Decision #92/09 - Type: Workers Compensation
Preamble
On June 27, 2008, the worker filed a claim with the Workers Compensation Board (“WCB”) for “stress” that he related to multiple situations that took place over a 3 to 4 month period during the summer of 2006. The worker’s claim for compensation was denied by primary adjudication and Review Office on the grounds that his claim did not meet the WCB’s criteria of an acute reaction to a traumatic event. The worker disagreed with the decision and an appeal was filed with the Appeal Commission through the Worker Advisor Office. A hearing was held on August 12, 2009 to consider the matter.Issue
Whether or not the claim is acceptable.Decision
That the claim is not acceptable.Decision: Unanimous
Background
As noted in the preamble, the worker filed a workers compensation claim for stress which he related to multiple situations that took place at work over a 3 to 4 month period during the summer of 2006. The worker indicated that he did not seek medical attention in 2006 as he thought that a leave of absence would help him sort things out, but when it did not, he decided to see a doctor. His last day at work was March 10, 2008.
When speaking with a WCB adjudicator on July 14, 2008, the worker indicated that there were 3 incidents that occurred over a short duration of time in 2006 and which continued to affect him. In March 2008, his physician recommended that he apply to WCB for stress leave. The worker described 3 specific incidents/events that occurred which required him to perform first aid treatment until an ambulance arrived. The worker said he continued to work after the incidents but noticed a slow and steady decline in his health. He started drinking alcohol and smoked more than usual. He was depressed, could not sleep or eat, he stopped socializing with his friends, was very tired and had to call in sick at work as he did not think he could function. After each incident, the worker indicated that he was offered critical incident debriefing but did not want everyone to know that he was having difficulties with coping so he did not speak to anyone about his ongoing difficulties. The worker indicated that he had an appointment with a psychiatrist in August 2008.
The three incidents/events described by the worker on July 14, 2008 were confirmed by his employer on July 21, 2008.
The WCB obtained from the employer a “Leave Application and Absence Report” signed by the worker on March 4, 2008. It also obtained a report from a psychiatrist dated August 13, 2008 which diagnosed the worker with symptoms of post-traumatic stress disorder (“PTSD”) and major depressive episode.
On October 1, 2008, the worker was advised that his compensation claim did not meet the requirements of a stress claim outlined under The Workers Compensation Act (the “WCA”) or the Government Employees Compensation Act (“GECA”). The adjudicator indicated that to accept a claim for stress, it must meet the criteria of an acute reaction to a traumatic event. The WCB did not accept cumulative incidents for stress. The adjudicator noted that the worker was faced with three traumatic incidents at work in 2006 which were confirmed by his employer. She noted that the worker continued to work after each incident without any time loss, there were no complaints of difficulties to other coworkers or to his supervisor and the worker delayed in seeking medical attention until 2008.
On November 24, 2008, a worker advisor appealed the adjudicator’s October 1, 2008 decision to Review Office. The worker advisor outlined the position that the circumstances of the claim permitted its acceptance as either an accident or an industrial disease within the meanings provided under section 2 and 4(1) of the GECA.
On December 10, 2008, a Review Officer documented a conversation she had with the worker with regard to his claim for compensation. The worker was also interviewed by a WCB psychological advisor and his report is dated January 7, 2009.
On January 22, 2009, Review Office confirmed that the worker’s claim for compensation was not acceptable. Following review of all the evidence, Review Office was unable to establish that the worker’s psychological condition was a direct result of any or all of the three workplace incidents and that his claim did not meet any of the other conditions for acceptance. Review Office indicated that there were other factors thought to be significant in relation to the worker’s psychological condition such as workplace stressors, financial stressors, anticipation of a stressful event (an inquiry) and other situational stressors. It referred to the opinion expressed by the WCB psychological advisor that there was a lack of evidence to support that there was an acute reaction related to any or all of the three workplace events.
On March 25, 2009, the worker advisor appealed Review Office’s decision to the Appeal Commission and an oral hearing was arranged.
Reasons
Applicable Legislation:
The worker is employed by a federal government agency or department and his claim is therefore adjudicated under the GECA. The GECA provides that an employee who suffers a personal injury by an accident arising out of and in the course of employment is entitled to compensation.
Subsection 4(1) of the GECA states:
4(1) Subject to this Act, compensation shall be paid to
(a) an employee who (i) is caused personal injury by an accident arising out of and in the course of his employment; or (ii) is disabled by reason of an industrial disease due to the nature of the employment; …. Pursuant to subsection 4(2)(a) of the GECA, a federal government employee in Manitoba is to receive compensation at the same rate and under the same conditions as a worker covered under the WCA. The definition of accident under the GECA is: “accident” includes a willful and an intentional act, not being the act of the employee, and a fortuitous event occasioned by a physical or natural cause. The definition of industrial disease under the GECA is: “industrial disease” means any disease in respect of which compensation is payable under the law of the province where the employee is usually employed respecting compensation for workmen and the dependants of deceased workmen. Thus, for claims relating to federal employees in Manitoba, the GECA adopts the definition of “industrial disease” as it appears in the WCA. The disease for which compensation is payable under the WCA is termed “occupational disease” rather than “industrial disease”, but the difference in terms is of no consequence. The definition of “occupational disease” as contained in the WCA is as follows: “occupational disease” means a disease arising out of and in the course of employment and resulting from causes and conditions (a) peculiar to or characteristic of a particular trade or occupation; or (b) peculiar to the particular employment; but does not include (c) an ordinary disease of life; and (d) stress, other than as an acute reaction to a traumatic event. Worker’s position The worker was assisted by a worker advisor at the hearing. The position advanced on behalf of the worker was that he developed psychological difficulties related to his involvement in three separate events at work between March 2006 and July 2006. It was submitted that the evidence established the compensability of the worker’s claim either as an accident, within the meaning provided by the GECA, or alternatively as an industrial disease under that Act. Analysis The issue before the panel is whether or not the claim is acceptable. In order for the appeal to be successful, the panel must find that the worker is entitled to compensation pursuant to subsection 4(1) of the GECA because either (a) he was caused personal injury by accident as per subsection 4(1)(a)(i); or (b) he was disabled by reason of an industrial disease as per subsection 4(1)(a)(ii). Based on the evidence before us, the panel is unable to find that there was an accident or an industrial disease within the meaning of the GECA. In making this decision, the panel relied on the following: In the present case, it is not the panel’s impression that the worker was unable to perform his required duties. In fact, he carried out his duties very competently and was found to have reacted properly and appropriately during all three critical incidents. Nevertheless, the panel believes that the job was not one which suited the worker. His personality and disposition did not fit with the culture of the workplace and the panel is of the view that this was what caused his psychological distress. The short term alcohol abuse was caused by job dissatisfaction rather than as a reaction to a fortuitous or traumatic event. As a result, we find that the worker’s claim is not acceptable. The worker’s appeal is denied.
Panel Members
L. Choy, Presiding OfficerA. Finkel, Commissioner
P. Walker, Commissioner
Recording Secretary, B. Kosc
L. Choy - Presiding Officer
Signed at Winnipeg this 5th day of October, 2009