- Health care (medical aid) (marijuana)
- Health care (massage therapy)
- Procedure (Charter of Rights issue)
The worker appealed an ARO decision, dated June 9, 2021, and sought entitlement to health care benefits for his post-traumatic stress disorder (PTSD), including medical cannabis purchased on or after March 1, 2019 and massage therapy. The worker's representative also served a Notice of Constitutional Question, challenging the validity and/or applicability of OPM Document No. 17-01-10, "Cannabis for Medical Purposes." In accordance with the Tribunal's Practice Direction, the Tribunal decides the merits of the appeal under the applicable statute and policy; the constitutional question is then addressed if necessary, depending on the outcome of the appeal on the merits.
The Panel denied the appeal.The worker's compensable injury of PTSD is not a "designated condition" under the policy. The worker's representative submitted, however, that some of the worker's symptoms, including muscle spasms and chronic pain, ought to be considered neuropathic pain as they are secondary to his PTSD. OPM Document No. 17-01-10 defines neuropathic pain as "pain arising as a direct consequence of a demonstrable lesion or disease affecting the somatosensory system (e.g., pain caused by a traumatic nerve injury)."The worker's representative submitted that the worker's "muscle spasms, though not related to a spinal cord injury, are akin to spasticity, another designated condition" and that "research has shown that the results of PTSD may include damage to nerves which create chronic pain." However, given the specific wording of the policy, namely that the spasticity result from a spinal cord injury, the Panel was not persuaded that the worker's muscle spasms would satisfy the criterion for a designated condition under the policy. Further, the Panel was not directed to any specific medical evidence that the worker's muscle spasms were indeed analogous to spasticity, or that the worker had neuropathic pain related to his compensable PTSD consistent with the definition provided in the policy. The Panel agreed with Decision No. 1799/21, that the Board's list of designated conditions cannot reasonably be interpreted to include emotional or psychological symptoms. It is clear that the Board chose to specify not just pain, but more specifically neuropathic pain (except in a palliative setting, which was not at issue here), and that psychological and emotional symptoms are not included. Lastly, the Panel found that the worker was not entitled to massage therapy as there was no medical evidence of significance that it was necessary and appropriate for the treatment of the worker's compensable PTSD. Should the worker wish to pursue a Charter/human rights challenge in this case, he is to advise the Tribunal within 30 days of the date of this decision of his intent to do so.