Decision #196/06 - Type: Workers Compensation
Preamble
This appeal deals with the causal relationship between the worker’s ongoing psychiatric condition and his compensable injury of November 14, 2004.
On November 14, 2004, the worker was involved in a motor vehicle collision which left him with post traumatic stress disorder (“PTSD”) and a major depressive episode. His claim for compensation was accepted by the Workers Compensation Board (“WCB”) who paid benefits until April 25, 2006, at which time the WCB considered the worker recovered. This decision was upheld by Review Office. It is this decision that the worker appealed to the Appeal Commission.
A review was held on October 24, 2006. The worker provided a written submission in support of his appeal. No submissions were provided by the accident employer.
Issue
Whether or not the worker is entitled to wage loss benefits beyond April 25, 2006.
Decision
That the worker is not entitled to wage loss benefits beyond April 25, 2006.
Decision: Unanimous
Background
Reasons
Background
On November 14, 2004 while driving truck, the worker was involved in a motor vehicle collision which resulted in a fatal injury to the other driver. The worker was subsequently diagnosed with PTSD and a major depression which was accepted by the WCB as a compensable injury.
Following an October 31, 2005 medical report from the worker’s treating psychiatrist noting a subjective report of no depressed mood or anxiety symptoms and remission of the worker’s recurrent major depressive disorder and PTSD, the causal relationship between the worker’s ongoing symptoms and his workplace accident was explored.
On March 1, 2006, a WCB psychological advisor examined the worker. A report dated April 11, 2006 outlines his findings. Of particular note is the worker’s reported self-decrease in medication since the summer of 2005, lack of psychiatric counselling, difficulties with sleep or reduced activity level, infrequent thoughts about the workplace accident, absence of easy-startle response, absence of PTSD and significant depressive symptoms but the presence of mild residual depressive symptoms. There is also a report of confidence in driving. Based on this examination it was the WCB psychological advisor’s opinion that the worker had no symptoms suggestive of symptomatic PTSD. He did find residual depressive symptoms that he thought were likely associated with a pre-existing chronic depressive disorder. He added that given the worker’s history, his risk of continuing depressive symptoms was high. For this reason, he recommended maintaining antidepressive pharmacotherapy. He thought that the worker could return to work gradually but that this return to work should be monitored to ensure against symptom exacerbation.
The worker did not, however, return to work. Nor did he remain on antidepressive pharmacotherapy. Rather, he continued to decrease his medication in favour of a course of homeopathic supplements.
A later report of April 28, 2006 from his family physician records ongoing depressive symptoms with reduced concentration and mental function. The family physician was not certain if the depression was related to the WCB claim.
The WCB psychological advisor reviewed this report. He reiterated his opinion that the worker was able to return to work. He thought that the worker might be having a recurrence of his recurrent depression secondary to stopping his medication.
On April 18, 2006, the WCB advised the worker that he was considered fit to return to work and that his wage loss benefits would cease effective April 25, 2006.
Worker’s Position
The worker says that he has still not recovered from the effects of his compensable injury. He says that he continues to have symptoms of PTSD. He points to feelings of being cornered, avoidance of social situations, loss of interest, feelings of detachment, restricted emotions, difficulties sleeping and concentrating and an exaggerated startle response.
Analysis
To accept the worker’s appeal we must find on a balance of probabilities that the worker’s ongoing complaints are related to the compensable injury and that he was not fit to return to his regular employment. We are not able to make those findings.
Indeed, the worker’s reported ongoing symptomatology is consistent with what was reported to the WCB psychological advisor. The WCB psychological advisor also had an opportunity to see the worker and assess his demeanour, as did the worker’s treating psychiatrist in October 2005 and his treating physician in April 2006. None of these medical practioners found symptoms consistent with a diagnosis of PTSD. What was found was residual symptoms of depression. We place more weight on the diagnosis of the medical practioners than that of the worker given their medical expertise.
We have turned our minds as to whether the worker’s ongoing reported symptoms of depression are related to the compensable injury. Once again the medical reports indicate that the worker’s major depression had resolved by October 2005 and that the worker was left with residual depression. We find that there is a lack of medical evidence to suggest that the worker’s residual depressive symptoms are causally related to the workplace accident.
Based on the foregoing, we find that it is more likely than not that the worker was not suffering from the effects of his PTSD or accident-related depression as of April 25, 2006 and that he was therefore fit to return to his regular employment. We therefore find that the worker is not entitled to wage loss benefits as of that date.
Accordingly, the worker’s appeal is denied.
Panel Members
L. Martin, Presiding OfficerA. Finkel, Commissioner
M. Day, Commissioner
Recording Secretary, B. Kosc
L. Martin - Presiding Officer
(on behalf of the panel)
Signed at Winnipeg this 13th day of December, 2006