Conditions for Entitlement –Traumatic Mental Stress Policy 21-103 | Effective Date: April 29, 2021

Policy

The WC Act excludes mental stress as a compensable condition, except when the disablement of mental stress or a disablement caused by mental stress is the result of an acute reaction to a traumatic event.

A claim for mental stress is compensable when the following three conditions are met:

• The worker has suffered an acute reaction (injury);
• The acute reaction was caused by a traumatic event (accident); and
• The traumatic event arose out of and in the course of the worker’s employment.

For emergency response workers covered by the presumptive legislation, when the emergency response worker is diagnosed with PTSD by a qualifying psychologist or psychiatrist, the PTSD is presumed to have arisen out of and in the course of employment unless the contrary is shown.

WorkSafeNB adjudicates all mental stress claims, except claims eligible for the PTSD presumption, using the criteria outlined in Policy 21-100 Conditions for Entitlement – General Principles and Policy 21-104 Conditions for Entitlement – Tests of Time, Place, and Activity.

Interpretation

1. A worker is considered to have experienced a traumatic event when:

• The worker is diagnosed with PTSD by a qualifying psychologist or psychiatrist and WorkSafeNB has confirmed the diagnosis is consistent with the diagnostic criteria set out in the most recent DSM at the time of diagnosis. In these instances, the occurrence of a traumatic event is inherent to the PTSD diagnosis; or
• The purported traumatic event, when considered objectively by using a “reasonable person standard”, meets the definition of traumatic event as defined in this policy. The “reasonable person standard” will consider whether the event, as experienced by a reasonable person, without regard to the personal, subjective perceptions of the individual worker, would qualify as an objectively traumatic event. 

2. Psychological and/or psychiatric information plays a key role in determining if the mental stress is compatible with the work-related traumatic event that caused it. To be compensable, the psychological and/or psychiatric information must show that:

• The sudden and unexpected traumatic event was significant enough to have caused an acute reaction;
• The acute reaction could have reasonably caused the psychological or psychiatric condition described;
• The psychological or psychiatric condition is a mental or physical condition that is described in the most recent American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders at the time of diagnosis; and
• The psychological or psychiatric conditions must be diagnosed by a psychologist or psychiatrist, who is registered with the appropriate regulatory body in the province in which they work.

3. A worker may be exposed to a single traumatic event or multiple traumatic events. WorkSafeNB recognizes that, in some cases, there may be a delayed expression of symptoms.

4. Normal work pressures or decisions of the worker’s employer relating to the management and monitoring of the worker’s employment do not qualify as a traumatic event.

5. WorkSafeNB applies the legislated PTSD presumption for workers if:

• They are an emergency response worker on or after June 28, 2016 and have a PTSD diagnosis by a psychiatrist or psychologist;
• They were an emergency response worker when they submitted a claim, and the diagnosis of PTSD by a psychiatrist or psychologist was made on or after June 28, 2016; or
• They cease to be an emergency response worker on or after June 28, 2016 and they are diagnosed by a psychiatrist or psychologist with PTSD within 24 months of their retirement from emergency response work.

6. For claims involving the legislated presumption for emergency response workers diagnosed with PTSD, legislation prescribes that the diagnosis for PTSD will be as that condition is described in the most recent edition of the DSM. WorkSafeNB will therefore confirm the diagnosis is consistent with the diagnostic criteria set out in the most recent DSM at the time of diagnosis prior to applying the presumption.