Case snapshot
At a glance
- Case
- Can WSIB Deny Ongoing Benefits After Maximum Medical Recovery?
- Court / Tribunal
- Workplace Safety and Insurance Appeals Tribunal
- Citation
- 2026 ONWSIAT 929 ↗
- Date
- August 14, 2026
- Area of law
- Employment Law
- Key issue
- Whether a worker was entitled to benefits for left shoulder tendinosis and a C5-C6 disc bulge, to ongoing benefits and a NEL award after the March 1, 2019 date of maximum medical recovery, to LOE benefits from October 30, 2018 because offered modified duties were unsuitable, and to a psychological assessment.
- Outcome
- The Tribunal allowed the appeal in part, granting entitlement to left shoulder tendinosis and LOE benefits from October 30, 2018 to March 1, 2019, while denying entitlement for the cervical disc bulge, ongoing benefits beyond MMR, a NEL award, and a psychological assessment.
- Why it matters
- The decision shows how WSIAT weighs contemporaneous clinical notes against later testimony, and how a worker can win LOE benefits for unsuitable modified duties while still losing ongoing entitlement after maximum medical recovery.
Legal principle
The rule from this case
Under the Workplace Safety and Insurance Act, 1997, an accident includes a chance event (an identifiable unintended event that causes an injury) and a disablement arising out of and in the course of employment. WSIAT applies the significant contribution test to causation: the accident must be a factor of considerable effect or importance, though not necessarily the only cause. Where imaging shows degenerative changes, the decision-maker looks at whether the evidence shows a mechanism of injury traumatic enough to have caused them. In this decision, the Vice-Chair found the compensable strains and shoulder tendinosis had reached maximum medical recovery without permanent impairment, and that the worker's later pain came from a degenerative neck condition that was not compensable. On that finding, ongoing entitlement after the MMR date and a NEL award were denied, even though the worker still had pain.
Important limits
What this does not mean
This decision does not mean that degenerative findings on an MRI automatically defeat a WSIB claim. The Tribunal expressly granted entitlement to left shoulder tendinosis, finding that the absence of prior treatment and the mechanism of injury made it probable that the accident caused the condition. Each injury and each imaging finding is assessed separately on its own evidence. The decision also does not mean that a return-to-work offer is automatically suitable just because it appears to fall within a worker's documented functional limitations on paper. The Tribunal found the October 2018 modified duties unsuitable because the worker's actual experience performing them — worsening pain requiring an emergency room visit — was supported by medical evidence from the treating and consulting physicians during that period. A theoretical match between job tasks and a Functional Abilities Form is not the end of the analysis.
What Does WSIB Mean by Maximum Medical Recovery?
Maximum medical recovery (MMR) is the point at which the WSIB determines that a compensable injury has healed as much as it is expected to, and further improvement is unlikely. What happens to benefits after that depends on the evidence in the claim. In Decision No. 767/26, 2026 ONWSIAT 929 (CanLII) (https://www.canlii.org/en/on/onwsiat/doc/2026/2026onwsiat929/2026onwsiat929.html), the Tribunal confirmed an MMR date of March 1, 2019, with full recovery and no permanent impairment, for the worker’s hand, wrist, shoulder, and neck strains and her shoulder tendinosis. It also found that the worker was entitled to LOE benefits from October 30, 2018 up to that date because the modified duties she had been offered were not suitable.
Can WSIB Deny a Claim for a Disc Bulge Found on MRI?
Yes — WSIB can deny entitlement for a disc bulge if the evidence does not show the accident was a significant contributing factor in causing it. Here, the worker’s January 2019 MRI revealed a broad-based disc bulge at C5-C6. The Tribunal reviewed a Medical Discussion Paper confirming that disc bulges are generally degenerative in nature. Crucially, the family doctor’s clinical notes from six days after the accident recorded unexplained left-hand pain that she said had started as a bruise a month earlier, and that she reported no injury or trauma. The Tribunal gave those contemporaneous clinical notes more weight than the worker’s later testimony about sudden onset pain, noted that a December 2018 x-ray already showed prominent degenerative changes, and concluded the accident was not traumatic in a way that would likely cause the disc bulge. Entitlement for the C5-C6 bulge was denied.
When Is a Workplace Injury Considered a ‘Chance Event’ vs. a ‘Disablement’?
A chance event is an identifiable unintended event that causes an injury, while a disablement develops through the work process over time. The decision sets out both definitions in the Act and WSIB policy. On the disc bulge, though, the Vice-Chair did not turn on that label. The question was whether the evidence showed a traumatic mechanism of injury capable of causing the bulge, and the contemporaneous records did not.
What Makes Modified Duties ‘Unsuitable’ Under WSIB Rules?
Modified duties are unsuitable when they actually aggravate the worker’s compensable condition, even if they appear to match the worker’s functional limitations on paper. The employer offered tasks that theoretically stayed within the worker’s documented restrictions. However, the worker testified that the repetitive movements, which required her to twist, worsened her neck and shoulder pain to the point where she ended up in the emergency room on October 29, 2018. Medical reports from that period — including a Functional Abilities Form completed after an October 31, 2018 neurologist visit that indicated no return to work, and a Musculoskeletal Program report recommending no return pending further investigations — supported her account. The Tribunal found the modified duties were not suitable, and granted full LOE benefits, less any amounts already received, from October 30, 2018 to March 1, 2019.
Can a Worker Get WSIB Benefits for Shoulder Tendinosis?
Yes, if the evidence supports a link between the tendinosis and the workplace accident. The Tribunal granted entitlement to left shoulder tendinosis in this case. Although the worker had a single March 2018 clinic note of shoulder and neck pain, about five months before the accident, there was no ongoing treatment for that issue and no evidence of a prior rotator cuff condition. An ultrasound performed after the accident showed left shoulder tendinopathy, and the January 2019 MRI confirmed mild tendinosis of the rotator cuff tendon. Taken together with the mechanism of injury — forcefully pulling a stuck piece from a machine with a plier — the Tribunal found it probable that the accident caused the tendinosis.
Does WSIB Have to Order a Psychological Assessment?
Not automatically. The worker’s representative argued that indicators in the medical record — including a recommendation for psychological assessment in a 2018 program report and a 2020 family doctor note describing depressed mood — required the WSIB to arrange a formal psychological assessment. The Tribunal disagreed. It noted that the family doctor did not refer the worker to a mental health professional and appeared to be managing symptoms as they arose. The Tribunal found the available evidence did not rise to the level requiring the WSIB to order an assessment, though it returned the question of whether a future assessment is warranted to the WSIB for further review if new evidence emerges.
Questions and Records to Discuss with a Lawyer
- Do you have contemporaneous medical records — such as emergency room notes, physiotherapy reports, or specialist referrals — that document your symptoms close to the date of your workplace accident?
- Were you offered modified duties after a workplace injury, and did those duties actually worsen your condition despite appearing to fit within your stated functional limitations?
- Has the WSIB declared maximum medical recovery for your injury, and do you have medical evidence suggesting your ongoing symptoms are still related to the compensable condition rather than a pre-existing issue?
- Has imaging such as an MRI revealed findings like disc bulges or degenerative changes, and do you have medical opinions linking those findings to the accident?
- Are there indicators in your medical records — such as program assessment recommendations or family doctor notes — that suggest a psychological component to your workplace injury?
If any of these questions resonate with your situation, the details of your own claim will determine what options may be available. Our Ontario employment lawyers can help you understand how WSIB and WSIAT decisions apply to your circumstances. To discuss your situation, contact UL Lawyers at /connect.
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
Not always. It depends on the claim and the medical evidence. In this decision, the Tribunal found the worker's strains and shoulder tendinosis had fully recovered, without permanent impairment, by March 1, 2019, and it limited her LOE benefits to October 30, 2018 to March 1, 2019. Her ongoing pain after that date was attributed to a non-compensable degenerative neck condition.
It can, where the evidence shows the degenerative condition, not the workplace accident, explains the problem. Here the Tribunal denied the C5-C6 disc bulge because the early clinical notes did not describe a traumatic event and an x-ray showed degenerative changes. In the same decision it granted the shoulder tendinosis seen on the MRI, so each finding is assessed on its own evidence.
A NEL award compensates a worker for a permanent impairment caused by a compensable workplace injury. In this case no NEL was granted, because the Tribunal found the compensable injuries reached maximum medical recovery without permanent impairment.