Stress came from interactions with management, not incidents with resident
A long-term care home worker is not entitled to worker’s compensation benefits for a mental disorder that stems from management’s exercise of its authority rather than incidents with a resident, the British Columbia Supreme Court has ruled.
The worker was a care aide at a residential care facility operated by Providence Health Care Society. The facility housed people with extended care needs.
In September 2017, a resident at the facility grabbed the worker’s buttocks. About a month later, the same resident touched her breasts, so the worker’s supervisor changed her work assignment and recorded the incident in the resident’s chart. The worker didn’t officially report the touching and brushed it off because the resident had dementia. Other female staff members experienced similar issues with the resident.
On Dec. 13, the worker entered the shower room while another care aide was providing a shower to the resident. There was a physical interaction and, two days later, the clinical nurse leader received a report on behalf of the resident saying that the worker had punched the resident in the chest.
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Upset in meeting
The clinical nurse leader and resident care manager met with the worker to discuss the complaint. The worker claimed that she had tapped the resident on the chest gently to say hello, but when they told her that the resident reported that she had punched him, she grew angry and spoke loudly. She continued to raise her voice throughout the meeting and made gestures towards the clinical nurse leader, critizing her for raising the complaint rather than addressing the incident when the resident had touched her.
Neither the nurse leader nor the manager had known of the inappropriate touching incidents before then.
After an investigation, Providence determined the resident’s complaint was unfounded. However, it also decided that the worker’s conduct in the meeting deserved performance management.
At a meeting on Jan. 12, 2018, management held a second meeting with the worker and her union representative. Four days later, Providence issued a letter to the worker stating that she would be suspended for one day without pay because of her conduct during the first meeting.
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Workers’ compensation claim for mental disorder
A few days later, the worker filed a workers’ compensation claim for a mental disorder. She identified the date of injury as Jan. 12, the date of the disciplinary meeting, with the location being a meeting room. She also filed a grievance that was later settled.
The worker told a WorkSafeBC counsellor that a prior incident in which she was accused of abusing a resident triggered the issues she was currently having. She said that she felt “picked on at work.” Around the same time, her family doctor diagnosed her with adjustment disorder and recurrent depression. He said that the worker would be fit to work once reassured by management that they were aware of her triggers.
The doctor later provided a letter stating that the worker’s triggers included hypersensitivity to questions about her work ethic, difficulty controlling her anxiety when faced with criticism, and being placed in a confrontational position.
WorkSafeBC denied the worker’s claim, finding that the two meetings were not traumatic events or significant work-related stressors. It also found that the touching incidents by the resident were not significant work-related stressors.
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Psychological assessment
The worker requested a review, so WorkSafeBC arranged an independent medical examination by a psychiatrist and a psychological assessment. The psychologist found that the main cause of the worker’s mental disorder was her interactions with her managers – although the resident incidents were “a moderate but significant contributor” - and the psychiatrist reported that the worker was sensitive to any criticism or feedback from people in authority, so the claim was again denied. The review division confirmed the decision, which the worker appealed to the Workers’ Compensation Appeals Tribunal.
The tribunal found that the worker’s mental disorder was not a reaction to a traumatic event arising out of and in the course of employment and agreed that the resident’s touching incidents were not significant stressors. Because the worker’s mental disorder was a reaction to Providence’s legitimate exercise of its authority to manage the workplace, it was not covered, said the tribunal.
The worker appealed one more time to the BC Supreme Court.
The court noted that the BC Workers’ Compensation Act allows compensation for a mental disorder if it was a reaction to one or more traumatic events arising out of or in the course of employment or was predominantly caused by a significant work-related stressor. The act also stipulates that the mental disorder must not be caused by a decision of the worker’s employer relating to the worker’s employment, the court added.
The court also noted that the worker brushed off the touching incidents because of the resident’s limited mental and cognitive issues, and she didn’t want to make a big deal of it. She also identified the date of injury in her claim as the date of the second meeting with management, after the touching incidents. Her evidence on the impact of the touching incident also varied over the course of her appeals, so it was reasonable for the tribunal to conclude that the touching incidents did not rise to the level of traumatic events, said the court.
For similar reasons, it was reasonable for the tribunal to determine that the touching events weren’t significant stressors, said the court. The evidence of the worker and colleagues was that such behaviour from residents with mental and cognitive issues could be expected as part of the working environment in a long-term care facility, and the worker did not want to pursue the matter after the incidents happened, the court said.
The evidence pointed to the fact that the worker’s mental health issues were caused by her interactions with Providence management in the meetings and the letter of suspension. These were reasonable exercises of management authority in the course of the worker’s employment and were protected under the act, said the court in upholding the tribunal’s decision dismissing the worker’s appeal. See De Jesus v. British Columbia (Workers’ Compensation Appeal Tribunal), 2023 BCSC 1320.
