Case snapshot
At a glance
- Case
- Can a Nurse Get WSIB Benefits for Chronic Pain in Ontario?
- Court / Tribunal
- Workplace Safety and Insurance Appeals Tribunal
- Citation
- 2026 ONWSIAT 932 ↗
- Date
- August 14, 2026
- Area of law
- Employment Law
- Key issue
- Whether a nurse's accepted upper-back and right-arm strains became permanent impairments, whether she was entitled to chronic pain disability or psychotraumatic disability benefits, and whether the WSIB had to pay for a psychological report it had not requested.
- Outcome
- The appeal was allowed in part. The Tribunal granted entitlement under the WSIB's Chronic Pain Disability policy and ordered reimbursement of the May 2022 psychological report under the WSIB fee schedule. It denied ongoing entitlement and a NEL determination for the strains beyond June 22, 2021, and denied ongoing or permanent psychotraumatic disability. Loss-of-earnings questions were referred to the WSIB.
- Why it matters
- A WSIB finding that a physical injury has resolved does not always end the claim. This decision shows the Tribunal recognizing ongoing non-organic pain under the Chronic Pain Disability policy, even where an MRI showed other shoulder findings, and treating related psychological symptoms as part of that pain condition.
Legal principle
The rule from this case
Ontario's workers' compensation system treats non-organic chronic pain separately from organic injury. Under WSIB Policy 15-04-03, Chronic Pain Disability (CPD) entitlement requires five things: a work-related injury occurred; the chronic pain was caused by the injury; the pain has persisted six or more months beyond the usual healing time; the degree of pain is inconsistent with organic findings; and the chronic pain impairs earning capacity, shown by consistent and marked life disruption. Where a worker seeks both CPD and psychotraumatic disability entitlement for the same accident, the decision explains that Tribunal case law requires deciding the predominant nature of the disability. If it is most closely associated with pain that cannot be attributed to organic causes, it is treated as CPD; if it is most closely associated with a psychiatric diagnosis distinct from the pain, it is generally compensated as psychotraumatic disability. In this case the panel found the predominant ongoing disability was CPD.
Important limits
What this does not mean
This decision does not mean that every worker whose physical injury resolves will receive CPD benefits. The panel worked through each criterion on this record, relying on orthopaedic reports that separated the trapezius pain from the MRI findings, a psychologist's diagnosis of somatic symptom disorder with predominant pain, and the worker's uncontradicted testimony. It also noted gaps in the record, including no medical notes of her complaints at the time of the accident, references to an earlier motor vehicle accident that she denied, and a non-work fall in February 2021. It also does not mean privately obtained reports are routinely paid for. Under Policy 17-02-03, an unrequested report is paid only if it is necessary or useful to the decision, and the panel ordered payment here because the psychologist's diagnosis helped establish the non-organic nature of the pain. The decision did not decide whether the worker is owed loss-of-earnings benefits; that question went back to the WSIB.
Can a Nurse Get WSIB Chronic Pain Benefits After Her Injury Heals?
It is possible. In Decision No. 143/26, 2026 ONWSIAT 932 (CanLII), https://canlii.ca/t/knqxb, a three-member panel of the Workplace Safety and Insurance Appeals Tribunal (WSIAT) agreed with the WSIB that a nurse’s work-related strains had resolved by June 2021, but found that her ongoing pain qualified under the WSIB’s Chronic Pain Disability (CPD) policy.
The nurse reported that she was injured on November 23, 2020 while sitting for about 30 minutes wrapping compression wraps around a patient’s legs. The WSIB accepted a disablement accident and recognized myofascial pain in the right interscapular area, right-sided thoracolumbar junction, right upper trapezius and right upper arm. In May 2021 the WSIB found she had fully recovered with no permanent impairment, and an Appeals Resolution Officer (ARO) later found the strains had resolved by June 22, 2021. The WSIB also denied CPD entitlement, psychotraumatic disability entitlement, and payment for a psychological report her lawyer had arranged.
If you have questions about a WSIB claim, our Ontario employment lawyers can help you understand your options.
What Are the Five CPD Criteria?
WSIB Policy 15-04-03 requires that:
- a work-related injury occurred;
- the chronic pain is caused by the injury;
- the pain persists six or more months beyond the usual healing time of the injury;
- the degree of pain is inconsistent with organic findings; and
- the chronic pain impairs earning capacity, shown by consistent and marked life disruption.
The first criterion was not in dispute. The employer’s representative did not dispute that the pain persisted six or more months beyond the usual healing time, and the panel was satisfied there was enough evidence of pain complaints since the accident. The main questions were whether the pain was caused by the injury and whether it was inconsistent with organic findings.
How Did the Panel Deal With the MRI Findings?
The WSIB had denied CPD in part because a June 14, 2022 MRI showed a low-grade partial-thickness tear of the supraspinatus, mild degenerative changes at the AC joint, and a suspected small degenerative labral tear. The WSIB treated these as non-compensable organic problems responsible for her pain. An ARO also found her complaints were not consistent and that a February 2021 non-work fall had aggravated her right shoulder.
The panel said those findings needed nuance. One orthopaedic specialist, Dr. El-Chabib, wrote that the MRI findings “may not necessarily be clinically relevant” given where her pain was, and another, Dr. LeBel, said the tear was “likely not the source of her pain at the moment.” Myofascial pain at the trapezius had been recorded since a January 2021 Occupational Health Assessment Program report and remained an ongoing complaint long after a strain would be expected to resolve. The panel found that the MRI findings were not the cause of her pain complaints and that her chronic trapezius pain was caused by the work injury.
On the fourth criterion, the panel relied on the orthopaedic reporting, a September 2021 report from Dr. Lansing noting inorganic causes for her behaviour, and a psychologist’s diagnosis of somatic symptom disorder with predominant pain. No opinion disputed that her pain was inconsistent with organic findings. For life disruption, it relied on her uncontradicted testimony that the pain affected her sleep, mood, ability to work and activities at home, and on the psychologist’s note of its impact on grocery shopping, driving and work.
Why Was There No Separate Psychotraumatic Disability Award?
The panel found that the predominant nature of her ongoing disability was chronic pain. It noted that the WSIB had allowed secondary entitlement for an adjustment disorder with depressed mood and later found the psychological condition had fully recovered as of May 11, 2021. The panel treated her ongoing psychological symptoms after May 2021 as symptoms of the CPD rather than a psychological impairment distinct from her pain, so it denied ongoing or permanent psychotraumatic disability entitlement.
The decision explains that Tribunal case law requires this predominance analysis when a worker seeks both CPD and psychotraumatic disability for the same accident, and that NEL awards for chronic pain are generally not stacked with awards for organic impairment or psychotraumatic disability arising from the same accident.
Why Did the WSIB Have to Pay for the Psychological Report?
The worker’s lawyer arranged a psychological assessment, and the psychologist’s $800 invoice was sent to the WSIB in June 2022. The WSIB refused to pay, finding the report was not requested and had no value to the adjudication. Under Policy 17-02-03, the WSIB pays for unrequested reports only if the information is necessary or useful for making a decision. The panel found the report useful because its explicit diagnosis helped show that the worker’s pain was non-organic, and ordered reimbursement in accordance with the WSIB fee schedule.
What Happens to Loss-of-Earnings Benefits?
The parties spent time at the hearing on return-to-work issues. The worker said she could not work for a period, and the employer disputed that. Because there was no final WSIB decision on the suitability of modified work offered by the employer or on loss-of-earnings (LOE) benefits flowing from the CPD finding, the panel referred LOE to the WSIB for further adjudication, with both parties keeping their usual appeal rights.
Questions and Records to Discuss With a Lawyer
- Do your medical records show consistent pain complaints in the area of your accepted injury since the accident?
- Has a specialist said whether imaging findings actually explain where your pain is?
- Has a psychologist or psychiatrist given a diagnosis, and does it describe a pain-predominant condition or a separate psychiatric disorder?
- Do you have records of how pain affects your sleep, mood, work, driving and household activities?
- Has the WSIB made a final decision on modified work or loss-of-earnings benefits that you may need to appeal?
If you are dealing with a WSIB decision on chronic pain, a closed claim, or a refused report payment, reach out to UL Lawyers through /connect to discuss your circumstances.
This article is automated commentary on a public court decision and is for general information only — not legal advice. Decisions rely on facts unique to each case. If you are affected by a similar issue, contact a lawyer for advice specific to your situation.
FAQ
Frequently asked questions
It is possible. In this decision the Tribunal agreed that a nurse's work-related strains had resolved by June 2021, but found that her ongoing trapezius pain met the five criteria of the WSIB's Chronic Pain Disability policy (Policy 15-04-03) and granted chronic pain disability entitlement.
Not necessarily. The WSIB relied on a June 2022 MRI showing a low-grade partial-thickness supraspinatus tear and degenerative changes. Two orthopaedic specialists doubted those findings explained her pain, which was centred on the trapezius, and the Tribunal found the MRI findings were not the cause of her pain complaints.
Only in limited cases. Under Policy 17-02-03, a report the WSIB did not request is paid only if the information is necessary or useful for making a decision. Here the Tribunal ordered reimbursement under the WSIB fee schedule because the psychologist's diagnosis of somatic symptom disorder with predominant pain helped show that the worker's pain was non-organic.