The Appeals Commission for Alberta Workers’ Compensation has directed the Workers’ Compensation Board (WCB) to conduct a deeper investigation into a claim for psychological injury. The case, which revolves around an incident on Feb. 23, 2020, where the worker alleges he was sexually assaulted by an unknown male at a jobsite, has been mired in debate over the nature of the injury and its connection to the workplace event.
The worker reported that a man approached him while he was on duty, asking for directions and then making physical contact that escalated to what the worker perceived as inappropriate and deliberate sexual touching. The worker stated that the man first touched his hips and later brushed his private area, which initially seemed accidental but was repeated in a way that made the worker feel threatened.
This led the worker to experience significant distress, and he immediately reported the incident to his employer, who contacted the police.
Despite the worker’s assertions and subsequent diagnosis of Post-Traumatic Stress Disorder (PTSD) by his treating physician, the employer challenged the claim, arguing that the incident did not meet the criteria for a traumatic event as defined under the Workers’ Compensation Act (WCA) and WCB policies.
The employer’s representative highlighted that the worker’s response to the incident, including walking with the man to another building after the first contact, indicated that he did not feel threatened at the time. Furthermore, the employer questioned the credibility of the worker’s PTSD diagnosis, pointing to a history of substance abuse and other psychological issues that may have predated the incident.
The Appeals Commission’s decision acknowledged these concerns, particularly the lack of comprehensive psychological evaluation that fully considered the worker’s past traumas and the potential for pre-existing conditions to have influenced his current psychological state. The decision emphasized the need for a detailed investigation into the worker’s mental health history, including any prior diagnoses of PTSD or other psychological disorders, and how these may have interacted with the February 2020 incident.
“Given the conflicting medical opinions and the worker’s complex psychological history, we find there has been insufficient psychological/psychiatric investigation upon which to determine whether the worker has an acceptable WCB claim on a presumption basis, or on a direct, or aggravation basis,” the Appeals Commission said in its decision.
The ruling highlighted several key points of contention:
Medical Evidence: While multiple medical professionals, including the worker’s family physician and a psychiatrist, supported the PTSD diagnosis related to the workplace incident, a comprehensive psychological assessment (CPA) conducted in November 2021 raised doubts. The CPA indicated that the worker might be over-reporting his symptoms, and the psychologist conducting the assessment did not believe the incident met the DSM criteria for sexual violence or trauma.
Pre-existing Conditions: The employer’s representative argued that the worker had a history of psychological issues, including a prior sexual assault during his teenage years, which the worker only disclosed during treatment in June 2021. This, along with a diagnosis of depression in December 2019, raised questions about whether the workplace incident was the primary cause of the worker’s current psychological state.
Presumption of Injury: The Appeals Commission reviewed the presumption under WCB policy that a psychological injury is compensable if it results from a traumatic event at work, unless contrary evidence is presented. However, in this case, the Commission found that the evidence was not sufficient to either confirm or rebut this presumption without further investigation.
Given these complexities, the Appeals Commission directed the WCB to arrange for an Independent Medical Examination (IME) and another CPA to clarify the worker’s psychological diagnoses and their connection, if any, to the workplace incident. The results of these assessments will help determine whether the worker’s claim for a psychological injury is compensable.
For more information, see Decision No.: 2024-0318, 2024 CanLII 79390 (AB WCAC).
