Psychological Injuries for Workers' Compensation (7:VII)
|This information applies to British Columbia, Canada. Last reviewed for legal accuracy by the Law Students' Legal Advice Program on July 31, 2020.|
A worker can claim for diagnosed psychological conditions which arise as a consequence of physical injuries or Occupational Diseases which are accepted under s 134, 135, or 146, (previously 5 or 6) of the Act. Common psychological consequences include chronic pain and difficulties adjusting to a new disability. In practice, psychological limitations and restrictions can often be an overlooked aspect of an injured worker’s reduced employability. However, they are important to recognize, diagnose and treat as this may be the difference between a successful rehabilitation and a failed one. When seeking acceptance of a psychological consequence of a compensable physical condition, the causal threshold is the same standard of “causative significance”: Is the accepted physical injury a significant contributing cause of the psychological condition, meaning something more than a trivial or insignificant factor? If so, the psychological consequence is compensable as well, including treatment. The physical injury does not need to be the sole or even most significant cause.
However, a worker may suffer a psychological injury alone, with no accompanying physical condition. Common examples include Post Traumatic Stress Disorder (PTSD) or Major Depressive Disorder (MDD). In such cases, the worker can claim for purely psychological injuries from their work under section 135 (previously 5.1) of the WCA and policy item #22.30.
Section 135 of the Act provides for two types of psychological injuries, each with a different causation test. A worker can claim for a psychological injury that is either:
- A reaction to one or more traumatic events arising out of and in the course of employment; or
- Predominantly caused by a significant work-related stressor, including bullying or harassment, or a cumulative series of such stressors, arising out of and in the course of employment.
A psychological injury which is caused by “stressors” (vs. “traumatic events”) must meet the “predominant cause” standard. This is a significant hurdle for workers with pre-existing psychological conditions who become disabled after work stressors, such as bullying or harassment.
Section 135 (previously 5.1) also requires that a psychological condition be diagnosed as a mental disorder by a registered psychiatrist or psychologist.
Section 135 also provides that mental stress arising from a decision by the worker’s employer related to the employment (e.g. a change in job description or working conditions, or termination of employment) is specifically excluded from compensation. However, an employer may not communicate a management decision in any way it wants and communication that humiliates, intimidates, or amounts to bullying, harassment, threats or abuse may be beyond 135(1)(c) (previously 5.1(1)(c)) protection.
Psychological injuries that result from interaction with WCB and the claims process are also not compensable (Noteworthy Decision: WCAT-2015-01459). Though they would not happen but for the workplace injury, they are too remote to be compensable. Exceptions may arise in special circumstances, e.g. where the Board has acted negligently, or in bad faith.
As of May 17, 2018, s 135(2) (previously 5.1(1.1)) came into effect, which creates a rebuttable presumption for eligible occupations that a worker’s mental disorder is a reaction to one or more traumatic events arising out of and in the course of their employment. The presumption applies where the worker is:
- exposed to one or more traumatic events arising out of and in the course of the worker’s employment in an eligible occupation; and
- diagnosed by a psychiatrist or psychologist with a mental disorder that is recognized in the most recent DSM at the time of diagnosis, as a mental or physical condition that may arise from exposure to a traumatic event.
The Act also defines an eligible occupation to mean the occupation of a correctional officer, emergency medical assistant, firefighter, police officer, or sheriff.
As of May 16 2019, this mental health presumption was extended to emergency dispatchers and publicly-funded health-care assistants.
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