- Permanent impairment {NEL} (degree of impairment) (psychotraumatic disability)
- Permanent impairment {NEL} (degree of impairment) (headaches)
The worker's Non-Economic Loss (NEL) award for psychotraumatic disability was set at 15%. The WSIB also accepted that the worker had a pre-existing migraine condition that had been permanently aggravated by her PTSD. The worker's NEL award for this condition was set at 3.75% The worker sought increases in the NEL awards for both conditions. The employer contended that rating the migraine condition separately resulted in a duplicative award for the worker with both awards containing recognition of the same restrictions.
The Panel allowed the appeal.The Panel accepted that the worker's migraine condition was a separate medical condition from her PTSD condition, that the WSIB had recognized the worker's entitlement to both conditions, and that the two conditions should be rated separately. The effects of the worker's migraine condition were episodic and not constant in a similar manner to her PTSD symptoms. Furthermore, despite the worker's migraine episodes being triggered by the worker's PTSD, the worker's migraine symptoms were for the most part distinguishable from her PTSD symptoms (physical versus psychological). Any overlap in symptoms between the two conditions must, however, be accounted for to avoid the potential for duplicative NEL ratings. In particular, interference with activities of daily living caused by the worker's PTSD symptoms was not to be taken into consideration in determining limitations on activities of daily living due to her migraine condition.The Panel concluded that the "best fit" for the worker's psychological condition was a Class 3, Moderate impairment and placed the worker within the middle of Class 3, at 35%. The worker's migraine headaches were rated under the AMA Guides as an Episodic Neurological Disorder. The severity of the worker's migraines placed her at the top end of the slight severity category which is associated with a 15% rating. The worker's pre-existing migraine headaches, which the Panel found to be ratable under the AMA Guides at 5%, reduced the worker's NEL award for her migraines to 10%. The worker's 35% PTSD award and her 10% award for migraines were combined for a total rating of 42%.