The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The employer appealed the Workers Compensation Board ("WCB") decision that the worker is entitled to benefits after December 15, 2025. At a hearing held on June 8, 2026, the appeal panel considered the employer's appeal.

Issue

Is the worker entitled to benefits after December 15, 2025?

Decision

The worker is entitled to benefits after December 15, 2025.

Background

The WCB accepted the worker's claim in relation to an injury that occurred at work on June 12, 2023 based on the diagnosis of non-specific low back pain and lumbar radiculopathy. The WCB provided benefits to the worker until October 22, 2023, when the WCB determined the worker was recovered from the injury sustained in the workplace accident. The Appeal Commission, in Decision No. 102/24 determined the worker was not recovered from the workplace accident by October 22, 2023 and therefore the worker was entitled to further benefits. Based on that decision, the WCB’s Compensation Services reopened the worker's claim for further adjudication.

On November 25, 2024, the worker advised the WCB that they had not returned to work and continued to have low back pain. The worker noted a recent visit to the treating back specialist on October 10, 2024, with follow-up planned for January 2025. The worker also advised they had injection procedures done involving nerve endings in their low back and completed physiotherapy. The WCB advised it would request updated medical information from the worker's treatment providers.

The updated medical information provided to the WCB indicated a February 8, 2024 referral to a pain clinic. The pain clinic physician noted the worker’s complaints of low back pain radiating into their left hip and thigh, and down to the calf. The physician noted the diagnostic imaging indicated degenerative changes. On examination, the pain clinic physician found tenderness with palpitation in the left lumbosacral region and “…pain consistent with potential piriformis syndrome” on testing hip range of motion. The physician diagnosed degenerative disc disease and outlined a treatment plan involving psychological treatment, exercise, and nerve blocks/injections. The worker underwent a nerve block and pain injection on March 6, 2024, and at follow-up on May 6, 2024, worker reported “60% pain relief” and that they were “doing much more”. A November 22, 2024 cervical spine MRI indicated “Mild multilevel degenerative changes in the cervical spine, without significant spinal canal or neural foraminal compromise. No neural compression demonstrated.” On February 12, 2025, the pain specialist noted the worker had no functional improvement and was not capable of working, recommending the nerve blocks and pain injections continue.

At the request of the WCB, the worker attended a call-in examination with a WCB medical advisor on June 17, 2025. The medical advisor, in an opinion dated July 22, 2025, concludes that, based on the reported mechanism of injury and the medical information on file, the worker sustained a lumbar sprain with no acute structural findings and that recovery from such an injury would be expected within a few weeks. The medical advisor concluded the worker’s current difficulties were not consistent with the natural history of recovery from a lumbar strain. The medical advisor noted that during the call-in examination, the worker did not present with significant lumbar mechanical signs and determined the worker recovered from the lumbar strain and appeared to have a non-compensable medical condition related to their current presentation, which they recommended the treating physician investigate further.

On December 8, 2025, the WCB advised the worker that it determined they recovered from the June 12, 2023 workplace accident and as such, their entitlement to benefits would end on December 15, 2025. The worker requested reconsideration of the WCB’s decision to Review Office on December 20, 2025 noting they continued to experience difficulties, and continued to receive treatment for their difficulties, including an upcoming appointment for a further MRI study. On January 6, 2026, Review Office returned the worker’s file to the WCB’s Compensation Services for further investigation. On January 23, 2026, the WCB advised the worker that on reviewing additional medical information, there was no change to the decision.

The worker again requested reconsideration of the WCB’s decision to Review Office on January 26, 2026. On February 9, 2026, Review Office determined the worker is entitled to further benefits after December 15, 2025.

The employer appealed that decision to the Appeal Commission on February 11, 2026 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.

A worker is entitled to benefits under s 4(1) of the Act when it is established that they sustained injury as a result of an accident at work. Under s 4(2), 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 a worker has a loss of earning capacity, an impairment or requires medical aid because of a workplace accident, compensation is payable under s 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.

The WCB established Policy 44.10.20.10, Pre-existing Conditions (the "Pre-existing Policy") which explains the WCB's approach to compensating a worker who has pre-existing health conditions that may contribute to the severity of a workplace injury or prolong a worker's recovery from such an injury. This Policy defines a pre-existing condition as any medical condition the worker had prior to their workplace injury. Pre-existing conditions may contribute to the severity of a workplace injury or significantly prolong a worker's recovery. Workplace injuries can also impact pre-existing conditions. When a worker’s pre-existing condition is temporarily worsened because of a workplace injury, this is considered an aggravation of a pre-existing condition. When a worker’s condition is permanently worsened because of a workplace injury, this is considered an enhancement of the pre-existing condition.

Employer's Position

The employer appeared in the hearing represented by its safety coordinator. The employer representative outlined the employer's position through an oral submission and in answering questions posed by members of the appeal panel.

The employer's position is that the worker is not entitled to benefits after December 15, 2025 as the evidence confirms the worker's ongoing lower back concerns are not a result of the injury sustained in the compensable accident of June 12, 2023 but rather can be attributed to the worker's other pre-existing or co-existing health conditions, including the worker's multilevel degenerative disc disease.

The employer representative noted the reporting from the worker's treatment providers contain multiple references to the worker's degenerative back condition and submitted that this could not be attributed to the injury sustained in the workplace accident. The employer representative further noted the opinion of the WCB medical advisor that there were other potential explanations for the worker's ongoing lower back symptoms including but not limited to their degenerative back condition. The representative urged the panel to give weight to the MRI study findings which indicate the worker's low back was already compromised prior to the accident.

The employer representative also noted that it could possibly have accommodated the worker with alternative job duties but that the WCB did not explore or support this option.

Worker's Position

The worker appeared in the hearing represented by a worker advisor. The worker advisor provided an oral submission outlining the worker's position that they are entitled to benefits after December 15, 2025. The worker provided testimony through answers to questions posed by members of the appeal panel.

The worker's position is that the evidence supports a finding that the worker has not recovered to the point of their pre-accident baseline condition and remained unable to return to work and required ongoing medical treatment beyond December 15, 2025 as a result of the injury sustained in the compensable workplace accident. The worker advisor outlined that the evidence does not support the WCB determination that the injury sustained was only a lumbar strain injury, and that if that were the case, the worker would have recovered by this point. The worker advisor noted the evidence that prior to the accident, despite the existence of the worker's pre-existing degenerative back condition, the worker exhibited a commitment to their work with a strong work ethic and did not complain of low back symptoms, but since that time, the worker has been unable to return to work and has not returned to their pre-accident functional baseline.

The worker advisor noted that the WCB did not seek any further healthcare opinion or consult with the worker's treatment providers after receiving additional medical information in late 2025 and early 2026. The worker advisor noted the worker continued to receive treatment from the pain clinic into 2026 and had an MRI study scheduled for February 2026. The worker advisor also noted the WCB medical advisor suggested other testing in relation to the worker's symptoms, but the WCB did not facilitate any such procedures. The worker advisor submitted that the WCB failed to fully investigate the worker's ongoing medical condition and as such, the evidence does not support a finding that the worker is fully recovered from the injury sustained in the workplace accident.

The worker advisor further noted that despite the employer's indication that it could have provided alternate work to the worker, the WCB did not take steps to facilitate a return to work or to prepare the worker for a return to work.

Analysis

This appeal considers whether the worker is entitled to benefits after December 15, 2025. For the employer's appeal to succeed, the panel would have to find that the worker did not sustain a loss of earning capacity or require medical aid beyond December 15, 2025 as a result of the workplace accident. As detailed in the reasons that follow, the panel could not make such findings and therefore the employer's appeal is denied.

The appeal panel, in this appeal, is bound by the findings of the previous appeal panel, as set out in Appeal Commission Decision 102/24.

There is no question as to whether this worker had a pre-existing degenerative back condition. The MRI findings indicate this to be the case, and the worker accepts that. While the employer's position is that this condition likely is the reason for the worker's ongoing symptoms, the panel noted that there is no evidence this condition limited the worker's functional abilities before the workplace accident. We also noted that a plain reading of the MRI findings from 2020 through 2026 indicates minimal change in the condition of the worker's spine over that period, despite the onset and continuation of low back symptoms since the workplace accident in June 2023. The panel also noted that although the WCB medical advisor noted possible aggravation of the worker's degenerative back condition arising out of the accident, they did not indicate any permanent impact or enhancement of this condition resulting from the accident. The panel is satisfied that the available evidence does not support the employer's position that the worker's ongoing low back complaints are the result of enhancement of their pre-existing degenerative back condition, nor related to the natural progression of a degenerative condition over time.

The panel noted that there is evidence of some improvement in the worker's symptoms with treatment by physiotherapy at first, and later with injections, but that these treatments did not provide ongoing and longstanding effect, such that the worker could resume their pre-accident function as of December 15, 2025.

The panel also considered the findings from the call in examination in June 2025. We noted there is evidence that certain testing was not completed due to the worker's pain response or tolerance, including lower extremity functional testing. We also noted the medical advisor found evidence of limited lumbar spine range of motion with guarding in all directions and guarded hip range of motion in all directions, as well as tenderness along the lumbosacral spine and paraspinal soft tissues, as well as at the left sacroiliac joint and gluteal soft tissues. The medical advisor commented on their suspicion that the worker's inflammatory medical condition is contributing to their symptoms and stated this is the "probable cause" of the worker's current back presentation. The panel finds that this conclusion to be speculative, as the proposed explanations have not been explored or confirmed by medical investigation to date and as there has been a continuity of symptoms since the date of accident that the WCB accepted as being related to the workplace injury until December 15, 2025. As such, we place little weight on the medical advisor's conclusion regarding an alternative cause.

The panel finds the evidence does not support a finding that the worker is recovered to their pre-accident condition, but rather that the worker continues to experience ongoing and debilitating low back symptoms, as supported by the reports of their treatment providers. We further find there is no evidence to indicate the worker could return to their physically demanding pre-accident job duties or any other work. We also find there is evidence that the worker requires additional medical treatment arising out of this injury, which potentially includes investigations suggested by the WCB medical advisor, although that is a matter for the worker's treatment providers to determine.

Having considered the evidence before us as a whole, and applying the standard of a balance of probabilities, we are satisfied that as of December 15, 2025, the worker continued to sustain a loss of earning capacity and continued to require medical aid as a result of the injuries sustained in the compensable accident of June 12, 2023. Therefore, the worker is entitled to benefits after December 15, 2025 and the employer's appeal 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 22nd day of June, 2026