The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker appealing the Workers Compensation Board ("WCB") decision that they are not entitled to benefits after January 24, 2024. A hearing took place on April 28, 2025 to consider the worker's appeal.

Issue

Whether or not the worker is entitled to benefits after January 24, 2024.

Decision

The worker is not entitled to benefits after January 24, 2024.

Background

The worker provided a Worker Incident Report to the WCB on May 11, 2023, reporting an injury to their left buttock and hip region that occurred as a result of an incident at work on May 3, 2023. The worker described feeling a tweak in their left hip when loading heavy objects into a customer’s truck. The worker noted they sought chiropractic treatment on May 4, 2023 and May 9, 2023 and medical treatment with their family physician on May 10, 2023, at which time the physician advised the worker to remain off work for two weeks.

The family physician’s report of May 10, 2023 noted the worker complained of pain in their left hip and decreased mobility after moving a heavy object and feeling a tweak/pop to their left gluteal muscles and hip area. The physician found decreased range of motion in the worker’s left hip and pain with both internal and external rotation and flexion. The physician diagnosed hip sprain and recommended time off work.

On May 11, 2023, the WCB received the employer’s Accident Report outlining a similar mechanism of injury to that reported by the worker and noting modified duties were not available. The WCB accepted the worker’s claim on May 15, 2023 and began providing benefits to the worker.

When the worker saw the family physician on May 23, 2023, they reported improvement in their symptoms but noted their hip hurt after performing yard work the previous day. On examination, the physician noted full range of motion, much improved from the previous appointment, with normal internal and external rotation, but some tenderness with active hip flexion. The physician noted the worker was continuing with physiotherapy and recommended sedentary duties.

The WCB provided the worker’s restrictions to the employer on May 25, 2023 and the employer again advised they could not accommodate the worker. On June 8, 2023, the worker advised the WCB that they attempted to return to work the previous Monday and Tuesday but lasted only a couple of hours due to pain. The same day, the employer confirmed the worker worked 2 hours on both June 5 and 6, 2023, and had not returned since.

On June 22, 2023, the WCB received a report from the treating chiropractor for the assessment of May 4, 2023. The chiropractor noted the worker’s report of left gluteal region pain that travelled into the back of the worker’s upper leg, pain when bending over and stretching to the right and pain into the lower left limb. The chiropractor diagnosed left glute and external rotator strain with associated myofascitis and left lumbar strain and recommended medium capacity duties for two months, with a subsequent return to work on reduced hours.

On June 26, 2023, the worker advised they were feeling fully recovered and had returned to their regular duties on June 20, 2022. The WCB wrote to the worker on the same date and advised them as they were working regular duties and not seeking medical treatment for their injury, the WCB would close the claim.

On July 10, 2023, the WCB received a report from the treating family physician indicating that on July 5, 2023, the worker reported that when doing physiotherapy stretches at home, they felt their hip "go" and had pain since that time. The physician also noted the worker attempted to work 7 hours the previous day with increasing symptoms. The physician found full range of motion in the left hip with pain with palpation of the greater trochanter and a positive Trendelburg test finding. The physician recommended further physiotherapy, acupuncture and massage therapy and light duties of minimal walking/carrying/standing.

A July 7, 2023 physiotherapy report outlined a diagnosis of grade 3 strain in the worker’s left hip and recommended restrictions.

On July 11, 2023, the employer confirmed the worker struggled when they attempted to resume regular duties and was off work since July 5, 2023. The employer confirmed it could not accommodate the worker’s restrictions and the WCB resumed payment of wage loss benefits.

A second physiotherapist assessed the worker on August 1, 2023, and provided a diagnosis of hip strain and hip joint sprain, recommended further treatment and outline workplace restrictions. The worker saw an orthopedic specialist on August 24, 2023 who reviewed x-rays taken on August 1, 2023 and noted the indication of osteoarthritis. The worker reported persistent left buttock pain, increased with walking and physical activity. On examination, the specialist found pain with deep palpation at the worker's left buttock and painful range of motion at the left hip. The specialist noted the worker had mild osteoarthritis and provided a diagnosis of fractured left acetabulum osteophyte. The specialist recommended desk duties and referred the worker to an orthopedic surgeon for a possible left hip arthroscopy.

An MRI study of the worker’s left hip on November 22, 2023 indicated mild left hip osteoarthritis and "Labral ossification bilaterally with paralabral cysts on the left resulting in acetabular over coverage. Small left femoral Cam deformity." On December 28, 2023, an orthopedic surgeon assessed the worker, noting their report of a twist injury to their left hip with acute onset of pain to the area, as well as "…left groin pain consistent with intra-articular hip pain" and mechanical symptoms with certain movements. The surgeon reviewed the MRI findings and concluded that "…given the extent of degenerative change it's not clear that a hip arthroscopy would be of any therapeutic benefit." The surgeon diagnosed left hip impingement and noted the worker may require a total hip replacement in the future but at that time recommended an ultrasound-guided injection.

On January 4, 2024, a WCB medical advisor reviewed the worker’s claim file and concluded that the diagnostic imaging confirmed the worker had "…significant pre-existing degenerative osteoarthritis with collar osteophytes." The medical advisor also noted the imaging was suggestive of a possible earlier dysplasia.

On January 18, 2024, the WCB advised the worker it determined they had recovered from their compensable left hip strain and were not entitled to further benefits after January 24, 2024.

A WCB orthopedic consultant reviewed the worker's file on January 25, 2024 and opined the worker's diagnosis was a left hip sprain/strain in the environment of significant pre-existing degenerative osteoarthritis, with a natural history of recovery with conservative management in two to three weeks. The orthopedic consultant also noted the worker would be recovered from the compensable injury and required no ongoing restrictions arising out of that injury. They also concluded that the mechanism of injury did not cause an aggravation or enhancement of the worker's pre-existing condition.

On May 1, 2024, the worker requested Review Office reconsider the WCB's decision, noting they had no previous difficulties with their hip and believed their difficulties resulted from the workplace accident and as such, they should be entitled to further benefits. On May 10, 2024, Review Office determined the worker was not entitled to benefits after January 24, 2024.

The worker submitted additional medical information to Review Office on January 25, 2025 and again requested reconsideration of the WCB's decision, noting their treatment providers believed their ongoing left hip difficulties resulted from the May 3, 2023 workplace accident and they should be entitled to further benefits. Review Office determined on February 4, 2025 that the worker was not entitled to benefits after January 24, 2024.

The worker filed an appeal with the Appeal Commission on February 5, 2025 and a hearing was arranged. Following the hearing, the appeal panel requested additional medical information which was shared with the interested parties before the panel met again, on August 7, 2025 to render a decision on the issue under appeal.

Reasons

Applicable Legislation

The Appeal Commission and its panels are bound by the provisions of The Worker’s Compensation Act (the “Act”), regulations under the Act and the policies established by the WCB's Board of Directors.

Section 4(1) of the Act provides that the WCB will pay compensation when a worker has sustained personal injury by accident arising out of and in the course of employment, and s 4(2) outlines that a worker injured in such an accident is entitled to wage loss benefits for the loss of earning capacity resulting from the accident. When the WCB determines that a worker has sustained a loss of earning capacity, an impairment or requires medical aid because of an accident, compensation is payable under s 37 of the Act. Section 39 of the Act sets out that wage loss benefits are payable until the worker's loss of earning capacity ends or the worker attains the age of 65 years.

Section 27 of the Act allows the WCB to provide medical aid to a worker entitled to benefits that “…the board considers necessary or advisable to cure or give relief to the worker or for the rehabilitation of the worker.”

The WCB established WCB Policy 44.10.20.10, Pre-existing Conditions (the "Pre-existing Policy"), to address eligibility for compensation in circumstances where a worker has a pre-existing condition. The Policy defines a pre-existing condition as any medical condition the worker had prior to their workplace injury, and notes that pre-existing conditions may contribute to the severity of a workplace injury or significantly prolong a worker's recovery. As well, workplace injuries can impact pre-existing conditions. A temporary worsening of a worker’s pre-existing condition is considered an aggravation of the pre-existing condition and a permanent worsening of the worker’s condition because of a workplace injury is an enhancement of the pre-existing condition. The Pre-existing Policy provides that wage loss benefits will cease when a worker has recovered from the workplace injury to the point that the injury is no longer contributing, to a material degree, to the worker's loss of earning capacity, and the pre-existing condition is not a compensable condition.

Worker’s Position

The worker appeared in the hearing on their own behalf and provided testimony in support of their position that they continue to experience symptoms and require further medical attention in relation to the injury sustained in the workplace accident of May 3, 2023. Further, the worker submitted that they have experienced a further loss of earning capacity after January 24, 2024 as a direct result of this injury, noting that the employer is unable to accommodate their restrictions.

The worker noted there is no evidence of any prior or pre-existing left hip condition and pointed to their ability to do their job until the injury occurred.

Employer’s Position

A representative of the employer appeared in the hearing in support of the worker’s position and provided a written submission in response to the additional medical information obtained by the appeal panel following the hearing.

The employer’s position is that the worker is entitled to further benefits after January 24, 2024 as they have continued to experience symptoms in the region injured as a result of the compensable workplace accident of May 3, 2023 and requires further treatment for that injury. Furthermore, as the employer is not able to accommodate the worker’s restrictions, the worker has a continuing loss of earning capacity arising out of their compensable injury and as such should be entitled to further wage loss benefits beyond January 24, 2024.

Analysis

This appeal is about the worker’s entitlement to benefits after January 24, 2024, arising out of the accident of May 3, 2023. For the appeal to succeed, the panel would have to decide that when the WCB terminated the worker’s benefits on January 24, 2024, the worker continued to have a loss of earning capacity or continued to require medical aid arising out of the injuries sustained in the workplace accident. For the reasons outlined below, the panel was not able to make such findings and therefore the worker’s appeal is denied.

The panel considered the evidence from the treatment providers who assessed the worker following the accident. Based on the initial reporting, we are satisfied that as a result of the workplace accident, the worker sustained a strain type of injury to their left hip region. While there is evidence that by late June 2023, the worker returned to their regular duties, we noted that their symptoms soon increased, and the worker again left work and sought further medical attention. There followed some investigations as to whether the worker had sustained a fracture, this was ruled out based on the imaging.

The panel noted the diagnostic imaging including x-rays and an MRI study confirmed the presence of osteoarthritis, a degenerative condition, in the worker’s left and right hip joints as well as some left hip labral ossification. The worker’s evidence is that they had no symptoms until after the accident. Nonetheless, the panel finds that the worker’s left hip had a significant pre-existing degenerative condition that is not the result of or related to the workplace accident. The panel further noted there is no evidence that the worker’s pre-existing left hip condition was aggravated or enhanced because of the workplace accident, although we accept that the worker’s recovery from the strain injury could have been prolonged by the pre-existing condition.

The panel also considered the opinions provided by the WCB medical advisor and WCB orthopedic advisor and is satisfied that the worker would have recovered from the compensable left hip strain injury, in the environment of “significant pre-existing degenerative osteoarthritis”, by January 2024, and further, that the worker would have been capable of a return to work without restrictions arising out of the compensable injury by that time if not sooner. As such, while the worker continued to obtain treatment for their left hip condition after January 2024, we find that the worker’s ongoing concerns did not relate to the compensable injuries, but more likely than not arose out of the worker’s pre-existing and non-compensable health condition.

Furthermore, we are satisfied that any loss of earning capacity beyond January 24, 2024 did not arise out of the injuries sustained in the workplace accident but, rather, resulted from the worker’s non-compensable and pre-existing health condition.

Based on the evidence and on the standard of a balance of probabilities, we are satisfied that the worker did not have a further loss of earning capacity or require further medical aid because of the injuries sustained in the workplace accident of May 3, 2023 beyond January 24, 2024. Therefore, the worker is not entitled to benefits after that date. The 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 14th day of August, 2025