The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker appealed the Workers Compensation Board ("WCB") decision that their permanent partial impairment rating of 5% and the associated monetary award of $7,300.00 were correctly calculated. A file review took place on April 22, 2025 to consider the worker's appeal.

Issue

Whether or not the worker's permanent partial impairment rating of 5% and the associated monetary award of $7,300.00 have been correctly calculated.

Decision

The worker's permanent partial impairment rating of 5% and the associated monetary award of $7,300.00 were correctly calculated.

Background

The WCB accepted the worker’s claim of a psychological injury that occurred as a result of an incident at work on June 4, 2020. Based on the report from the treating psychiatrist of August 9, 2020 and a review of the worker's file by a WCB psychological consultant on October 4, 2020, the WCB accepted the diagnosis of post-traumatic stress disorder (“PTSD”). The WCB established permanent restrictions on November 29, 2022 which the employer accommodated in an alternate position since January 2023.

On September 23, 2024, a WCB psychiatric consultant reviewed the worker’s claim file to determine eligibility for a permanent partial impairment (“PPI”) rating and award. The consultant reviewed the recent reports from the treating therapist and the treating physician as well as noting the worker’s own report to the WCB case manager and concluded the worker was at maximum medical improvement and recommended that the WCB arrange a PPI examination of the worker.

The worker attended an examination with a WCB psychiatric consultant on October 7, 2024. After meeting with the worker, the consultant provided the worker’s overall impairment rating was 5%, calculated as the median rating from the worker’s Brief Psychiatric Rating Scale (“BPRS”) score of 30%, the Global Assessment of Functioning Scale (“GAF”) score of 5% and the Psychiatric Impairment Rating Scale (“PIRS”) score of 5%. The consultant noted the worker did not have pre-existing or co-existing diagnoses that would affect this rating.

On October 24, 2024, the WCB advised the worker of the PPI rating of 5% and of the associated monetary award. On November 4, 2024, the worker requested Review Office reconsider the WCB’s decision. The worker provided additional information to Review Office on December 4, 2024 in support of their request and the employer provided its submission to Review Office on January 24, 2025. The worker submitted their responses to the employer’s submission on January 27, 2025 and February 3, 2025.

On February 5, 2025, Review Office determined the worker’s PPI rating of 5% and associated monetary award of $7,300.00 were correct. The worker filed an appeal with the Appeal Commission on February 19, 2025 and a hearing was arranged. The appeal panel requested additional medical information prior to discussing the case further. After the requested information was received and provided to the interested parties for comment, the appeal panel met on August 7, 2025 and rendered its decision on the issues under appeal.

Reasons

Applicable Legislation and Policy

The provisions of The Workers Compensation Act (the “Act”) in effect as of the date of the accident are applicable to the worker’s appeal. The Act provides in s 4(1) that compensation is payable when a worker sustains personal injury by accident arising out of and in the course of the employment. Section 37 of the Act outlines that compensation under the Act includes an impairment award. Section 38 of the Act provides that the WCB “…shall determine the degree of a worker's impairment expressed as a percentage of total impairment” and pay the worker a lump sum impairment award calculated as set out in s 38(2). Section 38(4) provides that to determine the amount of an impairment award, the amounts in subsection (2) in effect on the day of the accident are to be used. The WCB has established Adjustment in Compensation Tables which provide for the benefit levels for accidents from 1992 to 2025, which set out that for accidents after 2005, the impairment award only varies by the degree of impairment and legislative amount. Table 4 provides for an impairment award of $1,460 for each full 1% of impairment in relation to accidents occurring in 2020.

If a worker has a permanent impairment and experience a significant deterioration of their medical condition, they may apply to the board under s 38(6) to reconsider their degree of impairment and, where the reconsideration results in a change in the percentage of the impairment, the board shall treat the reconsideration as though it were an initial determination under this section but s 38(8) limits such applications to be made 24 months or more after a decision of the WCB or the Appeal Commission respecting a worker’s degree of impairment.

The WCB’s Policy 44.90.10, Permanent Impairment Rating (the "PPI Policy”) describes how permanent impairment ratings are calculated. The Policy provides that the degree of impairment will be established by the WCB's Healthcare Services Department in accordance with the Policy, and that whenever possible and reasonable, impairment ratings will be established strictly in accordance with Schedule A to the Policy. The Policy notes that PPI awards are not related to loss of earning capacity and are not a proxy for loss of earning capacity but represent the percentage of impairment as relates to the whole body.

Schedule A to the PPI Policy outlines the process by which the degree of permanent impairment from a workplace injury should be evaluated. The Schedule defines an impairment as “…a significant deviation, loss, or loss of use of any body structure or body function in a person with a workplace injury or occupational disease” and notes that an impairment is considered permanent when, in the opinion of the WCB, the condition to be rated has reached maximum medical improvement (“MMI”). Impairment rating of psychological function is determined through clinical examination or assessment of the medical information on file, in accordance with the specified scales outlined in the Schedule, when practical. The Schedule specifies that the following scales are used in determining a psychological impairment rating: Brief Psychiatric Rating Scale (“BPRS”), Global Assessment of Functioning Scale (“GAF”) and Psychiatric Impairment Rating Scale (“PIRS”), with the calculation process outlined in the Schedule. The Schedule also provides that an “impairment rating does not indicate whether an individual can work or not.”

Worker’s Position

The worker’s position as outlined in their submissions of April 9, 2025, April 10, 2025 and June 23, 2025, is that the psychiatric assessment findings do not provide an accurate picture of the worker’s overall psychiatric status and condition, but rather are biased and portray only a specific point-in-time that does not reflect the worker’s day to day functioning and degree of impairment. The worker noted that the assessment findings do not consider other information in their claim file, including information related to their family and spousal relationships, and that the WCB psychiatric consultant did not consider that information. The worker further noted that their degree of psychological functioning is due to their reliance on medications and that without those medications, their “progress swiftly disintegrates which would leave [them] impaired well beyond 5%.”

Employer’s Position

The employer representative outlined the employer’s position in their written submissions dated April 10, 2025 and June 27, 2025. The employer’s position is that the WCB correctly determined that the worker’s PPI rating is 5%, which resulted in a monetary award of $7,300 to the worker, and that the evidence, including the September 23, 2024 opinion of the WCB psychiatric consultant and the findings from the October 7, 2024 psychiatric examination of the worker by the WCB consultant support this conclusion. Therefore, the employer’s position is that the worker’s appeal should not be granted.

Analysis

The worker’s appeal arises out of the WCB’s determination that, as a result of the compensable psychological injury sustained in an incident on June 4, 2020, they have a permanent partial impairment rated at 5% and are entitled to a related monetary award of $7,300. For the worker’s appeal to succeed, the panel would have to find that the WCB failed to correctly apply the provisions of the Act and the applicable Policy in establishing the worker’s PPI rating and associated monetary award. As detailed in the reasons that follow, the panel was not able to make such findings and therefore the worker’s appeal is denied.

The panel reviewed the WCB claim file in relation to the worker’s psychological injury, and considered the written submissions provided by both the worker and the employer in relation to this appeal. We noted that the WCB determined on September 23, 2024 that the worker had reached the point of maximum medical improvement, as is required by the PPI Policy.

Schedule A of that policy defines maximum medical improvement as “…the point of recovery, as determined by the WCB, when a medical condition is well stabilized and unlikely to change substantially in the following year with or without treatment.” We noted that the consultant considered the most recent reporting by the worker’s treating therapist and physician, as well as the information the worker provided to the WCB, in reaching this conclusion, and that based on this determination, the WCB psychiatric consultant recommended that the worker attend a call-in examination for assessment of the extent or degree of impairment related to the worker’s compensable psychological injury.

The panel also considered the findings from the October 7, 2024 examination of the worker by the WCB psychiatric consultant, including the detailed scoring under the three psychological measurement scales outlined in Schedule A to the PPI Policy and the process by which the WCB consultant determined the worker’s specific PPI rating. In considering the evidence, the panel finds no fault in the process by which the WCB psychiatric consultant assessed the worker’s PPI rating in relation to their compensable psychological condition. Based on the October 7, 2024 report findings, the panel is satisfied that the WCB undertook the appropriate measures and processes in its assessment of the degree of the worker’s impairment as required under the provisions of the PPI Policy. We note the WCB psychiatric consultant assessed the worker’s BPRS, GAF and PIRS scores as required by Schedule A. The examination report indicates a BPRS score of 59, which corresponds to an impairment rating of 30% per Table 20-2, a GAF score of 61-70, which corresponds to 5% per Table 20-3, and the sum of PIRS middle scores of 3, which corresponds to 5% per Table 20-10. Based on these scores, the WCB psychiatric consultant determined, as required and set out in Table 20-11, that the worker’s PPI rating was 5%.

The worker submitted that the assessment scoring does not accurately reflect their current status and overall condition and further, that the scoring contains an element of bias or subjectivity. The panel acknowledges that these tools measure the findings of the psychiatric consultant only on a particular date at a particular time, and as such, may not be indicative of the worker’s status and condition on any other date or time. We further acknowledge that it is possible that the worker’s condition may have changed since the assessment was conducted but that does not invalidate the psychiatric consultant’s findings at that time. We also acknowledge the subjective nature of such assessments and as such, given the nature of the worker’s diagnosis, agree that it is possible that the findings could be different today or even could have been different soon after the assessment date. In this regard, we note that the Act provides that if there is a change in the worker’s status and condition, after 24 months following such assessment or a determination of the worker’s PPI rating, the worker may be entitled to a reassessment of the degree of permanent impairment under the provisions of the Act.

The panel also considered whether the WCB appropriately calculated the worker’s PPI monetary award as required and we are satisfied based on the file information and applying the provisions of the Act and the applicable Adjustment in Compensation Tables that the WCB correctly determined that the worker was entitled to an award of $7,300 based on a 5% PPI rating.

Based on the evidence before us and on the standard of a balance of probabilities, the panel is satisfied that the PPI rating of 5% and the monetary award of $7,300 were correctly calculated. The worker’s appeal is denied.

Panel Members

K. Dyck, Presiding Officer
J. Peterson, Commissioner
M. Kernaghan, Commissioner

Recording Secretary, J. Lee

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

Signed at Winnipeg this 8th day of August, 2025