Worker returned to work without a problem for years following accident but didn’t claim ongoing effects until he was terminated
An Ontario worker who reported physical and psychological effects from a work-related injury after he was dismissed three years later is not entitled to benefits for ongoing impairment and psychotraumatic disability, the Ontario Workplace Safety and Insurance Appeals Tribunal has ruled.
The 63-year-old worker joined his employer in June 2001. He worked for six years without any major problems until a workplace accident on June 25, 2007. In the accident, the worker suffered a laceration to his scalp after he was hit on the head with a falling metal bar. He went in for a CT scan, which revealed no serious injury. An MRI confirmed this finding, and the Ontario Workplace Safety and Insurance Board (WSIB) granted the worker initial entitlement for his claim arising from the injury.
Shortly after the injury, the WSIB determined the worker reached maximum medical recovery with no evidence of permanent impairment. The worker continued to work for three years, taking on a more demanding job without event.
The worker’s employment was terminated on April 20, 2010. The following month, he was suffering from headaches, shoulder pain, neck pain, and a tender scalp at the site of his injury three years earlier. He also had trouble sleeping or doing any work.
The worker filed a claim for psychotraumatic disability and loss-of-earnings benefits due to lingering effects of his workplace injury. He provided a doctor’s note diagnosing him with post-traumatic stress disorder (PTSD) and a sprain of his neck and shoulder. However, the WSIB ruled there was no ongoing entitlement for his physical injuries as had been ruled recovered, nor was there entitlement for psychotraumatic disability benefits.
In May 2011, medical examinations found the worker had degenerative problems in his spine, pelvis and knees, plus thickness tears in both shoulders. He was also diagnosed with sleep apnea.
The worker went to a psychologist in October 2011 complaining of pain and numbness in his head, legs, back and shoulders, as well as frequent headaches and dizziness, which he claimed had been happening since his workplace accident. The psychologist diagnosed the worker with chronic pain that was “secondary to work accident,” high stressors, and severe sleep apnea.
The worker appealed his claim denial to an appeals resolution officer, who found that the worker was able to fully function without complaint for three years and there was no medical documentation of any medical issues during that time. The worker didn’t make any claim until after his employment was terminated.
The appeals resolution officer also found the worker complained of problems with several different parts of his body which weren’t compatible with the head injury he suffered at work. In addition, some of these injuries were diagnosed as degenerative, said the officer.
The appeals resolution officer determined the worker fully recovered from his work injury and there was no ongoing impairment from it — the other physical and mental injuries were unrelated. As a result, there was no entitlement to further benefits.
The worker appealed once more, arguing his physical injuries were related to his job, which involved lifting heavy material from the floor and placing it at a two-metre height. He also said he was treated poorly and not given assistance after his injury and his termination was unfair and devastating, contributing to his psychological problems.
The worker also claimed he did have problems following his accident and he had to take pills for some time.
The tribunal found the evidence didn’t show any lingering effects from the workplace injury once the worker’s head healed. He was able to return to work and continued with the same job duties without accommodation or report of ongoing work-related impairment. CT and MRI scans confirmed there was no lingering injury. No further problems were reported until the worker was terminated in April 2010, said the tribunal.
The tribunal noted that WSIB policy stipulated that entitlement for psychotraumatic injury required an “organic brain syndrome” secondary to a head injury, stress from an emotional reaction to the injury, or relation to extended disablement and non-medical factors that were directly related to the injury. None of these were applicable to the worker’s circumstances, the tribunal said.
Psychological issues stemmed from other causes
The tribunal found that much of the worker’s psychological issues were related to the effect of the termination itself, not ongoing issues with injuries from his workplace accident.
“In my view, the worker’s termination from his employment on April 20, 2010, and the difficulties that he experienced in his workplace leading up to that, including a suspension earlier in the month, had a profoundly deleterious impact on his psychological state,” said the tribunal. “This was so much so that following the termination his health care providers felt that he could no longer work whereas prior to the termination, he was able to sustain full-time employment without medical accommodation for over two years.”
The tribunal found that the worker’s “intense reaction” to his termination — piled on top of his belief that he employer had been unfair to him — was the cause of his psychological issues and not related, directly or indirectly, to his work-related injury years earlier. This was not a basis for psychotraumatic disability benefits, said the tribunal.
The tribunal also agreed with the appeals resolution officer in that the worker’s numerous physical issues weren’t related to his work-related injury, due to their location and degenerative nature, as well as the fact they didn’t seem to bother him for more than two years while working normally.
The worker’s appeal was dismissed and the original denial of benefits for ongoing physical impairment and psychotraumatic disability was upheld.
For more information see:
