Psychological injuries and illness are a leading cause of absences from work in Canada. The most obvious that may come to mind when you think about this is probably post traumatic stress disorder (PTSD) which is the result of trauma. Most commonly we think of this illness affecting first-responders like firefighters, police and ambulance paramedics. Certainly these folks pay a heavy price for putting themselves in the way of harm as part of their day-to-day job.
PTSD however can affect anyone who has suffered trauma on the job. And PTSD is not the only psychological injury workers suffer; there are many. Depression, anxiety, adjustment disorder, pain disorder are just a few of the conditions that injured workers may also suffer.
A great number of injured workers in BC suffer from severe and intractable chronic pain, and where there is chronic pain, there is very likely any combination of the above.
So how does our Workers Compensation Board (aka WorkSafeBC) deal with these injured workers? Let's just say, you wouldn't want to find yourself in that situation.
The WCB has a number of psychologists and others in the mental health field whom they call on quite regularly for opinions on whether to accept a worker’s psychological condition, and if so, how to treat it. Some of these “mental health professionals” make a good deal of their income from their contracts with the WCB.
Here are some examples I have encountered: a worker was accepted for depression due to her chronic pain. She had also slid into alcohol abuse as her way of coping with the pain and the devastation it had caused in her life. Through a long series of appeals we eventually also had the alcohol abuse accepted as a WCB responsibility, but before we got to WCAT on that issue, a psychologist commonly used by the WCB instructed that while the worker’s depression was compensable, any treatment they offered her wouldn't matter anyways since she also drank. He told the Board that alcohol abuse is voluntary and they wouldn't cover a woman who made that choice. The Review Division added that “No one told her to use alcohol to cope with her pain.” She was offered no help.
We won this at appeal but it is typical of what happens to those who are struggling in the Workers Compensation system and crying out for help.
Last year the WCB issued a bulletin saying that they were going to use a new contract for mental health professionals. It said that, “A preliminary review … revealed that many individuals receiving treatment did not appear to have serious or severe impairments that would warrant ongoing support.” And on this basis they would cut back on support for injured workers with psychological problems.
On this basis the WCB said it was going to revise its guidelines. A worker now has to have a 75% permanent functional impairment award (PFI) before they will get ongoing psychological help. Very, very few injured workers are ever granted 75%. And then the WCB announced that using their new guidelines:
Even using a substantially more conservative estimate, less than 10% of existing Workers receiving Maintenance treatment would qualify for this service.
This means that 90% of those who were getting psychological counselling and support before October 2014 will now not qualify for help!!
The WCB offers such low rates to mental health professionals now, (trying to save the employers money), that many psychologists will no longer take work from them. Nowadays, a worker referred for psychological treatment is likely to be sent to a family counsellor or social worker for support. For some who are suffering severe and complex psychological problems, a family counsellor is just not qualified to offer the treatment they need.
It’s a sad and desperate situation. Our best advice for those who are suffering psychological problems as a result of a work injury or incident is to seek out your own professional help. See your GP and get him or her to refer you to a psychologist or psychiatrist. Not only do you need to ensure that you get proper support from a proper mental health professional, but if the WCB turns down your claim, you will likely need your own expert to provide a report and documentation for the appeal. If you aren’t getting the help you need from the WCB, go out and find help now. Don’t wait for help; it may never come.
Sarah O'Leary, Rush Crane Guenther, Barristers & Solicitors,
300 - 111 Water Street, Vancouver BC V6B 1A7
E-mail: so@rcga.com