- Post-traumatic stress disorder
- Board Directives and Guidelines (stress, mental) (traumatic event)
The worker was a record processing clerk with the police force until he went off work due to psychological symptoms. The worker was diagnosed with Post-Traumatic Stress Disorder (PTSD). The worker sought initial entitlement to compensation benefits for a work-related psychological injury, on the basis of either Traumatic Mental Stress (TMS) or Chronic Mental Stress (CMS).
The Panel allowed the appeal for TMS. The worker did not come within the definition of first responders under the WSIA, and the presumption of causation under section 14 did not apply. The question was whether the worker's exposures in his job to traumatic stress was a significant contributing factor in the development of his PTSD. It was the worker's role to take calls from officers at the scene, in which the officer dictated information about the occurrence. The worker then created a summary or synopsis of the occurrence. The worker received and processed information for any type of incident or crime for which the police might be contacted. The worker processed 15 to 20 calls (occurrence reports) in a shift. The worker's role did not involve direct contact, as his exposure was through the officers dictating to him. The Panel found that in the course of his work, the worker was repeatedly exposed to the details of traumatic and at times gruesome events. He was routinely exposed to matters involving violence and sexual violence. The worker's treating psychologist and psychiatrist stated that the effect was likely cumulative. The examples of traumatic events provided in the TMS policy are worded to contemplate first hand exposure. The policy also includes a clause indicating that exposure must be first hand. The worker's exposure in this case was not first hand. The Panel noted that for the diagnosis of PTSD, unlike most diagnoses, the DSM criteria require the medical professional to assess causation of the condition as part of making the diagnosis. The medically assessed cause of the worker's PTSD was the worker's exposure to aversive details of traumatic events in the course of his work as a Records Systems Operator. The Panel interpreted the first hand clause to mean that generally, or in most cases, the worker will have been exposed to the traumatic events through first hand exposure. However, it is not an absolute requirement in each case. In the Panel's view, the clause regarding "first hand" exposure must be read in light of the DSM diagnostic criteria. The policy acknowledges those diagnostic criteria as the standard. The policy must be read as intended to be consistent with those criteria. Therefore, the policy must be interpreted to include PTSD that is a result of any of the circumstances medically considered traumatic under the DSM-5 Part A criteria for PTSD. Interpreting the policy so as to give full weight to the current DSM criteria for PTSD was considered more consistent with the underlying legislative provisions, the accepted standard of diagnosis in the psychological community, as well as other parts of the TMS policy addressing what counts as an accepted diagnosis. In addition, the list of traumatic events in the TMS policy is not exhaustive, and this interpretation was consistent with the prevailing case law that the type of exposures which may be found to be objectively traumatic is not a predetermined list.