- Second Injury and Enhancement Fund {SIEF} (severity of preexisting condition)
- Second Injury and Enhancement Fund {SIEF} (vulnerability)
- Preexisting condition (psychological condition)
The issue under appeal was whether the employer was entitled to Second Injury and Enhancement Fund (SIEF) relief with respect to the costs of this worker's claim. The worker was diagnosed with Acute Stress Disorder and treated for Post Traumatic Stress Disorder (PTSD) arising from a workplace incident.
The appeal was denied.The employer's representative submitted that the worker's previous psychological condition made her more vulnerable to develop a disability of greater severity than a normal person. The clinical evidence supported that the worker had prior psychological issues. In Decision 431/89, the Panel stated: "Where the prolonged recovery is attributable to non-organic factors by the medical practitioners, the assumption of at least a minor pre-existing psychological condition, is, prima facie, a reasonable one."The Vice-Chair found that there was no indication that the worker's recovery was prolonged or enhanced by her pre-existing psychological conditions. While the Medical Discussion Paper (MDP) on PTSD identifies some pre-trauma risk factors that may affect response, it also reports that: "At the present time, there is no consensus whether personal vulnerability or trauma characteristics are more important in the development of PTSD." In addition, certain work environments present a greater risk of workers developing PTSD, and health care providers are identified as a high risk population for PTSD. The Vice-Chair found that this was the strongest identified link for the worker's development of PTSD. The worker was engaged in youth health care at a hospital when she was unexpectedly assaulted with scissors, while trying to de-escalate risky behavior by the patient. The development of PTSD from this event, in light of the worker's occupation as identified in the MDP, was not considered out of the ordinary. As such, the employer was not entitled to the requested SIEF cost relief.