Decision No.: 2022-0181  
Page 1  
Appeals Commission for Alberta Workers’ Compensation  
Docket No.: AC0360-19-36  
Decision No.: 2022-0181  
Introduction  
[1]  
[2]  
[3]  
The worker is seeking Workers’ Compensation Board (WCB) coverage for a back  
injury. Specifically, he alleges a back injury developing over time caused directly or  
aggravated by his job duties as a mail dispatcher.  
The worker is a federal government employee who elected to claim  
compensation for his injury under the Government Employees Compensation  
Act, RSC 1985, c-G-5 (GECA).  
The panel determined GECA applies to this appeal. GECA provides that when a  
federal government employee sustains an injury in an accident arising out of and  
in the course of their employment, they can claim compensation under applicable  
provincial legislation in the province where they usually work. In this worker’s  
case, that is Alberta.  
[4]  
Consistent with previous Appeals Commission decisions, we interpret these provisions  
to mean that when a federal government employee makes a claim for worker’s  
compensation in Alberta, the Workers’ Compensation Act, RSA 2000, c W-15 (WCA)  
and WCB policies govern the worker’s compensation claim.  
Procedural history  
a. Decision Appealed  
[5]  
The worker is appealing a September 6, 2019 Dispute Resolution and Decision  
Review Body (DRDRB) decision. The DRDRB decision upheld an August 28,  
2018 WCB adjudicator’s decision denying the worker’s claim since his back injury  
was neither caused nor aggravated by his work duties.  
b. Administrative Procedures Communicated to the Parties  
[6]  
[7]  
The Appeals Commission received the worker’s October 10, 2019 Notice of Appeal  
form.  
By way of letters dated October 17, 2019, the Appeals Commission provided the  
employer and the WCB with notice of the worker’s appeal and the opportunity to  
attend the hearing. The employer and WCB declined to participate.  
[8]  
The Appeals Commission scheduled an in-person hearing date. At the  
representative’s request, the Appeals Commission adjourned the hearing and  
advised that they would reschedule the matter once in-person hearings resumed.  
Classification: Protected A  
Decision No.: 2022-0181  
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[9]  
On April 15, 2021, the Appeals Commission notified the worker that due to  
success with video conference hearings, viewed as equivalent to an in-person  
hearing, they would no longer accept adjournment requests for new appeals  
based solely on a preference for an in-person hearing. As this hearing was not  
new, the Appeals Commission adjourned the hearing a second time at the  
worker’s request. The Appeals Commission gave notice to the worker that if he  
did not contact them within 6 months that they may consider dismissing his  
appeal.  
[10]  
On October 14, 2021, the Appeals Commission requested a written submission  
prior to deciding whether to dismiss the appeal. The worker’s representative  
replied to the Appeals Commission on October 25, 2021, requesting a further  
adjournment until an in-person hearing was available. The Appeals Commission  
responded on November 1, 2021 requesting a written response to a series of  
questions from the representative. Upon receipt, the Appeals Commission  
indicated they would then send the file to a review panel. The Appeals  
Commission included the remedies available under the appeal rules and  
provided a two-week deadline for response.  
[11]  
[12]  
The representative confirmed on November 2, 2021 that the worker still preferred  
an in-person hearing but would proceed by teleconference if in-person hearings  
had not resumed.  
An in-person hearing was tentatively scheduled but given the changes in pandemic  
restrictions, the Appeals Commission rescheduled the matter to a teleconference  
hearing and communicated the final hearing date to the representative. At that  
time, the Appeals Commission also sent the representative an updated appeal  
documents package (ADP) and the WCB, an ADP Document Index.  
Preliminary Matters  
Pre-Hearing  
[13]  
[14]  
As this hearing proceeded via WebEx teleconference, the Appeals Commission  
obtained a signed Privacy Agreement from the worker in advance of the hearing.  
The representative provided the Appeals Commission with a six-page written  
submission.  
At the Hearing  
[15]  
[16]  
[17]  
The representative confirmed that she reviewed the submission with the worker  
and provided him a copy of the ADP.  
The representative confirmed receipt on January 11, 2022, of an electronic copy of  
the updated 152-page ADP sent from the Appeals Commission.  
There were no other preliminary issues.  
Classification: Protected A  
Decision No.: 2022-0181  
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Issue  
[18]  
[19]  
With the consent of the representative, the appeal issue was reworded to more  
accurately reflect the submissions made as follows:  
Does the worker have an acceptable Workers’ Compensation Board claim for  
a back injury on either a direct or aggravational basis?  
Analysis  
Legislation and Policy  
[20]  
As previously outlined, we have determined that GECA applies to this appeal.  
Given the substantive similarity in definitions of “accident” and in provisions  
governing eligibility for compensation in both GECA and the WCA, the Appeals  
Commission has historically interpreted that the WCA and WCB policies apply to  
appeals made by federal government employees in Alberta. We concur with this  
interpretation.  
[21]  
Throughout the decision, we refer to legislation current as of the hearing date  
and to policy effective on the WCB decision date (August 28, 2018), unless  
directed otherwise. In this appeal, the April 1, 2021 version of the WCA applies  
to the appeal issue. The following WCB policies also apply:  
[21.1]  
Policy 02-01, Part I (Issue Date: April 3, 2018), Interpretation 1.0, 2.0, 3.0  
and 4.0);  
[21.2]  
Policy 02-01, Part II, Application 1: Employment Hazards, Questions 1, 3  
and 9 (Issue Date: April 3, 2018); Application 2: Time and Place  
Questions 1, 2 and 6 (Issue Date: April 3, 2018); Application 7:  
Causation, Questions 1, 2, 3, 4, 5, 8 and 9) (Issue Date: April 3, 2018);  
[21.3]  
Policy 03-01, Part I (Issue Date: July 4, 2018), Interpretation 1.0, 2.0 and  
4.0; Policy 03-01, Part II Application 1: Relationship to Compensable  
Accident, Questions 1, 2 and 8 (Issue Date: July 4, 2018); and  
[21.4]  
Policy 03-02, Part I, (Issue Date: April 3, 2018), Interpretation 1.0 and 2.0;  
and Policy 03-02, Part II, Application 1: Aggravation of a  
Pre-Existing Condition, Questions 1, 2 and 7 (Issue Date: April 3, 2018).  
[22]  
[23]  
We have appended full excerpts of all legislation and policy cited in the decision in  
Appendices A and B.  
Jurisdiction to hear appeals  
The Appeals Commission’s authority to hear the worker’s appeal flows from section  
13.1(1) of the WCA which provides it exclusive jurisdiction to examine, inquire into,  
Classification: Protected A  
Decision No.: 2022-0181  
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hear and determine all matters and questions arising under the WCA and its  
regulations, including the September 6, 2019 DRDRB decision.  
[24]  
[25]  
The Appeal Commission is the final level of appeal of DRDRB decisions under the  
WCA.  
Section 13.2(6)(b) requires the Appeals Commission to follow the WCA and  
relevant WCB policy when hearing an appeal.  
Legislative and Relevant WCB policies  
[26]  
[27]  
The WCA and WCB policies provide that the WCB will compensate a worker who  
suffers personal injury by an “accident” that occurs at a time and place consistent  
with work and results from exposure to circumstances that create a risk of injury.  
(WCA, sections 1(1)(a) and 24(1) and Policy 02-01, Part I, Interpretation 1.0, 2.0  
and 3.0).  
Policy 03-01, Part I provides that the WCB will determine whether an injury resulted  
in a compensable injury. When determining responsibility, the WCB will evaluate  
the relationship between the injury and the “accident”. Where the relationship  
between the injury and the “accident” is not obvious, policy states that the WCB  
should examine other information, particularly medical information, to determine  
whether a relationship indeed exists.  
[28]  
Policy 03-02, Part I directs that when an “accident” causes a pre-existing condition  
or disease to deteriorate or become symptomatic to the point where a worker is no  
longer able to perform all aspects of their job, the WCB shall allow entitlement  
based on an aggravation factor. The same policy indicates a “pre-existing  
condition” is any pathological condition which, based on a confirmed diagnosis or  
medical judgment, pre-dates a work-related injury. An “aggravation” is the clinical  
effect of an “accident” on a pre-existing condition, resulting in temporary or  
permanent clinical impairment (PCI) and/or a loss of earning capacity (Policy 03-02,  
Part I, Interpretations 1.0 and 2.0).  
[29]  
Adjudication under Policy 03-02, Part II requires clear documentation of a  
pre-existing condition and evidence that the “accident” aggravated the condition.  
WCB determines if an “accident” has aggravated a pre-existing condition by  
considering the relationship between the pre-existing condition and the “accident”,  
including the mechanism of injury, the extent or severity of the underlying condition,  
and the degree to which the injury may have affected the condition. The policy  
indicates there must be clear documentation of a pre-existing condition and it must  
be apparent from objective medical information that the “accident” caused the  
condition to worsen, at least on a temporary basis (Policy 03-02, Part II, Application  
1, Questions 1 and 2)  
[30]  
The combined effect of these legislative and policy requirements is the following:  
Classification: Protected A  
Decision No.: 2022-0181  
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[30.1]  
[30.2]  
There must be a cause and effect relationship between an injury and the  
worker’s employment activities.  
In situations where there is a pre-existing condition, the medical evidence  
must show the pre-existing condition worsened because of an “accident”  
that arises out of and occurs in the course of employment.  
[30.3]  
Coverage for personal injury caused by performance of employment  
activities occurring over time is permissible based on our interpretation and  
following precedent set by previous Appeals Commission Decisions starting  
with Decision No. 2009-990 and Decision No. 2010-836 among others.  
Questions for the panel to Answer  
[31]  
The following facts are not in dispute:  
[31.1]  
The date of accident is August 22, 2017, which is consistent with the date  
reported by the worker on the Worker Report and by the employer on the  
Employer Report.  
[31.2]  
There is no evidence of a specific event that caused the worker personal  
injury on August 22, 2017. The “accident” in this case is purportedly the  
worker’s performance of work duties (operating a forklift) over various  
periods while employed with the employer.  
[31.3]  
The worker suffered from pathological conditions in his low back that pre-  
date the accident. We understand the pre-existing pathological conditions at  
issue in this appeal also involve the worker’s low back and specifically,  
pre-existing multilevel degenerative disc disease at the L4-5 and L5-S1 (the  
pathological back conditions).  
[32]  
As we understand the representative’s submission, the worker is seeking claim  
acceptance for the progressive development of a back injury on either a direct basis  
or an aggravation of a pre-existing condition. To decide the appeal, we must  
answer the following questions:  
[32.1]  
Were the worker’s low back symptoms, occurring on or about  
August 22, 2017:  
causally related to performing work duties (direct responsibility) with the  
employer; or,  
the result of performing work duties with the employer that caused his  
pre-existing back condition to deteriorate or become symptomatic to the  
point he was no longer able to perform all aspects of his job  
(aggravational responsibility)?  
Key Submissions  
Classification: Protected A  
Decision No.: 2022-0181  
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[33]  
The representative’s submissions, both oral and written, are in summary:  
[33.1]  
[33.2]  
[33.3]  
The worker noticed he had a sore and stiff low back after operating a forklift  
at work on August 22, 2017.  
Over the next few months, his back “somewhat” loosened up if he was not  
operating the forklift.  
The worker initially submitted an extended health care claim with the  
employer’s disability insurer. The insurer accepted his claim but later  
indicated to the worker that it could be a work-related matter.  
[33.4]  
[33.5]  
The worker subsequently attended his physician and made a WCB claim on  
July 11, 2018, approximately 11 months after he experienced a sore stiff  
back.  
Contrary to the employer’s position, operating a forklift was a work-related  
hazard because the forklift that the worker was operating in 2017 lacked  
suspension, the concrete floor in the plant was uneven in spots, and when  
unloading a trailer, he was required to drive over a dock plate that is, by  
design, not level.  
[33.6]  
[33.7]  
[33.8]  
Further, the hazards of driving a forklift include constant sitting, twisting,  
vibration and limited ability to change positions.  
The WCB medical consultant did not understand the duration of time that the  
worker spent per shift driving the forklift.  
Although the worker’s family physician provided no opinion on causation, his  
reporting purportedly provides a relationship between the worker’s back  
condition and operating a forklift. On May 8, 2019, the worker’s family  
physician advised the WCB the worker was under “medical investigation”  
and that he should not operate the forklift.  
[33.9]  
Alternatively, and contrary to the medical consultant’s opinion, the family  
physician’s reporting supported an aggravation of the worker’s back  
condition linked to operating the forklift. Specifically, chart notes pre-dating  
the accident confirmed a back condition and the physician advised the  
worker to avoid operating the forklift. The worker continued to operate the  
forklift and that caused him to eventually report an injury to the WCB. This  
supports an aggravation of the worker’s back injury.  
[33.10] The worker has met WCB Policy 02-01 requirements because he has  
identified a hazard and provided support to correlate that the work duties  
caused the medically supported back injury. As such, the worker asks this  
panel to determine that his work duties related to driving a forklift were the  
cause of his back injury, either on a direct or aggravational basis.  
Classification: Protected A  
Decision No.: 2022-0181  
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[34]  
[35]  
[36]  
[37]  
The hearing chair asked the worker if he had anything to add to his representative’s  
submissions. The worker did not.  
Evidence/Findings  
We find the worker’s back injury not causally related to the performance of work  
duties with the employer, and the employer not responsible for the worker’s back  
injury, based on either a direct (progressive) injury or an aggravation. Our reasons,  
findings and the evidence we relied on follow.  
WCB policy tells us that for the worker to succeed on a direct basis, he must on  
balance, prove an exposure to an employment hazard, at a time and place  
consistent with employment obligations, and an injury causally related to his  
employment duties.  
The panel questioned the worker at length about the mechanism of his injury and  
the purported hazards of employment in light of the representative’s repeated  
concerns about the adequacy of the WCB investigation. Prior to concluding the  
hearing, the representative confirmed that we had thoroughly explored these  
issues, understood the mechanism of injury (MOI) and she was confident that we  
had enough information to render a decision without the necessity of remitting the  
matter back to the WCB for further investigation. We agree.  
[38]  
The worker responded to the panel in a straightforward and candid manner. We  
accept that operating a forklift (without suspension) in the circumstances described  
(over uneven concrete floors and multiples times over an uneven metal plate) could  
potentially be a hazard of employment. However, in this worker’s case there was  
no consistent diminishing of symptoms when he stopped using the forklift.  
Moreover, there was evidence of low back pain with other activity that suggests  
some cause of his low back symptoms beyond the forklift.  
[39]  
[40]  
Since the worker advances this claim as a progressive injury, we accept that WCB  
attributed the date of accident to August 22, 2017. We do however note that the  
July 10, 2018 Physician First Report indicates the worker was first seen  
November 27, 2017, alleging a six month history of low back pain which would  
actually place the date of accident several months earlier than August 22, 2017.  
Even if we accept the worker suffered a low back injury in early 2017, to establish a  
progressive injury on a direct basis, the worker must still prove, on balance, a  
causal relationship between his injury and employment duties. The worker has  
failed to do so for the following reasons:  
[40.1]  
[40.2]  
According to the worker, he suffered a sore, stiff back on August 22, 2017.  
There is no persuasive, independent evidence (medical or otherwise) of a  
work injury occurring on or about August 22, 2017 in the materials before us.  
We therefore find that if an incident occurred at work in 2017, it was not  
Classification: Protected A  
Decision No.: 2022-0181  
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significant enough for the worker to report to his employer or to warrant  
immediate medical treatment.  
[40.3]  
Instead of reporting the incident to his employer or seeking medical  
treatment, the worker explained to the panel that he decided to test various  
work scenarios himself. First, he traded shifts with co-workers to operate an  
LR-7 instead of a forklift. That did not fully alleviate his symptoms but  
“somewhat” loosened up his back – we understand him to be saying his  
back was less stiff. He later sought an accommodation at work, which  
initially the employer granted without a medical note after noting the worker  
reported low back pain whether using the forklift or the LR-7. When the  
employer required a medical note in 2018, we find the worker attended his  
family physician to obtain a note.  
[40.4]  
The first medical reference to low back pain is a November 27, 2017 chart  
entry from the worker’s family physician. That entry indicates the worker  
suffered no injury; his low back had been bothering him for six months; and it  
would seize up if he sat for longer than 20 to 30 minutes. There is reference  
to a prior back injury three years ago and of significance, the diagnosis is  
intervertebral disc disease or discogenic pain. We find the physician clearly  
attributes the worker’s low back symptoms to his discogenic pain, not to his  
work. We acknowledge that the worker requested and obtained a doctor’s  
note recommending he avoid using the forklift at work but we find the  
physician made this recommendation to treat the source of the worker’s  
problem, which he indicated is prolonged sitting and not the forklift, which is  
what the worker identified as the work hazard.  
[40.5]  
The next recorded visit is on July 10, 2018. In the Physician First Report,  
the physician indicated he saw the worker on November 27, 2017 (nine  
months earlier) and reiterated the details above. Of note is the physician’s  
continued diagnosis in 2018 of “discogenic low back pain” and repeated  
reference to a prior low back condition from March 2012. We find it  
significant that the family physician did not attribute the worker’s ongoing low  
back symptoms in 2018 to work or to the alleged work hazard but rather, to  
the worker’s pre-existing discogenic condition.  
[40.6]  
The discogenic condition was addressed more fully in the August 22, 2018  
WCB medical consultant’s report. In that report, the medical consultant  
noted:  
“A March 26, 2012 MRI of the worker’s lumbar spine revealed  
degenerative disc disease at multiple levels with a right disc protrusion at  
the L3-4 level indenting the thecal sac, causing no nerve root  
impingement, as well as mild to moderate degenerative disc disease at  
the L4-5 and L5-S1 level with a small subacute annular tear noted at the  
L4-5 level.”  
Classification: Protected A  
Decision No.: 2022-0181  
Page 9  
[40.7]  
When asked to provide a diagnosis for the worker’s symptoms, the medical  
consultant stated:  
“The most reasonable diagnosis is nonspecific low back pain on a  
background of pre-existing disease of multilevel degenerative disc  
disease.”  
[40.8]  
We did not find the worker’s low back symptoms limited to operating a forklift  
nor did we find them alleviated when he stopped operating the forklift. By  
the worker’s own admission, on November 27, 2017 he asked his family  
physician for a note to avoid driving a forklift for a period of three months to  
see if his symptoms would resolve. They did not. There were also repeat  
medical notes past November 2017 recommending the worker continue to  
refrain from operating the forklift. We find this supports the medical  
consultant’s position that the worker’s symptoms were not related to the use  
of the forklift (the identified hazard), and were not causally related to his  
work. Had they been, we would have expected to see the worker’s  
symptoms alleviated when he stopped using the forklift from late 2017 to  
2021. This supports our finding that the purported work hazard was not the  
source of the worker’s symptoms.  
[41]  
[42]  
Moreover, we note the worker’s family physician maintained the diagnosis of  
discogenic low back pain through 2018 (March 1 and July 10, 2018) and noted the  
worker continued to stiffen up when driving his car or sitting too long. These  
activities are outside the scope of the worker’s employment and yet caused the  
worker discomfort.  
The medical consultant spoke to the family physician on March 1, 2019 and  
explained the conclusions in his report and his opinion that there was insufficient  
information to support a relationship between the worker’s low back symptoms and  
his job duties. The medical consultant also disclosed that he provided WCB with an  
opinion that the worker’s overall presentation of symptoms appeared more  
consistent with the natural progression of his underlying degenerative disc disease  
in his lumbar spine. To substantiate his position, he pointed out that the worker  
reported pain with prolonged standing or sitting, activities not necessarily related to  
work. The medical consultant asked the family physician if he had any further input  
regarding claim acceptance and he declined to provide any.  
[43]  
We acknowledge the representative’s submissions that the family physician  
continued to recommend avoidance of a forklift beyond the exchange with the  
medical consultant and she urged us to interpret his 2019 letters as supportive of  
the worker’s position that the forklift was the work hazard. Given the worker’s  
evidence that he stopped operating a forklift in November 2017 and did not resume  
until 2021 we find the family physician’s 2019 letters, on balance, more aligned with  
the medical consultant’s opinion that the worker’s symptoms were not in fact work  
related.  
Classification: Protected A  
Decision No.: 2022-0181  
Page 10  
[44]  
We also find the 2019 letters to be largely form letters that were minimally  
informative, that indicated the worker was “under medical review” but did not  
disclose the nature or outcome of any review, and whose purpose appeared to be  
to ensure the worker continue to avoid using a forklift which we understand he did  
from November 2017 until 2021. We find the fact that the family physician  
continued to provide these letters in these circumstances as evidence the worker’s  
low back symptoms continued and were unrelated to the purported employment  
hazard. Contrary to the representative’s submissions, we find that the physician’s  
2019 letters identify the activity that the worker was required to avoid was actually,  
prolonged sitting and the restricted use of the forklift incidental.  
[45]  
Finally, we note that none of the family physician’s reports expressly renders an  
opinion on causation that identifies the purported source of the worker’s low back  
symptoms as an employment hazard. Instead, we find on careful review that the  
family physician and the medical consultant appear to agree that the source of the  
worker’s back pain is his pre-existing discogenic condition and more likely, the  
progression of that condition which may explain why the worker exhibited  
symptoms when engaged in tasks beyond work.  
[46]  
When we considered all of the factors above we find, on balance, the weight of  
evidence (medical and otherwise) did not support that the worker suffered a  
progressive low back injury directly and causally related to his employment duties.  
[47]  
[48]  
We turn next to the representative’s submissions on aggravation.  
To succeed, WCB policy requires that the weight of medical evidence establish that  
the worker had a pathological condition that pre-existed the date of accident; and  
that the pre-existing condition deteriorated or became symptomatic to the point that  
the worker was unable to perform all aspects of his job, as a result of his exposure  
to a work hazard.  
[49]  
We find the March 26, 2012 magnetic resonance imaging (MRI) combined with  
medical corroboration from both the family physician and the medical consultant  
supports that the worker had pre-existing pathological conditions in his low back.  
Specifically, multilevel degenerative disc disease.  
[50]  
[51]  
For reasons already cited, the representative failed to direct us to and we were  
unable to locate any medical evidence to substantiate a deterioration of the  
worker’s pathological low back conditions due to his exposure to a work hazard.  
We find the only medical evidence available to the panel on a potential aggravation  
is that of the WCB medical consultant who indicated that objective medical  
reporting at this point on the file does not establish, on balance, that the work  
activity resulted in a deterioration, progression or acceleration of the worker’s  
pre-existing condition.  
Classification: Protected A  
Decision No.: 2022-0181  
Page 11  
[52]  
[53]  
Further, the medical consultant attributed the worker’s symptoms to being “likely  
related to the natural progression of the pre-existing multilevel degenerative disc  
disease”.  
For the reasons above, we find the weight of medical evidence does not support  
the worker suffered a low back injury that aggravated his pre-existing pathological  
conditions.  
Decision  
[54]  
[55]  
The worker does not have an acceptable back injury claim on either a direct or  
aggravational basis.  
We deny the worker’s appeal and confirm the Dispute Resolution and Decision  
Review Body’s September 6, 2019 decision.  
This decision is made with the full agreement of the hearing panel.  
Decision signed in Calgary, Alberta on June 24, 2022.  
G. Wong  
Hearing Chair  
(on behalf of the panel)  
Hearing Panel:  
G. Wong  
M. Amery  
G. Glavin  
– Hearing Chair  
– Commissioner  
– Commissioner  
Typed by: fw:jag  
E_DEC08D (20210701)  
Classification: Protected A  
Decision No.: 2022-0181  
Page 12  
Appendix A  
Legislation – Workers’ Compensation Act, RSA 2000, c W-15 (WCA)  
Section 1(1)(a) states, in part:  
“1(1) In this Act,  
(a) ‘accident’ means an accident that arises out of and occurs in the  
course of employment in an industry to which this Act applies and  
includes  
(i)  
a wilful and intentional act, not being the act of the worker  
who suffers the accident,  
(ii) a chance event occasioned by a physical or natural cause,  
(iii) disablement, and  
(iv) a disabling or potentially disabling condition caused by an  
occupational disease;”  
Section 13.1(1):  
“13.1(1) Subject to sections 13.2(11) and 13.4, the Appeals Commission  
has exclusive jurisdiction to examine, inquire into, hear and determine all  
matters and questions arising under this Act and the regulations in  
respect of  
(a) appeals from decisions of a review body under section 9.4,  
(b) repealed 2020 c32 s3(8),  
(c) any other matters assigned to it under this Act or the regulations  
under this or any other Act,  
and the decision of the Appeals Commission on the appeal or other matter is  
final and conclusive and is not open to question or review in any court.”  
Section 13.2(6)(b), states, in part:  
“(6) In the hearing of an appeal under this section, the Appeals  
Commission  
. . .  
(b) is bound by the board of directors’ policy relating to the matter  
under appeal,”  
Classification: Protected A  
Decision No.: 2022-0181  
Page 13  
Section 24(1)(a) states, in part:  
“24(1) Subject to this Act, compensation under this Act is payable  
(a) to a worker who suffers personal injury by an accident, unless the  
injury is attributable primarily to the serious and wilful misconduct  
of the worker,”  
Classification: Protected A  
Decision No.: 2022-0181  
Page 14  
Appendix B  
Government Employees Compensation Act, RSC 1985,  
c-G-5 (GECA)  
Section 4 of the GECA addresses eligibility for compensation and states, in part:  
“(1) Subject to this Act, compensation shall be paid to  
(a) an employee who  
(i) is caused personal injury by an accident arising out of  
and in the course of his employment, or  
(ii) is disabled by reason of an industrial disease due to the  
nature of the employment; and  
(b) the dependents of an employee whose death results from such  
an accident or industrial disease.  
(2) The employee or the dependant referred to in subsection (1)  
are, notwithstanding the nature or class of the employment, entitled to  
receive compensation at the same rate and under the same conditions as  
are provided under the law of the province where the employee is usually  
employed respecting compensation for workmen and the dependants of  
deceased workmen, employed by persons other than Her Majesty, who  
(a) are caused personal injuries in that province by accidents arising  
out of and in the course of their employment; or  
(b) are disabled in that province by reason of industrial diseases due  
to the nature of their employment.”  
Determination of compensation  
(3) Compensation under subsection (1) shall be determined by  
(a) the same board, officers or authority as is or are established by the  
law of the province for determining compensation for workmen and  
their dependants of deceased workmen employed by persons other  
than Her Majesty; or  
(b) such other board, officers or authority, or such court, as the  
Governor in Council may direct.”  
Under the GECA, the term accident is defined in section 2 as:  
‘accident includes a wilful and an intentional act, not being the act  
of the employee, and a fortuitous event occasioned by a physical or  
natural cause;”  
Classification: Protected A  
Decision No.: 2022-0181  
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Appendix C  
Workers’ Compensation Board Policy  
Policy 02-01, Part I Arises Out of And Occurs in the Course of Employment (Issue  
Date: April 3, 2018), Interpretation 1.0, 2.0, and 4.0 states:  
“POLICY:  
To be considered compensable, an accident must meet two conditions: it  
must arise out of and occur in the course of employment. When WCB is  
notified of an accident, it initiates inquiries to obtain all relevant evidence,  
and adjudicates the eligibility of the claim based on the weight of that  
evidence.  
If, after gathering all the available evidence, it is clear that one of the  
conditions is met but there is insufficient evidence on which to base a  
decision regarding the second condition, the statutory presumptions  
contained in s.24 of the Workers’ Compensation Act (WCA) will apply.  
Workers are not entitled to compensation if they have removed  
themselves from the course of employment by their actions, and may not  
be entitled if the accident was a result of serious and wilful misconduct.  
This policy is effective February 15, 1997, except when noted otherwise  
in a specific policy section(s).  
INTERPRETATION  
1.0  
Accident  
‘Accident’ is used in the usual and ordinary sense, and means an  
unexpected mishap or event. For the purposes of workers’  
compensation, ‘accident’ also includes the circumstances defined in the  
four subclauses of s.1(1)(a) of the WCA.  
2.0  
Arises out of Employment  
An accident arises out of employment when it is caused by some  
employment hazard. An employment hazard is defined as an  
employment circumstance which presents a risk of injury. The hazard  
may be directly related to the industry or occupation (for example,  
machinery, chemicals, worksite ergonomics), or may be incidental (for  
example, weather conditions, insect bites, third-party vehicles).  
Personal Risk and Conditions  
Risks or conditions which are personal to the worker (such as the  
worker’s physical condition or personal relationships) are not hazards of  
employment unless employment factors contribute to the occurrence of  
injury (see Part II, Applications 1 and 4).  
Classification: Protected A  
Decision No.: 2022-0181  
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3.0 Occurs in the Course of Employment  
An accident occurs in the course of employment when it happens at a  
time and place consistent with the obligations and expectations of  
employment. Time and place are not strictly limited to the normal hours  
of work or the employer’s premises, however, there must be a  
relationship between employment expectations and the time and place  
the accident occurs (see Part II, Applications 2 and 3).  
4.0 Evidence  
Evidence includes accident reports, witness reports, medical information,  
and accepted medical opinion, as well as any other facts relevant to the  
accident. If the information received on the required reports is not  
sufficient to adjudicate the claim, WCB is responsible for gathering  
additional evidence relevant to the claim.”  
Policy 02-01, Part II, Application 1: Employment Hazards, Questions 1, 3 and 9  
(Issue Date: April 3, 2018) states:  
“1.  
What factors are considered when determining if an injury  
resulted from an employment hazard?  
The employment must have contributed to the accident so that, if it were  
not for the employment, the accident would not have occurred at that time  
(see Application 7 – Causation). The hazard may arise directly from the  
occupation or industry itself, or it may arise from positional risk. The  
following conditions apply when determining whether an employment  
hazard caused or contributed to an accident:  
the hazard must be related to the worker’s employment  
employer-provided residential, recreational, and food facilities are  
considered hazards of employment only when the hazard arises from  
the premises or equipment and the worker is making reasonable and  
permitted use of the facilities.  
For injuries incurred while the worker was engaging in athletic activities,  
see Policy 02-01, Part II, Application 4. . . .  
3.  
What are a worker’s personal risks and conditions?  
These are characteristics and circumstances specific to the worker and  
present regardless of employment. For example, a degenerative or other  
pre-existing physical condition is a risk for the worker both in and out of  
employment.  
Personal relationships (e.g., spouse, family, friends) may also constitute a  
personal risk. Injuries resulting from personal relationships may  
coincidentally occur at the workplace, but claims will not be accepted if  
the cause is exclusively personal and has no direct or indirect relationship  
to the worker’s employment duties or the employer’s operations.  
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For example, if two co-workers who socialize outside of work fight during  
work hours because of some personal incident, the fight only  
coincidentally occurs during employment and does not arise out of  
employment. Any resulting injuries are not compensable (see Application  
5, Removing Oneself from Employment).  
However, if employment hazards increase the risk or aggravate a  
condition, the injury may be compensable (see also Policy 03-02,  
Aggravation of a Pre-Existing Condition).  
. . .  
9.  
When is this policy application effective?  
This policy application (Application 1 – Employment Hazards) is effective  
February 15, 1997, except when noted otherwise in a specific policy  
section(s).”  
Policy 02-01, Part II, Application 2: Time and Place Questions 1, 2 and 6  
(Issue Date: April 3, 2018) states:  
“1.  
What is the relationship between employment hazard and  
time and place?  
The two conditions are very closely linked, but are not identical.  
Employment hazard deals with how the injury occurs, while time and  
place considers when and where. For example, a worker at an employer-  
provided campsite falls and is hurt when a railing gives way. The broken  
railing is a hazard of the premises and therefore an employment hazard;  
however, WCB must also consider why the worker was at the campsite at  
that time, and if the reason is consistent with the worker’s employment.  
2.  
What factors are considered when determining whether the  
time and place of injury are consistent with employment?  
The following factors may be considered, together with any other facts  
relevant to a specific claim:  
• did the injury occur on the employer’s premises?  
• was the worker in the process of doing something for the benefit of  
the employer?  
• did it occur during a time period for which the worker was being paid?  
• was the worker in that time and place for employment reasons (for  
example, in a hotel because of an overnight business trip)?  
• did it occur in the course of using equipment or materials supplied by  
the employer?  
Compensation coverage generally begins when the worker enters the  
employer’s premises to start the work shift, and terminates on the worker  
Classification: Protected A  
Decision No.: 2022-0181  
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leaving the premises at the end of the shift. Coverage may begin with the  
journey to work if travelling is required as a condition of employment (see  
Application 3, Travel). Coverage may also be extended beyond normal  
work hours to workers who are staying in residential facilities such as  
bunkhouses or campsites.  
. . .  
6.  
When is this policy application effective?  
This policy application (Application 2 – Time and Place) is effective  
February 15, 1997, except when noted otherwise in a specific policy  
section(s).”  
Policy 02-01, Part II, Application 7: Causation, Questions 1, 2, 3, 4, 5, 8 and  
9) (Issue Date: April 3, 2018) states:  
“1.  
Why is causation important?  
Workers’ compensation compensates workers only for injuries and  
diseases that are work related (arise out of and occur in the course of  
employment). Therefore, it is a legislative requirement that the injury or  
disease be caused by work so, in every case, WCB must determine the  
cause of the injury or disease. In many cases, causation is clear and  
easily understood; for example, if a construction worker falls off a ladder  
at work and breaks his arm. In other cases, causation is more difficult to  
determine, particularly when there are multiple risk factors that may have  
caused or contributed to the injury or disease.  
2.  
What factors does WCB consider when determining  
causation?  
In determining causation, WCB considers a number of factors. These can  
be grouped into three categories:  
• Medical diagnosis – what is the diagnosis? Is it a recognized medical  
diagnosis? Is the diagnosis clearly established in this particular case?  
Work factors – what are the conditions at the workplace? What are  
the worker’s duties? What are the physical demands? What type and  
extent of exposures are there?  
Personal Factors – does the worker’s medical condition predate the  
accident? Are there non work related risk factors that may have  
caused the injury or disease?  
WCB reviews all these factors to determine if the worker’s injury or  
disease is work-related (meets the standard of causation).  
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3.  
What is a standard of causation?  
A standard of causation is the legal standard or legal test that is applied  
to determine whether the injury or disease is caused by work (that is, to  
have arisen out of and occurred in the course of employment).  
4.  
What standard of causation does WCB apply?  
The standard of causation used by WCB is the ‘but for’ test, except when  
specifically stated otherwise.  
5.  
What is the ‘but for’ test?  
The ‘but for’ test is a finding of fact – the work exposures were necessary  
for the accident and injury to occur. In other words, if not for the work  
exposures, the injury or disease would not have happened.  
In some cases there may be several causes that meet the ‘but for’ test  
that work in combination to cause an injury. Work does not have to be  
the only factor, or even the primary one, for the injury to be compensable.  
It must, however, be a necessary factor; if the injury or disability would  
have happened anyway, regardless of the work factor, it is not  
compensable. The finding of fact is based on the evidence and accepted  
medical knowledge, not on a speculative connection.  
. . .  
8.  
What is the relationship between this policy and other WCB  
policies that address causation?  
This policy (Policy 02-01, Part II, Application 7) provides a framework for  
all causation decisions; however, it must be read in conjunction with the  
criteria for specific situations, as set out in policies such as Policy 03-01,  
Injuries; Policy 03-02, Aggravation of a Pre-existing Condition, Policy  
04-08, Fatalities; and the other provisions in Policy 02-01. These policies  
contain criteria for specific situations that must be taken into consideration  
when applying the appropriate causation test.  
9.  
When is this policy application effective?  
This policy application (Application 7 – Causation) is effective  
April 1, 2014, and applies to all decisions made on or after that date,  
except when noted otherwise in a specific policy section(s).”  
Classification: Protected A  
Decision No.: 2022-0181  
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Policy 03-01, Part I (Issue Date: July 4, 2018), Interpretations 1.0, 2.0 and  
4.0 state:  
“POLICY:  
WCB will determine whether an injury has occurred as the result of a  
compensable accident, and will adjudicate appropriate compensation and  
services from the date of accident. WCB may also consider a second  
injury compensable if it is the direct result of the original compensable  
injury.  
When determining its responsibility, WCB will evaluate the relationship  
between the injury and the compensable accident. In second injury  
cases, WCB will evaluate the relationship between the original  
compensable injury and the second injury. This policy is effective  
February 1, 2012, except when noted otherwise in a specific policy  
section(s).  
INTERPRETATION  
1.0  
Injury  
Under s.24 of the Workers’ Compensation Act (WCA), compensation is  
payable to a worker who suffers personal injury by an accident. Injuries  
may be either physical or psychological. They may be the immediate  
result of an accident or develop over time.  
2.0  
Date of Accident  
When there is a specific incident which results in injury, the date of  
accident is the date on which the incident occurred.  
When the compensable condition or disease is progressive (i.e., there is  
no specific incident), the date of accident is normally the first date on  
which medical treatment is provided. If, however, the worker experienced  
earlier layoffs or loss of earnings which medical evidence indicates were  
caused by the compensable condition, the date of accident will be the first  
day of that earnings loss.  
The date of accident for cases of potential disablement due to  
occupational disease is the date the potential disablement comes to  
WCB's attention.  
. . .  
4.0  
Relationship Between the Injury and the Compensable  
Accident  
Many injuries (e.g., strains, sprains, burns, cuts, etc.) have an obvious  
relationship to the compensable accident; consequently, determining  
WCB's level of responsibility is relatively simple. However, there are  
Classification: Protected A  
Decision No.: 2022-0181  
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other injuries which, because of their progressive nature or less obvious  
relationship to employment, require consideration of relevant factors both  
in and outside employment which may have contributed to or caused the  
injury (see Part II, Application 1, Relationship to Compensable Accident).”  
Policy 03-01, Part II, Application 1 Relationship to Compensable Accident,  
Questions 1, 2 and 8 (Issue Date: July 4, 2018) states:  
“1.  
Why is the relationship of injury to compensable accident  
important?  
To be compensable, an injury must be the result of an accident as  
defined under Policy 02-01, Arises Out of and Occurs in the Course of  
Employment. Therefore, when adjudicating the eligibility of a claim, WCB  
looks at the nature of the injury and its relationship to the compensable  
accident.  
Often there is an obvious relationship between the nature of the injury  
and the compensable accident (e.g., a firefighter is burned when fighting  
a fire). However, the relationship is not always obvious. In these cases,  
there is a need for additional information, especially medical information,  
to establish the relationship to the compensable accident. For example,  
many occupational diseases have a long latency period. WCB's inquiries  
must establish whether the work-related exposure was sufficient to cause  
the condition (see Application 3, Occupational Disease).  
2.  
How does WCB adjudicate injuries?  
In general, every claim is subject to a similar adjudicative process. The  
relationship between the injury and the compensable accident is  
examined to determine entitlement. Additional medical advice is sought  
on an as needed basis. Complex claims may require additional  
investigation to determine work-relatedness.  
Special requirements for some types of injuries (e.g., cardiac,  
occupational disease) are given in Applications 2 to 8 and in the following  
questions.  
. . .  
8.  
When is this policy application effective?  
This policy application (Application 1 – Relationship to Compensable  
Accident) is effective February 1, 2007, except when noted otherwise in a  
specific policy section(s).”  
Classification: Protected A  
Decision No.: 2022-0181  
Page 22  
Policy 03-02, Part I, Aggravation of a Pre-Existing Condition (Issue Date:  
April 3, 2018), Interpretation 1.0 and 2.0 states:  
“1.0 Pre-existing Condition  
A pre-existing condition is any pathological condition which, based on a  
confirmed diagnosis or medical judgment, pre-dated a work-related injury.  
2.0  
Aggravation  
An aggravation is the clinical effect of a compensable accident on a pre-  
existing condition, resulting in temporary or permanent clinical impairment  
and/or loss of earning capacity.”  
Policy 03-02, Part II, Application 1: Aggravation of a Pre-Existing  
Condition, Questions 1, 2 and 7 (Issue Date: April 3, 2018) states:  
“1.  
When are claims adjudicated under this policy?  
For a claim to be considered under this policy there must be the  
confirmed presence of a pre-existing condition and evidence it was  
aggravated by a compensable accident. The fact that a worker has a pre-  
existing condition does not necessarily mean it was aggravated by the  
compensable injury. If the clinical diagnosis of a pre-existing condition is  
incidental to the nature of the disability, the claim is not subject to this  
policy.  
WCB does not extend coverage under this policy or under Policy 02-01  
(Arises Out of and Occurs in the Course of Employment) if the need for  
treatment or lay-off from work is due solely to a pre-existing, non-  
compensable condition.  
2.  
How does WCB determine if a pre-existing condition has  
been aggravated?  
There must be clear documentation of a pre-existing condition and it must  
be apparent from the objective medical information available that the  
compensable accident caused some worsening of this condition, at least  
on a temporary basis.  
WCB will consider the relationship between the pre-existing condition and  
the accident, including the mechanism of injury (for example, twisting,  
lifting heavy objects), the extent or severity of the underlying condition,  
and the degree to which the injury may have affected the condition.  
. . .  
7.  
When is this policy application effective?  
This policy application (Application 1 – Aggravation of a Pre-Existing  
Condition) is effective February 15, 1997, except when noted otherwise in  
a specific policy section(s).”  
Classification: Protected A  


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