Highlights of Noteworthy Decisions

Decision 166 21
M. Crystal - D. Thomson - S. Roth
  • Causation (medical evidence)
  • Hepatitis
  • Board Directives and Guidelines (stress, mental) (traumatic event)
  • Initial entitlement (eligibility)
  • Harassment (person in position of authority)
  • Stress, mental (chronic)

A worker sought initial entitlement for Hepatitis C (HCV) which he claimed arose from administering mouth-to-mouth CPR on a patient. He also sought benefits for Traumatic Mental Stress (TMS) arising from the same incident.

The Panel noted that it was possible that the worker contracted HCV as a result of the incident; however, for entitlement to be granted, the evidence must show a probable causal connection between the March 2005 incident and the worker's HCV diagnosis in 2015. From the review of the evidence, the Panel determined that such a causal connection was not probable. Factors in the decision included the following: it was not known whether the patient who was involved in the March 2005 incident was positive for HCV at the time of the incident; if the patient was positive at the time of the incident - according to information from the CDC, the average risk for HCV infection after a needle injection or other direct exposure to HCV infected blood is small, at about 1.8%, and the risk from exposure through the eyes, nose or mouth, is probably less; and the worker had some other non-occupational risk factors for HCV infection associated with his history. The Panel also noted that 10 years had passed between the time of the incident and the worker's positive HCV diagnosis.
However, the worker was granted entitlement for TMS arising from the same incident. The Panel noted that, in order to establish entitlement to benefits for TMS, it is not necessary to prove that a single factor was the exclusive cause of the worker's psychiatric diagnoses. Rather, entitlement may be established if a traumatic incident made a significant contribution to the development of the diagnoses. The Panel considered the objectively traumatic nature of the incident on March 18, 2005, the prominence of the incident in relation to the worker's psychiatric status as described in the medical information provided by the worker's treating practitioner, and the worker's testimony at the hearing. The Panel was satisfied, on a balance of probabilities, that the incident on March 18, 2005, while not exclusively responsible for the worker's psychiatric status, made a significant contribution to that status. On this basis, the Panel concluded that there was a causal connection between the incident and the worker's psychiatric status, and that entitlement to benefits for TMS was in order.