A Nova Scotia nurse who experienced a significant psychological relapse after a confrontation with her supervisor has successfully appealed a Workers’ Compensation Board (WCB) decision that denied her claim for compensation.
The Nova Scotia Workers’ Compensation Appeals Tribunal has ruled that the nurse’s psychological symptoms, which resurfaced in 2022, are a compensable recurrence of a psychological injury originally sustained in 2004-2005.
The nurse, whose identity remains confidential, had been working in palliative care when an incident with her supervisor on Jan. 21, 2022, triggered a severe psychological reaction, including symptoms of post-traumatic stress disorder (PTSD). The Tribunal found that these symptoms were directly linked to a prior workplace trauma that the nurse experienced nearly two decades ago while working in a neonatal intensive care unit (NICU).
In the initial WCB decision, the nurse’s 2022 claim was dismissed on the grounds that her symptoms were the result of personal relationship and labour relations issues, which are not covered under the Board’s policies. However, the nurse, who had previously been diagnosed with PTSD following a series of traumatic events at her workplace in 2004-2005, argued that the recent incident had exacerbated her existing condition.
During the appeal, the nurse testified that the confrontation with her supervisor brought back memories of her previous workplace trauma. The supervisor’s remarks, including questioning the nurse’s professionalism and mental health, caused her to “flash back” to the events of 2004-2005, leading to an emotional breakdown that left her unable to work.
The nurse had been seeing a psychiatrist, Dr. Neil Christians, who had been treating her for major depressive disorder since 2017. Dr. Christians supported the nurse’s claim, stating that the symptoms she experienced in 2022 were consistent with PTSD and that these symptoms were a recurrence of the trauma she suffered nearly 20 years earlier.
“Although it is now 18 years, she still fulfills the criteria for post-traumatic stress related to the events of 2004/2005,” Dr. Christians wrote in a report submitted as evidence. He further noted that the PTSD diagnosis was likely missed in the initial claim due to the more restrictive criteria for PTSD at the time.
The Tribunal agreed with Dr. Christians’ assessment, finding that the nurse’s psychological symptoms were indeed a recurrence of her earlier injury. Appeal Commissioner David Pearson, who presided over the case, ruled that the incident in 2022, while seemingly minor on its own, served as a significant trigger for the nurse’s PTSD due to its similarities with her past trauma.
“The January 21, 2022 meeting was one such innocuous event. On its own and without the prior workplace trauma, it would not be sufficiently outside the realm of conflict or disagreement that happens at work. Seen by itself, it would likely fall into the labour relations or interpersonal relationship category of conduct, making it non-compensable,” Pearson wrote in his decision. “However, their significance is made manifest by the relationship to the earlier injury.”
The Tribunal’s decision emphasized the importance of considering the long-term impact of workplace trauma and how it can be reactivated by later events, even those that might not appear traumatic in isolation.
In addition to Dr. Christians’ testimony, the nurse’s case was bolstered by reports from other mental health professionals, including a psychologist who diagnosed her with “Trauma and Stress Related Disorder Otherwise Specified: workplace bullying and harassment.” Although this diagnosis did not fully meet the criteria for PTSD under the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-V), it supported the argument that the nurse’s symptoms were related to her earlier workplace experiences.
The Tribunal found that the WCB had erred in treating the 2022 incident as a new and unrelated claim, without adequately considering its connection to the nurse’s prior compensable injury. The Board had also failed to address whether the 2022 symptoms could be seen as a recurrence of the 2004-2005 injury, despite the Workers’ Adviser’s request for a determination on this issue.
With the Tribunal’s ruling in her favour, the nurse’s psychological injury claim from 2022 has been reinstated, and the WCB will now determine the benefits to which she is entitled.
For more information, see 2022-392-AD (Re), 2024 CanLII 75324 (NS WCAT).
