- Board Directives and Guidelines (psychotraumatic disability) (five year guideline)
- Psychotraumatic disability
The WSIB recognized initial entitlement for the worker's accident in 1989, including permanent impairments to the neck and low back. The worker has a total PD award of 45%, which includes permanent disabilities to the neck (15%), the low back (25%), and the left ankle (5%). The WSIB denied entitlement for psychotraumatic disability in a decision dated September 19, 1997. The sole issue before the Panel was the worker's entitlement for psychotraumatic disability.
The Panel denied the appeal.The worker was injured in a chance event on May 29, 1989. The worker's psychological condition must have manifested on or before mid-1994 in order to establish entitlement under the WSIB's policy. The worker did not seek entitlement until 1997. There was no contemporaneous medical evidence regarding psychological issues or symptoms prior to 1996. The Panel found that the worker had not met the five-year rule set out in the policy as the worker's psychological condition did not manifest within five years of the work-related accident. The Panel also found that the work-related accident was not a significant contributor to the worker's psychological condition, due to the presence of several significant intervening events. As such, there were no compelling reasons or exceptional circumstances to warrant extending the five-year period set out in the WSIB's policy.The Panel acknowledged that the policy allows for the five-year limit to be reset with surgery, and that previous WSIAT decisions have found that this may, in certain circumstances, also apply to significant deteriorations (see Decision No. 2988/18). In this case however, the WSIB did not recognize a significant deterioration in the worker's compensable conditions until 2017. The Panel was bound by the WSIB's determination that the worker's compensable low back and neck conditions were more or less stable until 2017. As the available evidence established that the worker's psychological condition had become entrenched by 2017, the Panel could not find that the significant deterioration was a significant contributing factor leading to the development of the worker's psychological condition. Consequently, the exceptional circumstances described by Decision No. 2988/18 did not apply.