By
Madeleine F. Hearns, Legal Counsel, Workers' Compensation
Board of Nova Scotia*
Introduction:
Many Provincial Compensation Boards preclude stress from the definition of accident unless the stress is an “acute reaction to a traumatic event”. The federal legislation, however, has been interpreted to allow recovery for gradual onset stress.
This article will explain the criteria Nova Scotia has developed to adjudicate stress claims of federal employees.
What is Stress?
Stress is a commonly used term that describes an individual’s response to environmental demands or pressures that occur in life. Generally, it is believed that individuals require a certain amount of stress in order to maintain their well-being.1 However, an individual can experience so much stress that it challenges the body’s ability to cope. As outlined in the fourth edition Diagnostic and Statistical Manual of Mental Disorders (DSM IV), stressors in certain circumstances and under certain conditions can result in psychiatric or psychological diagnoses such as Posttraumatic Stress Disorder or Acute Stress Disorder.2
Criteria for Adjudicating Gradual Onset Stress Claims
Broadly speaking, stress in and of itself is not compensable. Everyone experiences stressful situations, in varying degrees, as part of their everyday lives. Stress can be caused by multiple factors some of which are related and some of which are unrelated to the workplace. Compensability of gradual onset stress claims must be determined pursuant to criteria for emotional reaction in response to unusual work-related stressors acting over time (gradual onset stress).
The criteria adopted by Workers’ Compensation Board of Nova Scotia is based on best practice and current medical thinking in the diagnosing of stress related psychological or psychiatric injuries:
Criteria #1 – The work-related events or stressors are unusual and excessive in comparison to the work-related stressors experienced by an average worker in the same or similar occupation:
Stressful situations, in varying degrees, are part of everyday life. Employers are not able to prevent all forms of stress in the workplace however, employers do have the ability to prevent stressors in the workplace that are excessive or unusual.3
Criteria #2 The mental or physical condition is caused by the work-related events or stressors:
Gradual onset stress can be caused by many factors some due to employment and some not. In establishing work-relatedness a range of information must be considered including the facts of the case, medical information, psychological assessment results, personal factors, employment information, etc.
Criteria #3 The worker is diagnosed with a mental or physical condition described in the DSM IV:
The DSM IV is generally accepted as the gold standard in diagnosing psychiatric and psychological conditions, it is the standard manual used by psychiatrists and psychologists for making clinical psychiatric diagnoses.
Criteria #4 – The condition is diagnosed by a psychiatrist or clinically trained psychologist:
Psychiatrists and psychologists are fully qualified based on their core training to diagnose psychological or psychiatric injuries using the DSM IV. As a result, psychiatrists and clinically trained psychologists are the most qualified to conduct medical assessments to determine whether or not the stress is work-related as well as to identify the most appropriate treatment to bring about full recovery.
Conclusion
There are many justifiable employment-related decisions that must be made by an employer that may be stressful for employees. These employment-related decisions are an inherent and sometimes unavoidable aspect of doing business and are actions that all workers may be subjected to from time to time. As a result, stress claims are not compensable if they arise from labour relation actions. These situations are more appropriately addressed by other applicable legislation including Human Rights Acts, Labour Standards Codes, collective agreements, etc.
Nova Scotia has developed the criteria necessary for acceptance of gradual onset stress claims. These criteria provide clarity regarding the factors to be considered in the adjudication of these stress claims and promote consistency in Nova Scotia’s decision making process.
1 Davis, F.A. Taber’s Cyclopedic Medical Dictionary (18 th Edition). F.A. Davis Company. 1997. Smith, Dr. Joseph F. Medical Library. The Thompson Corporation.
2 Abbass, Dr. A. Director of Education, Department of Psychiatry, Dalhousie University. Post Traumatic Stress Disroder and Acute Stress Disorder: Considerations for the WCB of Nova Scotia. 2005. Page 4.
3 Winter, Alan. Core Service Review of Workers’ Compensation Board of British Columbia, March 11, 2002. 175, 185-86.
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