Highlights of Noteworthy Decisions

Decision 280 21
E. Kosmidis
  • Drug addiction
  • Psychotraumatic disability
  • Labour market re-entry {LMR} (cooperation) (legitimate reasons)

The worker injured his low back in March 2007 when he slipped on ice. The worker's LMR program took place while he was also attending a drug treatment program. The Board determined that he was uncooperative in the LMR program due to his poor attendance, closed the program, and reduced his LOE benefits. At the final LOE review, it was determined that he could earn more than his pre-injury earnings and LOE benefits ended. The worker appealed, and also appealed decisions denying entitlement for psychotraumatic disability and drug addiction.

The appeal was allowed in part.
The worker had entitlement for psychotraumatic disability. He was diagnosed with depression following the injury and the medical evidence indicated that the depression was caused by the pain and his inability to work. At the time of the injury, he had no significant history of depression.
The worker was not uncooperative with his LMR plan. The worker had a valid reason for not attending his LMR program as he was required to attend mandatory appointments in the drug treatment program. The worker's addiction to pain medication was a preexisting condition that required accommodation in the development of the LMR plan. His psychologist had indicated that he needed to learn to manage his pain levels before he could participate in an LMR program. He was entitled to full LOE benefits less any actual earnings to the date of the final LOE review.
Given the finding that the worker was not uncooperative, the LMR plan was incomplete at the 72-month final LOE review date. He was entitled to partial LOE from the review date to the start of his subsequent WT assessment. Further entitlement after the start of the WT program was referred to the Board.
The worker was not entitled to benefits for his drug addiction. The evidence was that the addiction to painkillers predated the accident and the worker was still taking Percocet regularly at the time of his injury.