Decision #126/17 - Type: Workers Compensation

Preamble

The employer is appealing the decision made by the Workers Compensation Board ("WCB") that the worker experienced a recurrence of her psychological difficulties and was entitled to wage loss and medical aid benefits. A hearing was held on June 1, 2017 to consider the employer's appeal.

Issue

Whether or not the worker experienced a recurrence of her psychological difficulties; and

Whether or not the worker is entitled to wage loss and medical aid benefits.

Decision

That the worker did not experience a recurrence of her psychological difficulties; and

That the worker is not entitled to wage loss and medical aid benefits.

Background

The worker filed a claim with the WCB for stress that started in late November 2013 which she related to being physically abused and harassed by a co-worker at work. Following an investigation into the allegations made by the worker, the WCB accepted the claim and wage loss benefits were paid to December 8, 2013.

On September 18, 2014, a union representative advised the WCB that the worker had been continuously harassed and physically abused by her co-worker since she returned to work in December 2013 and that she was completely off work as of June 2014. The representative requested that the WCB re-open the worker's claim based on a recurrence.

On September 18, 2014, the worker confirmed that she wanted her claim reopened as a recurrence. The worker provided detailed information regarding the events that occurred in the workplace between her and the co-worker since she returned to work. The worker found the co-worker to be very intimidating and she behaved in the same way to others at the workplace. The worker said she reported the co-worker's behavior several times to at least two supervisors and was told not to notify the WCB as they would handle the situation internally. The worker said she sought ongoing medical treatment for stress.

On September 23, 2014, the union representative advised the case manager that she was representing the worker on another WCB claim for carpal tunnel syndrome (CTS) that had been filed on July 4, 2014. The representative noted that the worker was relating her disability and psychological issues beyond June 30, 2014 to work-related stressors, and not to the CTS claim.

In a submission to the WCB dated September 30, 2014, the employer's advocate outlined the belief that the proximate cause of the worker's current disability was in relation to her hand condition on another claim which had been rejected by both primary adjudication and Review Office. The advocate noted that the worker had been instructed to advise her employer if she had any further concerns or issues related to her stress claim. The worker did not do so and she demonstrated her ability to work fully functionally between December 2013 and June 2014, at which time she went off work citing only her hand condition.

On November 14, 2014, Compensation Services advised the worker that based on a review of her claim and consultation with a WCB psychological advisor, there was insufficient evidence to establish a diagnosis and causal relationship between her reported ongoing psychological difficulties and the November 28, 2013 workplace incident.

The WCB case manager noted in the decision that the medical information on file showed that the worker did not attend her family physician for treatment between December 2, 2013 and June 30, 2014. When she attended her family physician on June 30, July 7 and 24, 2014, there were no references to mood or stress. When seen for medical treatment on September 11, 2014, there was no reference made to the workplace incident of November 2013 or any mention of ongoing psychological issues at work.

The case manager noted that she personally interviewed the worker's manager, supervisor, CEO and co-workers and they did not support the worker's contention that she had been exposed to continued abuse and physical assaults after her return to work in December 2013. The documentation on file supported that she was off work since June 2014 due to her CTS condition, with no reference made with respect to her mood or emotional state.

Subsequent to the case manager's decision, new medical information was placed on the worker's file which was reviewed by the WCB's psychological advisor. On April 1 and May 8, 2015, the worker was advised by the case manager that the new information did not alter the original decision. 

On June 23, 2015, the union representative requested a reconsideration by Review Office and outlined the view that the worker's psychological injuries were directly related to the workplace events as evidenced by the medical information on file.

In a submission to Review Office dated July 28, 2015, the employer's advocate said there was no evidence to support that the worker experienced any workplace harassment in the several months preceding her leave from work in June 2014 nor was there any evidence that she experienced a recurrence of her workplace injury. He said there was no basis to overturn the WCB's decision to reject the worker's disability and time loss from work beginning June 2014.

On October 15, 2015, Review Office determined that the worker suffered a recurrence of her compensable injury and that she was entitled to wage loss and medical aid benefits.

Review Office's decision was based on medical information from the family physician dated November 17, 2014, a report from a psychiatrist dated December 5, 2014 and a report dated February 16, 2015 regarding an independent psychological assessment that was carried out on January 9 and 14, 2015. Review Office stated:

…The evidence suggests the worker was vulnerable, and after discussing her work experiences (about her supervisor actions towards her and her mental health), and filing a police report, the Review Office accepts that on a balance of probabilities, this caused a recurrence of her psychological injury. Both of these circumstances caused the worker to relive and heighten her experiences of verbal and physical abuse from her supervisor which gave rise to this claim in 2013. Thus, there was a connection to the original injury.

On January 17, 2017, the employer's advocate appealed Review Office's decision of October 15, 2015 to the Appeal Commission and an oral hearing was held on June 1, 2017.

Following the hearing, the appeal panel requested additional medical information as well as information from the worker's union representative. The requested information was received and was forwarded to the interested parties for comment. On August 3, 2017, the panel met further to discuss the case and rendered its final decision on the issue under appeal.

Reasons

Applicable Legislation and Policy

The Appeal Commission and its panels are bound by The Workers Compensation Act (the “Act”), regulations and policies of the WCB's Board of Directors.

Under subsection 4(1) of the Act, where a worker suffers personal injury by accident arising out of and in the course of employment, compensation shall be paid to the worker by the WCB. Under subsection 4(2), a worker who is injured in an accident is entitled to wage loss benefits for the loss of earning capacity resulting from the accident, but no wage loss benefits are payable where the injury does not result in a loss of earning capacity during any period after the day on which the accident happens.

Subsection 27(1) provides that the WCB may provide the worker with such medical aid as the board considers necessary to cure and provide relief from a work injury.

Subsection 39(1) of the Act provides that wage loss benefits will be paid: "…where an injury to a worker results in a loss of earning capacity…" Subsection 39(2) of the Act provides that the WCB will pay wage loss benefits until such a time as the worker’s loss of earning capacity ends, or the worker attains the age of 65 years.

Policy 44.10.20.50.10, Recurring Effects of Injuries and Illness (Recurrences) provides that "A recurrence is a clinically demonstrated increase in temporary or permanent impairment which results in a current loss of earning capacity, or a relapse of an injury which has been directly related to a previous compensable condition which results in a current loss of earning capacity."

Employer's Position

The employer was represented by an advocate and its CEO. The advocate provided a written submission in advance of the hearing and made a presentation to the panel.

The employer confirmed that the issue under appeal was the acceptance of a recurrence, as opposed to the acceptance of a claim. The employer's position was that there is no evidence that any further harassment occurred after December 2013, and no evidence to support that the worker's disability and time loss beginning June 2014 were due to workplace stress or any work-related psychological condition.

The advocate noted that there was no solid evidence that the alleged harassment in the first place was particularly severe. Having been alerted to potential problems, the employer took the allegations seriously and dealt with them. The worker was off work for a short time starting November 29, 2013, but was comfortable returning to work on December 9, 2013.

It was submitted that the worker was advised, and agreed, to let the employer know if there were any further incidents, and she never reported any further problems to the employer. The only intervening circumstance after December 2013 was the worker's renewed time loss starting in June 2014 due to her CTS.

Further, the worker did not indicate any recurrent psychological issues or workplace harassment prior to the rejection of her CTS claim in July 2014 and appeal in September 2014. Her claim for recurrence was only advanced after her CTS appeal was denied and she had filed a grievance and a police report alleging she had been assaulted.

The advocate submitted that there is no evidence to correlate the worker's disability from June 2014 to the previous 2013 accepted work-related stress claim. The WCB interviewed individuals in the workplace, but none of them were able to corroborate the worker's allegations of ongoing harassment, and their statements directly contradict the worker's allegations. There were no references to mood or stress issues in reports from the treating physician for June and July 2014; and notes for September 11, 2014 refer to the "stresses of life" piling up on her, but do not reference the workplace accident or injury. The WCB psychological consultant was also unable to provide a rationale for relating the compensable injury to the worker's psychological difficulties after June 2014.

In conclusion, it was submitted that the Review Office decision was fundamentally flawed, in that it appears to have been based on a determination that the worker's act of pursuing a claim, after her CTS claim was denied, triggered or caused a recurrence or new psychological problems. In the employer's view, without a continuum of problems at work or workplace harassment, a claim of recurrence which has been triggered by something else cannot be accepted, and the appeal should be allowed.

Worker's Position

The worker was represented by her union advocate at the hearing. The advocate provided a written submission in advance of the hearing and made a presentation on the worker's behalf.

The worker has an accepted claim for a psychological injury which she sustained as a result of harassment and abuse in the workplace. The worker's position was that she was entitled to the benefits she received with respect to a recurrence of her injury in 2014 which was directly related to the workplace trauma she previously endured.

It was submitted that all of the evidence on file suggests that the worker's current and ongoing psychological condition continues to arise directly as a result of the abuse she experienced in the workplace in 2013. Review Office determined that the recurrence occurred in November 2014, and the advocate emphasized that the issue related to what happened in November 2014, as opposed to June 2014.

The advocate submitted that the worker returned to work on December 9, 2013 out of financial necessity, not because she felt safe or better. She later reported that the harassment continued following her return to work, even though she had been assured that it would stop. She managed to continue working for a few months, hoping the abuse would stop, but it did not. While the worker went off work in June 2014 in relation to a progression of her CTS, it was later understood that her loss of earning capacity was due to a combination of the physical pain from her CTS and the mental stress due to the previous harassment. In their view, the physical and psychological injury became inseparable.

The advocate further submitted that regardless of whether the abuse continued after the worker's return to work in December 2013, the evidence supports that she developed a psychological condition as a result of the abuse she had experienced, the effects of which continued after her return to work. She suffered a recurrence of her injury because she was physically injured again, off work and suffering financial stress again, and struggling with her CTS pain, all of which reminded her daily of the physical and emotional abuse she had endured.

The advocate argued that the worker's entitlement to benefits was supported in particular by the December 5, 2014 report by the psychiatrist and the February 16, 2015 and subsequent reports of the independent psychologist. It was submitted that both the psychiatrist and the psychologist accepted the worker's comments as credible, and that this is the best evidence to corroborate that the worker's reports are true and factual. In their view, the psychiatrist and psychologist provided good evidence which supports that there was an ongoing psychological condition that had its roots in the abuse which the worker suffered in 2013.

In conclusion, it was submitted that there was clear and supportive evidence that the Review Office decision was correct, and the appeal should be dismissed.

Analysis

The employer has appealed a Review Office decision that the worker's ongoing psychological difficulties were a recurrence of her November 2013 psychological injury claim. The employer is also appealing the ongoing payment of associated medical aid and wage loss benefits as a result of the recurrence.

For the employer's appeal to succeed, the panel would have to find that the worker's ongoing psychological difficulties were not related to her November 2013 claim. After consideration of the evidence on the file as well as the submissions and evidence at the hearing and acquired subsequently, the panel was able to make this finding, for the reasons that follow.

In our review of the file, the panel notes that a claim of relatively short duration had been filed by the worker on December 12, 2013 for a November 2013 psychological injury caused by the abuse/harassment by a co-worker. By the time the claim had been filed, the worker had already gone off work on November 29 and returned to work on December 9. She continued to work with the employer until June 30, 2014, soon after which a second claim was filed by the worker for bilateral CTS that she attributed to her job duties.

The November 2013 claim remained silent for a time. The first mention on file of a possible recurrence of a psychological injury occurred when the worker's then union representative contacted the WCB on September 18, 2014 to advise that the worker had ongoing psychological difficulties since she left work in June 30, 2014 that she related to continuous harassment by the co-worker. As the file proceeded, the union representative advised the worker to file a police report. Her union representative also requested a one-time assessment by an independent psychiatrist, which took place in November 2014. The worker was then provided with ongoing treatment by a clinical psychologist under the worker's health benefits plan. It was the worker's position that both healthcare professionals support that her ongoing psychological conditions were related to work.

The worker's position at the hearing was that she left work on June 30, 2014 because of her psychological difficulties and not because of the physical difficulties associated with her bilateral CTS conditions, and that the continuity of her condition was later confirmed by her doctor, psychiatrist and psychologist.

A contrasting position was taken by the employer who stated that they had intervened in the workplace in November 2013, and that the worker did not complain further about the co-worker, nor did her co-workers note any ongoing intimidation or harassment between the worker and the specific co-worker in the months following the November 2013 claim. The worker also had not sought medical treatment for psychological issues after December 2, 2013. The employer further stated that the evidence supports that the worker left work on June 30, 2014 because of her physical issues and not her psychological issues, as evidenced by the medical report of her attending physician on that date, and that the gap between the end of treatment on December 2, 2013 and the first report to the WCB on September 18, 2014 of a recurrence is not consistent with the file record.

The panel notes that adjudication of this claim has been complicated by the worker's concurrent WCB claim for bilateral CTS. A review of the CTS claim indicates that the worker reported that her CTS symptoms increased dramatically with a job change in March 2013. The worker continued to work to June 30, 2014 and eventually had surgeries to both wrists. She filed a WCB claim for her bilateral wrist conditions on July 4, 2014 which was originally rejected by WCB primary adjudication and Review Office. That decision was later appealed to and accepted by the Appeal Commission following a hearing which was also held on June 1, 2017. (The facts and background associated with that claim are more fully described in Appeal Commission Decision 107/17). Given the overlap of the two claims, some of the information gathered on the CTS claim is relevant to the appeal at hand.

At the outset, we note that the worker's position relies heavily on the supporting reports of the psychiatrist and the psychologist, as well as the worker's evidence at the hearing. Accordingly, the panel must first determine how much weight to place on those reports, given that:

• The worker had continued to work from December 9, 2013 to June 30, 2014; 

• The interviews by these practitioners took place well after the worker departed from the workplace, with the psychiatric assessment in November 2014 (5 months later) and the first psychological treatment in January 2015 (more than 6 months later). The panel further notes that the medical reports relied heavily on the history and self-reporting by the worker to the healthcare professionals of the prior events. 

• The psychiatrist and psychologist did not receive copies of the worker's WCB file or prior medical reports, and did not undertake any collateral research or interviews, to test the worker's history as to the events of the workplace or the continuity of symptoms.

• A referral letter to the psychiatrist by a non-healthcare professional who was not from the workplace provided extensive details as to what happened at the workplace, which may or may not be factually accurate.

In the panel's view, these factors all have the potential to significantly weaken the value of the psychiatrist's and psychologist's opinions, as their medical opinions can only be as strong as the foundations of fact upon which they rely.

With that in mind, and given the significant time gaps and the issues we have just noted, the panel has turned its attention to the earlier and contemporaneous evidence on file to determine if the histories relied upon by the healthcare professionals accurately reflected events at that time, and more specifically, whether the actual events at that time support the ongoing harassment that the worker asserts had taken place.

The medical reports are quite specific on the types of harassment/abuse that form the basis of their opinions. The medical opinions can be summarized as follows:

The assessing psychiatrist: 

• A December 5, 2014 letter to the worker's union representative summarizes the psychiatrist's November 7, 2014 assessment. It indicates that the assessment had been requested to assist in representing the worker regarding her claims. At the assessment, the worker stated that she was the subject of physical and emotional abuse by her supervisor on a daily basis, and she had to return to work while her psychological claim was pending, without feeling ready. The report notes that the abuse and harassment continued to the point that the worker finally stopped working on June 28, 2014 due to physical and mental decompensation. The worker had reported ongoing extreme anxiety since she had been the subject of abuse. The psychiatrist concluded that the worker suffered significant work-related stresses (both physical and psychological) that led her to leave work in July 2014. The worker was significantly distressed in response to continuous physical assaults and emotional abuse that reportedly occurred in the workplace. It was the psychiatrist's opinion that the work-related stresses, as outlined, played major precipitating and perpetuating roles in the worker's clinical presentation. She also commented that "Generally speaking, no one should or could tolerate the types of abuse [the worker] was enduring."

o In our assessment of the stated history, the panel notes that a July 5, 2017 letter from the current union advocate subsequent to the hearing indicated there was no record of any additional documents being sent to the psychiatrist prior to or following the November 2014 psychiatric examination.

o In the absence of any external documentation or research by the psychiatrist, the panel also notes that a narrative was provided to the psychiatrist in an October 21, 2014 referral letter from a union representative. In the panel's view, this was the only external information available to the psychiatrist. The letter describes the worker as a "victim of harassment, bullying, intimidation and repeated physical assaults in her workplace," later refers to "several months of psychological harassment and physical assaults" and describes a "serious incident" where the worker was "assaulted with a weapon by her Lead Hand, when she rammed a metal cart into her leg." The letter then states that the worker "advises the harassment and physical assaults continued up until she left the workplace in June of 2014," and that "she remains disabled from working."

The treating psychologist: 

• The treating psychologist provided a first report on February 16, 2015 regarding her treatment/visits on January 9 and 14, 2015. The report indicates that the worker recounted an extensive history of abuse by a supervisor, who made her do tasks to intentionally aggravate her sore wrists which exacerbated her CTS to the point she could no longer work. 

o The panel notes that in response to our inquiry subsequent to the hearing, the psychologist wrote that "Given the more focused nature of the initial referral on support and treatment, there was no further secondary investigation."

The panel has compared the histories relied upon by the medical practitioners, the worker's evidence, the submissions of both parties and the evidence on file, and finds that the totality of the evidence does not support ongoing harassment or a recurrence of the worker's November 2013 psychological injury. As a result, we place little weight on the histories provided to the psychiatrist and psychologist, and to the causal relationships that they have proposed. In making this finding, the panel places particular weight on the following:

• The worker suffered a psychological injury in November 2013 which led to her leaving work on November 28, 2013 and filing a WCB claim on December 12, 2013. By that point in time, the worker had already returned to work, on December 9.

• The WCB accepted that the worker had been subjected to harassment by a co-worker which made her workplace untenable. File evidence indicates that the worker had been reporting these issues to her family doctor prior to the establishment of her claim, and continued to do so until her medical appointment on December 2, 2013.

• When the November 2013 workplace issues arose, there were interventions undertaken with senior management of the employer that were intended to provide the worker with a safe workplace.

• While the worker later advised the assessing psychiatrist that she had to return to work while her psychological claim was pending, without feeling ready, the panel finds that the worker had returned to work even before a WCB claim had been filed and had done so with the clearance of her doctor. She received a few days of wage loss benefits and did not seek further medical treatment. 

• The worker returned to her regular job duties which, as described at the hearing, required continuing daily interaction between the worker and the co-worker, much of it directly in the co-worker's location, and often in the presence of other co-workers and supervisors.

• The worker spoke with the WCB on December 16, 2013, and advised that everything had been going well and that she was glad she wasn't being harassed at work now.

• While the worker later indicated (in October 2014) that things were fine for only a couple of weeks after her December 9, 2013 return to work, the panel finds that the evidence from December 2013 to June 30, 2014 does not support continuing harassment by the co-worker. In particular: 

o The worker had ongoing contact with the WCB through December and January regarding her November 2013 claim (the claim was not accepted until December 31). There was no mention by the worker of ongoing difficulties with the co-worker despite the worker having ample opportunity to do so. 

o While the worker asserts that she received ongoing treatment from her physician for stress once back at work, the panel finds that the worker's physician did not corroborate either a history of ongoing harassment or psychological symptoms after December 2, 2013. The panel notes that the file history demonstrates that the worker had been very comfortable with discussing her mental health or mood or stress issues with her family physician on earlier occasions as well as much later in the file, and in our view, the physician's corroboration of complaints or treatment would be helpful. However, when the WCB asked for the worker's physician and staff to review the worker's medical charts, it is noted that they "went carefully through the chart notes from December 9, 2013 to June 28, 2014 and there is no record of documentation regarding the worker's mood/mental health or mention of the work environment." 

o A number of individuals at the workplace were aware of the original incidents leading to the November 2013 claim. As a result of this claim being reopened in September 2014 for a recurrence, file evidence indicates that a WCB case manager interviewed the worker's manager, supervisor, CEO and co-workers to determine what had gone on in the intervening period leading up to the worker leaving work on June 30, 2014. None of them were aware of the worker being exposed to continued abuse and physical assaults after her return to work in December 2013 and, indeed, one commented on how the co-worker seemed to go out of her way to avoid the worker. There were no reports made by the worker to her superiors or co-workers, no casual conversations initiated by the worker as to her relationship with the co-worker nor any observations of any of the types of incidents described by the worker. There was also no mention of any repeated physical assaults or incidents of intimidation of the types referenced by the worker's then union representative to the WCB or the assessing psychiatrist.

• The worker asserted very specifically at the hearing that she left work on June 30, 2014 because of her mental state and not because of her wrist issues. However, the panel finds that this is contradicted by the evidence at that time, and that the worker left because of her physical difficulties. In particular: 

o When the worker saw her treating physician on June 30, 2014, there were no references to mood or stress issues in her subsequent report of that visit to the WCB. 

o As noted in Appeal Commission Decision 107/17, the worker saw her doctor on June 30, 2014 and was diagnosed with bilateral CTS, and four days later, she filed a WCB claim for her bilateral hand conditions, with a narrative that described her regular job duties, her change in job duties in March 2013 leading to both her hands getting more achy to the point that she had to stop working on June 30, 2014. The panel notes that the worker's bilateral arm conditions were significant enough that they led to an August 2014 nerve conduction study and eventually to multiple surgeries to both wrists. 

o The worker also saw her treating physician on July 7 and 24, 2014 and again there were no references to any mood or stress issues.

• The panel further finds no evidence of work-related psychological issues during the summer months of 2014. The worker's CTS claim shows that there were numerous interactions between the worker and the WCB in July and August 2014 as her CTS claim file progressed, and there were no discussions during the summer of any parallel workplace or psychological issues associated with her 2013 harassment claim.

• As well, the panel places no weight on the worker's assertions at the hearing that she was continuously hit and slapped by her co-worker, including on the wrists, to the point where she was leaving bruises on her arm, or that she was subject to ongoing physical assaults as described in the referral letter to the psychiatrist. The panel notes: 

o These assertions were first made by the worker after a Review Office decision denying her bilateral CTS claim. However, when the worker filed her CTS claim on July 4, 2014, she referred only to her regular job duties as being the cause of her wrist symptoms: "Repetitive motions…and lifting heavy pots of food and also repetitive scooping and serving food; …work with pastry bags and squeeze out desserts manually and pressing and also dish/scoop desserts into dishes…lots of stirring, scooping and lifting food." 

o There was no mention of abuse or harassment or physical assaults at that time, or of the worker being hit and slapped on the wrists. This is confirmed as well by her physician's Attendance/Illness Certificate July 24, 2014: "…continues to be unable to work as a result of bilateral carpal tunnel syndrome. It is my opinion that [the worker's] carpal tunnel syndrome is the result of repetitive wrist motion at work." In the panel's view, if the worker had been continually hit on her hands and bruised, as she later says, it does not make sense that she wouldn't report this earlier, either to the WCB or her doctor; evidence of hitting/bruising would have supported both (CTS and stress) work-related claims. The panel finds that the worker had ample opportunities to describe this workplace conduct beforehand either in relation to the CTS claim or the psychological injury claim.

• The panel finds that the first new references to psychological difficulties do not occur until September 2014, and at this point, there is a clear split on who was reporting what to whom. The panel notes that the worker's then union representative advised the WCB on September 18 that the worker had been suffering a recurrence of her psychological injury, with a continuity of symptoms as described above. However, the panel finds that this narrative is not supported at that time by the worker's physician who has a long familiarity with the worker. We note in particular: 

o The physician's September 11, 2014 chart notes refer to "stresses of life are piling up on her"; "mood is subjectively and objectively depressed"; and "mood stems from current health state." The panel notes that there were no reported mental health issues in the physician's June and July reports, and in this first reference to mental health issues, there is no mention of abuse or other work-related factors. 

o The physician's September 22, 2014 chart notes refer to "mood/anxiety are terrible, "A/P: Adjustment disorder vs MDE [Major Depressive Episode]." Again, there is no mention of abuse. 

o The physician does not mention abuse until the worker's October 15, 2014 visit, over 3 months after the worker stopped working. At this time, she noted that the worker "feels situations are completely interrelated…Lead hand was physically abusive, would strike hands and wrists and…force patient to do tasks she wasn't able to do as a result of restrictions." The physician does not provide any indication or explanation as to why this was not mentioned earlier. More importantly, the panel notes that the worker had provided a new history to the physician which changed significantly from previous visits, and occurs after the worker's re-engagement with the WCB in mid-September 2014. We find that this new history is inconsistent with our earlier findings as to what was actually going on in the workplace. 

o The panel notes that a WCB psychological advisor reviewed the file several times, noting on November 6, 2014 that there was insufficient information to determine a diagnosis regarding the November 2013 claim, and there was no medical or other information to support presence of ongoing abuse from January to June 2014, and reiterated this assessment in March and May 2015 after reviewing the reports provided by the worker's psychiatrist and psychologist. Based on our assessment of the evidence on file, we accept the advisor's comments that the opinions of the worker's psychiatrist and psychologist that the diagnosis appears to be related directly to the abuse that the worker reported she experienced in the workplace are based only on subjective reporting of what occurred between December 2013 and June 2014. For all the reasons noted above, the panel does not find the subjective reporting to be accurate, and adopts the WCB psychological advisor's conclusions.

Based on this analysis, the panel finds on a balance of probabilities that while the worker clearly does have psychological difficulties that were identified in late 2014, they are not related to her November 2013 claim, as a recurrence. While the panel is not obligated to find an alternate cause for the worker's psychological issues, we do note that other stressors have been identified that may play a part in her ongoing psychological issues. These include the "stresses of life" identified by the worker's attending physician, as well as various references to financial and family stressors, the worker's reactions to the WCB's decisions on her CTS claim, other non-compensable physical issues, and the worker's frustrations (expressed at the hearing) that the co-worker continued to work while she was not at work and that her employer and co-workers had let her down.

The panel therefore finds that the worker did not experience a recurrence of her psychological difficulties. Given our finding on that issue, the second issue, namely, whether the worker is entitled to wage loss and medical aid benefits, is moot.

The employer's appeal is successful.

Panel Members

M. L. Harrison, Presiding Officer
A. Finkel, Commissioner
P. Walker, Commissioner

Recording Secretary, B. Kosc

A. Finkel - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 21st day of September, 2017

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