Decision #188/05 - Type: Workers Compensation
Preamble
An Appeal Panel hearing was held on November 1, 2005, at the request of a worker advisor, acting on behalf of the worker. The Panel discussed this appeal on November 1, 2005.Issue
Whether or not the worker's current mental health difficulties are related to the compensable injury of July 16, 2003.Decision
That the worker's current mental health difficulties are related to the compensable injury of July 16, 2003.Decision: Unanimous
Background
On July 22, 2003, the worker contacted the call centre at the Workers Compensation Board (WCB) to report a left thumb injury that occurred at work on July 16, 2003.The Employer's Accident report dated July 16, 2003, indicated that an unknown object punctured the worker's thumb and that the puncture wound produced blood. The object that punctured the thumb was not found.
On July 16, 2003, the worker attended a hospital emergency facility and she was diagnosed with "? [questionable] needle stick injury."
On August 19, 2003, the worker advised a WCB adjudicator that she was going to go to a medical clinic as she thought she needed a booster shot for hepatitis but she found out that she did not need one. The worker stated that she did not attend any doctor other than the hospital on July 16, 2003. The worker indicated that she was very ill due to the medication she was prescribed and that she had to take the prescription for 28 days. The worker stated she was returning to work on August 22, 2003. The adjudicator told the worker that she should have attended a doctor to authorize her time loss but the worker said she was not aware she had to do this. The adjudicator advised the worker that she was authorizing time loss benefits.
On September 22, 2003, the worker informed the WCB that she was having problems with her return to work, i.e. was feeling stressed, anxious, teary, etc. and was given the names of two psychologists by the employer's health nurse. The worker felt her stress was due to her thoughts about getting another needle stick injury and the potential consequences.
A Doctor's First Report showed that the worker was treated on August 25, 2003 for complaints of nervousness, nausea, crying spells, sleep difficulty and diarrhea. The diagnosis rendered was "needle prick R hand. Anxiety state."
In a letter dated October 4, 2003, a psychologist reported that he saw the worker on September 18 and 29, 2003. The worker was diagnosed with Post Traumatic Stress Disorder (PTSD) because of her work related injury.
On October 24, 2003, the worker returned to work on a graduated basis and to full time work effective April 5, 2004. The WCB accepted responsibility for the worker's time loss during this period.
On September 28, 2004, the worker informed the WCB that there had been several incidents at work that caused her to experience stress and anxiety. In a letter to the WCB dated October 6, 2004, the worker provided further details of the incidents that caused her stress.
In a letter dated October 1, 2004, the treating psychologist outlined his position that the worker's current problem was related to a series of events, which occurred at work that reminded the worker of the July 2003 incident.
On October 21, 2004, the worker was advised of the WCB's position that the stress she was experiencing did not meet the WCB's criteria for an acute reaction to a traumatic event. The adjudicator indicated that the worker's job was considered stressful in nature and that the events, which occurred between April 2004 and September 2004, contributed to her stress but were not solely related to the accident of July 16, 2003.
Subsequent to the above decision, a report was received from the treating psychiatrist dated October 6, 2004. The psychiatrist indicated that the worker's diagnosis continued to be PTSD and these were "recurrent symptoms".
On November 3, 2004, the adjudicator advised the worker that the report from the psychiatrist did not provide new information to allow the WCB to change its earlier decision.
In a submission dated January 10, 2005, a worker advisor contended that the worker was entitled to benefits under WCB policy 44.20.60, Psychological Conditions as the worker had been diagnosed with recurrent PTSD, directly related to her original workplace injury.
Prior to rendering a decision, Review Office asked a WCB psychiatric consultant to review the file and to provide a response to several questions. The consultant's response to Review Office is dated February 14, 2005.
On February 17, 2005, Review Office confirmed that the worker's mental health difficulties were not causally related to the compensable injury of July 16, 2003. In reaching this conclusion, Review Office stated, in part, that the worker's occupation was stressful in nature and that the incidents which occurred subsequent to April 6, 2004 were not unusual in the course of her job duties. Review Office also considered the opinion expressed by the WCB's psychiatric consultant that the worker's present psychological difficulties were "multifactorial" and were not causally related to the compensable injury. On June 27, 2005, the worker advisor appealed Review Office's decision and an oral hearing was arranged.
Reasons
This case involves a worker who has been diagnosed with PTSD. Her entitlement to worker's compensation benefits is governed by The Government Employees Compensation Act (GECA) and The Workers Compensation Act (the Act) to the extent it is incorporated in the scheme for federal workers.The Panel was asked to determine whether the worker's current mental health difficulties are related to the compensable injury of July 16, 2003. For the appeal to succeed, the Panel must find that the worker's mental health condition is related to her compensable accident. The Panel did find that a direct relationship exists.
Evidence and Argument at Hearing
The Panel reviewed the claim file and the evidence provided at the oral hearing. The worker attended the hearing with a worker advisor who made a presentation on her behalf. The worker answered questions posed by the Panel.
The worker advisor's submission noted that the worker's original symptoms included nervousness, nausea, crying spells, difficulty sleeping with an anxiety state and an inability to function. She stated that these symptoms are still evident. She referred to the opinions of the worker's treating psychiatrist and psychologist who agree upon a diagnosis of PTSD.
Regarding a return to work, the worker testified that "Just driving up to the actual building causes anxiety." She stated that she cannot return to work in this field. She advised that she started working in another field in 2005. She advised that she found it upsetting to hear her representative talk about the events surrounding her injury at the hearing.
Analysis
The Panel finds, on a balance of probabilities, that the worker suffers from PTSD which is directly related to her compensable injury of July 16, 20003. The Panel notes there had been a continuity of symptoms and treatments for this condition. The Panel finds that this case meets the requirements of the GECA and the Act.
In arriving at this conclusion the Panel accepts and relies on the opinion of the worker's treating psychiatrist set out in a report dated October 2, 2004:
The Panel also notes that the worker's treating psychologist supports this diagnosis and its relationship to the worker's employment."It is quite explicit that Ms. [the worker] has suffered from a resurgence of her original symptoms which have resulted in her present occupational impairment. This illness has arisen in the course her work.
The traumatic experience that she suffered in the course of her occupation has caused her serious psychological harm."
The worker's appeal is allowed.
Panel Members
A. Scramstad, Presiding OfficerA. Finkel, Commissioner
M. Day, Commissioner
Recording Secretary, B. Miller
A. Scramstad - Presiding Officer
(on behalf of the panel)
Signed at Winnipeg this 14th day of December, 2005