- Credibility
- Early and safe return to work {ESRTW} (cooperation)
- Evidence (inconsistencies)
- Psychotraumatic disability
- Non-economic loss {NEL}
- Permanent impairment {NEL}
- Strains and sprains (ankle)
- Benefits (reduction or suspension) (cooperation)
- Adjustment disorder
The Board granted the worker initial entitlement for a left ankle ligamentous injury. The issues under appeal were: a) the finding of non-co-operation for the period between September 23 and October 23, 2020; b) the quantum of the worker's loss of earnings (LOE) benefits from September 23 to October 7, 2020; c) entitlement to LOE benefits from October 7 to October 23, 2020; d) ongoing entitlement for the left ankle beyond April 15, 2021; e) entitlement to LOE benefits beyond April 15, 2021; f) recognition of a permanent impairment (PI) and entitlement to a non-economic loss (NEL) determination for the left ankle; and, g) entitlement for psychotraumatic disability.
The appeal was denied.The Vice-Chair found that the worker was non-co-operative between September 23 and October 23, 2020. The worker did not respond to multiple contact attempts and thereby frustrated the Board's ESRTW process. The worker also prevented a comprehensive assessment of her work-related injury and requested healthcare examination. There was no evidence to indicate that the worker was otherwise participating in healthcare measures related to her claim. The Board appropriately reduced the worker's LOE benefits from September 23 to October 7, 2020, and appropriately suspended the worker's LOE benefits from October 7 to October 23, 2020.The Vice-Chair found, on a balance of probabilities, that the worker fully recovered from her work-related left ligamentous injury, and that her left lower extremity pain was due to non-compensable factors. There was no medical evidence of significance to link the worker's work-related ligamentous injury to her continuing left ankle pain after April 15, 2021. Therefore, there was no ongoing entitlement for the left ankle after April 15, 2021. The Vice-Chair determined that the worker's psychological condition, including severe generalized anxiety, was caused by non-medical, socio-economic factors, i.e., financial hardship. Tribunal decisions have found that financial hardship, when caused by the worker's lack of participation in the Board's RTW process, is not considered a work-related factor. Decision No. 2338/10 determined that the worker's failure to co-operate in labor market re-entry, which resulted in financial difficulties, constituted an intervening cause that broke the chain of causation between the worker's work-related injury and the subsequent development of a psychological condition. The principles outlined in that decision have been followed in subsequent Tribunal decisions (see Decision No. 523/21). The Vice-Chair concluded that the worker's financial hardship was caused by her non-co-operation in the RTW process, rather than her work-related injury. Lastly, the Vice-Chair found that the worker's continued pain symptoms were, more likely than not, due to non-compensable factors. These factors overwhelmed the significance of the worker's now-resolved work-related condition as a cause of her psychological symptoms. While it is not necessary for the work-related injury to be the sole or primary contributing factor in order to attract entitlement for psychotraumatic disability, the contribution of the work-related injury must nonetheless be a significant one. While the Vice-Chair accepted that the worker's psychotraumatic disability was related to her extended disablement and to non-medical, socio-economic factors, these were not "directly and clearly related to the work-related injury," as required under the Board's policy.