The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker is appealing the decision made by the Workers Compensation Board ("WCB") that their claim is not acceptable. A teleconference hearing was held on August 13, 2024 to consider the worker's appeal.

Issue

Whether or not the claim is acceptable.

Decision

Background

The worker filed a Worker Incident Report with the WCB on September 28, 2009, describing that they felt “burnt out” and “stressed out” for months at work, noting the “…pressure was getting to be too much…” and they could no longer handle their job and needed a break. The worker did not indicate an accident date but reported they had not been at work since August 30, 2009. In an attachment to the Report, the worker outlined that they were claiming injury in relation to stress, that they sought medical treatment and that they requested a medical note. The worker also noted that in previous employment, they took medical leave due to stress.

In discussion with the WCB on September 30, 2009, the worker confirmed they related their stress to their workload, describing feeling burnt out as they did not have any assistance at work. On the same date, the WCB wrote to the worker denying the claim as stress from the daily pressures or stressors at work does not fall within the definition of accident under The Workers Compensation Act (the “Act”) and policies.

On November 3, 2023, the worker contacted the WCB to request reconsideration of this decision. The worker submitted copies of the paystubs from 2009 indicating the hours, including overtime, they worked during that time. The worker noted the employer did not offer help, even after the worker asked for it, and indicated this lack of assistance resulted in their stress and burn out at work. On the same date, the WCB advised the worker the information was reviewed and there would be no change to the decision that the claim was not acceptable.

On January 15, 2024, the worker requested Review Office reconsider the WCB’s decision, outlining the stressful conditions at work, including having to work double shifts due to staff shortages and being unable to take time off to rest. The worker noted they requested time off from the employer, but the employer denied that request. The worker included a document from a supervisor in a subsequent job who noted the worker to be a hard worker who at times felt overwhelmed and required time off.

Review Office determined on April 8, 2024 that the claim was not acceptable. Review Office found the worker’s claim for psychological difficulties related to stress and burn out from their employment due to a heavy workload, being understaffed and working long shifts resulted from the daily pressures of work, and did not fall within the definition of an accident.

The worker filed an appeal with the Appeal Commission on April 15, 2024 and a hearing was arranged.

Reasons

Applicable Legislation and Policy

The Appeal Commission and its panels are bound by the provisions of The Workers Compensation Act (the “Act”), regulations under the Act and the policies established by the WCB's Board of Directors. The provisions of the Act in effect at the time of the accident apply.

The Act defines accident in s 1(1) as “a chance event occasioned by a physical or natural cause” that includes: 

(a) a wilful and intentional act that is not the act of the worker, 

(b) any 

(i) event arising out of, and in the course of, employment, or 

(ii) thing that is done and the doing of which arises out of, and in the course of, employment, and 

(c) an occupational disease, 

and as a result of which a worker is injured…. 

The Act defines an occupational disease as including a disease arising out of and in the course of employment and that results from causes and conditions that are peculiar to or characteristic of a particular trade or occupation, or are peculiar to the particular employment, or that trigger post-traumatic stress disorder but does not include an ordinary disease of life or stress, other than an acute reaction to a traumatic event. Further, s 1(1.1) of the Act excludes from the definition of accident any change in respect of the employment of a worker, including promotion, transfer, demotion, lay-off or termination. The Act provides that a worker is entitled to benefits under s 4(1) when it is established that a worker has been injured as a result of an accident at work.

The WCB established Policy 44.05.30, Adjudication of Psychological Injuries (the “Psychological Injuries Policy”) to outline how the WCB will decide claims for psychological injury. The Psychological Injuries Policy confirms that such claims are decided in the same way as claims for physical injuries, in that the WCB will first determine whether there has been an accident arising out of and in the course of employment and if so, whether the worker has suffered an injury, and if so, whether the injury was caused by the accident. The Psychological Injuries Policy specifically excludes psychological injuries that occur because of burn-out or the daily pressures or stressors of work because the daily pressures or stressors of work do not fall within any part of the definition of accident, as there is no chance event, no wilful and intentional act, and no traumatic event.

Worker’s Position

The worker appeared in the hearing on their own behalf and provided an oral submission to the panel in support of their appeal.

The worker’s position is that as a result of their working conditions, including working while short-staffed, backfilling unstaffed positions, and the employer not authorizing time off, they experienced an increase in stress, which was compounded by their pre-existing psychological conditions, and they needed to take a stress leave. The worker submitted the employer’s treatment of them was unfair and undeserved, as they were a loyal and dependable employee.

The worker submitted that the panel should apply the provisions of the current Psychological Injuries Policy of the WCB which permit, in some cases, a claim in relation to cumulative stress arising from a period of overwork.

In response to questions posed by the panel, the worker confirmed that they could not provide any additional medical information in support of their position, as the medical records from 2009 were no longer available, noting they previously tried unsuccessfully to obtain those records when seeking benefits from another government program. The worker testified they sought medical treatment from their family physician at the time of the events outlined in their claim and were prescribed antidepressant medications, which they took until they returned to work.

Employer’s Position

The employer appeared in the hearing with counsel who made an oral submission on behalf of the employer.

The employer’s position is that the decision of Review Office was correct and should be upheld. Counsel submitted there is no medical evidence to support the worker's claim of a psychological injury, nor that they had any pre-existing psychological condition. Further, the circumstances described by the worker in their testimony and in the file materials, including the Worker Incident Report, do not amount to an accident as defined in the Act, noting that the daily pressures and stresses of work are excluded from the definition of occupational injury as set out in the Psychological Injuries Policy. The employer’s counsel further noted the absence of any medical support for the worker’s claim that their work conditions negatively impacted a pre-existing psychological condition. As such, the worker’s claim should not be accepted.

Analysis

The question on appeal is whether the worker’s claim is acceptable. For the worker’s appeal to succeed, the panel would have to determine the worker sustained a psychological injury as a result of an accident arising out of and in the course of their employment. As detailed in the reasons that follow, the panel was unable to make such a finding and therefore the worker’s appeal is denied.

In considering the worker’s claim, the panel applied the provisions of the Psychological Injuries Policy, which requires us to determine firstly if there is evidence of an accident as defined in the Act. The panel noted the definition of accident includes chance events resulting from a physical or natural cause, wilful and intentional acts of third parties, any event “arising out of, and in the course of, employment, or thing that is done and the doing of which arises out of, and in the course of, employment” and occupational disease. Occupational disease is defined as a disease arising out of and in the course of employment that results from causes and conditions that are peculiar to or characteristic of a particular trade or occupation, or are peculiar to the particular employment, or that trigger post-traumatic stress disorder but does not include an ordinary disease of life or stress, other than an acute reaction to a traumatic event.

The evidence before the panel suggests that the worker was subjected to a period of significant workplace pressure because of staff shortages, staff holidays and other staffing issues which resulted in the worker taking double shifts, backfilling other staff positions while continuing with their own responsibilities. The worker described working for a period leading up to late August 2009 without adequate support from the employer. The worker testified that they felt this was unfair to them, and that the pressures from working in this environment caused them to feel stressed out and mentally and physically finished by the time they were able to take time off work. This is not disputed by the employer and the panel noted the claim file evidence includes the worker’s paystubs from January 5, 2009 to August 2, 2009 which confirm ongoing overtime hours during this period.

The worker submitted that these workplace pressures and stresses caused them to experience burnout and that this occurred in the context of their previously diagnosed psychological conditions. The panel, however, finds there is no medical evidence from that period that supports the worker’s claim of injury, nor is there evidence that supports any findings in relation to worsening of any pre-existing psychological injury. In reviewing the Psychological Injuries Policy, the panel noted that the provisions explicitly state that the ordinary pressures and stresses of work do not amount to an accident. In reviewing the circumstances described in the claim file and in the worker’s testimony, the panel is satisfied that these circumstances fall within the parameters of the ordinary pressures and stresses of work, and as such, do not amount to an accident, as defined in the Act.

The worker also submitted that the panel should apply the WCB Psychological Injuries Policy that took effect on May 1, 2023 as that version of the Policy allows the WCB to determine that the definition of traumatic event includes a workload over a prolonged period that is excessive or unusual in intensity. The panel acknowledges there has been a change in the WCB’s policy in relation to defining traumatic events, but noted this change explicitly applies only to accidents occurring on or after May 1, 2023. In this case, the applicable Policy is the version in effect at the time of the worker’s accident claim in 2009, as referenced above.

Based on the evidence before us and applying the standard of a balance of probabilities, the panel finds that the worker did not sustain a psychological injury as a result of an accident arising out of and in the course of their employment. Therefore, the claim is not acceptable, and the worker’s appeal is denied.

Panel Members

K. Dyck, Presiding Officer
J. Peterson, Commissioner
P. Kraychuk, Commissioner

Recording Secretary, J. Lee

K. Dyck - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 23rd day of August, 2024