The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The employer is appealing the decision made by the Workers Compensation Board ("WCB") that the worker is not entitled to benefits beyond June 10, 2025 due to the November 13, 2024 accident. A videoconference hearing was held on December 11, 2025 to consider the employer's appeal.

Issue

Is the worker entitled to benefits beyond June 10, 2025 due to the November 13, 2024 accident?

Decision

The worker is entitled to benefits beyond June 10, 2025 due to the November 13, 2024 accident.

Background

The worker filed a Worker Incident Report with the WCB on November 19, 2024, reporting they sustained an injury to their right shoulder at work on November 13, 2024, when they rolled up a blind, extending their right arm as it was at a higher height when their arm just dropped and they continued to roll up the blind with the left arm. The worker noted they reported the incident to their manager on November 16, 2024 as they had self-treated their right shoulder, thinking the pain would go away but it did not.

The worker sought medical treatment on November 16, 2024, reporting they were reaching overhead to roll up a blind when they experienced sudden pain and weakness to their right shoulder. They reported complaints of severe pain to their anterior right shoulder and inability to move due to pain. The treating physician found the worker's right shoulder was very tender at the anterior region, extremely limited range of motion to abduction, flexion and external rotation. An x-ray taken that date found "There are at least 2 small foci of amorphous calcific density projecting over the rotator cuff insertion, suggestive of sites of calcific tendinopathy. No fracture or erosive bone lesion is visible. There is no evidence of a dislocation. Moderate acromioclavicular degenerative changes are also present." The physician diagnosed the worker with a rotator cuff sprain, recommended over-the-counter pain medications, rest and gentle range of motion exercises and for the worker to follow-up with a sports medicine physician when the pain subsided. Work restrictions of no use of the right arm were placed.

On November 20, 2024, the WCB contacted the worker to discuss their claim. The worker confirmed the mechanism of injury, noting their arm is completely outstretched upwards when they roll up the blind, which they do daily. The worker advised there was initially a little bit of pain, then their right arm suddenly gave out. The pain started off being minor and their arm was sore throughout the day, then increased to the point where they could not lift their right arm without pain. The worker further advised they asked their coworkers to do the heavier duties as they were in too much pain. The worker described that they currently could not use their right arm, that when they hold their arm close to their body and take the pain medication, it is fine, but when they actively use their right arm, they experience pain. They noted consistent, ongoing pain and weakness. The worker also noted they had not worked since November 14, 2024, and that they also had a concurrent employer but had not missed any time. The WCB advised the worker that their claim was accepted, and the payment of various benefits commenced.

The worker attended for an initial physiotherapy assessment on December 2, 2024, and was diagnosed with a rotator cuff strain and median nerve irritation after reporting right anterior lateral shoulder pain, radiating into their neck that was aggravated with lifting of the arm, lying on the arm, lifting and carrying. The worker described being woken up 2 or 3 times a night due to pain, stiffness on waking and tingling in the lateral upper arm region. Testing was positive for a rotator cuff and median nerve injury. Restrictions of no use of right arm were provided. The restrictions were provided to the employer on December 6, 2024, who confirmed they could accommodate the worker and a graduated return to work program began on December 11, 2024.

The worker was seen by a sports medicine physician on December 19, 2024. The worker described feeling pain and their arm dropping after rolling up a blind at work on November 13, 2024. The worker reported a sharp pain in their right shoulder, which increased when lifting their arm or reaching for an object. On examining the worker, the treating physician noted no swelling, redness, bruising, scaring or deformity, along with no supraspinatus, infraspinatus or deltoid deformity to the worker's right shoulder. Tenderness was noted on palpitation on greater tuberosity. Active range of motion was noted to be reduced with passive range of motion limited due to pain; abnormal testing was found for impingement/rotator cuff, and a normal neurological examination was indicated. The sports medicine physician diagnosed the worker with right shoulder pain due to rotator cuff tendinopathy and referred the worker for an MRI study. At a follow-up appointment on January 30, 2025, the physician updated the worker's diagnosis to right shoulder rotator calcific cuff tendinopathy.

On March 3, 2025, the worker underwent a right shoulder MRI study, which indicated:

1. Moderately severe tendinosis of infraspinatus and also supraspinatus likely sequela of hydroxyapatite deposition disease. No significant subacromial bursitis. 

2. Myotendinous junctional cyst in infraspinatus tendon is suggestive of an occult interstitial tear. No high-grade rotator cuff tear. Muscle bulk of the cuff is well preserved. 

3. AC (acromioclavicular) joint osteoarthritis.

In response to a request for an extension of treatment by the worker's treating physiotherapist, the WCB's physiotherapy advisor reviewed the worker's file on March 5, 2025. Four additional physiotherapy sessions were authorized with the advisor noting that the mechanism of injury involved a minor force and was not expected to cause a significant soft tissue injury to the right shoulder. The expected recovery was noted to be 2 to 8 weeks. The worker was seen for a follow-up with the sports medicine physician on March 10, 2025, and to review the MRI results. The physician noted the MRI study indicated moderate to severe tendinitis and calcium deposit. The diagnosis of right shoulder rotator calcific cuff tendinopathy was noted, and the physician performed a pain injection to the worker's right shoulder. During a follow-up appointment with the treating sports medicine physician on April 23, 2025, it was noted the worker had ongoing pain and they were referred to an orthopedic surgeon for further treatment.

The worker's file was reviewed by a WCB medical advisor on April 29, 2025. The advisor provided the worker was diagnosed with right shoulder rotator calcific cuff tendinopathy by the treating sports medicine physician, supported by the findings on the March 3, 2025 MRI study. The advisor noted that calcific rotator cuff tendinopathy was of unknown etiology, "…characterized by the formation of deposits of calcium hydroxyapatite crystals in one or several rotator cuff tendons, leading to pain and dysfunction. It is generally accepted that the condition is not caused by trauma or overuse." The WCB medical advisor further described stages of the condition, with some stages where patients with the tendinopathy may experience pain similar to rotator cuff tendinopathy or shoulder impingement syndrome. The advisor opined the worker's current right shoulder difficulties were related to the calcific rotator cuff tendinopathy and not the November 13, 2024 minor mechanism of injury. On May 22, 2025, the WCB advised the worker they were not entitled to benefits after May 30, 2025, as it had been determined their ongoing right shoulder difficulties were not related to the workplace accident. As the employer was not notified by the WCB of the change in the worker's benefits, a revised decision letter was provided to both parties on June 10, 2025, extending the worker's entitlement to benefits to that date.

The worker requested reconsideration of the WCB's decision to the Review Office on July 3, 2025. In their submission the worker noted the blind they had been rolling up on November 13, 2024, had been reported broken several times but the worker continued to have to roll it up every shift for over 2 years, noting the blind was fixed after they were injured. The worker noted the sports medicine physician's advice that calcific tendinitis/tendinopathy had often been associated with wear and tear of the tendons and also linked to repetitive strain injuries and overuse. The worker also advised they continued to experience the effects of the workplace accident, with pain and limited range of motion in their shoulder and as such, should be entitled to further benefits. 

The Review Office determined on September 16, 2025, the worker as not entitled to benefits after June 10, 2025. The Review Office found the medical evidence on file supports the worker had a pre-existing calcific tendonitis/tendinopathy condition in their right shoulder that was not caused or structurally changed by the November 13, 2024 workplace accident. The Review Office further found the worker's treating sports medicine physician consistently reported the worker's diagnosis and presentation being right shoulder calcific rotator cuff tendinopathy, not related to the workplace accident and accepted that diagnosis. As such, the Review Office could not establish a relationship between the worker's current right shoulder difficulties and the November 13, 2024 workplace accident and found the worker was not entitled to benefits after June 10, 2025.

The employer filed an appeal with the Appeal Commission on October 23, 2025, 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 April 23, 2026, the appeal panel met further to discuss the case and render its final decision on the issues under appeal.

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, (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. 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 a workplace injury is an enhancement of the pre-existing condition.

Employer’s Position

The employer was present at the hearing, supporting the worker. The employer made an oral submission and answered questions posed by members of the appeal panel.

The employer noted that the worker had no shoulder problems prior to the accident at work. The employer confirmed that following the accident the worker has been on reduced duties and that in their position as a manager they do have some duties that are not physical. The employer stated that co-workers are assisting by doing the worker's physical duties, while the worker does the non-physical duties.

The employer’s position is that the worker should be entitled to further benefits.

Worker’s Position

The worker appeared in the hearing on their own behalf. 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 after June 10, 2025, in relation to the injury sustained in the workplace accident of November 13, 2024. The worker submitted that their symptoms were such that they continued to experience a loss of earning capacity and to require medical aid after June 10, 2025.

The worker submits that they did not have any shoulder problems prior to the incident on November 13, 2024 and that the onset of their pain was sudden.

The worker’s position is that their benefits should not have ended and that they are entitled to further benefits in relation to their November 13, 2024 workplace injury.

Analysis

The question in this appeal is whether the worker is entitled to wage loss benefits after June 10, 2025 in relation to the accident of November 13, 2024. For the appeal to succeed the panel would have to determine that the worker is entitled to benefits beyond that date. As set out in the reasons that follow, the panel is able to make such a finding and therefore the appeal is granted.

The panel is satisfied that the worker sustained a compensable injury arising out of and in the course of their employment on November 13, 2024. The question to be determined is whether the effects of that injury continued beyond June 10, 2025 such that the worker remained entitled to wage loss and medical aid benefits.

The panel finds, on a balance of probabilities, that the worker continued to experience a loss of earning capacity and required medical treatment beyond June 10, 2025 as a result of the workplace accident.

The panel places significant weight on the evidence regarding the onset of the worker's symptoms. The worker consistently reported that while rolling up a blind overhead on November 13, 2024, they experienced sudden pain and immediate weakness in their right shoulder, followed by an inability to continue using the arm normally. The worker sought medical attention within days of the incident and described severe pain and marked restriction in shoulder movement. The contemporaneous medical reporting was consistent with an acute injury.

The panel acknowledges the medical evidence indicating the presence of pre-existing calcific rotator cuff tendinopathy. Diagnostic imaging identified calcific deposits and degenerative changes, and the WCB medical advisor opined that calcific tendinopathy is generally not caused by trauma or overuse. However, the existence of a pre-existing condition does not, in itself, disentitle a worker to compensation. Pursuant to the Pre-existing Policy, the relevant consideration is whether the workplace accident caused, enhanced, aggravated or prolonged the effects of that condition such that it resulted in a loss of earning capacity or need for medical aid. The panel notes that the worker denied experiencing right shoulder difficulties prior to the workplace incident. There is no evidence on file of any previous medical treatment, restrictions, limitations, or functional impairment involving the right shoulder. Despite the imaging findings, the worker was able to perform their regular employment duties before the accident without reported difficulty. The panel agrees with the worker’s treating physician who opined in their letter of March 18, 2025 that the shoulder issues may have predated the workplace accident, but the workplace accident could have contributed to an exacerbation of the worker’s shoulder symptoms.

The evidence is that the worker's employment involved active physical duties and was not sedentary in nature. The evidence establishes that the worker's role required the regular use of the upper extremities, including overhead activities such as rolling up blinds, lifting, carrying, and completing other physically demanding tasks. Following the accident, the worker reported being unable to perform heavier duties and relied on coworkers for assistance. Medical practitioners repeatedly imposed restrictions involving no use of the right arm in recognition of the worker's ongoing functional limitations.

The panel further notes that the worker's symptoms persisted well beyond the expected recovery period for a simple strain injury. Physiotherapy records documented ongoing pain, sleep disruption, stiffness, tingling and objective findings consistent with rotator cuff involvement. This evidence supports a conclusion that the worker continued to require medical aid after June 10, 2025.

While the treating sports medicine physician diagnosed calcific rotator cuff tendinopathy, the panel is not persuaded that this diagnosis necessarily severs the causal connection between the worker's ongoing symptoms and the workplace accident. The evidence establishes that the worker experienced a sudden and significant deterioration in shoulder function following the incident of November 13, 2024. The panel finds it more likely than not that the workplace accident enhanced the worker's previously asymptomatic pre-existing shoulder condition, rendering it symptomatic and functionally limiting.

The panel is not persuaded that the worker had recovered from the effects of the workplace accident by June 10, 2025. At that time, the worker continued to report pain and restricted function, remained under the care of a sports medicine physician, had recently undergone diagnostic imaging and injection treatment, and had been referred for orthopedic assessment. The medical evidence does not establish that the worker's ongoing difficulties were solely attributable to the natural progression of the pre-existing condition independent of the workplace injury.

Considering the totality of the evidence, the panel finds that the worker's loss of earning capacity and need for medical aid beyond June 10, 2025 were, on a balance of probabilities, related to the November 13, 2024 workplace accident. The accident caused a significant change in the worker's shoulder function and materially contributed to the worker's ongoing symptoms and disability.

Accordingly, the panel finds that the worker is entitled to benefits beyond June 10, 2025 in relation to the November 13, 2024 workplace accident.

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 16th day of June, 2026