The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker is appealing the decision made by the Workers Compensation Board ("WCB") that their claim is not acceptable. A hearing was held on May 5, 2025 and reconvened on June 9, 2025 to consider the worker's appeal.

Issue

Whether or not the claim is acceptable.

Decision

The claim is not acceptable.

Background

On October 8, 2024, the worker filed a Worker Incident Report with the WCB reporting a lower back injury that occurred at work on July 12, 2024. The worker described loading objects into a truck then experiencing a lot of pain when they finished their shift. They felt the pain would get better and took over-the-counter pain medication. The worker noted they were in a lot of pain the following day but was leaving for vacation and was unable to make an appointment for medical treatment as they were out of the country. The worker advised when they returned from vacation, they were still in pain and sought medical treatment.

The WCB contacted the worker on October 15, 2024 to discuss the claim. The worker confirmed they felt the onset of their symptoms on July 12, 2024 after lifting heavy objects over their head and that they did not advise their supervisor or any of their coworkers about their difficulties, advising the WCB they felt their pain symptoms were normal given the work they were doing. When asked by the WCB, the worker further advised they managed their pain symptoms while on vacation with over-the-counter pain medication. It was noted the worker returned to work on August 19, 2024 and had been performing light duties since that date. The worker also indicated they had initially attended for treatment at a foot clinic, believing they required orthotics for their foot pain. They were later informed their foot pain was due to lower back pain. The worker advised the WCB they had been admitted to the hospital on October 8, 2024 as they could not walk due to bilateral leg pain, which they related to the workplace injury. The worker further advised the WCB they had reported the July 12, 2024 incident to their treating physician and was aware the physician had provided an assessment of their condition indicating it was not related to work, with which they disagreed.

Medical information from the worker’s treating healthcare providers was requested by the WCB. A Doctor First Report dated September 13, 2024 indicated the worker attended to discuss follow-up for lower back pain, among other issues and provided a diagnosis of low back pain for the worker. The Report noted an x-ray of the worker’s lumbar spine had been conducted and was noted to be normal and that the worker was to be on restricted duties and to attend for physiotherapy. A follow-up report on September 19, 2024, noted the worker’s request for the physician to find their symptoms were related to work however, the physician noted the worker had not reported that previously, only that their symptoms happen when they attend work. The worker attended for a further appointment on October 3, 2024 for an unrelated injury but the treating physician noted mild restricted range of motion in the worker’s lower back and referred the worker for a CT scan. The following day, the worker attended to discuss the results of cervical spine x-rays taken the previous day which were noted to be normal and the worker was referred for chiropractic treatment.

The WCB also received information from the local emergency hospital for the worker's admission on October 10, 2024. The medical information from the hospital recorded the worker's entrance complaint of low back pain with paresthesia in their legs. The worker reported they had fallen at work in June after pulling out boxes and falling from standing onto their buttocks. Their initial pain radiated into their thighs and now presented as numbness and weakness in both their legs. Various tests were performed at the hospital including x-rays, lumbar spine and brain MRI studies and a lumbar puncture. The worker was discharged on October 14, 2024 with a referral for physiotherapy and to the outpatient clinic for chronic pain and back injuries. The worker attended an initial chiropractic assessment on October 17, 2024 reporting pain in both their legs and shoulders which they related to the physical nature of their work, especially in cold conditions. The worker described constant numbness, weakness and heaviness in both legs and reported difficulty with walking occasionally. The treating chiropractor recommended the worker follow-up with their treating physician for referral to a neurologist.

On November 12, 2024, the worker's file was reviewed by a WCB medical advisor who opined after reviewing the medical information, "…there is no identified pathology or medical condition to attribute to a specific activity / movement." On November 19, 2024, the employer provided the WCB with a copy of the chart notes from their health unit along with a copy of their internal investigation. The chart notes from the health unit noted the worker reported to the unit on August 20, 2024 with complaints of pain to their low back and legs, which pain started approximately 2 weeks previously. The worker advised they could not perform their regular job duties due to the pain. It was noted the worker reported different dates and times when their pain started, advising it began on July 12, 2024, prior to leaving on a pre-scheduled vacation and then began to experience low back and leg pain 2 weeks later. The notes indicate the worker was provided with modified duties. The employer's investigation report summarized the health unit notes and confirmed the worker was provided with light duties. The WCB advised the worker on November 19, 2024, their claim was not acceptable as a causal relationship between their low back and leg difficulties and their job duties could not be established.

The worker requested reconsideration of the WCB's decision to Review Office on December 18, 2024. In their submission, the worker noted they advised the employer on August 17, 2024, they were having difficulty performing their job duties due to pain, which they did not have prior to that date and as such, believed their claim should be accepted. Review Office found on January 13, 2025, the worker's claim was not acceptable. Review Office further found the information on file from the worker noted inconsistencies with the worker's reporting of their difficulties to the WCB, the employer and their treating healthcare providers, including their submission to Review Office which did not indicate a work-related incident occurring on July 12, 2024. In addition, Review Office placed weight on the information that the worker's treating family physician indicated the worker had not reported a work-related incident to them. As such, Review Office determined the worker's claim was not acceptable.

The worker filed an appeal with the Appeal Commission on January 29, 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 June 18, 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 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 where a worker suffers personal injury by accident arising out of and in the course of employment, compensation shall be paid. The Act defines “accident” in Section 1(1) as follows:

(a) a chance event occasioned by a physical or natural cause, 

(b) a wilful and intentional act that is not the act of the worker, or 

(c) an event or condition, or a combination of events or conditions, related to the worker's work or workplace, 

that results in personal injury to a worker, including an occupational disease, post-traumatic stress disorder or an acute reaction to a traumatic event.

Section 17(1) of the Act requires that a worker give notice of an injury caused by an accident to their employer as soon as practicable and no later than 30 days after the accident occurs. Section 17(5) provides grounds for excusing a failure to give the notice required and includes where "the board is of opinion that the claim is a just one and ought to be allowed."

The WCB has established Policy 44.05, Arising Out of and in the Course of Employment (the "Arising Policy") which confirms that an injured worker will be entitled to compensation under the Act if the WCB determines that they suffered a personal injury by accident and that the accident arose out of and in the course of employment and provides how the WCB determines whether an accident arose out of and in the course of employment.

The WCB has also established Policy 44.10.20.10, Pre-existing Conditions (the "Pre-existing Policy"), to address eligibility for compensation in circumstances where a worker has a pre-existing condition, which is defined as any medical condition the worker had prior to their workplace injury. The Pre-existing Policy outlines that the WCB will not provide benefits for disablement resulting solely from the effect of a worker’s pre-existing condition as such a condition does not fall within the definition of personal injury by accident arising out of and in the course of employment. It also outlines that a pre-existing condition may contribute to the severity of a workplace injury or significantly prolong a worker's recovery, and workplace injuries can impact pre-existing conditions. 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.

Worker’s Position

The worker was present at the hearing. The worker made an oral submission to the appeal panel and provided evidence by way of answering questions posed by members of the panel.

The worker’s position is that the decision of the Review Office should be overturned. The worker states that the accident happened at work and they followed the appropriate procedure in reporting and seeking medical care. The worker noted that they did not seek medical treatment because they travelled abroad the day after the injury on July 12, 2024. After they returned on August 19, 2024 they made an appointment with their doctor.

The worker had the Safety Captain of the employer give evidence before the panel in support of their position. However, the witness was only able to speak to a prior incident involving the worker dated August 2023 and could not speak to the July 12, 2024 incident.

The worker acknowledged that their medical team found that they have a rare medical condition, which may be causing some of their symptoms.

The worker is seeking a finding that their claim is acceptable.

Employer’s Position

The employer was represented by an advocate who made an oral submission to the panel. The employer’s representative also answered questions posed by members of the appeal panel.

The position of the employer is that the claim was correctly denied by the WCB and the Review Office as a result of the worker’s delay in seeking medical attention, delay in reporting the injury, and insufficient evidence that an injury, as defined by the Act, occurred.

The employer notes that the worker delayed in filing the report for three (3) months after the injury. The employer also notes that the worker reported an inconsistent area of injury and an inconsistent mechanism of injury.

The position of the employer is that the worker’s claim does not meet the evidentiary criteria under the Act and therefore compensation is not warranted.

Analysis

The question on appeal is whether the worker’s claim is acceptable. 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 their employment. As outlined in the reasons that follow, the panel was unable to make such a finding and therefore, the worker’s appeal is not acceptable.

In determining whether the claim is acceptable, the panel has considered the totality of the evidence, including the additional medical documentation obtained following the hearing.

The evidence before the panel demonstrates that the worker did not report the injury in a timely manner. The delay of three (3) months is an unreasonable delay and suggests that the worker’s symptoms are unrelated to the incident on July 12, 2024. The evidence also demonstrates that there is a lack of support for an injury which arose out of the course of the worker’s employment. The worker’s medical file indicates that the mechanism of injury was inconsistent, as the worker reported several different mechanisms of injury to the various treating medical professionals. Additionally, the reported timing of the worker’s injury has been inconsistent with various dates given to the worker’s treating medical professionals.

Further, the worker’s medical file indicates that there is another medical condition affecting the worker, which could explain some of the symptoms that they appear to be experiencing. In reviewing the worker’s medical file, it is clear that the documentation supports the physician’s diagnosis of a rare medical condition, which is non-compensable.

Accordingly, the panel finds it more likely than not that the worker did not sustain an injury to their lower back by way of a workplace accident, as defined by the Act. Further, the worker’s file does not establish a causal relationship between their low back and leg difficulties and their job duties.

The panel is therefore satisfied that the injury did not arise out of and in the course of the worker’s employment.

The claim is not acceptable.

Panel Members

N. Smith, Presiding Officer
J. Peterson, Commissioner
M. Kernaghan, Commissioner

Recording Secretary, J. Lee

N. Smith - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 30th day of July, 2026