- Benefits (reduction or suspension) (cooperation)
- Benefits (reduction or suspension) (material change in circumstances)
The worker, a paramedic, was granted entitlement for post-traumatic stress disorder after responding to a motor vehicle accident on February 22, 2012. He received LOE benefits until September 2012, when he returned to work. In August 2012, the employer and Board discovered that the worker had been involved in activities as a volunteer firefighter continuously since the accident. The Board determined that he failed to report a material change and rescinded entitlement to all LOE benefits. The worker appealed.
The appeal was allowed in part. The worker failed to report a material change and/or failed to cooperate in the return to work process. Under the Act and Board policy, workers are required to report material changes in circumstances, which means any change that they know or ought reasonably to know may affect their entitlement to benefits. Workers are also required to provide all information relevant to the return to work process. The worker did not fully disclose the extent of his volunteer firefighter activities to his treating doctors, the Board, or his employer. The worker's description of his firefighter duties as "administrative" was misleading, as he had responded to emergency situations and was therefore engaged in activities that could potentially expose him to PTSD-triggering situations. He knew or ought to have known that a more accurate account of his firefighter activities would be relevant to the return to work process. However, full reduction of the worker's benefits from the date of the accident was not in order. It was reasonable that the employer would not have offered modified work until after the initial medical investigation and reporting. He was entitled to full LOE benefits from February 23, 2012 to March 20, 2012, which was the date of his assessment with a specialist.