Executive Summary: Key Legal and Evidentiary Issues

• Dispute centered on whether Ms. LeBlanc’s shoulder condition was a temporary exacerbation or a compensable aggravation of a pre-existing condition.

• Tribunal preferred medical findings from an independent assessment team over those of treating physicians.

• Interpretation of section 7 of the Workers’ Compensation Act was key, particularly regarding compensation for exacerbated pre-existing conditions.

• Evidence supported that her condition—osteoarthritis—was not caused by a workplace injury and had resolved.

• Tribunal applied Commission policies distinguishing between temporary and permanent worsening and found no objective evidence of aggravation.

• Court of Appeal upheld the Tribunal’s legal interpretation and evidentiary findings, dismissing the appeal without costs.

Background and factual history

Ms. Yvette LeBlanc began experiencing increasing shoulder pain while working in December 2020. She filed a workers’ compensation claim on April 19, 2021, which was accepted on August 20, 2021. Her treating physician, Dr. Massé, initially provided a provisional diagnosis of frozen shoulder (capsulite rétractile). On August 31, 2021, Dr. Massé noted she had severe shoulder pain, could not lift her arms, and was unable to work. An MRI performed on September 1, 2021, reported mild capsulitis and mild tendinopathy in the left shoulder, and moderate findings consistent with capsulitis in the right.

Orthopedic surgeon Dr. Frenette diagnosed a frozen right shoulder in a report dated September 2, 2021. Surgery was performed on March 8, 2022, involving arthroscopy, acromioplasty, and bursectomy. Postoperative reports in May 2022 showed some improvement through physiotherapy, though Ms. LeBlanc was hesitant to move her shoulder due to pain. A follow-up MRI on July 13, 2022, found no evidence of capsulitis but did reveal severe osteoarthritis in the right shoulder.

Subsequent medical opinions began to challenge the initial diagnosis. Dr. Matthew Landry, a consulting physician for the Commission, concluded in a July 14, 2022 report that her symptoms were better explained by myofascial pain and highlighted behavioral factors such as pain avoidance. A second MRI on July 17, 2022, showed only mild osteoarthritis of the acromioclavicular joint, without mention of capsulitis.

On October 24, 2022, orthopedic surgeon Dr. Fawaz reported ongoing pain and suggested persistent capsulitis. However, Ms. LeBlanc’s restored range of motion within two days of a local analgesic injection raised doubts. A comprehensive independent medical examination was conducted by Health Solutions Canada and summarized in a January 26, 2023 report. The expert panel found no evidence of capsulitis and instead concluded that her symptoms were due to pre-existing osteoarthritis, temporarily worsened by work activity.

Dr. Sheehan, an orthopedic surgeon on the panel, emphasized that her condition was not caused by a specific workplace injury and did not qualify for compensation. The examination concluded that her symptoms aligned with osteoarthritis, supported by MRI evidence, and her shoulder’s rapid improvement post-injection was inconsistent with frozen shoulder.

On February 27, 2023, Dr. Massé participated in a call with Dr. Barry (from Health Solutions Canada) and acknowledged that arthritis was the source of pain, temporarily exacerbated by work but now resolved. He also expressed concern that Ms. LeBlanc perceived her disability as more severe than what was clinically supported. A follow-up letter from Dr. Barry summarizing the discussion was confirmed as accurate by Dr. Massé.

Based on this, Ms. LeBlanc’s loss of earnings benefits were terminated, as she was deemed fit to return to work with accommodations. She appealed this decision to the Workers’ Compensation Appeals Tribunal.

Policy and legal discussion

The Tribunal’s analysis focused on section 7 of the Workers’ Compensation Act, R.S.N.B. 1973, c. W-13. Under subsection 7(1), a worker is entitled to compensation for personal injury by accident arising out of and in the course of employment. Subsection 7(5) allows compensation if a workplace accident aggravates a pre-existing condition, provided it was not previously disabling.

Policy 21-101 outlines the distinction between:

• Aggravation: a permanent worsening of a pre-existing condition due to work.

• Exacerbation: a temporary worsening due to work activity.

Policy 21-113 establishes the standard of proof as the balance of probabilities—whether it is more likely than not that the workplace incident caused the disability.

Ms. LeBlanc claimed that her condition was a permanent aggravation resulting from her employment and that the Tribunal failed to apply the correct legal standard. She requested that the Commission reopen her claim retroactively to May 10, 2023.

Tribunal and appellate court outcomes

The Tribunal concluded that her condition was a temporary exacerbation of osteoarthritis that had resolved, not a permanent aggravation warranting continued benefits. It gave greater weight to the independent medical evidence from Health Solutions Canada, which included MRI findings and expert opinions rejecting the frozen shoulder diagnosis. Dr. Massé’s own acknowledgment during the February 2023 call reinforced this conclusion.

The New Brunswick Court of Appeal reviewed the case under the correctness standard for legal interpretation, as established in Canada (Minister of Citizenship and Immigration) v. Vavilov, 2019 SCC 65. The Court found the Tribunal properly interpreted section 7 and correctly applied Commission policies. It emphasized that the Tribunal considered contradictory evidence and made a reasoned determination based on the preponderance of evidence.

The Court dismissed the appeal on May 29, 2025, and, consistent with longstanding practice in workers’ compensation matters, made no award of costs.