The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker is appealing the decision made by the Workers Compensation Board ("WCB") that they are not entitled to benefits after August 15, 2023. A hearing was held on February 11, 2025 to consider the worker's appeal.

Issue

Whether or not the worker is entitled to benefits after August 15, 2023.

Decision

The worker is not entitled to benefits after August 15, 2023.

Background

On February 10, 2023, the employer submitted an Employer’s Accident Report to the WCB reporting the worker injured their back after being involved in a motor vehicle accident while at work on February 8, 2023. The WCB spoke with the worker on February 17, 2023, who advised they were currently in the hospital and had been admitted on February 9, 2023. The worker advised their current symptoms as “…hurting all over, lower back, legs aren’t good, nothing is broken”.

The hospital report of February 9, 2023 was received by the WCB on February 23, 2023. The worker reported to the treating physician they had been in a motor vehicle accident the previous day, where they fell to the ground with pain to their lower back and were unable to get fully upright for several hours. The worker reported eventually a bystander helped them up and their coworker drove them back home. They were then driven to the hospital. The physician noted the worker did not report hitting their head and did not make any complaints of neck pain. The treating physician also recorded the worker’s past medical history including chronic lower back pain and listed the worker’s current medications. A CT scan of the worker’s head, chest, abdomen, pelvis and lumbar spine was reviewed, with the treating physician indicating no intracranial hemorrhage or acute intra-abdominal injury was seen. With respect to the worker’s lumbar spine, no acute lumbar spine fracture was identified. The worker was diagnosed with lower back pain noted to likely be acute on chronic due to trauma and chronic spinal stenosis seen on CT scan. The WCB had a further discussion with the worker and their spouse on February 24, 2023. The worker advised they were still in the hospital and had started physiotherapy to help improve their symptoms so they could return home. The worker confirmed the injury was to their back and legs, with their left leg being worse than their right. The worker also noted their pre-existing conditions of poor circulation in their legs, pins in their left ankle from prior surgery and advised that their back had bothered them a little in the past. The worker was discharged from the hospital on February 28, 2023, with a diagnosis of multiple soft tissue injuries.

The WCB accepted the worker’s claim on March 2, 2023 and the payment of various benefits started.

The worker was seen by their family physician on March 9, 2023, reporting pain in their back and both legs, worse on the left than the right, poor mobilization, pain and fatigue. After examining the worker, the physician found tenderness in the back and legs, swelling in both legs and multiple areas of contusion. The physician recommended the worker continue with physiotherapy and remain off work. In speaking with the WCB on March 21, 2023, the worker reported their back was feeling “okay”, their left leg was still painful, they were using crutches to ambulate and numbness in two fingers of their right hand and their right arm due to a suspected pinched nerve. With respect to their back, the worker reported sleeping in a recliner as their back got sore when they laid in bed. A March 29, 2023 follow-up report noted ongoing issues with tenderness with their shoulder, back and lateral knee. The treating physician noted the worker’s treating physiotherapist’s concern of the worker’s ability to return to their pre-accident employment. The physician’s chart notes indicated the worker was progressing in their recovery but had fallen the previous day hitting their head and noted they felt light-headed prior to falling. Ongoing dull pain, numbness and decreased range of motion with pain in their right arm was noted. The physician also noted pain in the worker’s left knee and queried if the worker had a tibial plateau fracture.

The worker attended an initial physiotherapy assessment on April 11, 2023. A diagnosis of a right rotator cuff strain/tendinopathy and long head biceps tendinitis along with a left knee contusion/strain was made after examination. It was recommended the worker remain off work as the treating physiotherapist indicated the worker had “…severe amount of pain, decrease overall mobility, poor strength, unable to perform a squat, poor grip strength, unable to perform regular ADL (activities of daily living), had hard time walking and standing, and getting in and out of the car…” due to their injuries. On April 27, 2023, the worker attended for a follow-up with their treating physician, who noted the worker’s reporting of improved mobility and belief they were nearly ready to return to work. The physician indicated by the end of May 2023, a further assessment would be done to determine if the worker could return to work. It was noted that the worker needed to increase their strength and balance.

On July 11, 2023, the worker attended a call-in examination with a WCB medical advisor at the request of the WCB. After examining the worker, the advisor provided the diagnosis in relation to the February 8, 2023 workplace accident was upper back, right shoulder strain and multiple contusions, with a natural history of recovery and improvement in symptoms within several weeks. The WCB medical advisor noted the absence of any acute spinal pathology on a February 9, 2023 spinal CT scan and the results from the call-in examination and opined that they were unable to medically account for the worker’s current difficulties in relation to the February 8, 2023 workplace accident. On August 9, 2023, the WCB advised the worker it had been determined they had recovered from the effects of the compensable upper back and right shoulder strain and multiple contusion injuries and as such, they would not be entitled to further benefits after August 15, 2023.

The worker requested reconsideration of the WCB’s decision to end their entitlement to benefits to the Review Office on September 14, 2023. In their submission, the worker noted they continued to experience ongoing difficulties as a result of the workplace accident and required further benefits. The worker’s treating physician submitted a letter in support of the worker’s request on November 20, 2023, noting the worker’s difficulties with their right arm and shoulder pain developed after the February 8, 2023 workplace accident and stating that the worker required further benefits. On December 6, 2023, the Review Office determined the worker was not entitled to benefits after August 15, 2023. The Review Office found the worker had been provided with appropriate treatment such as athletic and physiotherapy for recovery of their soft tissue/strain injuries and further found the medical evidence supported the worker had chronic pre-existing conditions, which were affecting the worker prior to the workplace accident. In addition, the Review Office found the results of testing conducted by the worker’s treating neurologist were not the result of the February 8, 2023 accident and as such, the worker was not entitled to further benefits after August 15, 2023.

The worker’s representative filed an appeal with the Appeal Commission on July 30, 2024, and a 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 September 24, 2025, the appeal panel met further to discuss the case and render its final decision on the issue under appeal.

Reasons

Applicable Legislation and Policy

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

A worker is entitled to compensation under Section 4(1) of the Act when it is established that they sustained personal injury as a result of an accident at work. Section 4(2) of the Act provides that a worker injured in an accident is entitled to wage loss benefits for their loss of earning capacity resulting from the accident, but wage loss benefits are not payable where the injury does not result in a loss of earning capacity during any period after the day of the accident.

When, because of an accident, the WCB determines that a worker has sustained a loss of earning capacity, an impairment or requires medical aid, compensation is payable under Section 37 of the Act. 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.”

Subsection 39(2) of the Act states 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.

The WCB has established a policy to address eligibility for compensation in circumstances where a worker has a pre-existing condition. A pre-existing condition is any medical condition the worker had prior to their workplace injury. Policy 44.10.20.10, Pre-existing Conditions, (the "Pre-existing Policy") advises that the fact that a worker has a pre-existing condition does not disentitle them to compensation for their workplace injury. However, the WCB only provides compensation for workplace injuries, not all injuries and therefore, it is important to determine the role the pre-existing condition plays on the workplace injury or vice versa.

Worker’s Position

The worker appeared at the hearing, represented by a worker advisor. The worker advisor provided a written submission in advance of the hearing and made an oral submission in support of the appeal. The worker provided information to the panel in response to questions posed by the worker advisor and the panel.

The position of the worker is that they had not recovered from the injuries caused by the February 8, 2023 accident, specifically related to their upper back, right shoulder and right elbow.

The worker’s evidence is that they sustained injuries to multiple areas of the body, which led to a hospital stay of over 2 weeks. The worker states that they experienced no difficulties to their upper back, right shoulder or elbow prior to the accident, and that continued difficulties in those areas after August 15, 2023 are therefore related to the workplace accident.

The worker relies on the treating physiotherapist’s notes which indicate no obvious improvement from April 11, 2023 to the final assessment on July 17, 2023. The worker also states that the WCB medical consultant (physio advisor) also noted the lack of evidence of improvement in a healthcare opinion dated July 26, 2023.

The worker argues that they continued to require medical aid and that they are entitled to benefits after August 15, 2023 as they had not recovered from injuries sustained in the workplace accident.

Employer’s Position

The employer did not participate in the appeal.

Analysis

The issue for the panel to determine is whether or not the worker is entitled to benefits after August 15, 2023. For the appeal to succeed, the panel would have to find, on a balance of probabilities, that when the WCB ended the worker’s benefits, 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 worker was diagnosed following the workplace accident with multiple soft tissue injuries. The chart notes and diagnostic imaging reports from the worker’s initial treatment at hospital do not indicate any acute injuries, fractures or dislocations. The worker’s evidence was that their symptoms were mainly related to their back and right shoulder, left leg and right arm (elbow).

A review of the medical evidence indicates that the worker was experiencing multiple concurrent and pre-existing health conditions prior to their workplace injury. This was expressed by all of the worker’s treating health providers. The medical consultant opined on July 11, 2023 that the presence of reported degenerative processes in the lumbosacral spine may be a factor contributing to a delay in recovery and that the worker’s physician noted that a history of diabetes and elevated body mass index may also be contributing to a delay in recovery. Additionally, the treating specialist opined on September 1, 2023 that the worker presents in the setting of severe diabetic polyneuropathy. The panel acknowledges the worker’s argument that they were able to work without issue prior to their accident, however the panel must consider the severity of the worker’s pre-existing conditions and their ability to impact the worker.

The worker’s treating physician noted in a Doctor Progress Report from an examination on April 27, 2023 that they expected a “clear pic after next assessment” and that they would reassess the worker’s return to work in one month. The worker also advised the physician at that appointment that they felt “nearly ready to go back to work.” The corresponding chart notes also indicate that the worker is “doing well nearly ready to go back to work.”

The panel specifically relies on the evidence, in said chart note of April 27, 2023, that the worker passed their motor vehicle medical assessment. As a result, the panel is of the view that the worker, while continuing to experience difficulties, had recovered to their pre-accident baseline by August 15, 2023.

The panel also relies on the evidence from the treating physiotherapist and notes that the Application for Additional Treatment dated May 31, 2023 indicates there are factors unrelated to the injury that are prolonging recovery. The physiotherapist queries whether the worker’s diabetes neuropathy is impeding the worker’s progress and indicates that there is limited progression.

The panel reviewed the call in examination notes from July 11, 2023, and accepts the opinion of the medical consultant that the natural history for improvement and resolution of symptoms for a diagnosis of upper back and right shoulder strain and multiple contusions would be several weeks. The panel has also considered the diagnostic imaging completed after the call-in examination and notes the presence of degenerative changes in the worker’s right shoulder.

Based on the evidence before the panel, it is accepted that the worker continued to experience difficulties, however the panel finds, on a balance of probabilities, that any continuing difficulties beyond August 15, 2023 are not causally related to the injury sustained in the compensable workplace accident of February 8, 2023.

The worker’s appeal is denied.

Panel Members

R. Lemieux Howard, Presiding Officer
J. Peterson, Commissioner
M. Kernaghan, Commissioner

Recording Secretary, J. Lee

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

Signed at Winnipeg this 10th day of November, 2025