Highlights of Noteworthy Decisions

Decision 1369 22
B. Pollock
  • Psychotraumatic disability
  • Health care (attendance allowance) (arrears)

The issue in this appeal was the Independent Living Allowance ("ILA") entitlement arrears date. Decision No. 1318/21 found that the worker was entitled to a 25% NEL award for psychotraumatic disability, which increased the worker's whole person impairment to 62% in September 2021.

The appeal was allowed. The worker's entitlement to an ILA began as of May 2, 2008.
OPM Document No. 17-06-02 provides for entitlement to an ILA when an injured worker is considered severely impaired (with permanent disability (PD) benefits totalling at least 100%, or NEL benefits totalling at least 60%). The criteria were met in this case. The Tribunal has considered the issue of the appropriate ILA arrears date in a situation where the worker qualified as severely impaired as a result of the level of permanent impairment increasing pursuant to the onset of a secondary psychotraumatic disability, which began some time after the physical date of injury.
The Vice-Chair accepted that the ILA arrears date should reflect the date by which the totality of the worker's compensable permanent impairments that result in ILA eligibility first became manifest. This involves a determination of a notional accident date on which the secondary psychotraumatic disability, resulting in a NEL rating meeting or exceeding 60%, became manifest. OPM Document No. 15-04-02 "Psychotraumatic Disability", provides that a worker is entitled to benefits when a diagnosis of psychotraumatic disability is attributable to a work-related injury or a condition resulting from a work-related injury.
In the present appeal, the medical reporting established that medical assistance for the worker's psychotraumatic disability was first sought by the worker in a May 2, 2008 consultation where she was first diagnosed. Accordingly, May 2, 2008 was found to be the notional accident date on which the worker's psychological injury which resulted in her being found to be "severely impaired" first became manifest.