- Second Injury and Enhancement Fund {SIEF} (severity of accident)
- Second Injury and Enhancement Fund {SIEF} (vulnerability)
The worker was a Vascular Technologist at a large metropolitan hospital. On November 4, 2020, she was redeployed to an acute COVID-19 ward during the second wave of the pandemic. She was assigned the dedicated role of Safety Officer, to monitor the safety of the staff on the unit, particularly their use of mandatory personal protective equipment (PPE) while they provided patient care. The worker began to lose time on March 9, 2021, due to emotional distress and crisis from being in the hospital. She was diagnosed with post-traumatic stress disorder (PTSD) and was granted entitlement to chronic mental stress (CMS) on October 21, 2021.
The employer sought an increase in the quantum of cost relief under SIEF to 75% for the worker's PTSD claim. The Vice-Chair denied the appeal. The Vice-Chair agreed with the ARO's finding that the accident was of moderate severity, given that the Safety Officer role the worker was redeployed to was such a departure from her Vascular Technologist role, exposing her to aspects of healthcare that she was not previously exposed to, particularly in the high-stress context of COVID-19 and the level of responsibility she bore in her role. The Vice-Chair did not accept the employer's submission that the SIEF Policy bound the Vice-Chair to only consider the accident history components of Safety Officer as a standalone role. The Vice-Chair noted that there are significant differences in the nature of the work performed from unit to unit in a hospital. For example, the nature and severity (in terms of life-or-death consequences) are vastly different in an emergency department as compared with an outpatient unit. Furthermore, these units, particularly in large metropolitan hospitals, are separated, enclosed, and often secured spaces, and workers from one unit may never or rarely enter another. When assessing the nature of the duties the worker was assigned as a Safety Officer in an acute COVID-19 unit in comparison with her typical duties on the vascular doppler unit, the moderate severity of the accident was clear. A significant change in psychological demands for someone unaccustomed and unacclimated to the intensity of those psychological demands would reasonably be expected to experience a disabling psychological injury. The Vice-Chair confirmed the ARO's finding that the medical significance of the worker's pre-existing psychological vulnerability was minor. Although there was an absence of a pre-existing psychological impairment, there was prior psychic trauma resulting from life experience, including a cancer diagnosis and treatment in the worker's youth, which could be considered as evidence of vulnerability. As noted in the SIEF Policy, the presence of prior psychic trauma may be sufficient, even in the absence of a pre-existing psychological impairment. The Vice-Chair noted that the worker's prior cancer history did have some effect on the processing of her PTSD. However, the degree to which the prior psychic trauma made the worker liable to develop a disability of greater severity than a normal person was minor.