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 coverage for a left knee injury. A teleconference hearing was held on March 4, 2026 to consider the worker's appeal.

Issue

Whether or not the worker is entitled to coverage for a left knee injury.

Decision

The worker is entitled to coverage for a left knee injury.

Background

The WCB received the Worker Incident Report submitted by the worker on April 4, 2025. The worker reported injury to both their knees and their shoulder as the result of a motor vehicle accident while at work on March 19, 2025, later corrected to March 18, 2025. The worker attended a local emergency department on March 18, 2025, complaining of pain behind their right knee and across their left upper chest from the seat belt. It was noted that the worker was able to ambulate after the accident. X-rays taken of the worker's chest and right knee taken that date were noted to be normal, with no obvious deformity noted in either region. The worker was diagnosed with right knee pain, post motor vehicle accident.

The worker then sought treatment from their treating physician on April 3, 2025. The worker reported being in a motor vehicle accident then experiencing sudden onset of pain to their bilateral knees. The worker described pain to their left knee with instability, which was worse with stairs. After examining the worker, the physician found laxity to the knee on lateral collateral ligament examination and tenderness to the prepatellar bursa. The physician did not provide a diagnosis but recommended rest, icing, physiotherapy and an MRI study. The worker also attended an initial physiotherapy assessment on April 11, 2025, reporting that they were in a car accident on March 19, 2025, and the following day they felt pain to both knees, with the left being worse than the right, which pain worsened. Then approximately a week later, after picking something up off the floor, the worker reports feeling instant pain to their left knee after pivoting. The treating physiotherapist found pain with overpressure on flexion to the worker's left knee and full extension but also pain with overpressure, and pain to the posterolateral and anterior knee area. The worker was diagnosed with a knee sprain/contusion and patellar bursitis. Work restrictions of no lifting more than 10 pounds from ground to waist and no repetitive squatting on reduced hours of 4-hour shifts were recommended.

On April 14, 2025, the employer submitted the Employer's Accident Report to the WCB confirming the accident description provided by the worker. On April 17, 2025, the employer advised the WCB that the worker's employment had been terminated on March 20, 2025.

The WCB spoke with the worker on May 2, 2025 to discuss their claim and gather further information. The worker confirmed the motor vehicle accident occurred on March 18, 2025, and that they hit both their knees at the time. Initially, the worker advised their right knee hurt more than the left and they did not have any bruising to their left knee. The worker noted they had been advised by the treating providers at the emergency department that their injury would heal on its own and within a week of the accident, their right knee felt better. The worker further noted approximately a week after the accident, the pain in their left knee increased and gradually got worse until they sought medical treatment on April 3, 2025. The worker advised the WCB that their initial symptoms were pain to their right knee and pain to their whole body, including their shoulder and left knee. They described their current symptoms as a lot of pain in their left knee but stated that the pain to their right knee and shoulder had resolved. On June 4, 2025, the WCB contacted the worker's treating physiotherapist who confirmed they were only treating the worker for a left knee injury.

The WCB provided the worker with a formal decision letter on June 4, 2025, advising their claim for a right knee and left upper chest injury was accepted, however, their claim for a left knee injury was not accepted as it had been determined the evidence did not support they sustained a left knee injury as a result of the March 18, 2025 workplace accident.

The worker's representative requested reconsideration of the WCB's decision to the Review Office on November 5, 2025. In their submission, the representative noted that when the worker attended the emergency department the treating healthcare providers may have ignored the worker's complaints of injuries to both their knees and only treated the worker's right knee. As well, the representative further noted when the worker attended for a meeting with the employer during the week of March 24, 2025 to March 28, 2025, after being advised that their employment had been terminated, the worker was required to immediately remove their work tools and belongings from the employer's premises and in doing so, reportedly lifted and twisted a heavy container and felt significant pain to their left knee. As such, the representative noted their belief that the worker should be entitled to coverage for a left knee injury.

On November 25, 2025, the Review Office determined the worker was not entitled to coverage for a left knee injury. The Review Office found that, had the worker sustained an injury to their left knee on March 18, 2025 and been experiencing symptoms, they would have sought medical treatment prior to April 3, 2025. In addition, the Review Office noted inconsistency in the worker's reporting of when the left knee difficulties began, noting the worker reported to their treating physiotherapist and their WCB adjudicator that they started feeling pain in their left knee about a week after the accident but their representative noted the worker had pain immediately after the March 18, 2025 accident and felt significant pain in their left knee while loading a heavy container during the week of March 24, 2025 to March 28, 2025. As such, the Review Office found a left knee injury could not be accounted for in relation to the workplace accident.

The worker's representative filed an appeal with the Appeal Commission on December 11, 2025 and a hearing was arranged.

Reasons

Applicable Legislation and Policy

The Appeal Commission and its panels are bound by The Workers Compensation Act (the "Act"), regulations and policies of the WCB's Board of Directors.

Subsection 4(1) of the Act provides that where a worker suffers personal injury by accident arising out of and in the course of employment, compensation shall be paid.

Subsection 4(2) provides that a worker who is 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.

Subsection 27(1) of the Act states that the WCB "…may provide a worker with such medical aid as the board considers necessary to cure and provide relief from an injury resulting from an accident."

Subsection 39(2) of the Act provides 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's Board of Directors has established WCB Policy 44.10.20.10, Pre-existing Conditions, the stated purpose of which is identified, in part, as follows:

The Workers Compensation Board (WCB) will not provide benefits for disablement resulting solely from the effects of a worker's pre-existing condition as a pre-existing condition is not "personal injury by accident arising out of and in the course of the employment." The WCB is only responsible for personal injury as a result of accidents that are determined to be arising out of and in the course of employment.

Worker’s Position

The worker appeared in the hearing with the support of a representative, who outlined their position that the worker experienced symptoms and required medical attention in relation to the injury to their left knee sustained in the workplace accident of March 18, 2025.

The worker’s evidence is that they injured both knees in the motor vehicle accident. The worker stated that their legs were twisted and they hit the dashboard during the accident. The worker acknowledges that the initial medical reports from their visit to the emergency room did not indicate that the worker had an injury to their left knee, however the worker states that both knees were in pain, but they prioritized their right knee as it was bothering them more at that point. The worker’s evidence is that they did report that their left knee was bothering them the next day at their work as that is when they noted pain when attempting to climb stairs.

The worker advises that they were eventually referred for imaging of their left knee, and their treating physician has indicated that they have a torn ACL and require surgery on their knee.

The worker’s position is that the accident during the course of employment caused the injury to the left knee and therefore they should be entitled to coverage.

Employer’s Position

The employer did not participate in the appeal.

Analysis

The issue before the panel is whether the worker is entitled to coverage for a left knee injury arising from the March 18, 2025 workplace motor vehicle accident. For the worker’s appeal to succeed, the panel would have to determine that the worker sustained an injury as a result of an accident arising out of and in the course of employment on March 18, 2025. The panel finds that it is more likely than not that on March 18, 2025, the worker experienced an injury to their left knee.

There is no dispute that the worker was involved in a motor vehicle accident arising out of and in the course of employment on March 18, 2025. The claim was accepted for right knee and left upper chest injuries. The central question at issue is whether the worker also sustained an injury to the left knee in that same accident.

The panel considered the fact that the worker’s attendance at the emergency department on the date of accident focused primarily on pain behind the right knee and discomfort across the chest from the seatbelt. No specific diagnosis was made in relation to the left knee. While the absence of contemporaneous reporting is a relevant factor, it is not determinative. The panel accepts that following a motor vehicle accident, a worker may focus on the most acute symptoms at the time, particularly where multiple areas of the body are affected. The worker consistently explained that the right knee was initially more symptomatic and therefore became the priority during that appointment.

The worker later reported bilateral knee pain to their treating physician on April 3, 2025, approximately two weeks after the accident. At that appointment, the worker specifically described left knee pain with instability that worsened on stairs. Clinical findings included laxity on lateral collateral ligament testing and tenderness to the prepatellar bursa. These findings provide support for an injury involving the left knee rather than merely relying on the worker’s reported complaints.

The panel places weight on the physiotherapy assessment of April 11, 2025. At that time, the worker reported both knees were painful following the accident, with the left becoming worse than the right. The physiotherapist recorded pain with flexion and extension overpressure and diagnosed a knee sprain/contusion and patellar bursitis. These diagnoses are consistent with trauma such as striking the dashboard or twisting forces during a motor vehicle collision, as described by the worker.

The Review Office relied heavily on the delay in seeking treatment and perceived inconsistencies in the reporting of symptoms. The panel acknowledges there were some variations in how the worker described the progression of left knee symptoms, including references to worsening pain approximately a week after the accident and increased pain while lifting or twisting with a container after termination of employment. However, the panel does not find these variations sufficient to determine there was no causal connection to the workplace accident.

In the panel’s view, the evidence more reasonably supports that the worker sustained an initial left knee injury in the March 18, 2025 accident which may have been relatively less symptomatic at first, then became more apparent as the right knee improved and the worker resumed normal movement. It is also plausible that subsequent activities temporarily aggravated or drew attention to an already injured knee. That does not negate the existence of the original compensable injury.

There is no persuasive evidence before the panel of any significant pre-existing left knee condition that would account for the worker’s symptoms independent of the accident.

After considering the totality of the evidence, including the mechanism of injury, the worker’s explanation, the reporting of bilateral knee symptoms within a relatively short period after the accident, and the later clinical findings consistent with trauma, the panel finds on a balance of probabilities that the worker sustained a left knee injury as a result of the March 18, 2025 workplace accident.

Therefore, the worker is entitled to coverage for a left knee injury. The worker’s appeal is granted.

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 30th day of April, 2026