The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The applicant filed a claim with the Criminal Injuries Compensation Board (hereafter the “CICB”), presently known as Compensation for Victims of Crime Program (hereafter the “Program”) on June 27, 1995 for an assault that took place on June 14, 1995. At the time of the assault, The Criminal Injuries Compensation Act (hereafter the “CICA”) was in effect.

In July 2006, the applicant appealed the Program’s decision that his psychological counselling was subject to a financial cap of $2000.00. On August 15, 2006, the Program’s director upheld its decision and relied on CICB policy 4.01 which stated that effective April 1, 1996, there would be a $2000 cap on counselling services. She also made reference to a July 15, 1996 letter from the Assistant Deputy Attorney General to the Chair of the CICB wherein the implementation of the cap for counselling/psychological treatment was discussed. The applicant appealed this decision to the Appeal Commission. On April 26, 2007 a file review was held and the applicant’s submission dated February 4, 2007 was considered.

Issue

Whether or not the victim’s claim under The Criminal Injuries Compensation Act is subject to a financial cap in relation to the provision of psychological counselling services.

Decision

That the victim’s claim under The Criminal Injuries Compensation Act is subject to a financial cap in relation to the provision of psychological counselling services.

Decision: Unanimous

Background

Reasons

As stated in the preamble, the issue before this panel is whether the applicant’s psychological counselling was legally subject to a cap as alleged by the Program. The answer to this query can be found in the legislation that was applicable at the time of the applicant’s application (and which continues to govern his claim to this day) and well as the policies of the CICB.

Subsection 4(1) of CICA provides that the CICB could determine its own procedure. In examining the history of the implementation of the cap relied on by the Program, it appears that the cap was first instituted by the Provincial Government and then adopted by the CICB as Policy.

Indeed, in July 1996, the Provincial Government informed the CICB that it had approved implementation of a maximum amount to be paid for psychological counselling as follows: a maximum hourly rate of $90.00 and a $2000.00 maximum per claim. This direction was effective April 1, 1996. All new cases approved after April 1, 1996 were to be subject to this maximum. All cases with existing counselling agreements were to be honoured and further counselling was to then be subject to the maximum.

Subsequent to this information, the CICB met on February 28, 1997 and approved the following exceptions to the $2,000 cap on counselling as follows:

“Exceptions to the $2000 cap will be granted on a one time only basis and only up to a maximum of an additional $2,000.

Exception A: Employed Victims

Employed victims may receive wage loss benefits in addition to counselling costs. In some situations it may be identified that $2000 of counselling will not be sufficient to deal with the effects of the incident. Additional sessions would be required up to a maximum of $2000 to allow for a return to work and therefore reduce the need to pay continued wage loss benefits.

Exception B: Claimants at Risk

There may be isolated cases where a crisis occurs and the victim is at risk of harming themselves or others. An extension of counselling beyond the $2000 will allow for short term intervention until access to hospital based care can be facilitated.

It is expected that the need to grant an exception of this kind will be rare. In most cases these problems will be identified early in the counselling process and referral to hospital based care or a psychiatrist will be part of the initial counselling plan and expect to be accessed prior to the utilization of the initial $2000.”

Against this backdrop, we find that the statutory and policy framework specifically provide for financial caps which deal directly with the circumstances of the appellant’s case. Neither this panel nor other levels of adjudication are provided with discretion elsewhere in the CICA to override these provisions. As such, adjudicative decisions with respect to psychological counselling are subject to this policy.

The applicant’s appeal is therefore denied.

To be clear, this panel has not considered or ruled on whether the applicant is entitled to any further counselling benefits, as that issue was not before us.

Panel Members

L. Martin, Presiding Officer
A. Finkel, Commissioner
B. Malazdrewich, Commissioner

Recording Secretary, B. Kosc

L. Martin - Presiding Officer

Signed at Winnipeg this 14th day of June, 2007