WCAT Decision Number:  
A2102306 (July 25, 2022)  
DECISION OF THE WORKERS’ COMPENSATION APPEAL TRIBUNAL  
WCAT Decision Number:  
A2102306  
WCAT Decision Date:  
July 25, 2022  
Introduction  
[1]  
On November 20, 2020, the worker, a labourer, filed a claim for compensation with the Workers’  
Compensation Board (Board)1 for neck symptoms that she attributed to a February 17, 2020  
incident at work.  
[2]  
[3]  
A Board officer denied the worker’s claim in a December 18, 2020 decision.  
The worker requested a reconsideration of this decision and, on February 16, 2021, a Board  
entitlement officer concluded that the December 18, 2020 decision would not be changed.  
[4]  
A review officer with the Board’s Review Division confirmed the February 16, 2021 decision on  
October 19, 2021 (Review Reference #R0276314). The review officer was not satisfied that the  
reported incident of February 17, 2020 was of causative significance in producing a new neck  
injury or aggravating a pre-existing neck condition. Consequently, it was not necessary for the  
review officer to consider whether, as the employer has submitted, the worker was barred from  
compensation owing to her delay in reporting her injury to the employer and in filing her claim.  
[5]  
[6]  
The worker has appealed the Review Division decision to the Workers’ Compensation Appeal  
Tribunal (WCAT).  
I held an oral videoconference hearing of the appeal on May 9, 2022. The worker, the worker’s  
representative (a workers’ adviser), and the employer’s representative (an employers’ adviser)  
participated in the hearing.  
Issue(s)  
[7]  
The issue addressed in the Board decision and Review Division decision is whether the worker  
sustained a neck injury, including an aggravation injury, arising out of and in the course of her  
employment during the reported February 17, 2020 work incident.  
1
The Board operates as WorkSafeBC. Colloquially, the Board is also referred to as “WCB”.  
1
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
[8]  
[9]  
In the alternative, the parties have also addressed whether the worker failed to report her injury  
to her employer as soon as practicable and, if so, whether her claim is barred by section 149 of  
the Workers Compensation Act (Act).  
As noted in Review Reference #R0276314, the Board had authority to issue the February 16,  
2021 reconsideration decision as it was made within the 75-day time limit set by the Act.  
Jurisdiction and Standard of Proof  
[10]  
[11]  
This appeal was filed with WCAT under section 288(1) of the Act, which provides for appeals of  
final decisions by review officers regarding compensation matters. Section 308 of the Act gives  
WCAT exclusive jurisdiction to inquire into, hear, and determine all those matters and questions  
of fact, law, and discretion arising or required to be determined in an appeal before it.  
This appeal is a rehearing by WCAT, which means that WCAT reviews the record from previous  
proceedings and can hear new evidence. WCAT has inquiry power and the discretion to seek  
further evidence, although it is not required to do so. WCAT exercises an independent  
adjudicative function and has full substitutional authority. It may confirm, vary, or cancel the  
appealed decision or order.  
[12]  
[13]  
The standard of proof in this appeal is the balance of probabilities, subject to section 303(5) of  
the Act. Section 304 provides that if WCAT is hearing an appeal regarding the compensation of  
a worker and the evidence supporting different findings on an issue is evenly weighted in that  
case, the appeal tribunal must resolve that issue in a manner that favours the worker.  
I am bound to apply the published policies of the board of directors of the Board, subject to the  
provisions of section 304 of the Act. The applicable Board policies for this appeal are set out in  
the Rehabilitation Services and Claims Manual, Volume II.  
Background  
[14]  
[15]  
The worker is employed in the employer’s lumber mill.  
On October 19, 2019, the worker reported to the employer that she had a sore right forearm.  
She did not seek medical attention and she returned to work the following day.  
[16]  
[17]  
The worker missed some time from work over the next few month but continued working.  
The job the worker was performing on February 17, 2020 involved standing at a chain line and  
examining boards for defects. When she identified a defective board, she was responsible for  
removing it from the chain and stacking it so that a forklift could remove it. She would press  
2
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
down on the end of the board nearest to her so that the other end would rise up and she could  
then push the board to the side and slide it off the line.  
[18]  
[19]  
The worker did not report an injury and continued working until March 9, 2020. Following that,  
she stopped work and began receiving short-term disability benefits from the employer’s  
disability insurer. She still did not report her injury to the employer or the Board.  
As reported in the worker’s November 20, 2020 Teleclaim application (the 2020 claim) and  
clarified in her February 2, 2021 request for reconsideration, the worker said that, on  
February 17, 2020, she was standing at the line. All of the boards passing by her were  
defective. She did not realize that one of the boards she was about to stack was broken. She  
used her body weight to press down on the board to lift one end up and, when she did this, the  
board snapped/broke.  
[20]  
The worker advised the teleclaim call centre agent that the snapping of the board caused her  
upper body to fall downward unexpectedly. She felt a squish in her neck at that moment and a  
jolt down her right arm but she continued to work. The worker said that, over the next month,  
she noticed a decrease in the range of motion of her neck and missed occasional days from  
work, but she did not report her symptoms or the absences being related to these symptoms to  
the employer. She said that she had been off work since March 2020 and that her employer was  
aware she had prior right arm issues from October 2019. Although she thought that her neck  
issues were possibly connected to the October 2019 injury to her shoulder and arm, due to  
extreme anxiety and stress, she did not wish to discuss the details of her October 2019 injury  
further with the call centre agent. Also, she said that there were reasons why she did not report  
her February 2020 injury to the employer, but she did not want to provide details about them to  
the agent.  
[21]  
In her February 2, 2021 request for reconsideration, the worker said that her neck snapped back  
at the time of the February 17, 2020 work incident and this was when she felt a squish in her  
neck. Also, when she picked up the end of the board that had fallen onto the ground, she felt an  
electric volt feeling down her left arm. The worker said that, in the month following February 17,  
2020, she experienced a decrease in range of motion and was unable to pick up a cup of  
coffee. Her arm was tingling and going numb. She said she told the employer that her arm pain  
was getting worse and going into both arms, but she did not mention her neck injury. She said  
the neck injury was not diagnosed until June 2020 and that she was attending physiotherapy for  
months prior to the neck injury.  
[22]  
On April 7, 2021, the worker filed a second application for compensation in which she sought  
compensation for the right forearm condition she had reported to the employer on October 19,  
2019 (the 2021 claim). She identified this as a repetitive, gradual onset injury that came on over  
the period October 1, 2019 through October 19, 2019 and had resulted from using a long pole to  
push any strips that had been left on boards as they came off the hoist in the mill. She said the  
3
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
condition started as more of a tennis elbow-type pain and that there was also a particular area  
in her right shoulder that was painful. Earlier, in November 2020, the worker had also requested  
a reopening of a 2014 compensation claim relating to a low back injury.2  
[23]  
In a March 26, 2021 statement to the Review Division, the worker said that the February 2020  
neck injury exacerbated her right arm symptoms, which included her hand going numb and  
tingling and her shoulder waking her up at night. She developed tingling in her left hand and, as  
time went on, she was unable to pick up a coffee cup in her right hand, was dropping her work  
tools, and the back of her neck would hurt if she rested on a pillow. She said she was in serious  
pain and having problems and would soon be unable to work. On March 9, 2020, she called in  
to work and told them that she could not come in, but did not mention her neck injury to the  
employer.  
[24]  
[25]  
During the course of the claim, the employer identified a number of reasons for objecting to its  
acceptance.  
In a December 3, 2020 letter, the employer said that, in a November 19, 2020 email, the worker  
had advised the employer that she had started a compensation claim because she required  
treatment and the only way to get this was to start a claim. The employer said the worker stated  
that she did not believe her injury had anything to do with her work at the employer and, instead,  
was a consequence of an unresolved (pre-existing injury). The employer noted that the worker  
was receiving disability benefits on the basis that her disability was a non-work related issue.  
The employer also said that it held an investigation meeting with the worker on December 2,  
2020 and she contradicted her November 19, 2020 email.3 The worker now alleged that the  
injury occurred at work on February 17, 2020. When questioned why she did not follow the  
reporting process, the worker stated that she did not think it was a big deal, she was already  
having issues with her arms, and she did not want to raise another issue with the employer. The  
employer also said that the worker provided contradictory information about the location of her  
pre-existing injury. In her November 19, 2020 email, she said she was having issues with her  
arms due to a pre-existing injury and, during the December 2, 2020 meeting, she stated she had  
a pre-existing injury to her neck.  
2
Some of the medical records from the worker’s 2021 claim and the prior claim for a low back injury in  
the 2014 claim are not included in the 2020 claim file. However, these were comprehensively  
summarized in a September 9, 2021 opinion that the review officer obtained from Review Division  
medical advisor Dr. Galbraith. In view of this comprehensive summary and the fact that the parties had  
access to all of the relevant medical history through their representatives, I did not request disclosure of  
the 2014 claim file or of the 2021 claim file.  
3
The employer provided typewritten notes from the manager who conducted this investigation with the  
material it provided to WCAT.  
4
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
[26]  
[27]  
In its submission to the Review Division, the employer said that the worker had been trained to  
report all injuries or illnesses to the employer on a timely basis; however, the worker did not  
report the February 2020 injury until nine months after the alleged incident occurred.  
New evidence the employer provided to WCAT in conjunction with the appeal shows that the  
employer provided the worker with safety and injury reporting orientation in June 2019 and that  
the worker acknowledged having received this training on June 5, 2019. This included  
confirmation of her obligation to immediately report all injuries to her supervisor or the first aid  
attendant, regardless of the perceived severity, and that all incidents, including accidents, near  
misses, property damage, injury, and hazardous material spills, must be reported to her  
supervisor. The worker was also advised to direct all questions about more information of the  
employer’s injury management program to her supervisor.  
[28]  
[29]  
The employer also submitted to the Review Division that the worker had advised that she filed  
her claim because she had exhausted her employer-paid benefits and wanted increased benefit  
coverage.  
Over the course of the claim, the worker was asked to explain why she did not report a  
February 17, 2020 injury to the employer at any time prior to filing her claim and why reference  
to a work injury was absent in the early medical reports following that date. The claim includes  
the following evidence regarding the delay in reporting her injury and in filing her claim:  
The worker did not want to work at a desk job, which is what the employer would offer her by  
way of accommodation if she disclosed the full extent of her physical injuries to the  
employer (May 21, 2020 chart note from Dr. S1,4 the worker’s family physician, in which the  
worker and Dr. S were discussing her back condition) and, later, she was worried about  
losing her job if she filed a compensation claim (December 20, 2020 chart note from Dr. S1).  
The worker had been instructed by the employer not to put in a claim because, if she did,  
she and the rest of the employees would not get a safety bonus (November 20, 2020  
telephone conversation with a Board officer), the employer discourages workers from filing  
injury claims (November 26, 2020 telephone conversations with a different Board officer),  
and she had been worried about reporting yet another injury to the employer as she felt  
there was pressure from the employer about work injuries affecting their safety rating  
(November 16, 2020 telephone conversation with a Board entitlement officer).  
The worker’s neck symptoms were not improving and she had no choice but to file a claim  
with the Board (November 26, 2020 telephone conversation) and she thought her neck  
injury would work itself out but it had not and she felt she had to pursue this claim as she  
4
In accordance with item #19.2 of WCAT’s Manual of Rules of Practice and Procedure (MRPP), I have  
identified treatment providers by title or initial where this was needed to safeguard the worker’s  
confidentiality and privacy.  
5
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
had run out of benefits from her prior injuries (November 26, 2020 conversation with a Board  
entitlement officer).  
When the worker started to see Dr. S1 on March 9 or 10, 2020, she told him about the  
February 17, 2020 incident but told him not to report it because she was not filing a claim for  
compensation. She said that, for this reason, Dr. S1 may not have documented it in his chart  
notes, but he knew about the work-related cause of injury (December 17, 2020 telephone  
conversation with the Board officer who made the December 18, 2020 decision).  
The reason for the gap in the reporting the worker’s injury to Dr. S1 and to physiatrist Dr. P,  
whom she saw on June 8, 2020, was COVID-19 (May 10, 2021 submission to the Review  
Division).  
Stemming from a long history of adverse experiences, the worker has difficulties related to  
significant challenges she experiences with low self-esteem and lack of assertiveness and  
her difficulties in initiating her compensation claim also stemmed from being told by her  
manager at the beginning of her employment to avoid reporting work-related accidents; she  
struggled for many months with what she felt was betraying her manager should she initiate  
a claim, and she also had fears about causing trouble for her co-workers should she report  
her accident. She said she was told by her manager upon being hired that, “if you were to  
ever go to Worksafe you would have over 200 people pissed off at you”; the employer has a  
good safety record, and she “does not want to be the one to change that” (April 3, 2020  
letter from a counsellor the worker began seeing on June 1, 2020).  
The worker was experiencing extreme stressors related to the health of her daughter, an  
unhealthy relationship, finances and homelessness, and there was no doubt that stressors  
contributed to the worker’s difficulties in submitting her claim (April 3, 2020 letter from the  
counsellor).  
She did not report the February 2020 injury to her neck to her employer for the following  
reasons: she had had unpleasant experiences with the Board in the past; when she was  
hired by the employer, she was told, “Never report to WorkSafe. Ever! If you do you will  
have 200 people pissed off with you”, followed by, “Don’t make me regret hiring you.”; and,  
she had a long history of not reporting wrong doings in her life at the expense of herself and  
her children she never wants to get anyone in trouble and have anyone disappointed in  
her (March 26, 2021 statement the worker provided to the Review Division).  
Regardless of whether the worker was in fact trained to report illnesses/injuries, she was  
subsequently informed5 not to do so; the crux of the reporting issue is that the worker felt  
5
The evidence, including the testimony the worker provided during the WCAT oral hearing, shows that  
the workers’ adviser is mistaken. The worker has provided clear, uncontradicted evidence that her  
conversation with the plant manager occurred at the time she was being hired, prior to the date on  
which she commenced working for the employer and prior to the date on which she received training in  
reporting injuries and confirmed her understanding of the employer’s policies in that regard.  
6
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
intimidated and that her employment may be in jeopardy if she filed a claim (rebuttal  
submission by the workers’ adviser to the Review Division).  
[30]  
Up to December 18, 2020, when the initial decision to deny the worker’s claim was made, the  
medical records, including additional records the worker provided to WCAT, show the following:  
On November 27, 2017, the worker saw rheumatologist Dr. Godin. Dr. Godin documented  
that the worker had been involved in three motor vehicle accidents from 2008 to 2011. The  
worker also had a longstanding history of pre-existing chronic low back pain and prior L4-5  
segmental instrumentation fusion and single level decompression done by orthopaedic and  
spinal surgeon Dr. Splawinski on October 20, 2016.  
Physiotherapy records indicate the worker was seen beginning in late October 2019 for a  
two- to three-month history of right upper extremity symptoms, including waking with numb  
hands and decreased right hand strength. In an initial assessment document dated  
October 30, 2019, there is also mention of neck stiffness and tightness in conjunction with a  
history of three prior motor vehicle accidents. At intake on October 30, 2019, the  
physiotherapist noted the worker had findings on palpation at the C2 through C5 levels of  
her spine (“Thickened (deep)”) and right radicular nerve symptoms that the worker provoked  
with tension testing at the C7 and C8 levels. The worker was seen for a total of three visits  
from October 30 to November 25, 2019. Treatment on November 25, 2019 included  
suboccipital massage bilaterally with a focus on the C2 to C4 levels of the worker’s spine.  
The physiotherapist diagnosed upper thoracic and cervical tension and right radicular  
symptoms of epicondylitis. Continuing treatment was planned that included the cervical and  
thoracic spines as well as the worker’s elbow. The worker did not attend the next scheduled  
appointment and the next record was for a treatment on May 25, 2020.  
Medical records obtained by the Board from Dr. S1 show that, between January 2019 and  
March 10, 2020, the worker did not receive any medical attention from Dr. S1 for her neck or  
shoulders.  
In a March 9, 2020 note, Dr. S1 recorded the worker’s report of a six-month history of right  
lateral forearm and elbow pain, and subsequent left elbow pain, and that both arms were  
numb when she laid on her back. There was no mention of these being work related. Dr. S1  
planned to refer the worker to physiatrist Dr. P.  
In a March 10, 2020 chart note, Dr. S1 recorded that the worker had returned to see him as  
she was not doing well and was struggling with back and neck pain, making it difficult for her  
to function after work. Dr. S1 diagnosed chronic pain and multiple stressors, and  
recommended that the worker take time off work. Again, no work-relatedness was  
described.  
On March 17, 2020, the worker completed a consultation history for her chiropractor. The  
worker identified her major complaints as being right neck pain radiating into both arms and  
low back pain with numbness and tingling. The worker said that she had had the low back  
7
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
pain since 2013 and that it was an old compensation claim, but her neck pain was more  
recent, “4 months”,6 and was not a WCB claim. The worker saw the chiropractor again for a  
total of 12 visits from March 17 to September 8, 2020 and, at all of these visits, the  
chiropractor identified the same symptoms of neck pain with or without stiffness, headaches,  
right shoulder pain, arm and hand numbness, and low back pain and sciatica. The  
chiropractor noted decreased neck range of motion at the first visit on March 17, 2020, but  
this was not documented at the 11 subsequent visits. There is no record that the worker  
reported that her symptoms were possibly work related at any of her 12 visits with the  
chiropractor.  
At Dr. S1’s request, a March 18, 2020 MRI of the worker’s cervical spine was undertaken to  
address a history of “neuropathy both arms when lays on back.” This showed the presence  
of a slight C5-6 disc protrusion that mildly indented the spinal cord. There was also: a small  
right foraminal disc herniation at C4-5, with moderate right neural foraminal narrowing;  
moderate bilateral neuroforaminal narrowing at C5-6; and, mild canal stenosis was at C5-6  
and C6-7. In an addendum to the March 18, 2020 MRI report the radiologist noted that, in  
comparison to a January 4, 2013 CT scan, the finding of a right C5-6 disc protrusion which  
mildly indented the spinal cord was unchanged.  
On March 20, 2020, a locum for Dr. S1 (Dr. S2) stated that the MRI showed multiple levels  
of “PID”7 with possible nerve involvement but there was no significant stenosis. A second  
locum for Dr. S1 (Dr. G) documented that the MRI showed degenerative disc disease in the  
worker’s cervical spine, with a right side central dis herniation at C5-6 that was touching the  
spinal cord. Dr. G referred the worker to Dr. Splawinski. There was no mention that the  
worker’s symptoms were work related in the notes for the March 20, 2020 and March 25,  
2020 consultations.  
In a March 30, 2020 consultation report, Dr. Splawinski reported that the worker had been  
referred for a “four week history of pins and needles in right arm, with some pain associated  
with it”. Dr. Splawinski said that the MRI showed no central disc protrusion, a widely open  
canal, some degenerative changes at C5-6 that were chronic in nature, and minimal  
impingement on the right side of the disc at C3-4. Dr. Splawinski did not believe that the  
worker had pathology that required surgical assessment and recommended conservative  
treatment of her symptoms.  
Between February 26, 2018 and July 8, 2019, the worker saw Dr. B, a general practitioner  
with an interest in pain management, for treatment of low back pain with referral down the  
right leg; this related to a September 2014 motor vehicle accident and subsequent bilateral  
L4-5 laminectomy undertaken in October 2017. Following July 8, 2019, the worker did not  
see Dr. B again until May 21, 2020. In the consultation report for the May 21, 2020 visit,  
6
All quotations have been reproduced as written, unless otherwise indicated.  
This acronym is generally used to refer to “pelvic inflammatory disease” although, within the context of  
7
all of the evidence, it here appears to refer to the worker’s neck condition, possibly progressive  
inflammatory disease.  
8
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
Dr. B documented that the worker did not require procedural pain management at that time  
but did report having sustained an injury to her neck in early March 2020 and, following this  
injury, the worker had a lot of pain in her neck. There was no mention of whether the injury  
was work related. On examination, Dr. B identified the following findings:  
Neck is 1 fingerbreadth anterior to neutral spine but she has obvious elevation in  
both scapulae. No suboccipital tenderness was cervical facet joint tenderness  
was present. She doesn’t have any muscle weakness or sensation deficits.  
Active trigger point tenderness was diagnosed in the upper trapezius and levator  
scapula muscles bilaterally.  
Dr. B administered trigger point injections to the worker’s upper trapezius and  
levator scapula muscles bilaterally.  
In a May 21, 2020 chart note, Dr. S1 documented that the worker had two significant  
problems: the recent neck pain and neuropathic symptoms, along with right forearm pain  
she had also recently developed and that was suggestive of tennis elbow; and, longstanding  
back pain. Dr. S1 recorded that:  
She says she is quite concerned about her job because it is physical and feels  
they might suggest desk job. The problem with that, is that she would then need  
to explain her chronic low back pain problem, which might make her employer  
not allow her to do physical work. [S]he cannot really sit still at a desk for very  
long. She prefers the physical job which improves her low back pain.  
Dr. S1 completed medical insurance forms. There was again no mention of the worker’s  
symptoms being work-related. Dr. S1 wrote, in part:  
She says she is quite concerned about her job because it is physical and feels  
they might suggest a desk job. The problem with that, is that she would then  
need to explain her chronic low back problem, which might make her employer  
not allow her to do physical work. [S]he cannot really sit still at a desk for very  
long. She prefers the physical job which improves her low back pain.  
During a May 22, 2020 telephone consultation with Dr. G, the worker reported that she  
especially had pain after the trigger point injections. Dr. G noted that the worker was  
stressed and anxious. Dr. G provided a diagnosis of degenerative disc disease in the  
cervical spine area.  
The worker saw a physiotherapist for treatment of her low back on May 25, 2020. The  
physiotherapist noted the worker’s report that her right arm condition was getting worse on  
March 10, 2020, that she went off work due to pain in her neck and right arm, and that she  
9
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
was also having pressure headaches. There is no mention that her symptoms were related  
to a work activity.  
On May 28, 2020, the physiotherapist noted the worker needed a functional abilities  
assessment to return to work. The worker reported pain in her right arm and neck with lifting  
10 pounds from floor to waist and from waist to overhead and with lifting and carrying  
10 pounds. Right arm pain symptoms were reported with pushing and pulling 10 pounds.  
On June 8, 2020, the worker was assessed by physiatrist Dr. P again, this time for the onset  
of neck pain “in March”, when a large wooden board kicked back on her at work and caused  
her neck to extend. The worker recalled that she felt a snapping sensation in her neck,  
which was followed by an electrical sensation down her left arm. She only had one episode  
of the electrical sensation, but had been bothered by neck pain since that time. She  
described having significant, generalized neck pain for approximately two months following  
the work event and said that she had been off work since March 10, 2020 because of it. She  
also had daily headaches associated with her neck pain, with the pain originating in the back  
of her skull and referring to the top of her head. Dr. P also documented that, over the past  
year, since starting to work at the employer, the worker had also developed pain in her right  
shoulder and lateral elbow and was experiencing intermittent numbness and paresthesias in  
both hands and arms at night during the winter. Dr. P examined the worker and also  
performed electrodiagnostic studies, which were reported as normal. Dr. P’s impression  
included chronic axial neck pain, subacute onset of persistent daily headache in the spring  
of 2020, right rotator cuff tendinopathy, right tennis elbow, and bilateral very mild median  
neuropathy. He recommended she continue to follow up with Dr. B, with physiotherapy for  
her shoulder and elbow diagnoses, and further investigation for her shoulder and elbow  
symptoms if they did not improve. Dr. P did not think the worker’s very mild median  
neuropathy required treatment.  
The worker saw her physiotherapist on June 12, 2020 and June 29, 2020 for neck  
symptoms. In the June 12, 2020 note, the physiotherapist diagnosed her with neck  
osteoarthritis. In a June 29, 2020 chart note, the physiotherapist documented that, the day  
prior, the worker’s neck felt as if the joints went out of place. The neck felt tight and full and  
she had a heavy head. The chart notes do not identify these symptoms as being work  
related but, on July 2, 2020, the physiotherapist wrote a letter to Dr. S1 stating that the  
worker reported having had neck pain since March 2020 when a jarring movement at work  
caused a snapping sensation and pain in her neck.  
On July 2, 2020, the worker spoke with Dr. A, a third locum for Dr. S1. Dr. A noted, “chronic  
neck pain, seemed worse over last weekend, waiting for injections … had been doing OK  
until Sunday, unsure why the pain got so bad all of a sudden.” The worker was planning on  
seeing Dr. T, a family physician with an interest in pain management, for injections. The  
worker also reported multiple other regional areas of pain at this visit. Dr. A diagnosed  
chronic neck pain and depression and queried if the worker might benefit from a  
multidisciplinary pain program.  
10  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
In a July 8, 2020 consultation report, Dr. T reported that he had seen the worker to address  
her bilateral cervical pain with cervical spasm. Dr. T wrote that, while at work “due to a  
heavy pallet, she experienced spasm in her neck.”8 The worker described ongoing cervical  
pain with some right side predominance but no history of any upper extremity weakness or  
paresthesia. Dr. T performed electrodiagnostic studies, all of which were reported as normal.  
On examination, Dr. T noted good range of motion in the cervical spine. Neurological  
examination, along with Spurling’s and modified Spurling’s,9 were negative bilaterally. Dr. T  
reviewed the recent cervical spine MRI findings and noted that the right C5 disc protrusion  
“…is similar to findings from 2 January 2013.” Dr. T’s impression was that the worker  
presented with undifferentiated bilateral cervical pain, which “may be facet-induced pain vs  
discogenic etiologies.” Dr. T administered nerve blocks at right C3, C4, C5, and C6 levels of  
the worker’s spine.  
Dr. S1 saw the worker in-person for a return-to-work assessment on July 17, 2020. He noted  
the worker would like to try a return to work. On examination, neck range of motion was  
80%. The worker’s lateral elbow and trapezius muscles were noted to be tender. Dr. S1  
said, “I believe a portion of the issue is her muscle tension from anxiety, therefore a trial of  
work should be ok. She has cervical pain and neuropathy as previously documented, but  
there seems no strong reason to not try work”. Under the heading “Plan”, Dr. S1 noted, “We  
decided on a 2 week period of light duty”.  
In a July 28, 2020 note, the worker’s physiotherapist documented that the worker had been  
taken to a hospital emergency department the day prior due to an intensely painful low back.  
She was considering reopening her prior low back claim.  
On August 17, 2020, the worker saw Dr. B again. She reported that, over the last three  
weeks, she had a lot more lower back pain in her left side. Dr. B administered facet medial  
branch nerve blocks to the worker’s lower lumbar spine and advised that, after this  
treatment, she reported reduced pain. There was no mention of any neck, upper extremity,  
or shoulder symptoms.  
In an August 17, 2020 chart note, Dr. S1 reviewed the worker’s prior history of injuries to her  
low back, dating back to 2000. The worker also reported that, in 2008, she was involved in a  
motor vehicle accident in which she sustained a whiplash injury mainly to the neck.  
In a September 9, 2020 chart note, Dr. S1 diagnosed chronic low back pain and more recent  
neck pain with neuropathic symptoms. Dr. S1 said that, as was often the case, the worker  
had tremendous trouble clarifying the purpose of her appointments. She had ongoing low  
back pain since 2014 that she related to a work injury and, after participating in several  
rehabilitation programs, had returned to work. However, she reported that the 2014  
employer could not accommodate her need for light duty work and she could not stay with  
8
In her February 2, 2021 reconsideration request, the worker stated that Dr. T’s description of the  
mechanism of injury was completely incorrect.  
Spurling’s tests are used to assess whether the source of pain is a nerve root.  
9
11  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
that job. “Other jobs have been problematic as well” and, more recently, she was working at  
the employer’s mill “and the back pain is intolerable when the activity levels are high.” In  
addition to this chronic issue, the worker had recently developed neck pain with neuropathy  
in the arm, which was the main reason she left work most recently, although the low back  
pain had flared up as well. Dr. S1 concluded that the worker remained unable to return to  
work.  
On September 23, 2020, Dr. S1 noted the worker’s neck pain was in the region of the left  
trapezius with no associated neuropathy in her limbs. He did not provide examination  
findings, a diagnosis, or mention work-relatedness. Dr. Screen referred to sending in a WCB  
form, which appears to have related to a request to reopen the worker’s 2014 low back  
claim.  
When the worker saw Dr. B again on September 29, 2020, she reported she had  
experienced very little relief since her last treatment. Dr. B said that the worker also had pain  
in her neck and was wondering if she could have treatment to alleviate this. On examination,  
Dr. B identified the following findings:  
Her neck is in neutral spine but she has slight elevation of both scapulae.  
Bilateral C5-6 facet joint tenderness was diagnosed in her pain levels [that]  
increased with facet loading. She doesn’t have any active trigger point  
tenderness at the present time. Bilateral L4-S1 facet joint tenderness was  
present but she doesn’t have any SI [sacroiliac joint] tenderness.  
Dr. B administered bilateral medial branch nerve blocks at the C5-6 level and the worker  
reported that her neck pain was reduced.  
In a lengthy October 5, 2020 chart note, Dr. S1 documented the worker’s report of ongoing  
back and neck pain with flare-ups and of emotional issues. Dr. S1 noted that having a  
central practitioner to manage the worker’s conditions would be preferable and suggested  
she start keep a diary of her symptoms.  
On November 13, 2020, Dr. S1 noted a visit for the worker’s chronic neck and back pain and  
prescriptions for a trial of mirtazapine and occasional Ativan for sleep.  
[31]  
Medical records that were prepared after the December 18, 2020 decision had been issued  
show the following:  
In a December 20, 2020 chart note,10 Dr. S1 wrote:  
Has explored coverage with WCB. She reminded me today of a neck injury on  
Feb. 17, 2020 where she suddenly hyperextended her neck to avoid a broken  
board, suffering a ‘whip lash’ type injury of the neck. Clearly this was mentioned  
10  
This note was enclosed with the worker’s February 2, 2021 request for reconsideration of the  
December 18, 2020 decision.  
12  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
(as I ordered an MRI at the time), but was not the primary purpose of the visit in  
March.  
This was all overshadowed by various stressors in March, and she was worried  
about the job if she filed a WCB claim. Therefore, it was not reported to WCB at  
the time, and I failed to mention it in my notes.  
In a December 31, 2020 chart note,11 Dr. S1 indicated that the worker was seeking to clarify  
her compensation claim for the February 2020 neck injury and was asking about some  
details regarding the timing of the MRI.  
On January 6, 2021, the worker sought medical attention from a new family physician,  
Dr. M. In a physician’s first report to the Board, Dr. M documented the worker’s report that,  
on February 17, 2020, she was pushing on a board to move it, the board broke, and “her  
neck snapped back/whiplash.”12 The worker also had a back injury in 2014 for which she  
had received continuing therapy, including various injections from Dr. B for pain. There had  
been limited improvement and these treatments were no longer successful. Also, her back  
condition had been aggravated by a neck injury. Dr. M advised that, due to her back injury,  
the worker would be unable to work for more than 20 days.  
On January 17, 2021, the worker reported to Dr. B that she had good relief of her neck pain  
for about two months but it then started getting worse. On examination, the worker’s neck  
was again in neutral spine with bilateral C5-6 facet joint tenderness. There was no  
suboccipital tenderness or localizing neurological deficit diagnosed. Dr. B again  
administered bilateral medial branch nerve blocks at the C5-6 level.  
On March 31, 2021, the worker sought medical attention from a new family physician at a  
third clinic. Dr. M2 completed a physician’s first report to the Board regarding an injury the  
worker reported she first received treatment for on January 21, 2020 from Dr. G. The worker  
said that she had right arm issues with her shoulder and elbow that began in October 2019  
and resulted from pushing strips with a long pole, and that Dr. P had diagnosed a right  
rotator cuff and tennis elbow injury. Dr. M2 did not note any symptoms or examination  
findings related to the worker’s neck, but said that she was unable to return to work at the  
moment due to neck and right arm pains.  
[32]  
[33]  
As noted, at the review officer’s request, Review Division medical advisor Dr. Galbraith  
reviewed the claim and provided a September 9, 2021 opinion. The purpose was to clarify the  
diagnosis for the worker’s neck symptoms and to discuss whether the described February 17,  
2020 work incident likely caused or aggravated that diagnosis.  
Dr. Galbraith comprehensively summarized the medical evidence from the multiple physicians  
who had treated the worker, the physiotherapist, and the chiropractor and noted that the  
11  
This was also enclosed with the worker’s February 2, 2021 request for reconsideration.  
Block capitalization has been removed.  
12  
13  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
diagnoses of the worker’s neck symptoms that had been provided by the various physicians  
included: chronic neck pain; undifferentiated bilateral cervical pain; chronic axial neck pain;  
cervical spine degenerative disc disease; and, cervical spine degeneration with possible nerve  
root irritation. Based on his review of the totality of the medical information available, it was  
Dr. Galbraith’s impression that the diagnosed chronic cervical pain or undifferentiated bilateral  
cervical pain likely represented the best working diagnosis for the worker’s reported neck  
symptoms.  
[34]  
[35]  
[36]  
Dr. Galbraith noted in particular that:  
None of the worker’s treating health care providers diagnosed an acute cervical  
strain or sprain injury, or a whiplash-associated disorder, the latter which was  
reported by the worker to have been diagnosed after three (or ? four) prior MVAs.  
As well, cervical spine degenerative disc disease is simply a reiteration of the  
worker’s cervical spine MRI findings and is not a clinical diagnosis.  
Although Dr. [S1] proposed a diagnosis of cervical spine degeneration with  
possible nerve root irritation at one time, the worker has always had a normal  
neurological examination in her upper extremities which would rule out  
discogenic or nerve root involvement secondary to cervical spine degenerative  
changes to explain her neck pain.  
With regard to the role that the reported work incident played in the worker’s condition,  
Dr. Galbraith acknowledged that it was accepted that the worker experienced neck pain after  
the work incident on February 17, 2020. However, in his view, it was clear from the worker’s  
own reporting to the chiropractor in March 2020 and to the physiotherapist in October 2019 that  
her chronic neck pain had already been present for at least several months prior to February 17,  
2020, and that she had daily cervical pain. As well, the worker had a well-documented history of  
chronic cervical pain following three motor vehicle accidents from 2008 to 2011. There were no  
medical records available to understand the status of the worker’s chronic neck pain from these  
incidents, but the worker had told the physiotherapist in October 2019 that she had persisting  
neck stiffness and tightness following her prior motor vehicle accidents. Dr. Galbraith confirmed  
that none of the multiple healthcare providers who examined the worker after February 17, 2020  
documented objective findings or a diagnosis consistent with an acute cervical sprain/strain  
injury and, accordingly, said that the medical information available did not support that the  
worker sustained a new or acute injury from the reported work incident on February 17, 2020.  
Dr. Galbraith also wrote as follows:  
The worker has a well-documented history of pre-existing chronic neck pain, for  
which there has been no medical consensus or unifying pathological explanation  
14  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
for her reported symptoms. While the worker’s MRI findings of multilevel cervical  
spine degenerative [disc] disease with possible nerve root irritation have been  
suggested, it is important to note that the radiologist specifically commented that  
the worker’s 2020 MRI findings at C5-6 were unchanged when compared to her  
2013 CT scan findings. Furthermore, the worker’s clinical presentation, including  
electrodiagnostic studies, has not been consistent with localized neurological  
symptoms or signs to support a diagnosis of specific or new cervical nerve root  
involvement to support aggravation of her stable cervical spine degenerative  
[disc] disease as a result of the February 17, 2020 work incident.  
[37]  
[38]  
[39]  
With respect to Dr. S1’s statement in his December 20, 2020 clinical note that it was clear that  
the worker must have mentioned in March 2020 that she had a work incident in February 2020  
“as I ordered an MRI at the time”, Dr. Galbraith noted that the history information recorded on  
the March 18, 2020 cervical spine MRI report was that of “neuropathy both arms when lays on  
back”. This was exactly what Dr. S1 recorded at the visit on March 9, 2020 and so the indication  
for the cervical spine MRI was not neck pain, which was what the worker is claiming for in  
relation to the February 17, 2020 work incident.  
Dr. Galbraith explained that chronic pain is purely a subjective experience, and typically  
fluctuates with waxing and waning over time without clearly identifiable triggers:  
An individual’s subjective experience of chronic pain is usually maintained by a  
complex interplay of multiple biopsychosocial factors, the latter which have been  
identified as relevant in this worker’s circumstances by several of the health care  
providers she has seen.  
In Dr. Galbraith’s opinion, the medical information available did not support that the worker  
sustained an acute cervical injury or an aggravation of her pre-existing cervical spine  
degenerative disc disease as a result of the February 17, 2020 work incident to explain her  
reported chronic neck pain. Furthermore, it was also Dr. Galbraith’s opinion that the worker had  
well-established pre-existing chronic cervical pain prior to February 17, 2020 which continued  
on following the reported incident, likely maintained by numerous psychosocial factors in the  
absence of objective signs or diagnosis of a new injury or condition.  
[40]  
[41]  
In response, the workers’ adviser obtained a September 26, 2021 medical opinion from Dr. S1.  
The workers’ adviser asked Dr. S1 to advise if he agreed with Dr. Galbraith’s opinion and  
provide reasons for this, provide the most appropriate working diagnosis for the worker’s  
condition, and provide an opinion regarding whether the February 17, 2020 work incident  
caused the diagnosis or aggravated or accelerated a pre-existing neck condition.  
Dr. S1 has known the worker since March 12, 2012. Dr. S1 confirmed that the worker had a  
history of neck pain after her last motor vehicle accident in 2011 and that he saw her for this up  
15  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
until 2015. However, after that, it was not brought up in the office and he believed it was not a  
“major issue.” It was brought up with another physician, Dr. Godin, in November 2017, but there  
were no further comments from doctors about neck pain until the worker’s visits to him in March  
2020. His records include many visits in 2018 and 2019 for chronic and severe low back pain  
and leg symptoms, as well as mental health issues, but he could not find any mention of neck  
symptoms. Also, the worker had trouble with elbow pain in the fall of 2019, but this was not  
attributed to her neck.  
[42]  
Dr. S1 said that, in March 2020, the worker presented to him with her ongoing back symptoms  
and mental health issues, “but she did also mention her neck pain and arm neuropathy.” Dr. S1  
wrote:  
My notes on this were minimal I believe because I had focused on her other  
issues, but I did order an MRI of the neck which I would have only done if her  
symptoms were severe. My notes in March 2020 are particularly poorly written  
because I often have some trouble following her story. [The worker] is often  
struggling with mental health issues, and moves quickly between topics with  
incomplete sentences. I believe this is the reason for the incompleteness of those  
notes. I have since carefully focused on her neck injury at work in February,  
2020, and she has consistently told me the same story. When I review all this as  
a whole, I am convinced that she did suffer a whiplash neck injury at work as she  
describes, on February 17, 2020. I am also confident she was NOT suffering any  
significant neck symptoms in the 2 years before this date.  
[43]  
Dr. S1 provided the opinion that the worker’s current neck pain is a “Whiplash injury from the  
incident at work on February 17, 2020.” Although she had past neck problems, with symptoms  
as late as 2017, they resolved and were not causing chronic neck symptoms. Also, while an  
MRI may have shown degenerative changes in the neck from old injuries, Dr. S1 said he was  
confident the worker had no notable neck symptoms in the two to three years prior to this injury:  
“If she had symptoms I am unaware of, then I would conclude at the very least, that the neck  
injury at work significantly exacerbated any neck symptoms she may have had prior.” Later in  
the opinion, Dr. S1 confirmed that, in his assessment, the worker’s status prior to the injury of  
February 2020 was that of “No neck symptoms” and that the old degenerative changes revealed  
on imaging were asymptomatic and thus irrelevant. He said that the soft tissue injury in  
February 2020 “was the only cause for the neck symptoms in that last year.”  
[44]  
[45]  
Dr. S1 also set out his examination findings from September 23, 2021. The worker had ongoing  
limitations in neck range of motion and soft tissue pain in her neck. Overall, these symptoms  
had improved over the last year but were consistent with a “Whiplash neck injury.”  
Finally, Dr. S1 said that he believed without a doubt that the worker delayed in bringing the  
February 2020 work injury to the attention of the Board because her employer strongly  
16  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
discouraged these reports: “She was fearful of losing her job and of disappointing others. She  
hoped the injury would resolve without fuss, but it didn’t.”  
[46]  
In Review Reference #R0276314, the review officer acknowledged there was a conflict between  
the opinions from Dr. Galbraith and Dr. S1 as to whether the worker sustained a new neck injury  
or aggravated a pre-existing neck condition as a result of the February 17, 2020 incident.  
However, the review officer placed more weight on Dr. Galbraith’s opinion. The review officer  
noted that Dr. S1 did not comment on the worker’s physiotherapy records or on the March 17,  
2020 chiropractic consultation history document that recorded the worker’s report of having had  
neck pain for four months. The review officer concluded that Dr. Galbraith’s understanding of  
the worker’s pre-February 17, 2020 baseline neck condition was more complete and consistent  
with the available medical evidence than was that of Dr. S1.  
[47]  
The review officer found it notable that, on reviewing Dr. S1’s chart notes along with the  
September 26, 2021 letter, it appeared that he believed the worker sustained a whiplash/soft  
tissue injury in the neck at work on February 17, 2020 because, during the December 20, 2020  
visit, the worker “reminded” him about the work incident/injury and subsequently consistently  
described the work incident/injury. However, the review officer found it significant that, while  
Dr. S1 documented the worker’s complaint of neck pain on March 10, 2020, he did not mention  
the February 17, 2020 work incident, record any clinical examination findings for the neck, or  
diagnose an acute, soft issue, or whiplash neck injury. The review officer placed more weight on  
Dr. S1’s chart notes that were closest in time to the February 17, 2020 incident than on his  
September 26, 2021 letter. Moreover, the review officer noted that Dr. S1 had eight  
appointments subsequent to March 10, 2020 with the worker regarding her neck pain (from April  
to November 2020), but he did not mention the February 17, 2020 incident or provide a  
diagnosis of an acute, soft tissue, or whiplash neck injury in any of these chart notes. Further,  
as Dr. Galbraith pointed out, the reason that Dr. S1 ordered the cervical spine MRI in March  
2020 was not the neck pain for which the worker related to the February 17, 2020 incident;  
rather, it was because, on March 9, 2020, the worker had reported “neuropathy both arms when  
lays on back.”  
[48]  
Regarding Dr. S1’s statement that the February 17, 2020 neck injury significantly exacerbated  
any pre-existing neck symptoms, the review officer noted that Dr. S1 did not explain the basis of  
his opinion, such as addressing the absence of any documentation of clinical examination  
findings of the worker’s neck in his March 2020 chart notes which were closest in time to the  
February 17, 2020 incident, and the fact that he did not diagnose an acute neck injury, including  
an aggravation injury, in any of his chart notes from March to November 2020.  
17  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
[49]  
In contrast, the review officer found that Dr. Galbraith had provided a detailed and  
well-reasoned explanation for her opinion that the worker did not sustain an aggravation of her  
pre-existing cervical spine degenerative disc disease as a result of the February 17, 2020  
incident. The review officer preferred Dr. Galbraith’s opinion over Dr. S1’s opinion:  
Specifically, the RDMA [Dr. Galbraith] considered that the 2020 MRI report noted  
no changes in the findings when compared to the 2013 CT scan. The RDMA also  
took into account the worker’s clinical presentation, including electrodiagnostic  
studies, which she found were not consistent with localized neurological  
symptoms or signs to support a diagnosis of specific or new cervical nerve root  
involvement.  
[50]  
[51]  
Furthermore, the review officer noted that, consistent with Dr. Galbraith’s opinion, neither Dr. P  
nor Dr. T, who were aware that a work incident had occurred prior to their respective  
appointments and neither attributed the worker’s neck symptoms to an acute neck injury,  
including an aggravation injury, resulted from the work incident. Instead, they diagnosed chronic  
axial neck pain and undifferentiated bilateral cervical pain, respectively.  
The review officer was not satisfied that the February 17, 2020 incident was of causative  
significance in producing a new neck injury or aggravating a pre-existing neck condition,  
particularly given that: the worker already had neck symptoms in the months leading up to the  
February 17, 2020 incident; and, none of the various physicians/specialists who  
assessed/treated the worker from March to November 2020 diagnosed the cause of the  
worker’s neck pain as an acute, soft tissue, or whiplash neck injury.  
New Documentary Evidence  
[52]  
[53]  
As noted above, both parties provided WCAT with new evidence in conjunction with the appeal.  
This new evidence has been identified and described above, with the exception that the  
employer also provided WCAT with the notes of observations by the worker’s supervisor of the  
worker performing her work duties on February 19, 2020 and February 25, 2020.  
On February 19, 2020, the supervisor observed the worker removing strips from logs. The  
worker was unjamming the strip belt while using a pike pole and the supervisor observed that  
she used good hand position and kept her body away from moving parts. The supervisor also  
documented that he asked the worker if she had any safety concerns and she advised that she  
did not.  
[54]  
On February 25, 2020, the supervisor again observed the stacking throw-outs. The supervisor  
observed that the worker stacked the throw-outs with good procedure.  
18  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
Testimony  
[55]  
[56]  
The worker was the only witness at the hearing. She testified that she started working for the  
employer in May 2019 and, at the time, had no issues with her neck.  
The worker said that, before the February 2020 work incident, there was nothing memorable  
about her neck. Her duties at work were very physical but she felt “good” and “great” and the  
last time her neck had interfered with her life was years prior. She said that she was not getting  
any treatment and it was not an issue that affected her life or work. Also, she was doing well at  
work and the employer was training her in other positions. She said that she just could not see  
how she would have been able to do some of the things that she had to do if she was having  
the issues that she was now having.  
[57]  
[58]  
The worker described the work incident of February 17, 2020. She said that, rather than going  
down with the board after it snapped, she snapped her neck back in a very quick motion in order  
to avoid smashing her face. She could not recall if she was holding the broken board or not, but  
said that she did this is in a very quick way in order to avoid injury to herself. The worker was  
unable to recall the exact date on which this incident occurred but, in response to a leading  
question from the workers’ adviser, agreed that it was around February 17, 2020.  
The worker considered it important to note that, after the board broke, she had to pick up the  
end of the board that had fallen on the other side of the line and she said that it was at this point  
that she felt an electrical volt/jolt and it went down her left arm. She said that the reason she  
was bringing this up was that, after that, the hardhat she had to wear at work was too heavy for  
her head and, whenever she had a chance, she took her hardhat off to help remove the weight  
and the pressure. Also, taking her hands and raising them up seemed to help the heaviness in  
her arms and neck. She said that, because she was continuing to work using her left arm and  
left hand, her left hand was tingling and numb. She also said that she reported to her doctor that  
she would get a dizzy feeling that kind of made her feel nauseous, but this was relieved if she  
changed the position of her head.  
[59]  
The worker said she has pain at the side of her neck that caused her to be unable to work or  
wear her hardhat and for which she needs medication. It causes her to feel as if her head is  
being squished down into her shoulders and this gives her pressure headaches, or a feeling of  
pressure in her head. For the longest time, the only way of relieving the pain she was in was by  
being horizontal so that the weight of her head was off her shoulders. She tries to do traction,  
which makes her feel better, and she uses ice. She said that there is still a spot in her neck  
where, if she goes for a chiropractic adjustment, she feels a burning pain; also, when she is  
lying down and rests that same area in her neck against something, the spot gets tender. She  
also said that she gets twitching in her left thumb that hurts a little bit.  
19  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
[60]  
[61]  
As of the date of the hearing, the worker no longer had numbness in her hands, but she still had  
issues with her neck. She said she still had the painful site on her spine that felt hot even though  
she had taken a Tylenol No. 3 and put Diclofenac cream on her neck. She said that looking up  
is the worst and, because of the pain that is right there in the same spot, she cannot really tilt  
her head back. She said her neck condition is not good at all.  
In response to the workers’ adviser’s question as to why she did not report her injury, the worker  
said that, initially when she started at the employer, she had already been told by the plant  
manager to not report injuries to the Board “and to report it to my employer.” She said that if she  
had gone to the Board, she would have had over 200 people “pissed off” at her and she did not  
want to make the plant manager regret hiring her. The worker said that she had some issues  
with her right arm in October 2019 and her supervisor had to remove her from her position and  
put her into something else. So, because of that, she came to the attention of the safety officer  
and the site superintendent, who had a meeting with her. This meeting (date unknown) was  
really intimidating. She said that, based on this experience, as well as on knowing what the  
plant manager had told her about work injuries, she did not want to go through “that again” and,  
as she felt it would have been “the same thing anyways,” she did not report her February 2020  
injury to her employer.  
[62]  
In response to the workers’ adviser’s question as to whether she remembered what she told  
Dr. S1 during her visits on March 9 and 10, 2020, the worker said that, on March 9, 2020, she  
did not tell Dr. S1 what happened to her neck because of what the plant manager told her and  
she did not want to tell anybody what had happened; but, on March 10, 2020, she was really  
scared because her neck was not getting better and she had already been taking time off work  
leading up to March 9 and 10, 2020. She said that her exact words to Dr. S1 when she went in  
to see him on March 10, 2020 were, “We need to talk” and “I’m in trouble.” She said that she  
told Dr. S1 what happened, and Dr. S1 said, “Okay, well if it happened at work then it’s  
work-related.” She said that she then said, “Well, no, this is what [the plant manager] told me”  
and she told Dr. S1 that she already had issues with her arm and she would not say anything  
about having issues with her neck. The worker said that she was really upset when she went in  
to see Dr. S1 because she felt like she was in trouble. She knew she was hurt and was now at  
the point where she could not go in to work, but she did not know what to tell the employer. The  
worker said that she asked Dr. S1 along the lines of, “If I tell you something is it between you  
and I, like is it confidential?” and Dr. S1 said, “Well, yes.” She said that she did not know if he  
asked her anything further, like what she was referring to, but it was important to her that she  
make sure what she said was confidential because it had to be or she would not have said  
anything to him at that point. She said that she did not want to go to the Board and she did not  
want her employer to know that she was even talking to Dr. S1 about what had happened.  
[63]  
The worker’s representative noted that the record showed that the worker went off work as of  
March 10, 2020 and asked why she had stopped working at that time. The worker said that she  
was actually off work before then. She was not sure what date she went off work, although it  
20  
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WCAT Decision Number:  
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could have been for the week prior. She said that she kept in touch with her supervisor daily and  
told him that she was not getting better. Her supervisor had told her that it was getting really  
difficult to schedule her work and that he thought it was best that she go off work. The worker  
said that she had to go off work because she was struggling with her regular duties at work.  
Because she had no strength in her hands and they were tingling and numb, she could no  
longer use a pike pole and her co-workers had to help her when the hopper got jammed. She  
was in quite a bit of pain and, when she woke up, her hands were numb. Her employer thought  
she was just going off work for the issues in her arm.  
[64]  
The worker said that, at the end of June or July 2020, she discussed the possibility of a  
graduated return to work with her supervisor. Because she was on short-term disability at that  
time, she was only getting 60% of her hourly wage, and, by that time, she had already run out of  
her work benefits for treatments and so she had to pay full price for chiropractic and  
physiotherapy treatments. She told her supervisor that she was not ready to use a pike pole and  
he said that, in that case, it would be best for her to come back when she was 100%. The  
worker said that she has office skills and, at one point, she was offered a position in the office,  
which would have allowed her to keep her regular hourly wage. However, she needed to be with  
her daughter and had just moved into a new condominium.  
[65]  
With regard to her statement in the chiropractic intake form that her neck pain was more recent  
(“4 months”) the worker said that she was talking about not just what was going on with her  
neck but was also listing all of the symptoms she had at that time and how long she had had  
them. She said that, when she filled in the form, she was thinking about her arm, and she had  
said that she had had that for about four months. She said that she was not just saying that she  
was having neck pain. Instead, she was stating where she “was at” at that point. She mentioned  
the tennis elbow for which she had been getting physiotherapy treatment, she mentioned that  
her neck pain was more recent, and the reference to four months was just an approximate date.  
[66]  
In her response to a question from the workers’ adviser as to why she decided to report her  
neck injury to the employer on November 19, 2020, the worker said that, unfortunately, she had  
honestly tried to get better but it was not working. She had no benefits or coverage for treatment  
and she had to give notice at her apartment. She said that she had called the Board  
anonymously over the course of a few months because she wanted to find out if she could  
report an injury without having to say why she waited. She said that she honestly did not want to  
bring up “the thing” with the plant manager, did not want to get the plant manager in trouble, and  
did not want “any of that to happen.” When she was put through to one of the representatives at  
the Board, they would tell her that this was claims suppression, and the term “fraud” would  
come up. One day, she got connected to a Board officer with whom she had previously talked.  
She told the Board officer that she was scared and did not want to lose her job. The Board  
officer told her that what she needed to do was pretend she was her daughter and think about  
what she would tell her daughter to do. The worker said that this pushed her to tell the employer  
about her injury, in spite of whatever consequences might come from the employer.  
21  
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Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
[67]  
In response to questions the employers’ adviser asked the worker, the worker said that:  
The conversation with the plant manager that included discussion of what would happen if  
she reported an injury to the Board that occurred at the time she was offered her job, prior to  
her starting work with the employer.  
She could not remember the exact date on which it occurred, but she did receive orientation  
training about reporting work incidents and she signed the form indicating she had received  
this training, which included confirmation that she was to report all incidents to the employer  
no matter how insignificant they may be.  
She was not sure if the information she said she received from the plant manager about  
reporting injuries confused her, but she was “maybe sort of disheartened” about it.  
She recalled that, when she first started, her supervisor would do job checks but she did not  
recall her supervisor performing any observations of her work in February 2020. She said  
that she would have known if her supervisor or anyone was in her area and that she just  
could not remember that happening.  
She was experiencing neck pain on both February 19, 2020 and February 25, 2020 that was  
severe enough for her to take any opportunity she could to take her hardhat off, but she  
would do that without anyone seeing her. Also, whenever she could during her work shift,  
she would also push her head up with her hands on her chin to stretch her neck.  
During the December 2, 2020 investigation meeting, she did tell the site superintendent and  
safety officer that she had not reported her injury at first because she did not think it was a  
big deal and she was already having issues with her arm and did not want to raise another  
issue for the company.  
She was not aware of anyone in the workplace having gotten in trouble for reporting an  
injury, but she did know one co-worker who had an eye injury; this co-worker had “kind of  
reinforced the no report WorkSafe policy.” He may not have been in trouble, but he was  
made to come back to work on modified duties because of something to do with not having  
a time loss. This co-worker told her about safety bonuses, which she did not previously  
know about.  
Of her prior motor vehicle accidents, the last accident in 2011 caused the worst neck  
symptoms. Following that, she had a sore neck off and on for up to a few years. She could  
not remember the last time she had treatment for her neck following that accident.  
She received short-term disability benefits from March 2020 until March 2021. She applied  
for long-term disability benefits but her application was denied because she had a  
pre-existing condition.  
[68]  
The employers’ adviser also asked the worker if she would be surprised to learn that, between  
February 2018 and March 2020, there were 12 compensation claims in the workplace, 4 of  
22  
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which involved lost time accidents, and all were accepted by the Board.13 The worker responded  
that she did not think she was surprised to learn that, but in order to report her injury, she would  
have had to not care what her employer told her, not worried about her job, and not worried  
about disappointing the plant manager or having 200 people “pissed off” at her and, if she had  
reported her injury, that was probably what would have ended up happening. She said, “All’s I  
know is what I was told” by the plant manager. However, she did agree that, based on what she  
learned during her orientation, it appeared that the employer’s policy was that all injuries were to  
be reported. She then clarified that she had been told to report even insignificant things and she  
said that is what she did when she told the employer about the issues with her arm; however,  
the meeting she had with the site supervisor and safety manager about that was intimidating  
and it made her feel that the plant manager actually meant what he said.  
[69]  
[70]  
In response to further questions from the employers’ adviser, the worker said that, during that  
meeting, the site superintendent told her that they had a computer program that could tell  
whether or not her injuries were caused by her duties at work. The site superintendent told her  
that it was unlikely that her arm issues were caused by her duties, even though she  
remembered what had caused them and she identified the piece of equipment that was  
involved. She said that they just wanted to know what she told her doctor and, remembering  
what the plant manager had told her about WorkSafeBC reporting, she was intimidated.  
I asked the worker when and how she identified February 17, 2020 as the date of the work  
incident. The worker said that she tried thinking back to the timeframe when the mill was  
processing Douglas fir (the type of wood involved in the incident) and, as she knew she was on  
an afternoon shift, she had to try and think about her schedule and just try to think the best way  
that she could that would make sense. She said that she did this thinking back and identified  
February 17, 2020 as the date of injury when she first started to call the Board anonymously,  
which she thought would have been around April or May 2020.  
[71]  
[72]  
The workers’ adviser did not ask any redirect questions of the worker following conclusion of the  
questions the employers’ adviser and I asked the worker.  
Submissions  
The workers’ adviser provided an oral submission at the close of the hearing. I allowed the  
employers’ adviser three weeks within which to file a written submission following the hearing  
and he did so. In rebuttal, the workers’ adviser provided WCAT with a final written submission.  
13  
As noted in a final written rebuttal the workers’ adviser provided to WCAT, the employer’s adviser did  
not specify whether these incidents occurred in the specific location where the worker was employed.  
23  
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Tel: (604) 664-7800 | 1-800-663-2782  
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WCAT Decision Number:  
A2102306 (July 25, 2022)  
[73]  
[74]  
In summary, the worker disagrees with the Review Division decision and seeks a finding that  
the February 17, 2020 incident was of causative significance in producing a new neck injury or  
aggravating a pre-existing neck condition and acceptance of her claim.  
Through her representative, the worker submitted that:  
The physiotherapy records do not support that she had a pre-existing neck pain prior to  
February 17, 2020.  
Although she did not report her February 17, 2020 injury to the employer until November  
2020, the evidence from Dr. S1 supports that she did report it to him on March 10, 2020.  
Although there is no written record of her reporting this as a work injury to Dr. S1, Dr. P’s  
June 8, 2020 report confirms that she reported a work injury at that time and she also  
reported a work injury to Dr. T on July 8, 2020.  
Her account of what happened remained consistent for at least five months prior to her  
filing her claim. This confirms that she did not invent a workplace incident at the time she  
filed her claim.  
The evidence, including in the counsellor’s April 30, 2021 letter, shows that her reason for  
not reporting her injury to the Board and the employer was a “fear of retaliation”.  
As a whole, the medical evidence supports that she sustained a neck injury on  
February 17, 2020 and she has described how her neck condition changed significantly  
after that incident.  
As she was unsure of the exact date the workplace incident occurred, it is possible that the  
incident occurred after the employer’s observation reports of February 19 and 25, 2020.  
Prior to the incident, she was able to perform her job duties at the mill whereas, after the  
incident, despite her best efforts, she was unable to do so.  
Her injury occurred during the start of the COVID-19 pandemic, which was a hectic time for  
the medical community and this affected her ability to get a diagnosis and seek medical  
treatment.  
With respect to the employer’s allegation that she only filed her claim because her  
employer-paid benefits had been exhausted, it was notable that she did not file her claim  
until several months later. Also, she attempted to return to work in July 2020 and the lack of  
a temporal connection between the end of her benefits and her attempt to return to work  
supports that she was not trying to take advantage of the system but, instead, was  
genuinely trying to recover and return to work.  
As Dr. S1 has been treating her since March 2012, is familiar with her history, and has had  
the benefit of seeing her in-person, his opinion should be given significant weight.  
Her financial situation has made it difficult to obtain a medical-legal response to  
Dr. Gallagher’s report.  
24  
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Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
Section 149 of the Act should not bar the worker’s claim and the interests of justice show  
that the claim should be allowed. The employer was not prejudiced by the worker’s late  
filing of her claim as it was able to conduct an investigation into the incident after it was  
reported and, as the employer was unable to accommodate the worker in June 2020 when  
it knew she had an arm injury, it would have made no difference if the employer had known  
about the worker’s neck injury at that time.  
[75]  
In the written reply submission the employers’ adviser provided to WCAT, the employer  
supported the Review Division decision and asked that it remain unvaried. In summary, the  
employer submitted that there is insufficient medical evidence to support a compensable injury  
arising on February 17, 2020 and that it is more likely than not that the worker’s neck pain  
pre-existed her employment activity on February 17, 2020; while something in the worker’s  
employment activity may have caused an increase in her neck pain, that does not mean that the  
activity was causative of a new injury or aggravation of her pre-existing condition.  
[76]  
[77]  
In the alternative, the delay in reporting prejudiced the employer, which should operate as a bar  
to the claim.  
To the extent they are relevant to my decision, I have discussed the content of the rebuttal  
submission the workers’ adviser provided to WCAT below in my analysis and findings.  
Analysis and Findings  
Did the worker sustain a neck injury, including an aggravation injury, arising out of and in the  
course of her employment on February 17, 2020?  
i.  
Overview of Law and Policy  
[78]  
Section 134(1) of the Act requires the Board to compensate a worker who sustains a personal  
injury that arises out of and in the course of the worker’s employment. For compensation to be  
paid, three questions must be answered affirmatively: (1) Did the worker sustain a personal  
injury? (2) Did that injury arise in the course of the employment? and, (3) Did it also arise out of  
the employment?  
[79]  
[80]  
The term “personal injury” is defined in policy item C3-12.00(A) as any physiological change  
resulting from some cause, and includes, for example, strains and sprains. A whiplash injury to  
the neck is a type of personal injury.  
Policy item C3-14.00 is the principal policy for determining whether a worker’s injury arises out  
of and in the course of the worker’s employment. “In the course of the employment” generally  
refers to whether the injury happened at a time and a place during an activity consistent with,  
and reasonably incidental to, the obligations and expectations of the employment. “Arising out of  
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WCAT Decision Number:  
A2102306 (July 25, 2022)  
the employment” generally refers to the cause of injury, and the focus of inquiry is on whether  
the worker’s employment was of causative significance in the occurrence of the injury.  
[81]  
In cases where a worker has a relevant pre-existing condition or disease, policy item #C3-16.00  
must be considered. It provides guidance on distinguishing between injuries that arise out of  
and in the course of the employment, and injuries that result from pre-existing conditions or  
diseases. Policy item #C3-16.00 provides that, in all cases, the medical and factual evidence is  
considered together, in order to determine the causative significance of the pre-existing  
condition or disease, and the employment activity or situation, in the resulting injury. Evidence  
that the pre-existing condition or disease has been accelerated, activated, or advanced more  
quickly than would have occurred in the absence of the employment activity may be  
confirmation that the aggravation resulted from the employment activity.  
[82]  
In considering causation, the focus is on whether the worker’s employment was of causative  
significance in the occurrence of an injury. The policy recognizes that both employment and  
non-employment factors may contribute to the injury. The employment factors need not be the  
sole cause. For the employment to be of “causative significance,” it must be more than a trivial  
or insignificant aspect of the worker’s injury.  
ii.  
Sufficiency of Medical Evidence  
[83]  
[84]  
The question of whether a particular work activity was of causative significance to a new  
personal injury or aggravation of a pre-existing condition is a matter that requires medical  
expertise. Therefore, as required by policy item #97.31, I have considered all of the medical  
evidence, including the opinions of Dr. S1 and Dr. Galbraith.  
Section 302 of the Act provides that, if WCAT determines that independent assistance or advice  
from a health professional would assist in reaching a decision on an appeal, the presiding  
member may retain such a health professional to provide such assistance. This is a  
discretionary provision and grants an authority that I exercise in situations where I am not  
satisfied that the available evidence is sufficiently complete and reliable to allow me to reach a  
sound conclusion, with confidence, on a matter requiring medical expertise.14  
[85]  
[86]  
As noted, the workers’ adviser submitted that the worker’s financial situation had made it difficult  
to obtain a medical-legal response to Dr. Gallagher’s report. I therefore considered whether to  
exercise my discretion to obtain the opinion of an independent health professional to address  
the matters of diagnosis and causation of the worker’s neck condition.  
I am satisfied that the available evidence is sufficiently complete and reliable to allow me to  
reach a sound conclusion in the appeal, with confidence, on the matter of whether the worker  
14  
In this regard, I take guidance from item 9.1 of WCAT’s MRPP.  
26  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
sustained an injury to her neck arising out of and in the course of her employment. Most  
importantly, Dr. S1 prepared his September 26, 2021 opinion in direct response to the request  
of the workers’ adviser, who specifically asked him to advise if he agreed with Dr. Galbraith’s  
opinion and provide reasons for this. I am satisfied that the available evidence is sufficiently  
complete and reliable to allow me to reach a sound conclusion, on the matter at issue in this  
appeal that requires medical expertise and so did not seek further medical opinion evidence.  
iii.  
Did the worker sustain a compensable aggravation of a pre-existing condition in her  
neck arising out of and in the course of her employment?  
[87]  
The medical evidence shows that the worker had degenerative changes in her cervical spine  
prior to February 17, 2020 in the form of osteoarthritis or degenerative disc disease. As of  
March 18, 2020, she also had a small C5-C6 disc herniation that was unchanged from a prior  
MRI in 2013 and a small right foraminal disc herniation at C4-5. Based on her comprehensive  
review of all of the medical evidence, Dr. Galbraith concluded that the worker’s clinical  
presentation, including electrodiagnostic studies, were not been consistent with localized  
neurological symptoms or signs to support a diagnosis of specific or cervical nerve root  
involvement to support aggravation of her stable cervical spine degenerative disc disease as a  
result of the reported February 17, 2020 work injury.  
[88]  
There is no contrary medical opinion and I am satisfied that Dr. Galbraith’s conclusion in this  
regard is consistent with the content of the medical records, including those that I have  
summarized above. Of particular significance, as noted, in her request for Dr. S1’s  
September 26, 2021 opinion, the workers’ adviser specifically asked Dr. S1 to advise if he  
agreed with Dr. Galbraith’s opinion and provide reasons for this. Dr. S1 disagreed with  
Dr. Galbraith’s view that the worker’s degenerative disc disease was likely symptomatic prior to  
the work injury. However, Dr. S1 did not disagree with Dr. Galbraith’s opinion that the reported  
February 17, 2020 work injury did not aggravate the worker’s stable cervical spine degenerative  
disc disease. Indeed, Dr. S1 was quite clear that, in his opinion, the only work injury the worker  
sustained was a soft tissue whiplash injury.  
[89]  
The workers’ adviser has asked that, as an alternative to accepting that the worker sustained  
the injury Dr. S1 has diagnosed, an aggravation injury be accepted. However, other than  
identifying that the radiologist who interpreted the March 18, 2020 CT scan did not comment  
that any finding other than the C5-C6 disc herniation were unchanged from the prior imaging in  
2013, she did not provide submissions to support this alternative relief. None of the worker’s  
physicians suggested that one of the other changes identified on the MRI was the cause of the  
worker’s neck symptoms and the representative did not identify any reasonable basis for  
rejecting Dr. Galbraith’s opinion that the worker did not suffer such an injury. I have also not  
identified any reasonable basis for discounting that opinion. I accept Dr. Galbraith’s opinion that,  
in the reported February 17, 2020 work incident, the worker did not aggravate the pre-existing  
condition in her neck.  
27  
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Tel: (604) 664-7800 | 1-800-663-2782  
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WCAT Decision Number:  
A2102306 (July 25, 2022)  
iv.  
Did the worker sustain a new injury to her neck arising out of and in the course of her  
employment during the reported February 17, 2020 work incident?  
[90]  
Policy item #97.32 provides that a statement of a worker about the worker’s own condition is  
evidence insofar as it relates to matters that would be within the worker’s knowledge, and it  
should not be rejected simply by reference to an assumption that it must be biased. Also, there  
is no requirement that the statement of a worker about the worker’s own condition must be  
corroborated. The absence of corroboration is, however, a ground for considering further  
investigation. A conclusion against the statement of a worker about the worker’s own condition  
may be reached if the conclusion “rests on a substantial foundation,” such as clinical findings,  
other medical or non-medical evidence, or serious weakness demonstrated by questioning the  
worker, or if the statement of the worker relates to a matter that could not possibly be within the  
worker’s knowledge.  
[91]  
I did not identify any reason to doubt that the worker honestly believes that an incident that  
occurred at work on or about February 17, 2020 caused an injury to her neck. However, her  
honest belief that she injured her neck on or about February 17, 2020 alone is not sufficient to  
support her claim. I accept the worker has attempted to truthfully report her recollections;  
however, I find her evidence concerning her belief that she sustained a personal injury to her  
neck arising out of and in the course of her employment to be unreliable and, on reviewing all of  
the evidence, I find that there is a substantial foundation for reaching a conclusion against the  
worker’s statement in this regard.  
[92]  
Policy item #97.00 sets out an example that has relevance in the current appeal. It states that,  
although there is no burden of proof on the worker, it is not uncommon to see that a claim will  
be denied when a worker, away from employment, begins to feel some pain and discomfort in  
the lower back, and seeking to find a reason for this condition, thinks back to the work being  
done over a period of time and concludes that the problem must have resulted from something  
which occurred on a certain day when certain heavy work was being performed. The question  
then arises whether there was anything other than the worker’s hindsight which would allow the  
Board to conclude that the work done some weeks or months previously had causative  
significance. It is at this point that investigation takes place and the evidence is weighed. If the  
evidence does not support a finding it is “at least as likely as not” that any activity at work was of  
causative significance in the reported condition, at or near the time alleged by the worker, it can  
fairly be said that causation has not been established. The worker has simply failed to present  
those fundamental facts which bring the provisions of the Act into play.  
[93]  
[94]  
I find that the circumstances of the current appeal fit within this situation.  
As noted above, the worker testified that it was only with the benefit of looking back several  
months after February 17, 2020 (she believed it was around April or May 2020, at the time she  
first started calling the Board to find out if she could file a claim without explaining why she had  
28  
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Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
waited so long) that she was able to identify as the day on which the board snapped on  
February 17, 2020.  
[95]  
Regarding the date of the work incident, I took from the worker’s response to my question as to  
how and when she identified February 17, 2020 to indicate that she had given considerable  
thought to the matter and checked records to confirm that it was in fact on February 17, 2020.  
As noted, she remembered that the mill was processing cedar and she was working afternoon  
shifts when the incident happened, and February 17, 2020 was the workday that matched those  
parameters. However, in submission to WCAT, the workers’ adviser raised the possibility that  
the incident may have occurred at a later date.  
[96]  
[97]  
This submission appears in the final rebuttal submission the workers’ adviser prepared in direct  
response to the business records the employer provided to WCAT, which document that, on  
February 19 and 25, 2020, the worker’s supervisor observed the worker performing work duties  
without any apparent difficulty.  
Because the possibility that the reported work incident may have occurred on a date after  
February 25, 2020 was first raised in the worker’s final rebuttal submission, I considered  
whether it was necessary to seek additional submissions from the employer or to reconvene the  
hearing in order to obtain clarification from the worker on this point. I concluded that this was not  
necessary. This is because, even if it was clarified that the incident did not occur on  
February 17, 2020, there would still be insufficient reliable evidence to support a finding that, on  
or about mid to late February 2020, the worker sustained a physiological change to the tissues  
in her neck as a result of her work activities.  
[98]  
Dr. Galbraith’s opinion that none of the medical evidence from the multiple healthcare providers  
who examined the worker after February 17, 2020 documented objective findings or a diagnosis  
consistent with an acute soft tissue injury sprain/strain injury accurately reflects the medical  
evidence. Moreover, up until Dr. S1 prepared his report of December 20, 2020, those records  
also do not identify objective findings or diagnosis to support that the worker may have  
sustained a whiplash injury in February 2020. Accordingly, the medical information available  
does not support that the worker sustained a new or acute injury from the reported work incident  
on February 17, 2020 or at any time in close proximity to that date.  
[99]  
I acknowledge that, based on a careful reading of the physiotherapy notes, it is apparent that  
Dr. Galbraith understood the neck symptoms the worker was experiencing prior to February  
2020 were more severe than is actually supported by those notes. In particular, he identified  
that the worker had told the physiotherapist that she had daily cervical pain. I agree that, as was  
noted by the workers’ adviser, the record in which the physiotherapist recorded this information  
comes from after the worker resumed physiotherapy treatments in May 2020, in conjunction  
with the worker’s attempt to return to work in June 2020. The physiotherapy notes confirm that,  
on May 28, 2020, the worker underwent assessment and a functional abilities form was  
29  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
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WCAT Decision Number:  
A2102306 (July 25, 2022)  
completed. It is apparent that the reference to daily cervical pain, as well as a reference to this  
pain being at a level of 5 to 8 out of 10 every day which the employers’ adviser noted in his final  
written submission, appears in the form that was completed at that time.  
[100] Nevertheless, the physiotherapy records show that, prior to February 2020, the worker had  
some ongoing neck symptoms as a result of her prior involvement in the motor vehicle  
accidents. Those records directly contradict the worker’s recollections that the last time her neck  
had interfered with her life was years prior and she had not been getting treatment for her neck  
since she started working with the employer. While she may not have understood that the  
physiotherapist was providing treatments to her neck, the records clearly support that this was a  
central component of those treatments. They also confirm that, as of October 29, 2019, the  
worker had ongoing stiffness and tightness in the neck owing to her prior involvement in the  
motor vehicle accidents.  
[101] I acknowledge that, looking back, the worker believes that her notation in the chiropractic intake  
form that her neck had been symptomatic for “4 months” was only intended to be a reference to  
the symptoms in her arm. However, it is apparent on reading that form that she was referring to  
the first of the two major complaints she identified, right neck pain radiating into both arms. I am  
not persuaded that the worker’s testimony on this point is consistent with the probabilities  
affecting the case as a whole.15  
[102] I also acknowledge Dr. S1’s view that, because he is not aware of the worker having had issues  
with her neck in the two or three years prior to February 17, 2020, he believes that she did not  
have neck pain that was a “major issue” and that she was either not suffering neck symptoms in  
the two years prior to February 17, 2020 or, if she was suffering such symptoms of which he  
was not aware, the neck injury at work significantly exacerbated these symptoms. However,  
Dr. S1 candidly admitted in his September 25, 2021 medical opinion that, during consultations,  
the worker is often struggling with mental health issues and moved quickly between topics with  
incomplete sentences. I am not persuaded that the absence of notations about neck symptoms  
in Dr. S1’s notes from prior to February 17, 2020 incident constitutes evidence that the worker  
was not having issues with neck pain. This is particularly so given that, while he believes the  
worker’s only complaints in the fall of 2019 related to her arm, his understanding in this regard is  
inconsistent with the physiotherapy notes referred to in Dr. Galbraith’s opinion and in relation to  
which Dr. S1 offered no comment when provided with the opportunity to do so.  
15 I note that, in assessing the reliability and credibility of the evidence, I have had taken the content of  
policy item #97.32 into account and I have also considered the guidance provided by the Courts in such  
cases as Bradshaw v. Stenner, 2010 BCSC 1398, affirmed 2012 BCCA 296, in Faryna v. Chorny,  
[1952] 2 DLR 354 (B.C.C.A), and Fraser v. Vancouver (City), 2016 BCSC 1074, which establish that,  
fundamentally, the question of whether the evidence of a witness is credible or reliable is whether the  
evidence is consistent with the probabilities affecting the case as a whole.  
30  
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WCAT Decision Number:  
A2102306 (July 25, 2022)  
[103] In addition, I acknowledge that the submission by the workers’ adviser that Dr. B’s records from  
February 26, 2018 to January 18, 2021 indicate that he was treating her lower back pain up until  
May 21, 2020, at which time he began treating her neck pain as well. His notes indicate that her  
neck pain was resulting from a neck injury that occurred in March 2020, which supports that she  
was not having issues with her neck for at least two years prior to the work incident. However,  
the workers’ adviser failed to note that, following July 8, 2019, the worker did not see Dr. B  
again until May 21, 2020. Given that there are no records from Dr. B in the period July 8, 2019  
through May 20, 2021, Dr. B had no way of knowing whether the worker did or did not have  
symptoms in her neck during this period and so they do not support that the worker was not  
having issues with her neck for at least two years prior to the reported work incident.  
[104] In submission, the workers’ adviser relied on the evidence from the worker’s chiropractor that  
support that the worker sustained an acute injury to her neck. She said that, on March 17, 2020,  
the chiropractor assessed the worker’s neck condition as “acute” as opposed to chronic,  
indicated that the cervical lordotic curve was severely decreased, and noted space narrowing  
at C5-6.  
[105] However, a reading of the full note for March 17, 2020 in the context of the chiropractor’s other  
notes does not support that the chiropractor diagnosed an “acute” neck injury. Rather, in the  
March 17, 2020 note, the chiropractor noted that the worker’s major problem was “Neck pain  
headaches Right shoulder pain numbing of the arm numbing of the hand” and that her  
secondary problem was “low back pain Sciatica”. The chiropractor did report that an x-ray  
showed a severely decreased lordotic curve and disc space narrowing at C5-6 but, at that same  
level, he also noted “hypertrophic arthritic changes”. Also, the chiropractor stated that “Patient is  
acute”, but this was clearly in reference to all three of her subjective complaints (“Neck pain /  
stiffness Headache Right Shoulder Pain Low Back pain / Stiffness Sciatica”). In this regard, in  
all of his subsequent reports (April 9, 16, 21, 23, and 30, 2020, May 20, 2020, June 30, 2020,  
July 23, 2020, and September 8, 2020) he also stated “Patient is acute” without specifically  
identifying any of the several conditions he was treating as an acute injury and without at any  
time confining this comment to the worker’s neck condition. I conclude that the chiropractor did  
not diagnose an acute injury to the worker’s neck.  
[106] The workers’ adviser said that the presence of an acute neck injury was supported by Dr. S1’s  
chart notes from March 9 and 10, 2020; less than a month after February 17, 2020, the worker  
was struggling with neck pain and numbness in her arms, and Dr. S1 ordered an MRI “as a  
result.” I acknowledge that Dr. S1 also said in his December 20, 2020 chart note that, because  
he ordered an MRI in March 2020, it was clear that the worker had mentioned suffering a  
“whiplash” type injury at work when he saw her at that time. However, as was noted by  
Dr. Galbraith and by the review officer, the purpose of the MRI, as set out in the MRI report, was  
not to review the worker’s neck symptoms. Rather, it was to investigate the concerns  
documented on March 9, 2020, the day before the worker identified that she was also having  
issues in her neck. I note that, in the September 26, 2021 medical opinion he provided in  
31  
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Tel: (604) 664-7800 | 1-800-663-2782  
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WCAT Decision Number:  
A2102306 (July 25, 2022)  
response to Dr. Galbraith’s opinion, Dr. S1 did not address this point. I am satisfied that the  
reason for the MRI was not, as was submitted by the workers’ adviser, to investigate the  
symptoms the worker reported on March 10, 2020. Nor was it ordered because Dr. S1 believed  
the worker may have sustained an acute neck injury. Rather, it was ordered to investigate the  
symptoms the worker reported on March 9, 2020, which did not include symptoms in her neck.  
[107] I acknowledge that, commencing on December 20, 2020, Dr. S1 has expressed the opinion that  
the worker sustained a soft tissue or “whiplash” injury on February 17, 2020. However,  
notwithstanding that he was provided with an opportunity to respond to Dr. Galbraith’s  
observation that there were no documented objective findings supporting that the worker had  
sustained an acute soft tissue injury, Dr. S1 did not provide evidence of any such findings. I  
accept that, since being advised by the worker on December 20, 2020 that she had reported to  
him on March 10, 2020 that she sustained a whiplash injury to her neck at work on February 17,  
2020, Dr. S1 has accepted that this report was made. However, I find it unlikely that Dr. S1’s  
recollection is accurate. First, as noted above, it is the worker’s sworn evidence that she was  
able to recall the date of injury only with the benefit of hindsight in April or May 2020, long after  
the March 10, 2020 consultation. Also, Dr. S1’s recollection of why he did not record the  
worker’s report of injury is very different than the reason the worker provided. Rather than  
stating that he did not record a work injury because the worker asked him not to do so, he  
attributed the omission to the fact that, as is often the case, he has trouble following the  
worker’s story. It is apparent that Dr. S1’s current firm belief that the worker sustained a  
whiplash injury on February 17, 2020 is not based on a direct recollection of the worker having  
told him on March 10, 2020 that she did so but, instead, is based on the fact that, since initially  
advising him on December 20, 2021 (two days after the initial denial of her claim) that she did  
report this injury, the worker has consistently told him the same story.  
[108] In addition, I acknowledge that, in her submissions, the workers’ adviser pointed out that Dr. M’s  
January 6, 2021 report indicates that the worker sustained a whiplash injury as a result of the  
February 17, 2020 workplace incident. However, the January 6, 2021 report (which is the first  
report to the Board in which both a February 17, 2020 injury and the mechanism of injury is  
mentioned) was based solely on the worker’s self-report. There is no indication Dr. M had ever  
seen the worker before and, as he practices in a different clinic that Dr. S1 and the worker’s  
other healthcare providers, he would not have had access to the worker’s documented prior  
medical history at the time he completed the report. More importantly, the report does not  
include any clinical findings to support the presence of the identified whiplash injury.  
[109] Finally, I acknowledge the submission by the workers’ adviser that, because of the COVID-19  
pandemic, the worker’s ability to get a diagnosis and to seek medical treatment was affected.  
However, the evidence does not support this submission. Within the several months following  
February 2020, the worker participated in telephone or in-person consultations with Dr. S1 on  
March 9, 10, 20, and 25 and May 21, 2020, was able to undergo very timely imaging for  
investigation of the concerns in her arms (March 18, 2020 MRI), saw her chiropractor on  
32  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
March 17, 2020, saw Dr. Splawinski on March 30 2020, saw Dr. B on May 21, 2020, and  
consulted with a locum for Dr. S1 on May 22, 2020. All of these consultations occurred prior to  
the first documented report of an injury to her neck at work and the first indication that she may  
have sustained a new acute injury in recent months. I am satisfied that there was ample  
opportunity for one or another of these practitioners to document a report of injury and to  
document the presence of objective signs of an injury to the neck. The absence of such  
documentation fully supports Dr. Galbraith’s opinion that the evidence does not support that the  
worker did sustained a new injury to her neck on February 17, 2020.  
[110] I find insufficient positive evidence to support that the worker sustained an injury to her neck on  
or about February 17, 2020. I conclude that it is not at least as likely as not that the worker  
sustained a personal injury to her neck arising out of and in the course of her employment on or  
about February 17, 2020.  
[111] In light of this conclusion, it is not necessary to reconcile the differences in the evidence  
regarding the mechanism of injury, including regarding the date of the reported work incident,  
the location and timing of the electric volt feeling, and the nature of neck movement involved.  
Did the worker fail to report an injury to her employer as soon as practicable, and if so, is her  
claim barred by section 149 of the Act?  
[112] Section 149(2) of the Act imposes an obligation on workers to report any injury to their employer  
as soon as practical after its occurrence. Section 149(5) of the Act provides that a failure to  
meet this requirement is a bar to compensation unless certain conditions are met. These  
conditions include consideration of whether the employer has been prejudiced by a delay in  
reporting and whether the interests of justice require that the claim be allowed.  
[113] As noted, both parties addressed the matter of whether, in the worker’s situation, the worker is  
barred from compensation by reason of section 149 of the Act. In summary, the worker submits  
that there were valid reasons for the delay in reporting her injury to the employer and that the  
employer was not prejudiced by the delay. The employer submits that it would have been  
practicable for the worker to report her injury on at least February 19 or 25, 2020, that the  
employer has been prejudiced by the substantial delay in reporting, and that the current case is  
analogous to the situations addressed in WCAT Decision A2002402 and WCAT Decision  
A2101207.  
[114] Given my conclusion that the worker is otherwise not entitled to acceptance of her claim, it is not  
necessary to address this matter and I make no findings regarding the application of section 149  
of the Act to the worker’s claim for compensation.  
33  
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Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102306 (July 25, 2022)  
Conclusion  
[115] I deny the worker’s appeal and confirm the Review Division’s October 19, 2021 decision.  
[116] I conclude that the worker did not sustain a neck injury, including an aggravation injury, arising  
out of and in the course of her employment on or about February 17, 2020.  
[117] There has been no request for reimbursement of appeal expenses. Therefore, I make no order  
in that regard.  
Deirdre Rice  
Vice Chair  
34  
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