Conditions for Entitlement – Traumatic Psychological Injuries Policy 21-103 | Effective Date: December 10, 2025

Policy

The Workers’ Compensation Act (WC Act) excludes mental stress as a compensable condition, except when it is the result of an acute reaction to a traumatic event. When this occurs, the worker may have a compensable traumatic psychological injury (TPI).

A TPI claim is compensable when the worker has:

  • Experienced one or multiple traumatic events that arose out of and in the course of the worker’s employment;
  • Suffered an acute reaction to the traumatic event(s); and
  • Been diagnosed with a psychological or psychiatric condition as a result of an acute reaction to the traumatic event(s).

For emergency response workers covered by the legislated post-traumatic stress disorder (PTSD) presumption, and who have been diagnosed with PTSD, it is presumed, unless the contrary is shown, that the PTSD arose out of and in the course of employment in response to one or multiple traumatic events to which the worker was exposed to in carrying out their duties as an emergency response worker.

Except for those claims eligible for the legislated PTSD presumption, WorkSafeNB adjudicates all TPI claims using the additional criteria outlined in Policy 21-100 Conditions for Entitlement – General Principles.

Interpretation

Determining date of accident

1. For TPIs, WorkSafeNB considers the date of accident to be the date of the reported traumatic event.

2. Where there has been exposure to multiple traumatic events, WorkSafeNB considers the date of accident to be the date of a reported traumatic event that predates diagnosis of the psychological or psychiatric condition.

Determining traumatic event

3. A worker is considered to have experienced a traumatic event when either:

  • The worker is diagnosed with PTSD by a psychologist or psychiatrist who is registered with the appropriate regulatory body in the province in which they work, and WorkSafeNB has confirmed that the diagnosis is consistent with the diagnostic criteria set out in the edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) that is most recent on the date of diagnosis. In this instance, the occurrence of a traumatic event is inherent to the PTSD diagnosis; or
  • The reported traumatic event meets the definition of traumatic event. In making this determination, WorkSafeNB uses the “reasonable person standard”, which considers whether the event qualifies as objectively traumatic without regard to the personal, subjective perceptions of the worker.

4. WorkSafeNB recognizes that, in some cases, there may be a delayed expression of symptoms between the reported traumatic event(s) and the resulting diagnosis of a psychological or psychiatric condition.

Arising out of and in the course of employment

5. To be eligible for compensation, a TPI must be work-related. This means the traumatic event or events must arise out of and in the course of employment. A worker is not entitled to benefits if the traumatic event or events were the result of non-work-related factors.

6. To determine if the event or events were work-related, WorkSafeNB uses an information-gathering model to ensure there is sufficient information to make an informed decision; this includes establishing any evidence to the contrary.

7. WorkSafeNB weighs this evidence, using the preponderance of evidence, meaning that it is more likely than not to have been caused by the worker’s employment. For more information, see Policy 21-104 Conditions for Entitlement – Tests of Time, Place, and Activity and Policy 21-113 Decision-making.

8. For emergency response workers covered by the legislated post-traumatic stress disorder (PTSD) presumption (see section 10), and who have been diagnosed with PTSD, it is presumed to have been caused by the worker’s employment. This presumption may be rebutted if the evidence shows the PTSD was caused by non-work-related factors.

Psychological and psychiatric information

9. Psychological and/or psychiatric information plays a key role in determining if the TPI claimed is compatible with the work-related traumatic event that caused it. To be compensable, the psychological and/or psychiatric information must show that:

  • The traumatic event was significant enough to have caused an acute reaction;
  • The acute reaction could have reasonably caused the diagnosed psychological or psychiatric condition;
  • The diagnosed psychological or psychiatric condition is a mental or physical condition that is described in the edition of the DSM that is most recent on the date of diagnosis; and
  • The psychological or psychiatric condition must be diagnosed by a psychologist or psychiatrist, who is registered with the appropriate regulatory body in the province in which they work.

Legislated PTSD presumption for emergency response workers

10. WorkSafeNB applies the legislated PTSD presumption if the worker:

  • Is an emergency response worker on or after June 28, 2016 and have a PTSD diagnosis by a psychiatrist or psychologist;
  • Was 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
  • Ceased to be an emergency response worker on or after June 28, 2016 and has been diagnosed with PTSD by a psychiatrist or psychologist within 24 months of their retirement from emergency response work.

11. For claims involving the legislated PTSD presumption, the WC Act prescribes that the diagnosis for PTSD will be as that condition is described in the most recent edition of the DSM. Prior to applying the presumption, WorkSafeNB will therefore confirm that the diagnosis is consistent with the diagnostic criteria set out in the edition of the DSM that is most recent on the date of diagnosis.

Previous versions

  • Policy 21-103 Conditions for Entitlement – Traumatic Mental Stress, release 6, effective April 29, 2021
  • Policy 21-103 Conditions for Entitlement – Traumatic Mental Stress, release 5, effective June 1, 2019
  • Policy 21-103 Conditions for Entitlement – Traumatic Mental Stress, release 4, effective March 29, 2017

Authority

Workers’ Compensation Act

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

Case law

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

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

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

New Brunswick Liquor Corporation v. Sauvageau et al., 2020 NBCA 61

 

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 (Workers’ Compensation 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 (Workers’ Compensation Act).

Firefighter – a 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 has met the qualifications for registration as a paramedic and whose name is entered in the register (adapted from the Workers’ Compensation Act, An Act Respecting the Paramedic Association of New Brunswick).

Police officer – a police officer and an auxiliary police officer, but does not include a member of the Royal Canadian Mounted Police or an auxiliary police constable (adapted from the Workers’ Compensation Act, Police Act).

Post-traumatic stress disorder – 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 (Workers’ Compensation Act).

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

Traumatic event - exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways:

  1. Directly experiencing the traumatic event(s).
  2. Witnessing, in person, the event(s) as it occurred to others.
  3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
  4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).

Criterion 4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision).

 

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