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 further benefits in relation to the January 24, 2025 accident. A hearing was held on November 26, 2025 to consider the worker's appeal.

Issue

Whether or not the worker is entitled to further benefits in relation to the January 24, 2025 accident.

Decision

The worker is not entitled to further benefits in relation to the January 24, 2025 accident.

Background

The worker filed a Worker Incident Report on January 28, 2025 to report an injury to their upper leg that occurred at work on January 24, 2025. The worker reported driving a different work vehicle than usual. When driving and using the clutch, they felt a pain in their upper leg around the groin area.

The worker attended the local emergency department on January 26, 2025, reporting constant, sharp left leg pain that radiated to their hip and groin and increased pain with weight bearing. The worker did not report a trauma to that area. On examining the worker, the treating physician found definite tenderness in the left medial thigh area and assessed possible musculoskeletal type pain. An ultrasound was recommended to rule out a deep vein thrombosis in the left leg (later excluded by ultrasound on January 27, 2025). The physician placed the worker off work for 5 days.

The employer submitted an Employer’s Accident Report to the WCB on January 29, 2025, confirming the mechanism of injury reported by the worker and advised modified duties were not available.

On January 30, 2025, the worker attended for an initial physiotherapy assessment. The worker described to the treating physiotherapist that on January 24, 2025, they were driving a different truck and found the clutch was farther away. The repetitive strain of using the clutch caused them to become sore and by that evening, they could hardly move or place weight on their left leg. The physiotherapist noted the worker was in pain and required assistance to get out of the chair and to lay supine. Reduced hip flexion, adduction and abduction were noted and the worker was diagnosed with a left hip flexor/adductor strain. Further time off work was recommended.

The WCB spoke with the worker on January 31, 2025 and advised their claim was accepted. The worker was paid wage loss benefits as of January 27, 2025.

The worker was seen at a local clinic on February 8, 2025. The treating physician recorded the worker’s reporting of pain to the anterior aspect of their left hip with any movement. The physician noted an x-ray taken of the worker’s left hip on that date and compared against a left hip x-ray taken in 2024. The x-ray report indicated “moderate degenerative change redemonstrated manifest with superior femoral migration and acetabular sclerosis/spurring”. A referral to an orthopedic surgeon was made. The worker attended at a different clinic on February 24, 2025 and was referred to a sports medicine physician. Further time off work was recommended.

The worker was seen by a sports medicine physician on March 14, 2025 reporting a repetitive hip injury from work. The sports medicine physician diagnosed the worker with a work-related exacerbation of previously asymptomatic left hip osteoarthritis, recommended the worker remain off work and noted the worker was on the list for a total hip replacement.

A follow-up appointment with the sports medicine physician took place on April 8, 2025, with the physician noting the worker had now been assigned to an orthopedic surgeon regarding their pre-arranged knee replacement surgeries, and that the surgeon also performed hip replacement surgeries. The orthopedic surgeon determined that the hip surgery would be addressed first.

A May 15, 2025 report from the worker’s treating family physician noted the worker’s ongoing chronic left hip/groin and lower left extremity pain and instability when walking. On examining the worker, the physician noted the worker had pain with left hip extension greater than 45 degrees. It was noted the worker was unable to return to work and was awaiting hip surgery on July 9, 2025.

On June 23, 2025, the worker’s treating family physician advised the WCB the worker’s July 9, 2025 surgery had been cancelled due to a non-claim related health issue.

The WCB spoke with the worker on July 8, 2025 to discuss their claim. The WCB advised the worker their claim was accepted for a soft tissue type injury, being a left hip flexor/abductor (should be adductor) strain in the environment of a pre-existing condition, which injury would typically recover in a few days to a few weeks. The WCB noted it had been over five months since the workplace accident and the worker had attended 16 physiotherapy sessions. As such, it had been determined the worker was sufficiently recovered from the January 24, 2025 workplace accident. On the same date, the WCB provided the worker with a formal decision letter outlining their discussion and advising the worker they were not entitled to further benefits in relation to the workplace accident after July 15, 2025.

The worker requested reconsideration of the WCB’s decision to Review Office on August 5, 2025. In their submission, the worker noted their treating healthcare providers supported that their ongoing left hip difficulties related to the workplace accident and that the worker requires surgery. As such, the worker noted their belief they require further benefits.

Review Office determined on August 14, 2025, the worker was not entitled to further benefits. Review Office found the medical evidence on file supported the worker’s pre-existing left hip osteoarthritis was temporarily worsened and/or aggravated by the January 24, 2025 workplace accident, but was not permanently enhanced. Review Office found the worker was provided with in-clinic physiotherapy treatment for the injury, as well as a home exercise program that would have helped with any residual symptoms arising from the injury thereafter. Review Office found the evidence did not support a relationship between the worker’s ongoing left hip difficulties and the workplace accident.

The worker filed an appeal with the Appeal Commission on September 2, 2025 and a hearing was arranged.

After the hearing the panel requested clarifying information from the worker’s sports medicine physician which was received on January 7, 2026 and March 4, 2026, and a report from WCB’s sport medicine advisor, which was received June 19, 2026.

Reasons

Applicable Legislation and Policy

The Appeal Commission and its panels are bound by The Workers Compensation Act (the “Act”), regulations made under the Act 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 to the worker.

Subsection 27(1) of the Act provides 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”.

Section 37 of the Act provides that compensation is payable where a worker, as a result of an accident, sustains a loss of earning capacity or an impairment, or requires medical aid. 

The WCB’s Board of Directors has established WCB Policy 44.10.20.10, Pre-existing Conditions (the “Policy”), which addresses eligibility for compensation in circumstances where a worker has a pre-existing condition. The Policy states, in part, as follows:

A pre-existing condition is 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 have an effect on 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.

…

When the WCB determines that the worker has a loss of earning capacity resulting in part from a workplace injury and in part from a non-compensable pre-existing condition or the relationship between them, wage loss benefits are payable to the worker.

…

Wage loss benefits will cease when a worker has: 

i) recovered from the workplace injury to the point that the injury is no longer contributing, to a material degree, to the worker’s loss of earning capacity, and 

ii) the pre-existing condition is not a compensable condition.

…

Pre-existing conditions may impact the provision of medical aid. The WCG will consider the worker’s pre-existing condition when providing medical aid to assist the worker in recovering from the effects of their workplace injury.

Worker’s Position

The worker was represented by counsel, who provided written submissions in advance of the hearing and made an oral presentation to the panel. The worker responded to questions from counsel, and the worker and counsel responded to questions from the panel. Counsel for the worker also provided further written submissions after receiving the medical information requested by the panel following the hearing. 

The worker did not dispute that there was osteoarthritis in their left hip prior to the compensable injury of January 24, 2025. The worker gave evidence that until the accident, the osteoarthritis had been asymptomatic. The worker noted the reports of their primary health care provider and their treating sports medicine physician in this regard. Counsel noted the temporal relationship between the worker’s accident and the onset of their symptoms.

The worker gave evidence that the now-symptomatic hip arthritis did not return to baseline at any time after the compensable injury and took the position that the accident had therefore enhanced (permanently worsened) their pre-existing condition. The worker argued that the temporal onset of symptoms, their sudden appearance and the fact that they have continued unabated are evidence of enhancement. The worker noted through counsel that an enhancement of a pre-existing condition is compensable pursuant to the Policy.

The worker also took the position that a previously asymptomatic pre-existing condition, when rendered symptomatic by a workplace incident, is compensable. Counsel pointed to several Ontario decisions in support of their argument in this regard. Those decisions were considered by the panel but do not bind our decision-making authority.

Employer’s Position

The employer did not participate in the appeal.

Analysis

The issue before the panel is whether the worker is entitled to further benefits in relation to their left hip injury of January 24, 2025. For the worker’s appeal to be successful, the panel must find, on a balance of probabilities, that the worker continued to sustain either a loss of earning capacity or required further medical aid as a result of the injury. As described below, the panel is unable to make such findings.

The panel considered the evidence of the worker with respect to the mechanics of their injury, which occurred when the worker was required to drive a different truck than they usually operated. The driver’s seat of the truck retracted less than usual and the worker was therefore required to repeatedly lift their leg higher than normal to operate the clutch over a number of days. It is not in dispute that the worker began to experience difficulties while operating the new truck.

The panel also considered the medical evidence provided, which included records of the worker’s treating professionals which assessed left hip flexor/adduction strain immediately after the accident, and the subsequent records which indicated pre-existing osteoarthritis of the left hip.

We note that the worker’s claim was accepted for a hip flexor/adduction strain, and closed approximately 5 months later on the basis that the strain was sufficiently resolved and the continued difficulties experienced by the worker were the result of their pre-existing osteo-arthritis. The worker was scheduled for total hip replacement surgery by the time the claim was closed.

The panel must now determine whether the ongoing symptoms experienced by the worker since their claim was closed are the result of the compensable injury, the pre-existing osteoarthritis, or a combination of both.

The report of WCB’s sport medicine advisor dated June 19, 2026 confirmed that the worker’s activity at work as described was temporally associated with the onset of symptoms and “capable of provoking symptoms in an individual with underlying osteoarthritis”. The report then noted that the available evidence, “does not demonstrate structural progression or alteration of the degenerative condition attributable to the exposure. Overall, the pattern of findings is most consistent with symptom provocation in a pre-existing degenerative condition, without objective evidence supporting permanent worsening.”

The report also provided a useful summary and analysis of relevant factors before the panel based on review of the worker's medical records, as follows:

An initial opinion of aggravation was provided on the basis that the patient was asymptomatic prior to the workplace activity and developed symptoms during exposure. This is consistent with the reported chronology of symptom onset during workplace activity and persistence thereafter. The presence of a temporal relationship between exposure and symptom is not in dispute.

Given persistence of symptoms without return to baseline, enhancement was subsequently considered. The central issue is the interpretation of these findings in the context of pre-existing moderately severe osteoarthritis and unchanged imaging.

One interpretation is that workplace activity precipitated symptoms arising from previously asymptomatic or minimally symptomatic osteoarthritis, with ongoing symptoms reflecting the natural clinical course of the condition. This is supported by pre-existing radiographic evidence of moderately severe osteoarthritis, the low-energy nature of the workplace exposure, and imaging demonstrating no interval structural change.

An alternative interpretation places greater weight on the absence of prior symptoms and ongoing symptom burden as indicators of permanent worsening of the underlying condition.

Both interpretations accept temporal association between exposure and symptom onset. The distinction lies in whether persistent symptoms, in the absence of structural progression on imaging, are sufficient to conclude permanent worsening of the pre-existing condition.

The panel is unable to conclude on the evidence before us that the worker’s accident resulted in permanent worsening of their pre-existing condition. The medical evidence on file does not indicate a change in the physical structure of the worker’s left hip after the workplace accident. Of note, the x-ray of the hip taken in 2024 (pre-compensable injury) was compared to the x-ray taken on February 8, 2025 (post-compensable injury) with no further deterioration noted.

The worker’s compensable injury occurred in the environment of their pre-existing, non- compensable osteoarthritis. The worker received benefits for their compensable injury which reached the plateau of what could be accomplished in light of the worker’s non-compensable, pre-existing osteoarthritis. The panel finds that the remaining difficulties experienced by the worker thereafter are more likely than not related to the natural progression of their pre-existing osteoarthritis, and not to the compensable injury.

For these reasons the panel finds that the worker is not entitled to further benefits in relation to the January 24, 2025 accident. The worker’s appeal is dismissed.

Panel Members

M. Murray, Presiding Officer
J. Peterson, Commissioner
M. Kernaghan, Commissioner

Recording Secretary, J. Lee

M. Murray - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 27th day of August, 2026