Highlights of Noteworthy Decisions

Decision 1551 16
14/07/2016
K. Cooper - J. Blogg - A. Signoroni
  • Permanent impairment {NEL} (psychotraumatic disability)

The worker suffered a shoulder injury in 2009, for which the Board granted a 24% NEL award. The Board also granted entitlement for psychotraumatic disability but denied a NEL award for permanent impairment. The worker appealed a decision of the Appeals Resolution Officer denying a NEL assessment for permanent psychotraumatic disability and denying full LOE benefits.

Board policy on psychotraumatic disability notes that the condition is considered to be a temporary condition, unless there are exceptional circumstances.
The Panel agreed with Decision No. 1926/11 that, for a worker to be entitled to an assessment for permanent psychotraumatic disability, there must be evidence to support a finding of permanent impairment, usually based on a DSM IV diagnosis, and that the worker is at MMR.
In this case, the first DSM IV diagnosis was in June 2011. One and one-half years later, he was still found to be suffering from depression related to the accident. Three different specialists were of the view that the worker had a DSM IV diagnosis of depression. A psychiatrist noted in December 2012 that the worker had reached MMR with an ongoing psychological impairment.
The Panel concluded that the worker came within the exceptional circumstances in Board policy, as he had a DSM IV diagnosis and had reached MMR. The worker was entitled to a NEL assessment for psychotraumatic disability.
The worker was incapable of earning income from employment as a result of his compensable condition. He was entitled to full LOE benefits to age 65, subject to statutory reviews.
The appeal was allowed.