If a specific work-related muscular effort or incident causes or aggravates a hernia, workers are entitled to benefits.
Hernias can result from excessive strain or direct trauma. Types include inguinal, femoral, umbilical, hiatal, and incisional hernias. Inguinal hernias (around the groin) are the most common.
Decision-makers may allow claims for work-related hernias if there is information on file confirming the diagnosis. A decision-maker may consult with WSIB clinical staff to assist in making this determination.
Initial health care
The WSIB pays initial health care benefits to workers if their work
- causes a hernia, or
- aggravates a pre-existing, work-related, or non-work-related, hernia.
If a worker's pre-existing, non-work-related hernia is aggravated through work and the worker elects to have it repaired, decision-makers do not allow benefits for surgery and related lost time unless one of the entitlement criteria (described following) for emergency repair are met.
Decision-makers allow benefits for emergency surgery for both work-related and non-work-related hernias aggravated by work if the hernia is
- incarcerated (irreducible), or
- strangulated (incarceration with compromised blood supply), or
- associated with, or is apt to cause, rupture of the bowel wall.
Lost time benefits
Recovery time - no surgery
Workers usually require no more than one week off work to recover from muscular pain when they do not need surgery.
Time off work before elective surgery
Time off is usually not needed unless the work is strenuous, in which case workers may be off work for up to 2 weeks before surgery.
Recovery after surgery
Recovery may take up to 8 weeks for an uncomplicated repair.
If necessary, a decision-maker may consult with WSIB clinical staff to assist in determining the worker's level of impairment post injury or pre/post surgery for hernia repairs.
Recurrent hernia + new accident = new claim.
If a definite new work-related incident causes a preexisting hernia to recur, decision-makers set up a new claim.
Recurrent hernia + no new accident = original claim.
If workers have a recurrence of a work-related hernia with no new incident, entitlement is considered under the original claim.
Second Injury Enhancement Fund (SIEF)
Decision-makers can consider cost relief for Schedule 1 employers under the SIEF (see 14-05-03, Second Injury and Enhancement Fund (SIEF)) if a worker needs emergency surgery for a pre-existing non-work-related hernia that is aggravated through work.
This policy applies to all accidents on or after November 3, 2008.
This document replaces 15-04-08 dated October 12, 2004.
This document was previously published as:
Workplace Safety and Insurance Act, 1997, as amended
Sections 2(1), 13
#6, October 15, 2008, Page 465