- Causation (thin skull doctrine)
- Post-traumatic stress disorder
- Preexisting condition (psychological condition)
- Board Directives and Guidelines (stress, mental) (traumatic event)
The worker, a youth services officer at a youth correctional facility, sought entitlement to benefits for Traumatic Mental Stress (TMS).
The Panel allowed the appeal.The worker had entitlement under the TMS policy for the diagnosis of post-traumatic stress disorder (PTSD). She was exposed to multiple traumatic events between 2003 and 2013 which, cumulatively, made a significant contribution to the development of her PTSD. These events included verbal abuse by inmates, suicide attempts, violent beatings and fights. While the worker's traumatic experiences did not involve the more severe examples described in the TMS policy, she was a first-hand witness to traumatized individuals on multiple occasions, and was herself the object of physical and verbal harassment at work. These events were clearly and precisely identifiable as required by the TMS policy.The Panel noted that WSIAT case law does not generally require corroboration of a worker's account of what happened in order to grant entitlement under the TMS policy. If other evidence, such as worker testimony and/or the preponderance of other evidence, including the medical reporting, support that the event(s) occurred on the balance of probabilities, then it is generally accepted that the worker has established that the event(s) occurred. Furthermore, the worker suffered from a pre-existing psychological condition. Her pre-existing psychological condition began in childhood as a result of family relationships. The Panel accepted that the worker's pre-existing psychological condition rendered her more vulnerable to the development of PTSD. Thus, the "thin skull" doctrine applied in this case. Dr. McCulloch endorsed a diagnosis of "Complex PTSD" which is discussed in the Tribunal's Medical Discussion Paper on PTSD. Complex PTSD relates to repeated childhood trauma with three core symptom groups: i) emotional regulation difficulties, e.g. problems calming down; ii) relationship issues, e.g. avoidance of relationships; and, iii) negative self-concept, e.g. beliefs about self as a failure.The Panel also accepted the worker's reasons for the delay in reporting her traumatic mental stress to her employer. She was among only a few females who worked in the correctional facilities and she worked on a "casual" basis. The Panel accepted that these factors likely played a role in her lack of willingness to report her mental stress to the employer or "rat" on co-workers who behaved badly. The worker testified that she did not want to jeopardize her employment. She also was not aware until 2017 that the WSIB compensated for mental stress arising from the workplace.