further confirmed that he felt his shoulder was at 100%.

The worker's representative relied on the September 30, 2022 report of the physician with an interest in occupational health medicine, noting the physician opined in that report that the March 2, 2020 work injury might explain "…the occasional episodes of shoulder instability that followed, and the development of degenerative changes on the December 29, 2020 MRI." The panel is unable to place much weight on that comment, which we find, without more, to be speculative in nature.

Based on the foregoing, the panel finds, on a balance of probabilities, that the worker has not suffered a further loss of earning capacity or required further medical aid in relation to the March 2, 2020 workplace accident of injury. The panel therefore finds that the worker is not entitled to further benefits in relation to the March 2, 2020 accident.

The worker's appeal on this issue is dismissed.

Date of Accident – November 21, 2020

Issue 2: Whether or not responsibility should be accepted for the worker's right shoulder surgery in relation to the November 21, 2020 accident.

For the worker's appeal on this issue to be successful, the panel must find, on a balance of probabilities, that the worker's right shoulder surgery is causally related to the November 21, 2020 workplace accident.

Based on our review of all the evidence which is before us, on file and as presented at the hearing and in response to a request from the panel following the hearing, the panel is able to make that finding.

Based on the evidence, the panel is satisfied that the mechanism of injury with respect to the November 21, 2020 accident was particularly significant and would have resulted in more than a sprain/strain injury. The worker provided further details with respect to the accident at the hearing. The worker noted that he had to work quickly, without observing due diligence, that he ran as quickly as he could to get down to the embankment, and after tying the rope to the rail, he jumped and it was a "very long way down" to the ground. He also noted that at the time he was wearing and carrying with him an extra 50 pounds of clothing and equipment at a minimum.

In his February 23, 2021 report to the WCB, the treating orthopedic surgeon recommended arthroscopic assessment with a view to a posterior labral tear repair, a check of the subacromial space and possible decompression. The WCB medical advisor reviewed the worker's file and considered that recommendation, together with two other WCB medical consultants, and noted on March 26, 2021 that it was agreed that "the proposed surgery is appropriate, but the need for it appears to be in relation to the pre-existing condition rather than any material effects of the ci. (compensable injury)". While the proposed surgery was therefore not authorized at the time, this was said to be because it was not considered to be related to the compensable injury.

The panel places weight on the April 6, 2021 report of the treating orthopedic surgeon, who opined:

I reassessed [the worker] in the office today. He has previously planned right shoulder scope for mild to moderate glenohumeral osteoarthritis and posterior labral tear with para-labral cyst that was not approved by WCB.

Going back over his history, there is definite temporal relation to work related injuries and in this picture, even though that it is an oseoarthritic premature degenerative picture, he likely had enhancement of work related injury with worsening pre-existing condition.

The panel also places weight on the March 15, 2022 correspondence from the treating surgeon which was submitted in advance of the hearing, where the surgeon stated:

I do maintain my opinion that there is a definite temporal relationship related to work related injuries in this picture even though there is an osteoarthritic premature degeneration and he likely had enhancement of work-related injury and worsening pre-existing condition…

I believe that both the pre-existing posterior labral tear, which actually leads to premature osteoarthritis of the shoulder, and the osteoarthritis were both enhanced by the injury…

I believe that the consultants' comments on March 26th, 2021, were accurately reflected with the exception that I believe the conclusions are those of the medical consultant rather than mine. That conclusion was more or less expressed to me by the medical consultant and I then took time to review the records or talk to the [worker] again. I reserved judgment, therefore, I still standby my previous statement having reviewed the records more extensively.

The evidence at the hearing indicated that the proposed surgery was subsequently performed by the treating orthopedic surgeon on May 16, 2022. A copy of the Operative Note of the surgery, which was provided at the request of the panel following the hearing, indicated that the procedure which was performed was "Right shoulder scope, debridement of glenoid, microfracture of glenoid, debridement of humeral head and posterior labrum repair."

The panel is satisfied that the evidence supports that the worker had not recovered from his November 2, 2021 injury as at April 2, 2021, and that he continued to experience shoulder pain, with discomfort at night, loss of range of motion, and shoulder instability through to the time of his May 16, 2022 surgery. At the hearing, the worker indicated that since the surgery, his shoulder is "really good as far as pain, but it's lacking some range…But I am glad I got it much more stable." Based on the evidence and on a balance of probabilities, the panel is satisfied that the November 21, 2020 workplace accident resulted in an enhancement of the worker's right shoulder condition and symptoms, and which led to the need for, and was causally related to, the May 16, 2022 surgery.

Based on the foregoing, the panel finds, on a balance of probabilities, that the worker's right shoulder surgery is causally related to the November 21, 2020 workplace accident. The panel therefore finds that responsibility should be accepted for the worker's right shoulder surgery in relation to the November 21, 2020 accident.

The worker's appeal on this issue is allowed.

Issue 3: Whether or not the worker is entitled to benefits after April 2, 2021.

For the worker's appeal on this issue to be successful, the panel must find, on a balance of probabilities, that the worker is entitled to benefits beyond April 2, 2021 in relation to his November 21, 2020 workplace accident. The panel is able to make that finding.

Given our findings on Issue #2 above, that responsibility should be accepted for the worker's right shoulder surgery in relation to the November 21, 2020 accident, the panel is further satisfied that the worker is entitled to benefits beyond April 2, 2021 in relation to that accident.

The worker's appeal on this issue is allowed.

Panel Members

M. L. Harrison, Presiding Officer
J. Peterson, Commissioner
M. Payette, Commissioner

Recording Secretary, J. Lee

M. L. Harrison - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 18th day of April, 2023