The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker appealed the Workers Compensation Board ("WCB") decision that they are not entitled to coverage for an electric stair lift and massage chair. A hearing took place on May 29, 2025 to consider the appeal.

Issue

Is the worker entitled to coverage for an electric stair lift and massage chair?

Decision

The worker is entitled to coverage for an electric stair lift and is not entitled to coverage for a massage chair.

Background

The WCB accepted the worker's claim for injury to their left knee that occurred at work on November 28, 1984. After surgery on their left knee, the WCB placed restrictions on the worker and provided vocational rehabilitation services until 1989. In Decision No. 80/91, the Appeal Commission determined the worker was not entitled to further vocational rehabilitation benefits and assistance.

In April 2008, the worker contacted the WCB about replacing the left knee brace they had used for approximately 20 years. At that time, the worker provided an update as to their employment status. A WCB medical advisor reviewed the worker's claim file, and on July 22, 2008, the WCB advised the worker their current left leg difficulties related to the effects of the workplace accident, and wage loss benefits were reinstated as of February 26, 2009. Following a further review by a WCB medical advisor who concluded the worker had pre-existing right knee and low back conditions, the WCB advised the worker on April 7, 2010 that it did not accept responsibility for their back and right knee difficulties.

On September 21, 2010, the treating physician provided a report to the WCB indicating the worker required help to get up the stairs in their home and requested the physician provide a note that the worker needed an electric stair lift due to the degenerative osteoarthritis in their left knee. On September 28, 2010, the WCB advised the worker that it would not provide coverage for a lift. On December 13, 2010, the worker's representative requested the WCB consider coverage for an electric stair lift and on December 23, 2010, the WCB advised that it would not provide coverage for an electric stair lift for their residence.

The treating physician wrote to the WCB on March 19, 2011 advising the worker reported difficulties resulting from injuries to their left and right knees, and an old back injury, with symptoms of "…painful muscle cramping in the lower back, left leg, gluteal muscles, hamstring muscles…". The physician recommended massage therapy and a massage chair for the worker.

On May 9, 2011, the worker requested the WCB consider the treating physician's recommendation for a massage chair. On May 18, 2011, the WCB advised the worker that it would not provide coverage for a massage chair, given the medical information indicated that request related to their lower back difficulties and not to the compensable left knee injury.

In August 2014, the worker requested assistance with snow clearing and housekeeping. In a report dated October 27, 2014, the WCB's rehabilitation specialist made recommendations related to snow clearing and housekeeping and noted the medical information on file did not support the request for a stair lift. On November 4, 2014, the WCB wrote to the worker confirming the decisions that it would not provide coverage for a massage chair or stair lift.

The WCB continued to provide wage loss benefits until the worker turned 65 years of age and continued to provide medical aid benefits.

On March 9, 2023, when the worker contacted the WCB to discuss their claim, the WCB recommended a new rehabilitation assessment to determine if the worker required further assistance. The worker refused the assessment at that time. On March 23, 2023, the worker provided copies of prescriptions from their treating physician for an electric stair lift and massage chair. On May 4, 2023, the WCB's rehabilitation specialist conducted a home visit to determine the worker's ongoing entitlement to independent living and personal care allowances. The specialist noted the worker's request for a stair lift, as recommended by their physician, and made recommendations to help the worker remain independent.

On May 31, 2023, the worker requested Review Office reconsider various WCB claim decisions including their entitlement to coverage for an electric stair lift and a massage chair. The worker provided a submission indicating their compensable condition had deteriorated and they required the stair lift and massage chair to help with their symptoms. On June 22, 2023, Review Office determined the worker is not entitled to coverage for an electric stair lift or a massage chair.

The worker's representative filed an appeal with the Appeal Commission on March 5, 2025 and a hearing was arranged. After the hearing, the appeal panel requested additional medical information which, when received, was provided to the interested parties for comment. On April 7, 2026, the appeal panel met again to discuss the appeal and render its final decision.

Reasons

Applicable Legislation and Policy

The Appeal Commission and its panels are bound by the provisions of The Workers Compensation Act (the "Act"), regulations under that Act and the policies established by the WCB's Board of Directors. The provisions of the Act in effect as of the date of the worker’s accident are applicable.

Section 4(1) of the Act provides that a worker is entitled to benefits under the Act when they are injured because of an accident at work. Section 24 of the Act allows the WCB to provide medical aid “as it may deem reasonably necessary…to cure and relieve from the effects of the injury.”

The WCB established Policy 44.120.10, Medical Aid (the "Medical Aid Policy") which sets out the general principles regarding a worker's entitlement to medical aid, which includes medical treatments, devices, and appliances. The Medical Aid Policy outlines that the WCB will determine if medical aid is appropriate and necessary, considering the following criteria:

• Recommendations from recognized healthcare providers; 

• Current scientific evidence about the effectiveness and safety of prescribed/recommended healthcare goods and services; 

• Standards developed by the WCB Healthcare Department.

Schedule B of the Medical Aid Policy confirms that for medical appliances and devices, the WCB will such items fund if:

1. The medical device or appliance is prescribed or recommended by a recognized health care provider; 

2. The need for the medical device and/or appliance is the result of a compensable injury; 

3. The Board determines that the medical device and/or appliance will likely be or has been effective in the treatment or ongoing care of a compensable injury; and 

4. The Board considers the cost of the medical device and/or appliance to be reasonable.

The WCB also established Policy 44.120.30, Support for Daily Living (the “Daily Living Policy”) which outlines the criteria for providing injured workers with assistance to engage in the activities required for daily living and summarizes the forms of assistance the WCB may provide. While decisions about whether to provide such assistance are made on a case-by-case basis, the general criteria for consideration under this policy are:

• The compensable injury must have reduced the worker's ability to engage in the activities required for daily living, which include but are not limited to: 

• …safely accessing the primary residence and portions of the primary residence… 

• The assistance should compensate in the most cost-effective way possible for additional costs the worker incurs in engaging in the activities required for daily living that he/she engaged in prior to the injury, where those costs arise because of the injury. 

• The assistance should not impede progress in other areas of the worker's rehabilitation, including medical recovery, vocational rehabilitation, and return to work. 

• The WCB is not required to compensate for costs for which it has not provided prior written approval. 

• The type, level and duration of assistance provided is based on regular, standardized evaluations of the injured worker's needs and abilities, and may be adjusted in keeping with the results of these evaluations.

The Daily Living Policy provides for both personal care attendants and equipment or appliances that help with personal mobility, such as transferring from a bed to a chair. The Daily Living Policy also sets out that assistance may be provided for services that allow an injured worker to live safely and independently in their home. Further, the WCB may provide home modifications to allow an injured worker to safely access the primary residence and parts of the residence they need to access as part of the requirement of daily living. The Administrative Guidelines to the Daily Living Policy outline parameters for eligibility for home modifications and for specialty equipment or devices that facilitate a worker's adaptation to the permanent effects of their injury.

Worker's Position

The worker appeared in the hearing represented by a worker advisor. The worker's position in respect of the question of entitlement to an electric stair lift is that the evidence supports a finding that the worker's ability to climb and descend stairs is limited because of their compensable left knee injury and that the worker requires the assistance of a stair lift to support their activities of daily living. In particular, the worker relies on the reporting from the worker's treating physicians from as early as 2010, and the 2024 report of the physician with an interest in occupational medicine, as well as the assessments by the WCB rehabilitation specialist. The worker advisor submitted that the worker's circumstances fall within the provisions of the Daily Living Policy that relate to eligibility for home modifications as required to facilitate a worker's adaptation to the permanent effect of their injury as the worker's inability to easily use the stairs in their home significantly impacts their daily living.

In respect of the question of entitlement to a massage chair, the worker advisor submitted the medical reporting from the worker's treating physicians supports this request. The worker's position is that a massage chair could provide them with easily accessible symptom relief in relation to their bilateral lower leg and back symptoms, which the worker relates to the compensable injury. The worker advisor submitted that a massage chair could be provided under the provisions of the Medical Aid Policy as a medical device, which could be effective in the ongoing care of the worker's compensable injury or under the provisions of the Daily Living Policy.

Employer's Position

The employer did not participate in the appeal.

Analysis

The worker's appeal arises out of the WCB's decision that it will not accept responsibility for the provision of a stair lift in the worker's home nor for a massage chair. As set out in the reasons that follow, the panel is satisfied that the WCB should be responsible to provide a stair lift in the worker's home, but the WCB should not be responsible to provide the worker with a massage chair.

Electric Stair Lift

For the worker's appeal to succeed the panel would have to determine that the worker requires modification to their home to install a stair lift to cure and provide relief from the effects of the compensable injury. The panel was able to make such a finding and therefore the worker's appeal on this request is granted.

The panel considered the evidence in relation to the nature and ongoing effect of the worker's compensable injury on their ability to ambulate stairs. In 2010, the worker's treating family physician noted the worker's mobility limitations arising out of their degenerative left knee osteoarthritis and that the worker needed help to ambulate stairs, recommending installation of an electric stair lift in the worker's home. The treating rehabilitation medicine specialist outlined on February 7, 2011in a letter to the treating family physician that the worker "…spends most of [their] time in bed as [the worker] has stairs in [their] house. … [The worker] can't get down [their] staircase." In 2015, the worker's then family physician also recommended a stair lift to assist the worker due to their bilateral knee osteoarthritis and back pain, and in 2023, provided that the worker required a stair lift "due to difficult climbing stairs secondary to left knee injury." More recently, a physician with an interest in occupational health assessed the worker and in their May 2024 report, noted the worker's report of limited stair climbing ability and use of their buttocks to go up and down since approximately 2005. This physician recommended installation of a stair lift to address that limitation.

The panel also considered the opinions of the WCB medical advisor in relation to the worker's request for a stair lift. On December 12, 2025, the WCB medical advisor provided that ongoing limitations to stair climbing are "reasonable for the diagnosis of advanced left knee osteoarthritis" and on March 6, 2026, the same WCB medical advisor opined that "A stair lift may be helpful for a person with advanced left knee osteoarthritis in the event that they are required to do repetitive stair climbing."

We noted that the WCB established permanent restrictions as of March 4, 2010 that include avoiding repetitive stair climbing. While the worker is not required to climb or descend stairs repeatedly as part of their daily living, being able to go up and down their stairs is nonetheless essential to the worker's daily life. There is evidence that the ongoing effects of the worker's compensable left knee injury have reduced the worker's ability to engage in the activities required for daily living, which include safely accessing the upper floor of their primary residence. The file evidence confirms that the worker's home contains two stories with the bedrooms on the second floor, at the top of a staircase with eleven stairs to a landing, where the stairs turn 90 degrees and there are four more stairs to the top. The file evidence further confirms there is a single railing for the lower eleven stairs, but no railing for the upper four stairs. At the time of the 2014 independent living assessment by the WCB, the rehabilitation specialist noted the worker's report they ascend and descend the stairs on their buttocks, going down and up just once each day. In a subsequent assessment in November 2015 the worker demonstrated an ability to ascend and descend three stairs with a railing, and reported they sometimes descended on their buttocks. Further, an assessment dated May 30, 2023 noted that the upper floor bathroom tub and toilet were non-functional, and that the worker relied on the first floor bathroom for bathing and toilet functions. At that time, the worker reported they could not walk up and down stairs due to instability in their left knee and that they travelled up and down the stairs on their buttocks, spending most of their day on the main floor due to the difficulty in navigating the stairs. Given the worker's difficulties with the stairs and the location of the working bathroom, the worker also reported reducing their water intake in the early evening so that they would not need to use the stairs to get to the toilet overnight. In the most recent assessment by the WCB rehabilitation specialist in April 2025, the worker again reported using the stairs only once per day in each direction due to the resulting pain, although demonstrating they could climb up and down approximately 4-5 stairs while relying heavily on the railing, a cane, and their right leg.

The Daily Living Policy explicitly contemplates coverage by the WCB for home modifications that allow an injured worker to safely access parts of the residence they need to access as part of the requirement of daily living. The panel finds these provisions apply in the worker's case, where there are medical recommendations made over the course of more than 15 years to provide a modification to assist the worker in safely accessing both the main and second floor of their home. The safety and mobility concerns raised by the worker, their medical providers, a consultant physician and even the WCB medical advisor can be addressed by installation of an electric stair lift as recommended. The panel finds that is not appropriate to rely on the restriction against repetitive stair use and the worker's adaptation of their daily activities to minimize their need to ambulate between floors when it is clear, on the evidence, that they struggle to ambulate the stairs at all, relying on a combination of railing, cane, and sliding on their buttocks to get up and down on a daily basis. Here, there is a recommended alternative available that would provide a safer option for this permanently injured worker, the provisions of which fall squarely within the ambit of the Daily Living Policy as a form of medical aid required to provide relief from the effects of the compensable injury.

The panel is satisfied, based on the evidence before us and on the standard of a balance of probabilities, that the WCB should provide coverage for a stair lift to be installed in the worker's home, between the main and second floor. The details and extent of that coverage are to be determined by the WCB in accordance with the provisions of the Act and the Daily Living Policy. The worker's appeal on this request is granted.

Massage Chair

For worker's appeal to succeed on this question, the panel to find that the WCB should provide coverage for the purchase of a massage chair for the worker, we would have to find, on a balance of probabilities, that the massage chair is a medical device, therapy or treatment required by the worker to cure and provide relief from their compensable left knee injury. The panel was not able to make such a finding and therefore the worker's appeal on this question is denied.

The Act requires that for provision of medical aid, whether as a treatment, medical device or to facilitate daily living, the assistance must be required to cure and provide relief from an injury resulting from an accident. The Medical Aid Policy outlines the requirements for provision of a medical device which must be prescribed or recommended by a recognized health care provider, needed as the result of a compensable injury, likely to be effective in the treatment or ongoing care of a compensable injury, and reasonable in cost.

The panel considered whether the evidence supports the worker's request for a massage chair as a medical device. The panel noted the initial recommendation for a massage chair outlined in a March 2011 note from the treating family physician, describing the worker's chronic pain arising out of their bilateral knee injuries and previous back injury and endorsing "…ongoing massage therapy and a massage chair as a tool to help" the worker's symptoms. The claim file also includes a May 2011 request from the worker via their treating family physician that the WCB provide a massage chair in the worker's classroom as part of their vocational rehabilitation program. That request outlined the worker's complaints of ongoing symptoms in their left knee, hips, back right knee and right ankle, but is not clear which symptoms the massage chair would address or what benefit it would provide. The panel also reviewed a June 2015 report from a new treating family physician who outlined that the worker required a "…electric stair lift, massage chair and massage therapy for bilateral knee osteoarthritis & back pain" and a March 2023 note from that physician prescribing a "Massage chair for leg numbness secondary to left knee injury". These reports and recommendations suggest that treatment providers believed a massage chair could offer symptomatic relief to the worker for their back and right leg symptoms, as well as the compensable left knee injury.

The worker submitted that a massage chair would provide relief to their low back symptoms and leg cramping, and as it would be available to them in their home, could be used multiple times daily unlike massage therapy. The panel considered that while a massage chair would be readily accessible to the worker to provide symptom relief, any relief provided will be temporary and not ongoing.

The panel also considered the May 2024 assessment by a physician with an interest in occupational health, who noted in their report that a lift chair is a "more appropriate intervention" to assist the worker in standing or sitting than would be a massage lounger chair. The panel further noted this physician did not recommend massage for the worker's ongoing symptoms.

The evidence before us does not, taken as a whole, support the worker's position that they require a massage chair to cure and provide relief from the compensable injury. The panel noted the treatment providers who recommended the massage chair are not consistent in their rationale nor in their assessment that such a chair would be effective to address the compensable left knee injury and ongoing symptoms. As such, the panel is not persuaded that a massage chair is required to provide relief from the worker's compensable injury. The worker also submitted a massage chair could be provided under the exceptional circumstances provisions of the Daily Living Policy. On the evidence before us, the panel finds this request does not fall within those provisions which address support for equipment or devices that "facilitate the worker's adaptation to the permanent effects of the workplace injury."

Based on the evidence before the panel and applying a standard of a balance of probabilities, the panel is satisfied that the WCB should not provide coverage for a massage chair. The worker's appeal on this question 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 16th day of April, 2026