A Case Study in Workers’ Compensation Advocacy
Appeals Commission Reinstates TTD Benefits for Office Manager Wrongly Declared Fit for
Alternative Work
2026 CanLII 15652 (AB WCAC)
I. Introduction
At Blue Collar Consulting, we see a recurring and troubling pattern in upper extremity injury cases: WCB declares a worker fit for alternative employment based on a narrow, theoretical analysis of job tasks, while ignoring the broader medical reality of what the worker can actually do in daily life. This is the story of an office manager whose injuries to both arms and her right shoulder were accepted as compensable — but whose Temporary Total Disability benefits were terminated on the basis that she could perform alternative work. The reality was that she needed help getting in and out of bed, help getting dressed, help brushing her hair, could not drive, and was managing disrupted sleep and ongoing pain. She was not fit for alternative work. She was not fit for much at all without assistance. We appealed, and the Appeals Commission reinstated her TTD benefits in full, effective December 6, 2023.
This case is a direct challenge to WCB’s practice of declaring fitness for alternative work based on unsupported assumptions rather than a full and honest engagement with the medical record. A fitness finding must be grounded in evidence. Where it is not — where it rests on assumptions about what a worker should be capable of, rather than findings about what she actually is capable of — it cannot stand.
II. Background of the Worker’s Case
Our client worked as an office manager — a role that, while not physically intensive in the way of trades or industrial work, nonetheless required functional use of both upper extremities for sustained periods throughout the working day: typing, writing, filing, using a telephone, managing documents. When she sustained accepted compensable injuries to both arms and her right shoulder, the impact on her capacity to perform that work — and indeed to manage the ordinary tasks of daily living — was profound.
The injuries were not minor. They were bilateral, affecting both upper extremities, and involved her dominant shoulder. The combination produced severe and permanent restrictions that permeated every aspect of her physical functioning. She required assistance with getting in and out of bed and the bathtub. She could not dress herself independently. She could not brush her own hair. She could not drive. Her sleep was consistently disrupted by pain, compounding the effects of the injuries on her overall function and capacity.
WCB had initially been providing TTD benefits, recognising that she was unable to work. In December 2023, WCB terminated those benefits on the basis that she was capable of performing alternative work. The termination decision did not engage with the full scope of her functional limitations. It did not grapple with what the evidence showed about her daily living restrictions. It rested instead on unsupported assumptions about what someone with her profile of injury should theoretically be capable of doing. Blue Collar Consulting was retained to challenge that decision.
III. The Fitness for Alternative Work Dispute
- WCB’s Position
WCB’s termination of TTD was premised on a finding that our client could perform alternative work — meaning some form of employment that accommodated her restrictions. The basis for that finding was not clearly anchored in the medical evidence. WCB had not demonstrated that the available alternative work was actually performable given the full scope of her restrictions, nor had it engaged adequately with the evidence of her daily living limitations.
The core problem with WCB’s position was its failure of engagement. A fitness-for-alternativework finding requires a genuine assessment of what the worker can do, matched against the demands of proposed alternative employment. What WCB produced instead was a conclusion that appeared to assume residual capacity without establishing it through the evidence. The IME that WCB relied upon had confirmed severe permanent restrictions in both upper extremities and acknowledged that any return to work would require no meaningful use of the arms and reduced hours. That is a very narrow and demanding set of parameters — and WCB had not demonstrated that the alternative work it identified actually met them.
- Blue Collar’s Advocacy
We appealed the DRDRB’s confirmation of WCB’s decision to the Appeals Commission. Our case was built around two interlocking arguments. First, WCB’s fitness finding was not supported by the evidence. The medical record, read in its entirety, did not support a conclusion that our client was capable of sustained alternative employment. Second, WCB had failed to engage with the broader medical record — in particular the evidence of daily living limitations — before arriving at its conclusion.
We led with the daily living evidence because it was the most vivid and concrete demonstration of our client’s actual functional state. A worker who cannot get out of bed or into a bathtub without assistance, who cannot dress or groom herself, who cannot drive, and whose sleep is chronically disrupted by pain is not a worker on the cusp of returning to alternative employment. These were not minor inconveniences. They were fundamental incapacities that revealed the true severity of her condition in a way that a theoretical analysis of job task compatibility could not.
We then turned to the formal clinical evidence. Functional capacity testing documented the scope and extent of her restrictions in objective terms. Occupational therapy evidence assessed her realworld functional limitations in her home and work environment. Her family physician’s reporting reflected the ongoing and disabling nature of her condition over time. And the IME — which WCB had used to support termination — had itself confirmed severe permanent restrictions in both upper extremities, with any return to work contingent on no meaningful arm use and reduced hours. We argued that if even WCB’s own IME set those conditions, WCB had an obligation to demonstrate that its proposed alternative work actually met them. It had not done so.
- Evidence Considered
- Functional capacity testing documenting the objective scope of our client’s upper extremity restrictions in both arms. This evidence translated clinical findings into concrete assessments of what tasks she could and could not perform, and at what level of effort and duration.
- Occupational therapy evidence assessing her functional limitations in real-world settings, including the home environment. The OT evidence was particularly important in bridging the gap between clinical findings and daily life — demonstrating how the restrictions manifested in the tasks that define independent living and working capacity.
- Family physician reporting documenting the ongoing, persistent, and disabling nature of the injuries across the relevant timeframe. The treating physician’s longitudinal record was essential to establishing that the condition had not improved to the point where alternative work was realistic.
- The IME relied upon by WCB, which confirmed severe permanent restrictions in both upper extremities and stated explicitly that any return to work would require no meaningful use of the arms and reduced hours. We asked the Commission to recognise that these conditions set an extremely narrow window for any alternative work, and that WCB had not demonstrated its proposed alternative fell within that window.
- Evidence of daily living limitations: the need for personal assistance with getting in and out of bed, assistance with bathing, dressing, and hair care, inability to drive, and chronically disrupted sleep due to pain. This evidence grounded the abstract language of restriction ratings in the lived reality of our client’s condition.
- The Decision
The Appeals Commission allowed the appeal in full. The DRDRB decision was reversed and TTD benefits were restored effective December 6, 2023. The Commission found that WCB’s fitness finding was based on unsupported assumptions and had failed to engage with the broader medical record. The evidence of daily living limitations, the functional capacity testing, the OT findings, and the longitudinal treating physician record collectively established that our client was not capable of performing alternative work at the time her benefits were terminated.
The Commission’s decision reinforced a principle that must be applied in every fitness-for-work determination: the finding must be grounded in the full medical record, including evidence of what the worker can and cannot do in her daily life. A theoretical assessment of job task compatibility is not sufficient where the medical evidence tells a different story.
IV. Policy and Legal Context
This case engaged several important principles in Alberta’s workers’ compensation framework relating to TTD benefits and fitness for work determinations.
- TTD benefits and the fitness standard: Temporary Total Disability benefits are payable where a worker is unable to perform her pre-accident employment or suitable alternative employment by reason of the compensable injury. The fitness determination must be based on evidence of actual capacity, not assumptions about theoretical capacity. Where the medical record documents ongoing and significant functional limitations, a fitness finding cannot rest on conclusions that the record does not support.
- The obligation to engage with the full medical record: WCB’s adjudicative decisions must engage with the evidence as a whole. Selectively relying on one element of the record — such as an IME that confirms restrictions but does not address alternative work compatibility in detail — while ignoring the treating physician record, OT evidence, and functional capacity findings is a reviewable error.
- Daily living evidence as a measure of functional capacity: Evidence about a worker’s ability to perform ordinary daily tasks — self-care, mobility, driving, sleep — is directly relevant to fitness-for-work determinations. A worker who requires personal assistance with fundamental daily activities cannot be assumed fit for sustained employment without clear evidence that proposed alternative work is compatible with those limitations.
- The IME as a ceiling, not a floor: Where an IME sets stringent conditions for any return to work — no meaningful arm use, reduced hours — those conditions define the outer boundary of what alternative work is permissible. WCB cannot use an IME to support termination while ignoring the conditions that IME attached to any return. The conditions must be applied, and the proposed alternative work must be shown to meet them.
V. The Broader Implications
This decision has direct implications for workers with bilateral upper extremity injuries and for any worker whose TTD benefits have been terminated on the basis of a theoretical fitness finding.
- 01.Theoretical fitness findings are challengeable: A WCB conclusion that a worker can perform alternative work is not self-executing. It must be supported by evidence. Where it is not — where it rests on assumptions the record does not sustain — it is vulnerable on appeal. Workers who have been declared fit for alternative work despite significant ongoing limitations should not accept that conclusion without scrutiny.
- 02. Daily living evidence belongs in the evidentiary record: Workers and advocates should ensure that the full scope of functional limitations — including what the worker can and cannot do at home, in daily self-care, in mobility — is documented and placed before the Commission. This evidence is not peripheral. It is often the most powerful demonstration of the gap between WCB’s theoretical fitness finding and the worker’s actual condition.
- 03. Bilateral injuries require bilateral analysis: Upper extremity injuries to both arms present particular challenges because they affect the full range of arm-dependent activity. WCB’s fitness analysis in bilateral cases must account for the combined effect of restrictions across both sides. An analysis that treats each arm in isolation and then assumes the worker has adequate residual capacity will often understate the true severity of the combined limitation.
- 04. Use WCB’s own evidence against it: In this case, the IME that WCB relied upon contained conditions for return to work so restrictive that they effectively undermined WCB’s own termination decision. Advocates should read WCB’s medical evidence carefully — often, the most powerful argument against a fitness finding is found within the document WCB used to support it.
VI. Advocacy Lessons
Several advocacy lessons can be drawn from this case.
- Lead with the daily living picture. Abstract restriction ratings and clinical language can distance a decision-maker from the reality of a worker’s condition. Concrete, specific evidence about what a worker cannot do at home — cannot dress herself, cannot get out of bed unassisted, cannot drive — grounds the appeal in a human reality that medical jargon alone cannot convey. Start there.
- Assemble the full evidentiary matrix. Functional capacity testing, OT evidence, treating physician records, and IME findings are each independently valuable. Together, they are far more powerful. A Commission panel that sees consistent findings across multiple sources and disciplines is much more likely to conclude that the evidence is reliable and the restrictions are genuine.
- Read the IME for what it actually says. WCB routinely cites IMEs as supporting fitness for work. Advocates should read those IMEs carefully and identify any conditions, qualifications, or limitations on the return-to-work opinion. Where the IME sets demanding conditions for return, those conditions become part of your case — and WCB must be held to them.
- Name the failure of engagement. In cases where WCB has not addressed significant evidence, the appeal should make that failure explicit. The Commission needs to understand not just that the evidence supports the worker, but that WCB failed to engage with it. That framing — this is not a close call that went the wrong way, this is a decision that ignored the evidence — is persuasive.
- Persist through the full appeal process. The DRDRB confirmed WCB’s decision in this case. The Appeals Commission reversed it. Workers with strong records should not treat a DRDRB confirmation as a final answer. The Commission is an independent tribunal with the authority and the mandate to correct errors in WCB’s adjudication, and it uses that authority.
VII. Conclusion
Our client was an office manager living with severe bilateral upper extremity injuries who needed help with the most basic acts of daily living. WCB declared her fit for alternative work and terminated her TTD benefits. That decision was wrong, and the evidence made it wrong clearly and compellingly. The Appeals Commission agreed, restoring her benefits in full effective December 6, 2023.
At Blue Collar Consulting, we are proud to have built the record and made the arguments that produced this result. The case required assembling a comprehensive evidentiary picture — functional capacity testing, OT evidence, physician reporting, the daily living account, and a careful analysis of what WCB’s own IME actually said — and presenting it in a way that made the error in WCB’s decision unmistakable.
This case is proof that fitness-for-work determinations are not beyond challenge. Where WCB has not engaged with the full medical record — where it has assumed capacity the evidence does not support — the decision can and should be appealed. Workers who have been told they can work, when the reality of their lives says otherwise, deserve an advocate who will take that gap seriously. Blue Collar Consulting is that advocate.