An Ontario firefighter who experienced traumatic events during their career has been granted entitlement for traumatic mental stress, depression, and aggravation of pre-existing Crohn’s disease in a significant decision from the Workplace Safety and Insurance Appeals Tribunal.
The tribunal partially overturned previous denials, ruling the worker was entitled to benefits for post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and aggravation of Crohn’s disease, along with a non-economic loss assessment and loss of earnings benefits dating back to January 2009.
Separate but related conditions
The case involved a firefighter who stopped working in January 2009 following years of traumatic workplace events and harassment. While the Workplace Safety and Insurance Board (WSIB) had previously granted presumptive entitlement for PTSD under section 14 of the Workplace Safety and Insurance Act as a first responder, it had denied several related claims.
A central question was whether the worker’s anxiety symptoms were part of their compensable PTSD condition or required separate entitlement. The tribunal found that anxiety symptoms were included within the PTSD diagnosis, but that MDD was a separate condition requiring entitlement under traumatic mental stress provisions.
“Taking a holistic approach, we find that the weight of the medical evidence describes the worker’s diagnosed PTSD and Major Depressive Disorder as separate disorders,” the tribunal wrote. “While we find that the weight of the medical evidence describes a web or constellation of inter-related symptoms including PTSD, Anxiety and MDD, given the separate diagnosis of Depression, and the wording of section 14, which limits entitlement to the diagnosis of PTSD, we find that the worker is not entitled under section 14 for the diagnosis of Major Depressive Disorder.”
Multiple traumatic events
The tribunal identified several traumatic workplace events that significantly contributed to the worker’s condition:
- In 1993, attending a motor vehicle accident where five young men were killed, with one dying while the worker was at the scene
- In 1994, being sexually assaulted by a senior member of another firefighting organization while at a conference
- In 1999, witnessing an 18-year-old boy die after jumping from a hospital ledge, and performing CPR at the scene
The tribunal found these events were “objectively identifiable and objectively traumatic” as defined in the WSIB’s traumatic mental stress policy.
The employer argued that these events were too remote to have significantly contributed to the diagnosis of PTSD in 2009, and that non-work events (including the worker’s brother’s death in 2004) outweighed workplace factors. The tribunal rejected this argument, finding the workplace events significantly contributed to the worker’s PTSD and depression diagnoses.
Crohn’s disease connection
In a notable aspect of the decision, the tribunal also found the worker’s compensable psychological conditions aggravated their pre-existing Crohn’s disease.
The tribunal accepted the opinion of the worker’s treating psychologist that “the worker’s psychological conditions of anxiety and depression both have a direct impact on her physical health and the course of her Crohn’s Disease.”
This finding was supported by medical research provided by the tribunal’s Medical Liaison Office indicating psychological factors can contribute to Crohn’s disease exacerbation.
“Considering all of the evidence, we find on a balance of probabilities, that the compensable psychological condition significantly contributed to the diagnosed recurrence or exacerbation of the worker’s Crohn’s Disease in February 2010,” the tribunal concluded.
Permanent impairment and wage loss
The tribunal determined the worker was entitled to a non-economic loss assessment for permanent psychological impairment with a maximum medical recovery date of November 3, 2016, when a psychologist described the worker’s PTSD as “chronic.”
The decision also granted entitlement to loss of earnings benefits dating back to January 5, 2009, finding that “the weight of the medical opinion in the case materials indicates that the worker was unable to return to work after January 2009 due to the compensable psychological conditions.”
The nature and duration of benefits flowing from these findings were returned to the WSIB for further adjudication.
For more information, see Decision No. 1696/23, 2025 ONWSIAT 223 (CanLII).
