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 July 30, 2025. A hearing was held on February 19, 2026 to consider the worker's appeal.

Issue

Whether or not the worker is entitled to benefits after July 30, 2025.

Decision

The worker is not entitled to benefits after July 30, 2025.

Background

The worker filed a Worker Incident Report with the WCB on November 6, 2024, reporting an injury to their left arm that occurred at work on October 31, 2024, and was reported to the employer on November 4, 2024. The worker described having pain in their arm previously and attending for medical treatment as the pain worsened. The worker noted their belief that the cause of their injury was due to working with their hands for a year and that they first noticed their symptoms 2 weeks previously but had not reported the arm pain as they did not relate the pain to their job duties. The worker advised on their Incident Report that the treating physician found swelling and tenderness to their arm and recommended modified duties of not using their left hand for 2 weeks and referred the worker to a specialist. The worker further advised that the employer had sent them home on November 5, 2024 as there were no modified duties available. It was noted that the worker had concurrent employment.

A copy of the Emergency Visit Summary from the worker's attendance at a local emergency department on November 1, 2024 was received by the WCB on November 7, 2024. The worker reported off and on pain with swelling to their left wrist for the previous 2 months, more to the ulnar aspect than the radial side. The pain was noted to be worse with movement and the worker noted they had difficulty holding objects. On examining the worker, the treating physician found mild swelling and tenderness to the ulnar tendon of the left wrist, limited ulnar and radial deviation due to pain and noted an x-ray taken found no fracture. The worker was diagnosed with ulnar tendonitis in their left wrist and physiotherapy along with a wrist brace were recommended. The physician also provided a note for the worker to be on modified duties for 2 weeks. The worker attended a follow-up appointment at a local walk-in clinic on November 4, 2024, reporting pain to their left wrist for approximately 2 months, which worsened on November 1, 2024 causing them to attend a local emergency department. The physician noted there was no particular trauma to the worker’s left arm but also noted the worker’s reporting of their job duties involving lifting boxes and packaging repeatedly. The physician referred the worker to a rheumatologist for work up on a possible autoimmune cause and recommended modified duties for the worker. A Work Capacity Assessment Form completed by the physician noted the worker could work 4-hour shifts, 4 days per week, with no use of their left hand, lifting floor to waist with right hand only up to 25 pounds and pushing/pulling with right hand only up to 15 pounds.

The employer submitted their Employer’s Accident Report to the WCB on November 8, 2024, indicating they were not aware of the worker’s left wrist injury until they came in to work on November 3, 2024 with a note for modified duties for 2 weeks due to swollen tendons in their arm. The employer noted they had sent the worker home that day as they were not aware of the worker’s restrictions. The following day, the worker returned to work and was provided with modified duties.

On November 15, 2024, the WCB contacted the worker to discuss their claim. The worker advised they had been experiencing pain in their left arm since mid September 2024 and self-treated with over-the-counter pain medications. The worker further advised they did not report their difficulties to the employer and continued to work until they sought medical treatment on November 1, 2024. The worker provided a description of their job duties to the WCB, noting they changed position every 3 hours and used both hands and arms in those duties. The worker also advised they sought medical treatment on September 6, 2024 at a local walk-in clinic but no x-rays were taken and they did not receive a prescription for any medication. They continued to work their regular duties until the pain worsened and they went to a local emergency department on November 1, 2024. The worker confirmed they had no prior issues with their left arm and described their current symptoms as pain and swelling in their left arm which they were treating with pain medication and ice and heat as needed.

At the request of the WCB, the employer provided a job description for the worker’s position on November 26, 2024. It was noted by the employer they had been accommodating the worker on modified one-handed duties. By December 2, 2024, the employer advised the WCB that the worker was missing work due to their injury as well as refusing the offered modified duties.

The WCB received a copy of the September 6, 2024 chart notes for the worker’s appointment at the walk-in clinic. The notes referenced a musculoskeletal deformity of hands but also noted no tenderness and normal range of motion.

Additional information on the worker’s job duties were obtained, with the worker clarifying with the WCB they initially began to experience pain in their left wrist in September 2024, and again in October 2024 and when the difficulties increased, they attended for treatment. The worker also confirmed their job duties, as described by them and the employer, had not changed, but the equipment they worked had changed and had gotten faster. The employer also advised the WCB the worker had concurrent employment, with the worker confirming their concurrent employment. The WCB accepted the worker’s claim and as they had returned to work on modified duties with reduced hours, partial wage loss benefits were paid.

On January 2, 2025, the worker attended for an initial physiotherapy assessment reporting pain in their left wrist with little to no movement, worse on the pinky side of their wrist that travelled across and up their arm and included numbness and tingling. The treating physiotherapist found swelling at the left wrist on the ulnar side that went up into the worker’s forearm. Pain on palpitation was found at the wrist joint line, triangular fibrocartilage complex (TFCC) area, forearm flexors and extensors and carpal tunnel areas and it was noted the worker was reactive to even light pressure to those areas. Positive carpal compression, TFCC and Tinels testing was noted for both medial and ulnar areas. The treating physiotherapist diagnosed the worker with a left TFCC/wrist sprain and queried a grade 2/3 tear. Restrictions of no lifting/push/pull/gripping with left arm/wrist; must keep brace on and avoid using left side; lift/push/pull up to 5 to 10 pounds, 6 to 8 hours a day were recommended. The WCB provided the employer with the restrictions on the same date. On January 6, 2025, the worker’s treating physiotherapist recommended the worker be placed off work for 2 weeks due to an increase in their symptoms.

The worker was seen by a rheumatologist on January 27, 2025, who referred the worker for a left wrist MRI “…to determine if there is any degenerative or mechanical causes for left wrist pain” after no overt findings of rheumatoid arthritis were found. The worker underwent the MRI study on February 11, 2025, which indicated “Osteoarthritis at the radiocarpal and distal radial ulnar joints. Degenerative triangular fibrocartilage complex tearing” and “Subluxation of the extensor carpi ulnaris tendon from the ulnar groove. The tendon remains intact and otherwise unremarkable.” The worker’s treating physiotherapist reviewed the MRI study with the worker on February 13, 2025, and noted the worker’s treating physician had referred the worker to an orthopedic surgeon or sports medicine physician for further treatment. Restrictions related to a gradual return to work on reduced hours and no use of the worker’s left hand/arm were recommended. The restrictions were provided to the employer who advised the WCB on February 24, 2025 that they were unable to accommodate the worker.

The WCB received reports from the worker’s treating physiotherapist on March 13, 2025 and their treating physician on March 18, 2025, both indicating the worker’s reporting of increasing symptoms and as a result, requested the worker attend for a call-in examination at the WCB on April 1, 2025. The worker was examined by a WCB plastic surgery consultant who placed their opinion on the worker’s file. The consultant opined that the initial diagnosis for the worker was left wrist ulnar tendinitis however, it was noted that the February 11, 2025 MRI did not indicate ongoing tendinitis, and the results of the call-in examination also did not indicate tendinitis. The WCB consultant provided that the worker’s current symptoms were those seen with disuse of the hand and a reactivation program was recommended for the worker. The WCB spoke with the worker on April 3, 2025, and discussed the findings of the call-in examination. The worker was encouraged to use their left arm and to attend a four-week reconditioning/activation program to help facilitate a return to work, which started on April 14, 2025.

On May 16, 2025, the physiotherapist from the worker’s reconditioning program provided a report to the WCB noting that due to the lack of progress with the worker’s left wrist and hand, along with a non-WCB related condition, it was recommended the worker’s reconditioning program be placed on hold and noted the worker was capable of returning to work with a temporary restriction of no use of their left hand. On May 29, 2025, the WCB provided the restriction to the worker and the employer. A June 3, 2025 follow-up report from the worker’s treating physician supported the worker could return to work on reduced hours and one-handed duties and the worker returned to work on June 4, 2025.

The WCB advised the worker on July 23, 2025, it had been determined, based on a review of the medical information on their file, their ongoing left wrist difficulties were not related to the October 31, 2024 workplace accident and as such, their entitlement to benefits would end as of July 31, 2025. The worker initially requested reconsideration of the WCB’s decision to the Review Office on August 6, 2025, however, the Review Office returned the worker’s file to the WCB’s Compensation Services as it was noted they were conducting a review of further medical information.

On August 14, 2025, the WCB received a copy of the July 8, 2025 chart notes from the worker’s treating physician. The chart notes indicated the worker’s request to be taken off work, with the physician noting that they were unable to remove the worker from work and recommended the worker continue to work the accommodated position provided by the employer. A report from the worker’s physiatrist was received by the WCB on August 21, 2025 for the worker’s July 28, 2025 appointment. The treating physiatrist diagnosed the worker with left TFCC dysfunction, left radiocarpal osteoarthritis and left extensor carpi ulnaris subluxation and provided the worker with a topical pain relief cream. A corticosteroid injection was also recommended. In an August 11, 2025 follow-up report, the treating physiatrist notes that the worker had been referred for a surgical consultation. On August 22, 2025, the WCB provided a further decision letter to the worker advising there was no change to their previous decision they were not entitled to further benefits after July 30, 2025.

The worker requested reconsideration of the WCB’s decision to the Review Office on August 26, 2025. In their submission, the worker noted their treating healthcare providers supported they required further treatment for ongoing pain in their left arm and wrist and may require surgery and as such, noted their belief they required further benefits. The Review Office determined on October 24, 2025, the worker was not entitled to benefits after July 30, 2025. The Review Office accepted and agreed with the opinion of the WCB plastic surgery consultant and found the worker’s current and ongoing left arm/wrist difficulties were not related to the workplace accident.

The worker filed an appeal with the Appeal Commission on November 17, 2025, and a hearing was arranged.

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 the 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.

A worker is entitled to benefits under Section 4(1) of the Act when it is established that a worker has been injured as a result of an accident at work. Section 4(2) of the Act states that a worker injured in an accident is entitled to wage loss benefits for the loss of earning capacity resulting from the accident, but no wage loss benefits are payable where the injury does not result in a loss of earning capacity during any period after the day on which the accident happens.

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 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 “as the board considers necessary to cure and provide relief from an injury resulting from an accident.”

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, 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 in the hearing on their own behalf, supported by their spouse. The worker made an oral presentation and answered questions posed by members of the appeal panel.

The worker’s position is that they continued to experience symptoms and required further medical attention in relation to the injury sustained in the workplace accident of October 31, 2024. The worker submitted that they continued to experience a loss of earning capacity and to require medical aid after July 30, 2025.

The worker’s position is that their benefits should not have ended and that they are entitled to further benefits.

Employer’s Position

The employer was present at the hearing and answered questions posed by members of the appeal panel. The employer’s position is that the medical opinion of the WCB plastic surgery consultant should be given significant weight and note that the worker was working two jobs when the injury occurred and following the injury.

The employer’s position is that the decision of the Review Office should be upheld.

Analysis

The panel is required to determine, on a balance of probabilities, whether the worker’s ongoing left wrist difficulties after July 30, 2025 are causally related to the workplace accident of October 31, 2024.

The panel acknowledges that the worker experienced left wrist symptoms and that the WCB accepted the claim for an injury consistent with ulnar tendonitis. The question before the panel is whether the worker’s ongoing symptoms beyond July 30, 2025 continue to be related to that compensable injury.

The medical evidence demonstrates that the worker reported left wrist pain beginning in approximately September 2024, prior to the reported workplace accident date. At the time of the November 1, 2024 emergency department visit, the worker described a two-month history of intermittent symptoms without any specific traumatic event. This suggests a gradual onset condition rather than an acute injury.

Further, diagnostic imaging obtained on February 11, 2025 identified osteoarthritis at the radiocarpal and distal radioulnar joints, as well as degenerative tearing of the triangular fibrocartilage complex (TFCC), and subluxation of the extensor carpi ulnaris tendon. The panel places significant weight on the characterization of these findings as “degenerative,” which indicates a pre-existing, non-acute condition not caused by a specific workplace incident. The panel also notes that the worker’s symptoms did not cease when the worker was off work.

The opinion of the WCB plastic surgery consultant, following the April 1, 2025 call-in examination, is also afforded significant weight. The consultant opined that the initial diagnosis of tendonitis had resolved and that the worker’s ongoing presentation was no longer consistent with that condition. Instead, the consultant noted the worker’s symptoms were consistent with disuse and deconditioning and recommended a reactivation program. The panel finds this opinion to be well-supported, as it is consistent with the absence of ongoing tendonitis on imaging and examination.

While the worker continued to report significant symptoms and treating healthcare providers later diagnosed conditions including TFCC dysfunction, osteoarthritis, and tendon subluxation, the panel is not satisfied that these conditions are causally related to the compensable injury. Rather, the evidence supports that these are degenerative or non-compensable conditions.

The panel also notes that the worker participated in a reconditioning program; however, progress was limited, and the program was discontinued in part due to a non-WCB-related condition. Despite ongoing symptoms, medical reporting in May and June 2025 supported that the worker was capable of returning to work with restrictions, specifically one-handed duties. The worker did return to accommodated work on June 4, 2025.

Importantly, the July 8, 2025 chart notes from the treating physician indicate that the worker requested to be removed from work, but the physician declined and instead recommended continuation of accommodated duties. This suggests that, from a medical perspective, total disability related to the compensable injury was not supported at that time.

The panel has considered the worker’s submission that ongoing treatment needs, including possible surgery, supports a continued entitlement to benefits. However, entitlement under the Act requires that the need for such treatment be causally related to the compensable injury. In this case, the weight of the evidence does not support that the worker’s ongoing condition after July 30, 2025 is attributable to the effects of the accepted workplace injury.

On a balance of probabilities, the panel finds that the effects of the compensable injury had resolved, or at least no longer materially contributed to the worker’s ongoing symptoms, by July 30, 2025. Any ongoing difficulties beyond that date are more likely related to underlying degenerative changes or other non-compensable factors.

Accordingly, the panel finds that the worker is not entitled to benefits after July 30, 2025. 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 20th day of April, 2026