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WCB Policy Changes: For Immediate Review

Nursing Stress

Consultation period for compensation for psychological injuries extended to October 31, 2013.

The WCB has decided to further extend our consultation with Nova Scotians about compensation for psychological injuries. Feedback on our position paper will now be accepted until the end of October.

This will allow more time for Nova Scotians to consider and provide their perspectives on this issue. Stakeholder groups and individuals have expressed a keen interest thus far, and the extended deadline will provide an opportunity for more research and conversation about the proposals.

Policy Change: Compensability of Psychological Injury Caused by Workplace Stress

AWARE-NS is looking for feedback from its stakeholders in regards to policy changes by WCB on Compensability of psychological injury caused by workplace stress.
We are asking the stakeholders to review the links below and respond back to [email protected] by October 31, 2013.
We will collect the responses and submit them to WCB by their deadline.
Consultation on compensation for psychological injuries
Policy 1.3.5 – Criteria for psychiatric conditions: occupational stress
Policy 1.3.6 – Compensability of Stress as an Injury Arising out of and In the Course of Employment – Government Employees Compensation Act (GECA)
We understand that this is a short consultation period for a major policy change. “Given some relatively recent legal developments in various jurisdictions across Canada, a concern arose in 2011 about whether certain aspects of Nova Scotia regime might become the subject of legal or constitutional challenge” WCB has opted for a one stage consultation process as opposed to the normal two stage process. Therefore this is the one time that the stakeholder will be able to provide there feedback to the board.
For your convenience below we have highlighted some of changes to the two policies affected.
Policies Affected
Policy 1.3.5-Criteria for psychiatric conditions: Occupational Stress
Policy 1.3.6-Compensability of stress as an injury arising out of and in the course of employment-Government Employees Compensation Act(GECA)
Highlights- Policy 1.3.5-Criteria for psychiatric conditions: Occupational Stress
The existing policy in the Nova Scotia Workers’ Compensation Act does not outline entitlement criteria for psychological injuries outside of those that are secondary to a compensable physical injury. The new policy could elaborate upon the phrase “acute reaction to traumatic event” and provide the phrase including a cumulative reaction to multiple traumatic events. This would provide a middle ground between claims of gradual onset stress and the current narrow interpretation of an acute reaction to a single event.
Changes to Policy 1.3.5
1. To determine the existence and degree of a worker’s permanent impairment due to compensable mental or behavioral (psychiatric) disorders, the Board relies on the American Medical Associations “Guidelines to the Evaluation of Permanent Impairment – Fourth Edition” (the “AMA Guidelines”).
2. Section 2 (a) of the Workers’ Compensation Act states that the definition of accident does not include stress other than that which is an “acute reaction to a traumatic event.” The following provide guidelines used by the Board in adjudicating stress claims.
“The purpose of this policy is to establish criteria for the individualized adjudication of psychological injury claims under the Nova Scotia Workers’ Compensation Act.”
Added Section: “Definitions”
1. The “DSM” is the most current edition of the Diagnostic and Statistical Manual of Mental Disorders, which is a compendium of psychiatric diagnoses produced by the American Psychiatric Association. The manual codes and describes all recognized psychiatric diagnoses and is regarded as the definitive work on the subject. (Source: The Canadian Health Care Glossary).
“Traumatic Event(s)” is defined as a direct personal experience of an event or directly witnessing an event that, reasonably and objectively assessed, is:
• Sudden;
• Frightening or shocking;
• Having a specific time and place; and
• Involving actual or threatened death or serious injury to oneself or others or threat to one’s physical integrity.
Examples of Traumatic Events may include, but are not limited to:
• A direct personal experience of an event that involves actual or threatened death or serious injury;
• An actual or threatened violent physical assault;
• Incident(s) of extreme workplace harassment;
• Witnessing or experiencing a horrific accident;
• Witnessing or being involved in a hostage taking; and
• Witnessing or being involved in an armed robbery.
Policy statement
An emotional reaction following an industrial injury is usually nothing more than a “startle reaction”, or a short period of anxiety or depression which subsides very quickly.
4. This initial emotional reaction, although minor in most cases can, however, increase depending on several factors. Every worker reacts differently to stressful situations, according to his or her individual personality. Factors include:
a) the severity of the injury;
b) whether or not the accident was of a frightening nature; and
c) the prior emotional stability of the worker.
5. The reaction to the injury may be aggravated as a result of prolonged medical treatment. Other factors, such as extended disablement and/or severe functional limitations, may also increase the emotional reaction to the point that the worker’s ability to carry out the activities of daily life is affected.
6. The emotional reaction is generally a temporary condition and the worker is left with no permanent psychiatric impairment. In considering cases of permanent impairment, for claims purposes, a clear causal relationship must be established between the injury and the emotional reaction (i.e. the injury must be shown to be a significant contributing factor).
The WCB will consider claims for compensation under the Nova Scotia Workers’ Compensation Act when the condition results from stress that is a reaction in response to one or more Traumatic Events and the specified criteria outlined below are satisfied. More specifically, the WCB will consider claims for compensation in respect of both: (a) acute response to a Traumatic Event; and (b) cumulative response to Traumatic Events. For greater certainty: (a) an acute response to a Traumatic Event is the most easily identified type of stress, which involves witnessing or experiencing a single event that is objectively traumatic. (b) a cumulative response to Traumatic Events involves a response to multiple Traumatic Events. Possible examples would include a paramedic who develops Post Traumatic Stress Disorder after responding to a number of fatal traffic collisions, or a drugstore pharmacist after multiple robberies.
• There must be one or more Traumatic Event(s) as defined herein;
Criteria Claims for psychiatric or psychological injuries resulting from Traumatic Events may be compensable if all of the following four criteria are satisfied:
• The Traumatic Event(s) must arise out of and in the course of employment;
• The acute or cumulative response to the Traumatic Event(s) has caused the worker to suffer from a mental or physical condition that is described in the DSM; and
• The condition is diagnosed in accordance with the DSM and by a health care provider being either a psychiatrist or a clinically trained psychologist registered with the Canadian Register of Health Service Providers in Psychology.
Non-Compensable Work-related Events Mental or physical conditions are not compensable when caused by labour relations issues such as a decision to change the worker’s working conditions; a decision to discipline the worker; a decision to terminate the worker’s employment or routine employment related actions such as interpersonal relationships and conflicts, performance management, and work evaluation.
Highlights-Policy 1.3.6-Compensability of stress as an injury arising out of and in the course of employment-Government Employees Compensation Act(GECA)
GECA policy allows for claims of both acute and gradual onset stress. This policy was last updated in 2005, and could benefit from some minor wording changes to bring it in line with current environment.
Changes to Policy 1.3.6
From “stress” to “psychological injury”
“American Psychiatric Association’s Diagnostic and Statistical Mental Disorders-4th edition (DSM IV)”
“The “DSM” is the most current edition of the American Psychiatric Association’s Diagnostic and Statistical Mental Disorders”
Under “examples of Traumatic Event(s) may include, but are not limited to:
“Incident(s) of extreme workplace harassment” was added
Omitted first paragraph (general discussion on stress)
From “reaction in response to a traumatic event”
to “reaction in response to one or more traumatic event” (this statement was change though out the policy)
Under “Gradual onset Stress” the following Paragraph was added
An accumulation , over time, of a number of work-related stressors that do not fall within the definition of Traumatic Event(s), or a significant work-related stressor that has lasted for a long time but does not fall within the definition of traumatic Events
For more information please contact:
Heather Matthews
Occupational Health & Safety Specialist
[email protected]
Toll Free 877-538-7228 (LETS ACT)

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