Canadian Safety Reporter - sample

3 Canadian HR Reporter, a Thomson Reuters business 2019 News |Canadian Safety Reporter Benefits for recurrence of mental stress injury 3 years after incident Ongoing modified work, PTSD diagnosis, similar symptoms that developed 3 years after original incident all pointed to compatibility with original mental stress injury BY JEFFREY R. SMITH AN ONTARIO worker who re- ceived benefits for a mental stress injury is entitled to addi- tional benefits for a recurrence of the injury stemming from a less-serious incident three years later that prompted similar symptoms, the Ontario Work- place Safety and Insurance Ap- peals Tribunal has ruled. The 56-year-old worker was a personal support worker in a nursing home. She was hired by the home in 1989. On March 27, 2010, the worker was performing her job duties caring for residents in the home. One of the residents became agitated and grabbed her, punching her repeatedly in the face, head, chest, and upper body before others could inter- vene. In addition, she was unable to fully defend herself against the blows because workers at the nursing home were prohibited from harming residents under the home's policies. The worker sustained a black eye and several bruises from the assault and was crying and shaking afterwards because she felt her life had been threatened. The worker took one week off work to let her injuries heal and then returned to her regular job duties as a personal support worker. Her black eye and bruis- es faded, but she continued to experience psychological effects from the attack, particularly when any residents became ag- gressive around her. Whenever such an incident occurred, it triggered stress and anxiety. The Ontario Workplace Safe- ty and Insurance Board (WSIB) granted the worker entitlement for traumatic mental stress — finding she met the entitlement requirement under the Work- place Safety and Insurance Act that compensable mental stress be "an acute reaction to a sud- den and unexpected traumatic event arising out of and in the course of employment" — and referred her to the psychological trauma program at the Centre for Addiction and Mental Health (CAMH). Reports from the pro- gram indicated the worker had anxiety disorder with features of post-traumatic stress disorder (PTSD) in relation to the work- place. In April 2011, just over one year after the attack, another resident in the home began showing signs of increasing ag- gression towards her. One day, the resident grabbed the work- er's arm and wouldn't let go, yelling at her about his wife and showing his fist to her. After the incident, the director of nursing at the home spoke to the shaken worker and let her go home for the day to recover. However, the incident awakened more men- tal trauma for the worker — she began having difficulty sleep- ing, poor concentration, mood swings, shakiness, crying spells, and flashbacks to the March 2010 assault. She had to stop working following the second incident due to the seriousness of her psychological symptoms. Worsening symptoms led to PTSD diagnosis Given the worker's anxiety dis- order diagnosis, the WSIB de- termined she was unable to work for a period of time and granted her entitlement to benefits for a recurrence of her mental stress injury following the April 2011 incident. A follow-up report in May 2011 diagnosed the worker with full PTSD. A WSIB return-to-work spe- cialist evaluated the worker and reached an agreement with the nursing home to have the worker re-integrate back into the work- place starting with two shifts a week, eventually progressing to regular shifts. The worker would perform modified duties including administrative tasks in an office, feeding residents in the lounge, and participating in the nursing rehab program with small groups of residents. However, the worker suf- fered another flare-up of her mental stress symptoms in May 2012 when she saw aggressive residents hitting staff members. She soon found herself waking up mornings crying, shaking, and feeling mentally drained. A psychologist observed that the worker experienced a "disso- ciative state" when witnessing assaults in the workplace. The WSIB granted entitlement to benefits for a second recurrence of the workplace mental stress injury. The worker expressed a de- sire to work in a retirement home adjacent to the nursing home, where her exposure to potentially aggressive residents would be limited and she felt safer. A return-to-work plan was developed in August 2012 that involved the worker working mostly in the retirement home's laundry room. The worker worked in the laundry room for several months until April 17, 2013. On that date, a resident came up behind her in the laundry room when she was Credit: Shutterstock/Heiko Kueverling PTSD > pg. 7

• Cover