Document name

Injuries – Following a Work Injury

Document number

POL 22/2025

Secondary injury means a separate and distinct clinically diagnosed injury, disease or condition that occurs as a consequence or complication of an initial compensable work-related injury.

1. The Workers’ Compensation Act, 2013 (the Act) directs that the Workers’ Compensation Board (WCB) has the exclusive jurisdiction to determine (Section 20(2)(a)(b)):
   1. Whether any condition or death was caused by an injury, and
   2. Whether an injury has arisen out of or in the course of employment.
2. Upon WCB approval, a worker entitled to benefits under the Act is also entitled to (Section 103):
   1. Any medical aid that may be necessary as a result of the injury,
   2. Any other treatment by a health care professional,
   3. Any prosthetic or apparatus that may be necessary as a result of the injury, and
   4. Any transportation or sustenance occasioned by the medical aid.
3. The WCB may take any necessary measures to assist injured workers with their recovery and return to work process (Section 111).
4. The WCB supports the functional rehabilitation model, which encourages health care providers and workers to recognize that successful long-term recovery is associated with returning an injured worker to functional activities relevant to their life, including returning to work, during the recovery period.

1. A worker is entitled to benefits (e.g., earnings loss, allowances, expenses) and treatment if their injury arises out of and in the course of employment (POL 16/2025, Arising Out Of and In the Course Of Employment).
2. A worker may sustain an injury, disease or condition secondary to their initial work-related injury. The WCB considers a compensable secondary injury to be an injury which has arisen out of and in the course of a worker’s employment.
3. The WCB will:
   1. Collect all available and relevant information to use as evidence to make, or help make, a decision,
   2. Make a decision based on the facts (merits and justice) of each claim. Decisions are not bound to follow any prior claim decisions or legal precedent,
   3. Resolve the issue in favour of the worker when evidence in support of both sides of an issue is approximately equal (POL 02/2019, Decision Making).
4. To promote a worker’s overall recovery, a secondary injury shall be integrated as part of the worker’s recommended health care treatment plan or individualized vocational plan (IVP) (POL 03/2024, Continuum of Care).

Consequence or Complication of an Initial Work-Related Injury

5. The WCB considers there to be a parallel between an injury arising out of and in the course of employment and a secondary injury that occurs as a consequence or complication of an initial compensable work-related injury.
6. Examples of a secondary injury may include, but are not limited to:
   1. Complications arising from a surgery for a work-related injury,
   2. Depression resulting from a prolonged or difficult recovery,
   3. Side effects of medication prescribed for a work-related injury, and
   4. An injury caused by failure of an appliance or prosthetic device prescribed for a work-related injury, provided the failure is not due to improper maintenance, misuse, or neglect by the worker.
7. The WCB will determine whether it is more likely than not (i.e., standard of proof) the effects of an initial work-related injury caused or contributed to the occurrence of a secondary injury.
8. For psychological symptoms that result from a worker’s initial work-related physical injury or occupational disease, the WCB will determine if there is a verifiable history of psychological symptoms connected to the initial work-related injury (POL 12/2025, Psychological Injuries – General Injury Presumption (Section 27)).
9. The costs of a drug treatment program may be covered if it is determined that an addiction or dependency resulted from medication prescribed for the treatment of a work-related injury.

Travel or Treatment for Medical Aid or Vocational Programming

10. For injuries that occur as a result of travel or treatment for medical aid or vocational programming, the WCB considers there to be a parallel between:
    1. Travel for the purposes of employment and travel for medical aid or vocational programming as required by a work-related injury, and
    2. Injuries that occur in the course of employment activities and those that happen on the premises where medical aid or vocational programming is being received for a work-related injury.
11. The WCB will provide coverage for injuries arising in the course of travel for medical aid or vocational programming when the worker is:
    1. Injured while being transported from the work site to a hospital or other place of treatment immediately after a work-related injury,
    2. Travelling for medical aid in an ambulance or air ambulance,
    3. Travelling for medical aid outside of the worker’s home community, or
    4. For vocational programming, pre-authorized a WCB travel allowance to travel outside their home community.
12. The WCB will not provide coverage for injuries arising in the course of travel for medical aid or vocational programming when:
    1. The medical aid or vocational programming is sought within the worker’s home community or
    2. The worker deviates from the most practical and reasonable route of travel.
13. The WCB will provide coverage for injuries sustained on the premises where the worker is attending medical aid or vocational programming for a work-related injury.
14. In accordance with POL 16/2025, Arising Out Of and In the Course Of Employment, the WCB will not provide coverage for injuries sustained on the premises where a worker is attending medical aid or vocational programming when the injury occurs:
    1. Solely from an imported hazard,
    2. While the worker was on, or crossing, public property (e.g., sidewalk, street, public parking area, etc.), or
    3. During rest breaks taken off the treatment or vocational premises for personal activities or personal business (including but not limited to personal shopping, attending a personal appointment, paying bills, or on a parking lot not under the control of the employer or treatment centre).

Pre-Existing Conditions

15. The WCB considers a pre-existing condition to be a non-work-related medical, physical or psychological condition that exists prior to a work-related injury.
16. Entitlement for a secondary injury will not be denied solely due to the existence of a worker’s pre-existing condition. However, the WCB does not assume any responsibility for a worker’s pre-existing condition.
17. The WCB will determine if a secondary injury resulted in either an aggravation or acceleration of a worker’s pre-existing condition (POL 12/2017, Pre-Existing Conditions – Aggravation or Acceleration, will apply).

Permanent Functional Impairment (PFI)

18. A worker may qualify for a PFI award for a secondary injury, even if they would not have qualified for a PFI award because of the initial work-related injury. POL 33/2024, Permanent Functional Impairment (PFI) Awards, will apply.

Cost Relief

19. In accordance with POL 03/2021, Second Injury and Re-Employment Reserve, cost relief may be provided to employers for additional claims costs associated with a secondary injury when:
    1. A secondary injury, disease or condition occurs as a result of a worker’s initial work injury.
    2. An injury arises in the course of travel for medical aid or vocational programming or while undergoing treatment for which the WCB is responsible.