The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker is appealing the decision made by the Workers Compensation Board ("WCB") that their L5/S1 disc protrusion and lumbar radicular symptoms were not accepted as being a consequence of the December 3, 2024 accident. A teleconference hearing was held on November 6, 2025 to consider the worker's appeal.

Issue

Whether or not the worker’s L5/S1 disc protrusion and lumbar radicular symptoms should be accepted as being a consequence of the December 3, 2024 accident.

Decision

The worker’s L5/S1 disc protrusion and lumbar radicular symptoms should be accepted as being a consequence of the December 3, 2024 accident.

Background

The worker filed a Worker Incident Report with the WCB on December 6, 2024, reporting an injury to their upper and lower back that occurred at work on December 3, 2024, when a student they were assisting "…lunged on my back and knocked the breath out of me." The worker noted a coworker witnessed the incident and helped the student off the worker. The worker advised that their back became quite sore a few hours later and they attended a walk-in clinic the following day for treatment. The chart notes from the walk-in clinic for the worker's appointment on December 4, 2024 indicated that the worker reported a very sore back due to an incident at work the previous day. The pain was noted to be worse, located in the worker's hips and down their spine, with pain radiating up to their upper spine when moving their hips forward. Also reported was pain in the legs and abnormal sensations in the toes. The worker noted a prior history of spinal surgery for a herniated disc in 2009. On examining the worker, the treating physician found the worker "…displayed discomfort when leaning forward and tenderness in the lower back area. No significant neurological deficits were noted." The physician diagnosed the worker with musculoskeletal back pain and recommended time off work and over-the-counter medication for pain.

The chart notes dated December 7, 2024 from the walk-in clinic indicated that the worker returned to the clinic complaining of severe pain along their back, extending into their pelvis and radiating into both legs. Concerned the worker may have a possible fracture and pelvic organ injury, the treating physician referred the worker to the local emergency department. The initial assessment by the emergency room physician noted the worker's report of initial localized back pain, then the development of pain in their hips, pelvis and around their abdomen. After examining the worker, the physician recommended a CT scan to rule out a spinal cord injury and noted "…very patch nonspecific numbness right foot to the ankle, not in any dermatomal distribution", and reflexes were equal in both legs. The CT scan did not identify an acute fracture, and the worker was diagnosed with musculoskeletal back pain, noting the worker's history and exam were not consistent with an acute spinal cord compression and recommended further time off work.

On January 7, 2025, the worker's file was reviewed by a WCB medical advisor who indicated that the worker's diagnosis was a low back strain based on the reported mechanism of injury and the medical report from December 4, 2024. On January 9, 2025, the WCB spoke with the worker for a status update. The worker advised that they continued to experience pain in their lower back, with pain and numbness in their left foot and calf, with their knee and thigh feeling “rubbery”. The worker noted similar symptoms on their right side but not as intense. The worker also noted the symptoms were less intense when sitting and worsened with extended walking. The WCB advised the worker that their claim was accepted for a low back strain injury. On the same date, the WCB provided the worker with a decision letter confirming the decision. On January 10, 2025, the worker emailed the WCB to advise of additional symptoms in their left arm of numbness in their hand and fingers.

The worker underwent an MRI study of their lumbar spine on January 31, 2025. The study indicated the worker had "Disc protrusion and annular tear at L5-S1 which contacts the left S1 nerve root and could result in irritation. No significant spinal canal narrowing."

On March 7, 2025, the worker attended an initial physiotherapy assessment reporting ongoing pain across their lower back, nerve pain down both legs, with the right worse than the left, feeling of numbness in both thighs, knees and calves as well as their right foot, with the numbness increasing with more walking. Decreased range of motion and an antalgic gait were found and the worker was diagnosed with an L4-L5, L5-S1 disc protrusion with radicular symptoms. The treating physiotherapist recommended further time off work.

The worker's file was reviewed by a WCB medical advisor on March 11, 2025. The advisor made note of the worker’s previous WCB claim from 2008 at which time, an August 22, 2008 CT scan of their lumbar spine noted posterior disc bulges at L4-L5 and L5-S1, with a possible mild compression of the right S1 nerve root noted at L5-S1. It was further noted that the worker underwent lumbar spine surgery in 2009 but no further medical information regarding the surgery or subsequent recovery was noted on file. The WCB medical advisor then went on to summarize the treatment the worker received after the December 3, 2024 workplace accident, including the diagnostic imaging and provided that the L4-L5 shallow posterior disc bulge found on the December 7, 2024 CT scan was also noted on the August 22, 2008 scan with no apparent change. The advisor opined the worker's reported difficulties did not correlate with the January 31, 2025 lumbar spine MRI and those difficulties were not medically accounted for. It was further noted that the worker reported bilateral lower extremity difficulties that also did not correlate with the diagnostic imaging, with particular note made of the motor findings related to the left S1 nerve root. On March 25, 2025, the WCB provided the worker with a decision letter advising they were not entitled to further benefits in relation to the December 3, 2024 workplace accident as it had been determined their current difficulties were not related to that accident.

The worker requested reconsideration of the WCB's decision to the Review Office on April 16, 2025. In their submission, the worker noted their belief the injury they sustained as a result of the workplace accident was more than a strain, as accepted by the WCB, and they continued to suffer the effects of the accident, requiring further benefits. On May 2, 2025, the Review Office determined the worker was entitled to further benefits in relation to an injury sustained on December 3, 2024, noted to be a low back strain in the environment of a pre-existing condition. The Review Office found the mechanism of injury, the change in the worker's function after the incident on December 3, 2024, and the clinical findings when the worker was examined by the treating healthcare providers all supported the worker required further benefits.

The worker's representative filed an appeal with the Appeal Commission regarding the accepted diagnosis of a low back strain on August 7, 2025, and a hearing was arranged.

Reasons

Applicable Legislation and Policy

The Appeal Commission and its panels are bound by the provisions of I(the “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 because of an accident at work. Under Section 4(2), 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 39(2) 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, which may contribute to the severity of a workplace injury or significantly prolong a worker's recovery. 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 an injury is an enhancement of the pre-existing condition.

Worker’s Position

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

The worker's evidence is that although they had prior spine surgery, they were symptom free and pain free before the accident. The worker states that their job is active and physical-in-nature. The worker’s prior surgery was in 2008, and the worker submits that this was far removed, being more than 15 years prior. The worker states that this all changed when the student fell on their back on December 3, 2024.

The worker states that the medical evidence supports a finding that the workplace accident caused the back and leg difficulties and notes that there was consistent reporting of symptoms following the December 3, 2024 accident, including a positive straight leg raise test. The worker states that the opinion of their family physician should be relied upon.

The position of the worker is that but for the workplace accident they would not have developed lower back and left leg symptoms, pain, paresthesia and difficulty walking. The worker submits that the workplace accident was the cause of the disc protrusion and radicular symptoms.

Employer’s Position

The employer did not participate in the appeal process.

Analysis

This appeal requires that the panel determine whether the worker’s L5/S1 disc protrusion and lumbar radicular symptoms should be accepted as a consequence of the compensable workplace accident of December 3, 2024. For the appeal to succeed, the panel would have to determine that the accident caused injury to the worker’s back or that the worker’s back difficulties were worsened by the December 3, 2024 workplace accident. As outlined in the reasons that follow, the panel was able to make such findings and therefore the appeal is granted.

The panel must consider whether there is a causal relationship between the accident and the diagnosed disc pathology and symptoms, taking into account the worker’s pre-existing lumbar condition.

The panel accepts that a workplace accident occurred on December 3, 2024 as described by the worker. The mechanism of injury - a student lunging onto the worker’s back with sufficient force to knock the breath out of them - is consistent with a sudden and significant loading of the lumbar spine. The worker’s account of the incident was reported promptly, was consistent throughout the claim, and was corroborated by contemporaneous medical reporting and the presence of a witness.

The medical evidence establishes a clear temporal relationship between the accident and the onset of the worker’s symptoms. The worker sought medical attention the day following the accident, reporting severe back pain with radiation into the legs and abnormal sensations in the toes. While the initial diagnosis was musculoskeletal back pain, the panel notes that the worker’s symptoms did not resolve as would be expected with a simple strain injury, but instead progressed and persisted.

Within days of the accident, the worker reported worsening pain radiating into both lower extremities, numbness, and altered sensation. These symptoms were repeatedly documented in medical records and were reported consistently to the WCB. The panel places weight on the fact that radicular-type symptoms were present early in the claim and continued thereafter, even if they were initially described as nonspecific.

The January 31, 2025 MRI identified a disc protrusion and annular tear at L5-S1 contacting the left S1 nerve root, with potential for nerve root irritation. The panel finds that this imaging provides an anatomical explanation for the worker’s ongoing symptoms and is consistent with the worker’s reported lower extremity pain, numbness, and functional limitations. The physiotherapy assessment further supported a diagnosis of disc protrusion with radicular symptoms, noting objective findings including decreased range of motion, antalgic gait, and worsening symptoms with walking.

The panel acknowledges the worker’s pre-existing lumbar spine condition, including disc bulges identified in 2008 and surgery in 2009. However, the evidence before the panel indicates that the worker was functioning at their regular duties and was symptom-free prior to the December 3, 2024 accident. There is no evidence of ongoing treatment, restrictions, or functional impairment attributable to the prior condition immediately before the workplace injury. On a balance of probabilities, the panel finds that the worker’s pre-existing condition was either dormant or asymptomatic at the time of the accident.

The panel considered the opinion of the WCB medical advisor that the worker’s reported symptoms did not correlate with the MRI findings and were not medically accounted for. While the panel acknowledges this opinion, it notes that the presence of bilateral or variable symptoms does not preclude a causal relationship, particularly in the context of an acute traumatic event and evolving clinical presentation. The panel is satisfied that the overall medical and factual evidence supports a conclusion that the workplace accident caused either a new disc injury at L5-S1 or a significant aggravation of a pre-existing condition, resulting in symptomatic disc protrusion and radiculopathy.

Applying the Pre-existing Policy, the panel finds that the December 3, 2024 accident at minimum aggravated the worker’s pre-existing lumbar condition, leading to a material worsening of their condition and the development of ongoing symptoms requiring medical aid and time away from work. The panel is satisfied that this aggravation is compensable.

Based on the mechanism of injury, the immediate and persistent onset of symptoms, the MRI findings, and the worker’s credible evidence of being symptom-free prior to the accident, the panel finds that it is more likely than not that the worker’s L5/S1 disc protrusion and lumbar radicular symptoms are causally related to the December 3, 2024 workplace accident.

Accordingly, the panel finds that the worker’s L5/S1 disc protrusion and lumbar radicular symptoms should be accepted as being a consequence of the December 3, 2024 accident, and the appeal is allowed.

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 29th day of December, 2025