Conditions for Entitlement –Traumatic Mental Stress Policy 21-103 | Effective Date: June 1, 2019

 

Policy

The WC Act excludes mental stress as a compensable condition, except when the disablement of mental stress or a disablement caused by mental stress is the result of an acute reaction to a traumatic event.

A successful claim for mental stress requires three conditions be met:

    • The worker has suffered an acute reaction (injury);
    • The acute reaction was caused by a traumatic event (accident); and
    • The traumatic event arose out of and in the course of the worker’s employment.

For workers diagnosed with PTSD by a qualifying psychologist or psychiatrist, WorkSafeNB does not need to assess whether there was a traumatic event, as the occurrence of a traumatic event is inherent to the PTSD diagnosis. In these cases, WorkSafeNB will only need to determine if the traumatic event arose out of and in the course of the employment.

For emergency response workers covered by the presumptive legislation, when the emergency response worker is diagnosed with PTSD by a qualifying psychologist or psychiatrist, the PTSD is presumed to have arisen out of and in the course of employment unless the contrary is shown.

WorkSafeNB adjudicates all mental stress claims, except claims eligible for the PTSD presumption, using the criteria outlined in Policy 21-100 Conditions for Entitlement – General Principles and Policy 21-104 Conditions for Entitlement – Tests of Time, Place, and Activity.

Interpretation

  1. In determining whether the event and the exposure to an event is traumatic, WorkSafeNB uses the most recent American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).
  1. Medical information plays a key role in determining if the mental stress is compatible with the work-related traumatic event that caused it. To be compensable, medical information must show that:
    • The sudden and unexpected traumatic event was significant enough to have caused an acute reaction;
    • The acute reaction could have reasonably caused the psychological or psychiatric condition described;
    • The psychological or psychiatric condition is a mental or physical condition that is described in the most recent American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders at the time of diagnosis; and
    • The psychological or psychiatric conditions must be diagnosed by a psychologist or psychiatrist, who is registered with the appropriate regulatory body in the province in which they work.
  1. A worker may be exposed a single traumatic event or multiple traumatic events. WorkSafeNB recognizes that, in some cases, there may be a delayed onset of symptoms.
  1. Normal work pressures or decisions of the worker’s employer relating to the management and monitoring of the worker’s employment do not qualify as a traumatic event.
  1. WorkSafeNB applies the legislated PTSD presumption for workers if:
    • They are an emergency response worker on or after June 28, 2016 and have a PTSD diagnosis by a psychiatrist or psychologist;
    • They were an emergency response worker when they submitted a claim, and the diagnosis of PTSD by a psychiatrist or psychologist was made on or after June 28, 2016; or
    • They cease to be an emergency response worker on or after June 28, 2016 and they are diagnosed by a psychiatrist or psychologist with PTSD within 24 months of their retirement from emergency response work.

 

Workers’ Compensation Act (RSNB 1973, c W-13)

7(1), 7(2), 7(2.1), 7.1(2), 7.1(3), 7.1(4), 34(1), 34(2) and 34(4)

Case Law 

D.W. v WHSCC and Via Rail Canada Inc., 2005 NBCA 70(CanLII)

Hébert v. Workplace Health, Safety and Compensation Commission et al., 2017 NBCA 43 (CanLII)

Perry v. Workplace Health, Safety and Compensation Commission et al., 2018 NBCA 80 (CanLII)

Accident – includes a wilful and intentional act, not being the act of a worker, and also includes a chance event occasioned by a physical or natural cause, as well as a disablement caused by an occupational disease and any other disablement arising out of and in the course of employment, but does not include the disablement of mental stress or a disablement caused by mental stress, other than as an acute reaction to a traumatic event (WC Act).

Diagnostic and Statistical Manual of Mental Disorders – a compendium of psychiatric diagnoses produced by the American Psychiatric Association. The manual codes and describes all recognized psychiatric diagnoses and is seen as the definitive work on the subject (The Canadian Health Care Glossary).

Disablement – a limitation in movement, senses or activity (adapted from Oxford Dictionary).

Emergency Response Worker – means a firefighter, paramedic or a police officer (7.1(1) of the WC Act).

Firefightera person who is employed or serves as a firefighter with a municipality or rural community or who serves as a firefighter with a fire brigade that provides fire protection services in a local service district or in a rural community (Firefighters’ Compensation Act).

Paramedic – a person who met the qualifications and who is registered as a paramedic with the register (An Act Respecting the Paramedic Association of New Brunswick).

Police Officera police officer and an auxiliary police officer, but does not include a member of the Royal Canadian Mounted Police or an auxiliary police constable (Police Act).

Post-traumatic Stress Disorder (PTSD) – means post-traumatic stress disorder as that condition is described in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association (WC Act).

Presumptionfinding of a basic fact that gives rise to the existence of presumed fact until the presumption is rebutted (adapted from Black’s Law Dictionary).

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