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Background information for consultation issues

We welcome your responses to the discussion questions set out in the Consultation Paper. Listed below is the background information for your review.

We encourage you to provide input on any other changes you think would improve the system overall, including identifying potential leading practices in other jurisdictions that could be adopted in Manitoba

The Workers Compensation Board (WCB) adjudicates psychological injury claims using the definition of “accident” under The Workers Compensation Act (the “Act”) and WCB Policy 44.05.30, Adjudication of Psychological Injury Claims (the “Policy”) found here.

To receive compensation for any claim, a worker must have suffered an “accident” that arose “out of and in the course of employment.” A worker’s accident arises out of their employment when employment related activities or exposures cause the accident. A worker’s accident arises in the course of their employment when it occurs at or during work.

“Accident” is defined in section 1(1) of the Act as:

  • a chance event occasioned by a physical or natural cause,
  • a wilful and intentional act that is not the act of the worker, or
  • an event or condition, or a combination of events or conditions, related to the worker’s work or workplace, that results in personal injury to a worker, including an occupational disease, post-traumatic stress disorder or an acute reaction to a traumatic event.

Section 1(1.1) of the Act specifically excludes certain events and acts from the definition of accident, including:

  • any change in respect of the employment of a worker, including promotion, transfer, demotion, lay-off or termination; and
  • any event or condition, or combination or events or conditions, that results in mental stress unless:
    1. the mental stress is an acute reaction to a traumatic event, or
    2. the presumption regarding post-traumatic stress disorder at section 4(5.8) applies.

The Policy clarifies how the WCB decides whether a claim for a psychological injury not arising from a physical injury, is compensable.

Following the Policy, the WCB considers “acute reaction” to refer to the severity of the response to a traumatic event, whenever it occurs. “Acute” does not necessarily mean immediately following the event. This means that a claim for psychological injury may be compensable even where time has passed between the traumatic event and onset of a psychological injury.

Psychological injuries may be caused by a traumatic event, or cumulative series of traumatic events, related to a worker’s work or workplace.

The Policy defines a traumatic event as an identifiable physical or psychological occurrence which:

  • takes place in a “discrete” (specific) time frame;
  • is not a series of minor occurrences; and
  • is reasonably capable of causing serious physical or psychological harm consistent with an acute reaction.

Under the Policy, traumatic events include:

  • events involving direct exposure to actual or threatened violence or harm at a specific time and place; or
  • workload over a prolonged period of time that is excessive or unusual in intensity.

The Policy offers guidance on how these claims are decided including those claims for excessive workload, bullying, or harassment.

It can be difficult to determine a connection between a worker’s injury and their employment in cases involving a psychological injury. The government made changes to the Act in 2015 to make it easier to establish a causal connection between a workplace event and post-traumatic stress disorder (PTSD) as described in the current Diagnostic and Statistical Manual of Mental Disorders (DSM).

The Act contains a presumption for claims arising from PTSD. Under the Act, PTSD must be presumed to be an injury from an accident that arose out of an in the course of employment, when:

  1. a worker is exposed to a traumatic event(s) of a type specified in the DSM as a trigger for PTSD;
  2. the events are related to the workers’ work or workplace; and
  3. the worker was diagnosed after 2015 with PTSD by a physician or psychologist.

This presumption can be rebutted by evidence that the workplace events are not the cause of the worker’s PTSD.

The PTSD presumption applies to all workers; it is not limited to specific occupations.

Occupational disease is defined by The Workers Compensation Act (the “Act”) as:

  • a disease prescribed by regulation as an occupational disease, or
  • any other disease, other than an ordinary disease of life, that is attributable to causes or conditions that are
    • peculiar to or characteristic of a particular trade or occupation, or
    • peculiar to the particular employment.

Occupational diseases can be frequently attributed to both work-related and non-work-related factors. This makes it difficult to establish a causal connection between a disease and the worker’s employment. Due to this difficulty, occupational disease claims in Manitoba are decided using a different standard of causation than claims for other injuries. Standard of causation is the legal standard that is applied to determine whether an injury or illness is caused by work.

In Manitoba, all other claims are currently determined using the “but for” standard. A WCB decision maker must be satisfied that a worker’s injury would not have occurred “but for” employment related factors. The “but for” test means that work activities or exposures must have been necessary for the worker’s injury to have occurred; however, they do not need to be the only or even the primary cause.

When the WCB adjudicates occupational disease claims, however, section 4(4) of the Act requires the WCB to apply the “dominant cause” standard. The dominant cause standard requires that work must be the dominant or principal cause of a worker’s disease, not just a necessary one.

In 2022, the Act was amended to include section 4(4.1) that made it easier to establish a causal connection between occupational diseases and work. Shortly after, the Occupational Diseases Regulation was created based on consultation with stakeholders. The regulation consists of two columns. The first column lists occupational diseases. The second column lists industries, trades, or processes that are linked to the corresponding occupational disease.

Section 4(4.1), together with the Occupational Diseases Regulation, creates a presumption of dominant cause in relation to certain occupational diseases. If a worker is diagnosed with an occupational disease in column 1 of the Occupational Diseases Regulation, and was employed in an industry, trade, or process listed in the opposite column in relation to that disease, the worker’s employment must be presumed to be the dominant cause of the worker’s disease, unless the contrary is proven. 

If a worker makes a claim for compensation due to an occupational disease that is not listed in the Occupational Disease Regulation, the claim is adjudicated on a case-by-case basis using the dominant cause standard.

The Workers Compensation Act (the “Act”) provides for several benefits to workers or their dependants in the case of fatality claims. Set out below is a brief description of benefits that may be available to workers or their dependants if a claim is accepted. More information on benefits can be found on the WCB’s site located here.

The Act sets out maximum dollar amounts for the benefits described below. On January 1 of each year, the WCB indexes benefit dollar amounts, and the maximum annual earnings level, set out in the Act. The WCB adjusts the benefit amount set out in the Act to account for inflation. The amounts set out below reflect the benefit amounts for 2026.

  1. Wage Loss

The WCB compensates workers for their loss of earning capacity while they recover from a workplace injury or illness. Loss of earning capacity is the difference between a worker’s net average earnings before the date of injury and their net average earnings after the injury.

In most situations, the wage loss benefit rate is based on 90% of a worker’s take-home pay (net pay). Wage loss benefits for injuries or recurrences that happened on or after January 1, 2022, are subject to a maximum earnings cap. The maximum for 2026 is $171,500.

A worker’s wage loss benefit rate is 100% of their net pay if their earnings fall below minimum annual earnings ($33,280 as of October 1, 2025).

The WCB uses a worker’s earnings before the injury to calculate their average gross earnings. Once gross earnings are established, the WCB reduces the gross earnings by probable deductions and tax credits to calculate net earnings. It does this because WCB benefits are not considered to be taxable income.

Probable deductions include estimated amounts for Canada Pension Plan (CPP), Employment Insurance (EI) and income tax. The WCB does not contribute to CPP or EI on behalf of the worker.

In calculating the probable amount of income tax payable, the WCB will consider the worker’s estimated deductions for basic personal amounts, spouse or common-law partner amounts, dependant children, childcare expenses, and spousal support payments.

  1. Medical Aid

Section 27 of the Act authorizes the WCB to fund medical aid, as the WCB considers necessary, to cure or provide relief from an injury resulting from an accident.

“Medical aid” is defined in the Act as including:

(a) transportation to a hospital or other place where medical care can be given,

(b) services provided by a hospital or other health care facility,

(c) treatment or services provided by a health care provider,

(d) diagnostic services,

(e) drugs, medical supplies, orthotics and prosthetics,

(e.1) academic or vocational training and rehabilitative assistance, and

(f) any other goods and services authorized by the board;

While the WCB determines medical aid on a case-by-case basis, the WCB has developed a policy in relation to the payment of medical aid (Policy 44.120.10 located here) that sets out general principles regarding a worker’s entitlement to it.

Medical aid includes vocational training and rehabilitative assistance. Vocational rehabilitation is intended to help a worker achieve maximum physical, psychological, economic, and social recovery from the effects of a work-related injury or illness. WCB’s Policy 43.00, Vocational Rehabilitation (located here), sets out the terms and conditions of academic, vocational, and rehabilitative assistance available to a worker under the Act.

  1. Permanent Impairment Benefits

Under sections 4(9) and 38 of the Act, the WCB may compensate a worker for an impairment suffered as a result of an accident. Impairment is defined in the Act as “a permanent physical or functional abnormality or loss, including disfigurement, that results from an accident.” This benefit is separate and apart from wage loss benefits.

The WCB calculates impairment benefits by determining a rating that represents the percentage of impairment as it relates to the whole body. The determination of impairment ratings is set out in the WCB Policy 44.90.10 and its related schedules which can be found here.

  1. Fatality Benefits

The Act provides benefits to a worker’s spouse, common law partner, dependants, or estate if a worker dies because of a workplace injury. The amount of each benefit is tied to the year of death. The amounts set out below represent the benefit that would be payable if a worker died in 2026. 

Death Benefit

Section 28(2) of the Act provides a lump sum benefit to cover expenses like burial, cremation, memorial services, and other incidental expenses related to death. The death benefit amount if a worker dies in 2026 is $16,140.

Fatal Lump Sum Benefit

The Act provides for a lump sum payment to a worker’s spouse, common law partner, or estate. The fatal lump sum benefit in 2026 is $104,840.

Benefits Payable to Spouse or Common Law Partner

In addition to the death benefit and fatal lump sum benefit, a worker’s spouse or common law partner may be entitled to additional benefits. These benefits include:

  • A monthly payment equal to 90% of the deceased worker’s net average earnings before the date of death (less any amount payable to any other dependant(s)) that is generally payable for a period of five years or until their youngest child turns 18. Special provisions apply to spouses or common-law partners over the age of 60.
  • In some cases, the WCB may provide a spouse or common law partner with vocational rehabilitation services to help them enter the workforce or increase their participation in the workforce to become self-sufficient.
  • There are provisions of the Act that apply to a spouse or common law partner who is over the age of 50 or is an invalid and where the worker’s death would result in undue hardship. In this case, the Act allows an extension of monthly benefits in lieu of the fatality lump sum benefit set out above.

Benefits Payable to Children or other Dependant’s

Children or other dependants of a deceased worker may be entitled to monthly benefits under the Act:

  • A monthly payment of $580 to each child of the worker who is under the age of 18.
  • A monthly payment of $580 to each child of the worker who is over the age of 18, where:
    • The child is applying themselves, to the satisfaction of the WCB, in a course of study that is acceptable to the WCB, and
    • does not have a university degree and has not completed a course in technical or vocational training.
  • A monthly payment of $1,150 to a child who is an orphan or becomes an orphan within one year of the death of a worker if the child is under 18, or over 18 and continuing education subject to the same requirements set out in the bullet above.
  • A monthly payment of $580 to a dependent not listed above.

Monthly benefits payable to children or other dependants are subject to a maximum amount depending on the year of death. 

  1. Retirement Annuities

The intent of a retirement annuity is to assist workers with their retirement income which may be adversely affected by a work-related injury or illness. Generally, the annuity is payable at the earlier of age 65, or when the WCB determines that a worker has retired from the workforce, but not before age 55.

Retirement annuities are available only after a “qualifying period” under the Act. The qualifying period is a total period of 24 months during which a worker receives wage loss benefits.

The WCB invests the following percentage of future wage loss benefits into an annuity:

  • Where employer’s contribution rate before the accident was 5% or less, the difference between 5% and the employer’s contribution rate after the qualifying period;
  • Where employer’s contribution rate before the accident was more than 5% but did not exceed 7%, the difference between the employer’s contribution rate before the accident and the employer’s contribution rate after the qualifying period; or
  • where the employer’s contribution rate before the accident was more than 7%, the difference between 7% and the employer’s contribution rate after the qualifying period.

Workers may elect to make contributions to the fund of any percentage up to the same percentage the WCB contributes.

  1. Group Life Insurance

Workers are automatically covered by the WCB group life insurance plan if the workplace injury occurred on or after January 1, 1992, and if the worker died after receiving wage loss benefits for more than 24 months following the injury. Life insurance coverage is available to workers who are receiving wage loss benefits at the time of their death, or who die within 90 days after their last day of receiving wage loss benefits.

This benefit is not available to a worker if they have an active life insurance plan through their employer at the time of their death. WCB group life insurance is still available to a worker who has additional private carrier life insurance policies.

The life insurance benefit payable depends on the year in which the worker dies. The 2026 rates are:

  • $16,140 if the worker is not survived by a dependant; and
  • $62,900 if the worker is survived by a dependant.

Dependant is defined by the Act as

“those members of the family of a worker who were wholly or partly dependent upon his earnings at the time of his death or who, but for the incapacity due to the accident of the worker would have been so dependent, but a person shall be deemed not to be partially dependent upon the earnings of another person unless he was dependent partially on contributions from that other person for the provision of the ordinary necessaries of life.”

Workers are entitled to select their own healthcare provider to obtain treatment and medical care that supports recovery from their injury or illness. The WCB, however, has the authority under the medical aid provisions of the Act to determine the necessity and nature of medical care provided to a worker who applies for, or is receiving, workers compensation. 

Medical aid includes, among other things, treatment or services provided by a healthcare provider.

Healthcare providers are defined in the Act as a physician, nurse, dentist, chiropractor, occupational therapist, optometrist, physiotherapist, podiatrist, psychologist, or a member of any other healthcare profession or occupation recognized by the WCB.

The WCB contracts with physicians and other healthcare providers who are consultants to the WCB, known as WCB healthcare advisors. They typically have specialized training in various areas of medicine to enable them to provide the WCB with a broad range of expertise.

The role of WCB healthcare advisors is to provide advice, opinions, and support to WCB decision makers and healthcare provider colleagues in the community. WCB healthcare advisors are not decision makers they can, however, help WCB decision makers understand medical details in a claim file.

The WCB can request medical evidence as part of its fact-finding process at any point during the life of a worker’s claim. WCB decision makers, however, must arrive at their own conclusions about where the weight of the evidence lies.

Under section 21(1) of the Act, a worker who applies for, or is receiving compensation, may be required by the WCB to submit to a medical examination. The WCB may arrange for a medical examination for several different reasons. The opinions and findings of medical examinations help WCB decision makers:

  • determine the nature of the worker’s injury, work-relatedness, the worker’s level of disability or impairments, or appropriate workplace restrictions;
  • determine appropriate return to work activities that take into account the worker’s functional abilities and limitations;
  • expedite the worker’s access to treatment; or
  • determine the necessity and nature of any medical aid provided to the worker.

The WCB has the power to suspend benefits of a worker who fails to attend a medical examination without a justifiable reason, or who obstructs a medical examination, until the examination takes place.

The WCB generally exercises this legislative authority by initially requesting that workers attend an examination conducted by a WCB healthcare advisor. These examinations include prior review of any relevant medical records submitted to the WCB, and a physical examination if applicable.

The WCB may also request a worker attend a similar medical examination conducted by a healthcare provider who is not affiliated with the WCB. This is generally done when an opinion from a particular specialty is required.