Decision #45/24 - Type: Workers Compensation


The worker is appealing the decision made by the Workers Compensation Board ("WCB") that the additional PPI rating of 4.08% and the monetary award of $6,250.00 was correctly calculated. A file review was held on March 13, 2024 to consider the worker's appeal.


Whether or not the additional PPI rating of 4.08% and the monetary award of $6,250.00 was correctly calculated.


The additional PPI rating of 4.08% and the monetary award of $6,250.00 was correctly calculated.


The worker has an accepted WCB claim for an injury to their right index finger that occurred at work on July 23, 2013. The worker sustained a transverse fracture to their finger after a hoist slipped and jammed their right index finger, causing a fracture. The worker underwent surgery on July 31, 2013. The worker's claim was accepted, and they received various benefits including wage loss and medical aid.

On September 16, 2014, the worker attended at the WCB for a call-in examination with a WCB medical advisor for the purpose of determining a permanent partial impairment (“PPI”) rating and monetary award. After examining the worker, the WCB medical advisor opined the worker was entitled to a 2.00% cosmetic impairment rating and a 0.92% rating for loss of mobility in their right index finger for a total PPI rating of 2.92%. On September 17, 2014, the WCB advised the worker of the rating and the monetary award of $2,500.00. The worker requested reconsideration of the WCB's decision and Review Office determined on December 22, 2014, the PPI rating and monetary award were calculated correctly.

A report from the worker's treating hand specialist was received by the WCB on November 22, 2019 for a November 20, 2019 appointment. The worker reported ongoing difficulties with their right index finger and increased difficulties after jamming that finger while carrying and lifting something heavy. X-rays taken after the incident did not indicate a fracture but the worker was given a splint to use. The specialist discussed different treatment options with the worker including a fusion of their proximal interphalangeal (“PIP”) joint or amputation of the index finger at the PIP joint or proximal to the metacarpophalangeal (“MCP”) joint. The worker advised the specialist they would like to think about the options and would contact them again if they wished to proceed with surgery.

A further report was received on September 24, 2020, indicating the worker's reporting of discomfort and pain and decision to proceed with surgery. On November 27, 2020, a WCB plastic surgery consultant spoke with the worker's treating hand specialist regarding the proposed surgery. The specialist advised the consultant the worker's right index finger was "…very stiff and sticks straight out, and could pose a hazard if it gets in the way when he is working." While the specialist could not provide a guarantee, they advised the WCB consultant "…the surgery will be of benefit functionally and the current level of hand function is not likely to worsen." On December 1, 2020, the WCB provided authorization and accepted responsibility for the proposed amputation surgery, which took place on January 27, 2021.

A further surgical procedure was requested by the hand specialist on August 17, 2021 and approved by the WCB on October 26, 2021. On November 15, 2021, the worker underwent an excision of bony exostosis at the right index finger metacarpal.

The worker attended on May 9, 2023 for a further call-in examination to determine if they were entitled to a further PPI rating and monetary award. The WCB medical advisor conducting the examination opined the scarring on the worker's right hand, when compared to folio images on file at the WCB, provided for a cosmetic impairment rating of 1%. With respect to the amputation of a portion of the worker's right index finger, it was noted the WCB's rating schedule provided for a maximum amputation rating of an index finger of 5.0% for the whole finger and 2.5% for the entire metacarpal, with the worker's amputation being 33%, giving a rating of 0.83%. In total, the WCB medical advisor calculated the worker's PPI rating to be a combined rating of 7.00%. On May 12, 2023, the WCB advised the worker they were entitled to a further PPI rating of 4.08% and monetary award of $6,250.00 representing the difference between the 7.00% PPI rating recently calculated and the 2.92% rating they had already received in 2014.

The worker requested reconsideration of the WCB's decision to Review Office on October 10, 2023. The worker noted the PPI examination and subsequent rating and award did not give consideration to the size and length of the scar after their surgeries and in addition, did not take into consideration the limitation and restrictive use they had of their hand due to the amputation.

Review Office found on October 12, 2023, the worker's permanent partial impairment rating of 4.08% and monetary award of $6,250.00 were calculated correctly. Review Office accepted and agreed with the calculations provided by the WCB medical advisor after examining the worker and finds the 7% PPI rating was an accurate rating for the worker's impairment. Review Office acknowledged the worker's concerns noted in their submission but found there are no provisions in the WCB's legislation or policies that cover impact to a worker's activities or pain.

The worker filed an appeal with the Appeal Commission on December 13, 2023 and a file review was arranged.


Applicable Legislation and Policy

The panel is bound by The Workers Compensation Act (“the Act”), regulations and policies of the WCB's Board of Directors. The provisions of the Act in effect on the date of the compensable accident are applicable to the worker’s appeal.

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. Section 37 of the Act outlines that compensation under the Act includes an impairment award, as provided in s 38.

Subsection 38(1) of the Act provides that the WCB "shall determine the degree of a worker's impairment expressed as a percentage of total impairment."

Subsection 38(2) provides a formula to determine the monetary value of an impairment award.

Calculation of impairment award 

38(2) Where the board determines that a worker has suffered an impairment, the board shall pay to the worker as a lump sum an impairment award in the following amount, for an impairment that is determined by the board to be

(a) 1% or greater but less than 30%: $1,030. for each full 1% of impairment;

(b) 30% or greater: $30,900. plus $1,240. for each full 1% of impairment in excess of 30%.

The PPI Policy

The WCB's Policy 44.90.10, Permanent Impairment Rating (the PPI Policy) provides a method for determining the entitlement rating arising out of an injury or disfigurement. The PPI Policy provides that the degree of impairment will be established by the WCB's Healthcare Services Department in accordance with the PPI Policy, and that whenever possible and reasonable, impairment ratings will be established strictly in accordance with the PPI Schedule which is attached as Schedule A to the Policy. Section 3.7 of Schedule A of the PPI Policy provides a step-by-step analysis as follows:

The rating for amputation(s) or loss of movement of a finger, thumb or hand follows a four-stage process:

1. determine which hand chart to use (see Section 3.7.1); 

2. assign the appropriate percentage to each impaired joint (from lateral (thumb); to medial (little finger); 

3. add the percentages together along each digit (from proximal to distal); 

4. Combine the values for each impaired digit using the Combined Values Chart

In all cases of impaired digits, work from the proximal to distal phalanx.

An impairment rating for amputation includes any disfigurement and loss of symmetry associated with the injury.

If a single finger is involved, the single finger chart is used.

Worker's Position

The worker stated they were appealing the PPI award decision as they felt it did not take into account the size of the scar for their amputated finger and did not consider the loss of full use of their dominant right hand and the permanent restrictions they have on their right hand.

Employer's Position

The employer did not participate in the appeal.


The review requires a determination of whether the process in calculating the worker’s rating was done pursuant to WCB’s Policy 44.90.10, Permanent Impairment Rating (“PPI Policy”).

Step 1 of the Analysis: determine which hand chart to use

The worker’s appeal is limited to the injuries that he suffered to his right hand, particularly the total amputation of his right index finger. The Single Finger Chart is the appropriate chart to use in assessing the worker’s PPI rating.

The Single Finger Chart provides percentage points reflecting the amputation level from the phalanx to the ‘joint’ of the finger. The level of phalanx to the joint being removed is rated by percentage points starting from the distal interphalangeal joint (“DIP”) at 2.0%, the proximal interphalangeal joint (“PIP”) at 2.0%, and to the metacarpal phalange joint (“MCP”) at 1.0%. The single hand chart provides a total possible rating of 5.0% for the amputation of the entire finger.

Step 2 and 3: the Amputation and assigning the appropriate percentages

The worker’s entire right index finger was amputated resulting in a maximum 5.00% rating for his finger.

In addition, the Single Finger Chart provides that the carpometacarpal joint (“CMC”), which connects the finger bones to the rest of the hand, provides (in the event of a total amputation of this joint), an additional 2.5% rating to be added to the calculation.

33% of the worker’s CMC joint was removed. This would result in a rating of .83% (or looked at another way, 33% of a possible 2.5% rating).

Therefore, the amputation of the entire right index finger and the partial amputation of the CMC would provide a total rating of 5.83% pursuant to the Single Finger Chart.

The Disfigurement

The disfigurement PPI rating is assessed pursuant to section 9 of Schedule A of the PPI Policy which states: "In order to maintain consistency in ratings for disfigurement, and to make the ratings as objective as possible, the WCB will make reference to a folio of disfigurement ratings established in previous cases."

Schedule A provides that the rating for disfigurement typically ranges between 1.00% to 5.00%, and that an extreme case would garner 25.00%.

The worker’s disfigurement relates to the scarring from the amputation of his right index finger. This scarring was described as ‘scarring/soft tissue thickness’ during the worker’s PPI Examination of May 9, 2023 (“PPI Exam”).

The WCB’s medical advisor provided a 1.00% rating, as they found that the worker’s scar was “sufficient to warrant a cosmetic impairment beyond that included in the amputation rating”. The Panel understands this finding to mean that the worker’s scar met the minimum threshold to trigger a 1.00% rating over and above the rating awarded from the actual amputation.

The WCB medical advisor’s explanation and application of the PPI Policy gives the panel a reasonable explanation regarding how the PPI percentage was achieved. Accordingly, the panel is satisfied that the WCB medical advisor's assessment was conducted in accordance with the process that is set out in the PPI Policy and accepts the medical advisor's conclusion of 1.00% in this regard.

Step 4 combining the ratings under the Combined Values Chart

Combining the aforementioned ratings, the panel found that the worker’s PPI rating is to be calculated as follows:

The Combined Values Chart requires an initial addition of all ratings without rounding up the figures. This would result in the following calculation:

0.83% for the CMC joint partial amputation 

1.00% for the disfigurement 

5.00% for the total loss of the right index finger 

6.83% sub total rating

Next, the figures are then rounded to whole numbers for ratings greater than 5.00%. This results in a rounding up of 6.83% for the worker’s total PPI Rating, for an overall rating of 7.00%.

The panel notes that there were no findings relating to the range of motion issues, as the PPI Exam found that the worker’s “Active guided bilateral thumb, finger, and wrist mobility was observed to be full and equal.” As a result, no values were added for a loss of a range of motion under the Combined Values Chart.

The Review Office, in carrying out the calculation pursuant to the PPI Policy, awarded the amount of $6,250.00 to the worker. This figure factors the worker's total rating, less the previous award provided to the worker in 2014.

The Review Office provided the following calculation, which the panel now adopts:

“Subsection 38(4) of the Act indicates the monetary awards for PPI ratings are calculated as of the date of accident. For accidents occurring in 2013, $1,250.00 for each full 1% of impairment is payable. We note the following calculations:

PPI rating increased to 7% = $1,250.00 x 7 = $8,750.00 

Less 2.92% PPI award issued in 2014 = $2,500.00 

Increased PPI award due = $6,250.00

The Review Office determines, given the increased PPI rating, the worker is entitled to a further monetary award of $6,250.00.”

The panel finds that the calculation of the PPI rating and the monetary amount has been correctly calculated in accordance with the formula in subsection 38(2) of the Act.


Based on the foregoing, the panel finds that the WCB correctly applied the provisions of the Act, regulations and WCB Policy in calculating the worker's degree of permanent partial impairment and associated monetary award in this case. The panel therefore finds that the worker's additional PPI rating of 4.08% and $6,250.00 monetary award have been correctly calculated.

In arriving at our decision, the panel acknowledges the worker's submission with respect to the fact that the worker feels that the PPI award was incorrect in part due to their current scarring being “double or triple the size” of their pre amputation scar, and that there should be a PPI award for the limited and restrictive use of their dominant right hand.

However, the panel is limited to interpreting the Act and the applicable policies of the WCB. The PPI Policy is limited to calculating the specific ratings for disfigurement or permanent impairments. It does not provide for awards for the types of losses that the worker raises.

The worker's appeal is dismissed.

Panel Members

R. Mamucud, Presiding Officer
J. Peterson, Commissioner
M. Kernaghan, Commissioner

Recording Secretary, J. Lee

R. Mamucud - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 10th day of May, 2024