Highlights of Noteworthy Decisions

Decision 1544 17
20/09/2019
G. Dee
  • Medical report (opinion of medical assessor)
  • Psychotraumatic disability
  • Evidence (weight) (medical report)

The worker tripped and struck her head in April 2011, suffering a concussion. The worker appealed a decision of the Appeals Resolution Officer denying entitlement for psychotraumatic disability.

There was no history of psychological problems. There was a close temporal relationship between the accident and the development of the worker's psychological difficulties. All of the worker's treating or assessing health care providers were of the view that the worker's psychological problems were caused by her compensable accident. The most significant of those reports was from CAMH.
In Decision No. 1544/17I, the original vice-chair had concerns with the report of the doctor from CAMH and decided to obtain a report from a Tribunal medical assessor. The report of the Tribunal assessor did not support a causal connection between the accident and the worker's psychological condition.
The Vice-Chair concluded that the compensable accident was a significant contributing factor to the worker's development of her psychological difficulties, considering the lack of prior psychological difficulties, the lack of identified non-compensable stressors, the temporal relationship between the accident and the psychological symptoms, and the medical evidence as a whole.
Regarding the medical evidence, the doctor from CAMH did not conduct formal psychological testing; rather, the doctor conducted a less structured psychiatric interview. However, the absence of formal psychological testing was due to the worker's apparent inability to participate in the testing. Despite that and some other concerns, the Vice-Chair found the report to be thorough and thoughtful. The Vice-Chair preferred it, and the other opinions consistent with it, over the medical opinion of the Tribunal assessor. The Vice-Chair noted that the Tribunal assessor appeared to question whether a head injury occurred at all and whether the worker suffered a concussion. However, these were accepted facts in the proceedings. The lack of acceptance of these facts lessened the weight to be attached to the report of the assessor.
The worker had entitlement for psychotraumatic disability. The appeal was allowed.