ARO Decision No.20220103 dated June 30, 2022
The Employer’s appeal of several decisions in this presumptive Post Traumatic Stress Disorder (PTSD) for First Responder (Police) claim was granted, in part.
By way of background, this worker’s claim was legitimately allowed under WSIB policy #15-03-13, Posttraumatic Stress Disorder in First Responders and Other Designated Workers. Health care, specifically psychological assessments (CAMH) and counselling, as well as full Loss of Earnings (LOE) benefits were granted at the outset of the claim and ongoing. In the early part of the claim, the worker enrolled in university courses in an area of interest that she had previously enjoyed but had not completed. She also identified some specific alternate career options. Unfortunately, these efforts were confounded by ‘red tape’ and delays. Subsequently, treatment was discontinued and the WSIB RTW efforts focused on employment in the general labour market – which the worker was not interested in. The employer pursued a formal appeal regarding decisions made regarding the accepted level of impairment and ability to engage in return to work/RTW services.
The Appeals Resolution Officer (ARO) in this decision confirmed the entitlements granted including a permanent impairment (NEL award) but denied total disability and denied the conclusion that the worker was not fit to engage in any RTW activities. Most importantly, the ARO found that the restriction of ‘no RTW with the accident employer’ was not valid and directed that the WSIB explore RTW opportunities with the employer as a priority.
This is an important decision for those dealing with PTSD or other mental stress injury cases in light of the WSIB’s common acceptance of psychologists’ recommendation of ‘no RTW with the accident employer’. These claims are often complicated by long durations without significant recovery or RTW potential recognized before the final LOE lock-in to age 65. This decision represents an important message to the WSIB Operating Area and all stakeholders (including treating psychologists) that early intervention and consideration of individual interests is critical to more positive outcomes.
