- Permanent impairment {NEL}
- COVID-19 (long)
The worker was a Registered Practical Nurse (RPN) for the employer, a long-term care facility. Under Claim A, the worker was granted entitlement for contracting the COVID-19 virus, which was later determined to have developed into COVID-19 syndrome. The designated date of injury for the condition was January 5, 2021. The worker was diagnosed with Posttraumatic Stress Disorder (PTSD) in relation to her experience in the workplace during the COVID-19 pandemic. A different claim, Claim B, was filed and the WSIB granted the worker entitlement for PTSD under Policy 15-03-13.
The issues under appeal were: a) ongoing entitlement for COVID-19 syndrome beyond December 20, 2021, including recognition of a permanent impairment and entitlement for a Non-economic Loss (NEL) award, under Claim A; b) entitlement for LOE benefits beyond August 11, 2021 under Claim A; and, c) entitlement to LOE benefits from November 2, 2021 under Claim B. The Panel allowed the appeal, in part.COVID-19 syndrome is a condition involving the continuation of COVID-19 related symptoms beyond the typical two weeks of the virus. Some of the symptoms related to the worker's COVID-19 syndrome under Claim A and her PTSD under Claim B were similar and overlapping from a time perspective. The worker's COVID-19 syndrome presented as ongoing fatigue, cognitive difficulties (i.e., difficulty focusing, and difficulty remembering simple things), generalized weakness, nausea, sleep difficulties, low activity tolerance, increased anxiety and low mood. The worker's PTSD symptoms were similar to some of these.The medical evidence indicated that as the worker's physical stamina and symptoms were gradually improving, there was a gradual shift in the focus of treatment to her psychological and trauma-based symptoms, ultimately becoming the primary focus of treatment by December 20, 2021. By December 20, 2021, the worker's PTSD had become the overwhelming reason for the worker's ongoing symptoms and the primary barrier to the worker's return to work. By December 20, 2021, the worker's COVID-19 syndrome was no longer a significant contributing factor to the worker's impairment.Based on the balance of evidence, the worker's PTSD and related symptoms overwhelmed any contribution the COVID-19 syndrome may have had towards the worker's impairment beyond December 20, 2021. There was no substantive evidence or medical opinion, such as from an infectious disease specialist, to substantiate that the ongoing symptoms were related to "Long COVID." Accordingly, the worker was not entitled to a NEL determination for COVID-19 syndrome, under Claim A. Under Claim A, the worker had entitlement to partial LOE benefits from August 11, 2021 to November 1, 2021. Under Claim B, the worker had entitlement to full LOE benefits from November 2, 2021 to September 1, 2022 and from September 2, 2022 to February 19, 2025. The worker's LOE benefit entitlement after this date was returned to the WSIB for adjudication.