Marcus thought the worst was behind him. After five years of fighting with WCB and finally getting the shoulder surgery he needed, he was ready to move forward. His back injury had stabilized, the shoulder reconstruction was successful, and he was back to work in his family’s trucking business. Then came the phone call that changed everything again.
“I’ve got this severe tendinitis in my left shoulder,” Marcus told his advocate. “The doctor says it’s from overusing my good shoulder while the right one was injured. Now I need physiotherapy and possibly more treatment.”
Marcus’s story illustrates one of the most misunderstood aspects of workers’ compensation: secondary injuries. When your original workplace injury leads to new problems, you may be entitled to coverage for these additional conditions under your existing claim. But many injured workers don’t know their rights, and WCB doesn’t always volunteer this information.
What Exactly Is a Secondary Injury?
Under WCB Alberta Policy 02-01, Part II, a secondary injury is a condition that develops as a direct consequence of your original compensable injury. The key test is simple: would this new injury have occurred if your original workplace injury had never happened? If the answer is no, then you likely have a secondary injury that should be covered under your existing claim.
The Appeals Commission has consistently supported this principle. In Decision No. 2006-578 (2006 CanLII 78858), they accepted an overuse syndrome in both wrists and arms, noting that “these physical activities can contribute to the development of overuse syndrome” and placing “greater weight on the opinion of the worker’s treating physician, who supports a relationship between the workplace activities and the development of the bilateral hand/forearm overuse syndrome.”
Secondary injuries aren’t limited to physical conditions. The Appeals Commission has also recognized psychological injuries that develop as a result of chronic pain and disability from the original injury, acknowledging that mental health consequences can flow directly from physical workplace injuries.
The Overuse Phenomenon: When Compensation Creates New Problems
Marcus’s shoulder tendinitis represents one of the most common types of secondary injuries: overuse of the uninjured side. When you can’t use one part of your body normally, you naturally compensate by relying more heavily on other parts. This compensation is not only normal but necessary for daily functioning.
Consider what happens when you injure your dominant shoulder. Suddenly, simple tasks like dressing, cooking, or even brushing your teeth require creative solutions. Your non-dominant arm, which previously handled lighter duties, now bears the full load of daily activities. Over weeks and months, this increased demand can lead to overuse injuries in the previously healthy limb.
WCB Alberta has accepted numerous cases of this type. A worker with a fractured right wrist who develops tendinitis in the left hand from overuse. A construction worker with a knee injury who develops hip problems on the opposite side due to altered gait patterns. A nurse with a back injury who develops shoulder problems from using mobility aids.
In 2014-0730 (Re) (2014 CanLII 66981), the Appeals Commission accepted an overuse injury where a worker developed problems in her right arm “because of overuse of her right arm because she has a weakened left arm.” The Commission noted that the worker’s “current problems have resulted from the overuse of her right arm” and that this overuse was directly related to her compensable injury.
The medical evidence in these cases typically shows a clear timeline: the secondary symptoms develop after the original injury, during the period when compensation was necessary. There’s usually no other trauma or explanation for the new condition. Most importantly, medical professionals can establish that the overuse pattern was the most likely cause of the secondary injury.
Injuries During WCB-Approved Treatment and Rehabilitation
Another category of secondary injuries involves complications or new injuries that occur during WCB-approved treatment or rehabilitation. These situations can be particularly frustrating because they happen while you’re actively trying to recover from your original injury.
Imagine you’re attending physiotherapy for a back injury when you slip and fall in the clinic, injuring your shoulder. Or perhaps you develop an infection following WCB-approved surgery. Maybe you suffer an adverse reaction to medication prescribed for your compensable injury, resulting in gastric ulcers or other complications.
Under Policy 02-01, Part II, these injuries should generally be accepted as secondary to your original claim. The rationale is straightforward: you wouldn’t have been in that physiotherapy clinic, undergoing that surgery, or taking that medication if not for your original workplace injury.
The Appeals Commission addressed this principle in Decision No. 2021-0562 (2020 CanLII 123154), where they considered whether injuries that occurred during the recovery period from a compensable injury should be accepted as secondary injuries. The Commission noted that “second injuries may be compensable if they occur as a direct result of WCB-approved medical or rehabilitation treatment for a compensable injury, or as a result of the weakened limb or failure of a prosthesis or appliance related to a compensable injury.”
However, WCB sometimes resists these claims, arguing that the new injury was caused by an “intervening event” unrelated to the original injury. This is where proper documentation and legal argument become crucial. The key is establishing that the activity during which the injury occurred was a direct result of your need for treatment or rehabilitation from the original injury.
When WCB Tries to Deny Secondary Injury Claims
Not all secondary injury claims are straightforward, and WCB may resist acceptance in certain situations. Understanding their common arguments can help you prepare a stronger case.
WCB often denies secondary injury claims when they believe too much time has elapsed between the original injury and the secondary condition. They may argue that the new injury is unrelated (i.e. intervening cause) or the product of normal wear and tear rather than compensation from the original injury. In these cases, medical evidence becomes critical. You need clear documentation showing the timeline of symptom development and medical opinion linking the secondary condition to your original injury. Make sure there’s a paper trail to prove continuity.
Another common denial occurs when WCB argues that the secondary injury resulted from activities outside the scope of reasonable recovery behavior. For example, if you injure yourself while participating in recreational sports during your recovery period, WCB might argue this was an unrelated new trauma rather than a secondary injury.
Pre-existing conditions also complicate secondary injury claims. WCB may argue that your secondary condition was simply the progression of an existing problem rather than a new injury caused by compensation. This is where baseline documentation becomes important. If you can show that the secondary condition represents a significant change from your pre-injury status, you strengthen your case considerably.
Building a Strong Secondary Injury Case
If you believe you’ve developed a secondary injury, taking the right steps early can make the difference between acceptance and denial of your claim.
First, report the secondary condition to WCB as soon as you become aware of it. Don’t wait for it to become severe or for someone else to suggest it might be related to your original injury. Early reporting creates a clear timeline and demonstrates that you’re not trying to retroactively connect unrelated conditions.
Second, ensure your medical providers understand the potential connection between your secondary condition and your original injury. Many doctors focus on treating the immediate problem without considering the broader context of your workplace injury. Ask your doctor to specifically address whether your secondary condition could be related to compensation or overuse from your original injury.
Third, document the functional impact of your original injury on your daily activities. Keep a record of how you’ve had to modify your activities, what tasks have become difficult, and how you’ve compensated for your limitations. This documentation helps establish the logical connection between your original injury and any secondary conditions that develop.
Fourth, gather evidence about your pre-injury status regarding the secondary condition. If you’re claiming a secondary shoulder injury, for example, evidence that your shoulder was previously healthy strengthens your case that the current problem is truly secondary rather than a progression of existing issues.
The Appeals Process: When WCB Says No
If WCB denies your secondary injury claim, don’t assume the decision is final. The Appeals Commission has been quite supportive of legitimate secondary injury claims, often overturning WCB denials when the evidence supports a causal connection.
The Appeals Commission applies the same “balance of probabilities” standard used for original injury claims. They don’t require scientific certainty about causation, just that it’s more likely than not that your secondary condition resulted from your original injury.
In preparing an appeal, focus on the causal chain connecting your original injury to the secondary condition. This might involve demonstrating how your original injury limited your function, how you necessarily compensated for those limitations, and how that compensation led to the secondary condition. Medical evidence supporting each link in this chain strengthens your appeal significantly.
The Commission also considers the foreseeability of the secondary injury. Conditions that are natural and predictable consequences of the original injury are more likely to be accepted. Overuse injuries, for example, are highly foreseeable when someone has limited function in one limb.
Practical Steps for Injured Workers
If you’re currently dealing with a workplace injury, there are steps you can take now to protect your rights regarding potential secondary injuries.
Stay aware of how your injury affects your daily functioning and how you’re compensating for limitations. If you notice new aches, pains, or problems developing in other parts of your body, don’t ignore them. Consider whether they might be related to how you’re compensating for your original injury.
Also maintain open communication with your healthcare providers about all aspects of your recovery, not just the original injury site. If you develop new symptoms, make sure they’re documented in your medical records along with any potential connection to your original injury.
Next, keep WCB informed about your overall condition, not just the status of your original injury. If secondary issues develop, report them promptly and request that they be considered under your existing claim. And don’t hesitate to seek professional help if you’re unsure about your rights or if WCB denies a secondary injury claim. The rules around secondary injuries can be complex, and having experienced advocacy can make a significant difference in the outcome of your claim.
The Bigger Picture: Why Secondary Injury Coverage Matters
Secondary injury coverage isn’t just about individual claims; it reflects the fundamental principles underlying workers’ compensation. The system is designed to provide full compensation for work-related injuries and their consequences. When secondary injuries go unrecognized or uncovered, injured workers bear the financial and physical burden of complications that flow directly from their workplace injuries.
Marcus’s case illustrates why this matters. After five years of fighting for proper treatment of his original injury, he now faces additional treatment and potential time off work for a condition that developed solely because of how he had to compensate for his workplace injury. Without secondary injury coverage, he would face the full cost of this additional treatment and lost wages, despite the clear connection to his original workplace injury.
The recognition of secondary injuries also encourages proper early treatment and rehabilitation. When workers know that complications and secondary conditions will be covered, they’re more likely to seek appropriate care and follow through with treatment recommendations. This ultimately leads to better outcomes and lower long-term costs for the system.
Understanding your rights regarding secondary injuries empowers you to advocate effectively for comprehensive care. Your workplace injury may have started with a single incident, but its effects can ripple through your life in ways that weren’t immediately apparent. Knowing that you have rights to coverage for these secondary effects helps ensure that you receive the full compensation and care that the workers’ compensation system was designed to provide.
