- Second Injury and Enhancement Fund {SIEF} (severity of accident)
- Second Injury and Enhancement Fund {SIEF} (severity of preexisting condition)
- Preexisting condition (psychological condition)
The WSIB granted the worker initial entitlement for PTSD under the presumption for first responders. The issue under appeal was the quantum of the accident employer's SIEF cost relief.
The Vice-Chair allowed the appeal, in part. Based on a moderate work-related accident, superimposed on a moderate pre-existing condition, the accident employer was entitled to 50% SIEF cost relief.The employer's representative submitted that the primary causes of the worker's PTSD were a toxic work environment and interpersonal conflict. As this line of argument was an attempt to rebut the presumption underlying the worker's initial entitlement to benefits, it was outside the scope of the current appeal. The employer's representative also submitted that the worker's most recent employment involved fewer trauma events when compared to his previous employment, and therefore, the work-related accident was minor in severity when contrasted with the worker's previous exposure to traumatic incidents. The Vice-Chair noted that although the first responders policy provides entitlement to benefits for cumulative exposure to traumatic incidents, it is silent on how, or whether, different traumatic incidents should be weighed in the event that the worker had multiple exposures under different employers. The Vice-Chair noted that the worker had entitlement to benefits for the consequences of the cumulative traumatic events he experienced in his history of employment as a first responder. The Vice-Chair also accepted that the worker's pre-2013 traumatic exposures, while related to his employment as a firefighter and first responder, should be considered a pre-existing condition in the context of the WSIB's SIEF policy. An adjudicator must consider the severity of the work-related accident as whether it would be reasonably expected to cause a non-disabling or minor disabling injury, a disabling injury, or a severe injury. The significance of a pre-existing condition, if any, is assessed in terms of whether it made the worker more liable to develop a disability of greater severity than a normal person. The Vice-Chair noted that although a triggering event(s) was not required for the worker to establish initial entitlement in this claim (as compared to the TMS policy), it did not necessarily follow that the events underlying the worker's PTSD diagnosis were of a less traumatic nature. The Vice-Chair determined that repeated exposure to the types of traumatic events described by the worker would reasonably be expected to cause a disabling injury, notwithstanding the fact that the incidents were part of the worker's expected and regular duties. The work-related accident was one of moderate severity, as defined by the WSIB's SIEF policy. Similarly, the Vice-Chair found that the worker's trauma experiences from his previous employment, also as a first responder, represented a moderate pre-existing condition. Such exposures would more likely than not cause a disabling injury.