- Preexisting condition (alcoholism)
- Second Injury and Enhancement Fund {SIEF} (pre-existing disability) (causation)
The issue under appeal was whether the employer was entitled to SIEF relief with respect to the costs of the worker's claim. The worker was involved in a fatal crash while operating a truck for the employer. The toxicology report tested positive for alcohol and another substance.
The appeal was denied.OPM Document No. 14-05-03 indicates: "In situations where alcoholism plays a role in the causation of an accident, it is not considered to be a pre-existing condition with regard to the application of SIEF relief." The Vice-Chair noted that it is unclear whether "alcoholism" is to be understood as a medically diagnosed condition of dependency on alcohol, or simply being under the influence of alcohol while in the course of employment. In this case, there was also an added factor of drug use. For these reasons, the Vice-Chair found it was necessary to examine whether intoxication by alcohol and drugs constituted a "prior disability which caused or contributed to the compensable accident." There was no evidence that the worker's alcohol or drug consumption "produced periods of disability in the past requiring treatment and disrupting employment." Although the family indicated that the worker's history was "significant for […] alcohol use," a finding that the worker had a "pre-accident disability" based on this vague statement would be speculative. The confirmation that the worker had used alcohol in the past was vague. It gave no information about the nature or degree of use, and it did not amount to a statement that the worker was an alcoholic. Based on the foregoing, the Vice-Chair concluded that there was no basis for entitlement to SIEF cost relief.The employer's representative referenced section 17 of the WSIA which reads: "If an injury is attributable solely to the serious and wilful misconduct of the worker, no benefits shall be provided under the insurance plan unless the injury results in the worker's death or serious impairment." The Vice-Chair clarified that this is not a valid argument in the context of a claim for SIEF claim cost relief. Section 17 relates to initial entitlement to benefits under the Act, and not to the special fund established under section 98(1).