Highlights of Noteworthy Decisions

Decision 353 17
M. Crystal
  • Pensions (assessment) (psychotraumatic disability)

The worker was the victim of a physical and sexual assault in 1987, while working for a government agency overseas. She was attacked by an intruder who broke into her apartment, which was part of the staff quarters maintained by the agency. The Board granted the worker a 20% pension for psychotraumatic disability, with an increase to 35% in 2010. The worker appealed a decision of the Appeals Resolution Officer regarding the quantum of the award in 2010.

The Vice-Chair reviewed the categories of impairment in Board Operational Policy Manual, Document No. 15-04-02, on psychotraumatic disability. The Board characterized the worker within Category 3 for major impairment of the total person, which has a rating range of 30% to 50%. The Vice-Chair compared Category 3 with Category 4 for severe impairment of the total person, which has a rating range of 60% to 80%.
The worker met the description of the various elements stated in Category 4. The Vice-Chair then took a step back from the "granular" analysis, which parses the Category 4 description and identifies detailed medical information fitting the description.
The Vice-Chair applied the rating schedule to the worker's case in a more global or holistic sense. The Vice-Chair considered the conceptual differences between a worker properly placed in Category 3 and a worker properly placed in Category 4.
Many of the descriptors that apply to Category 3 also apply to Category 4. The main difference between the two categories is the level of functionality described. Category 3 describes an individual who has lost a significant degree of functionality but remains somewhat functional. Category 4 describes an individual who has lost most psychological functionality. In making this distinction, the Vice-Chair noted terms in Category 3 such as "incipient breakdown" and "tendency to avoid anxiety-creating situations," whereas Category 4 includes terms such as "clearly displays" limitations in adaptation and function.
Considered on this basis, the worker was better considered to fit in Category 4 rather than Category 3.
The rating for a psychotraumatic disability is determined by the extent of the psychological symptoms that a worker manifests after an accident and the extent to which a worker is able to cope with life following psychological injury. The rating is based on the extent of the disability that is experienced by the worker, rather than upon how traumatic the event may have been, when considered objectively. Nevertheless, in this case, it is appropriate to consider the nature of the accident. The worker was held at knifepoint for a period of hours and was sexually assaulted. From an objective standpoint, this case would be highly likely to cause a psychological reaction of some significance. The nature of the incident in this case provides further support for the conclusion that the worker is properly placed in the most severe category of the applicable rating schedule.
On the evidence, the worker exhibited a limited level of functionality, which placed her at the low range of Category 4. The worker was entitled to a 60% pension. The appeal was allowed in part.