PDF version of Work-Related Stress – WSIB Fact Sheet 5
- Traumatic mental stress (TMS)
- Chronic mental stress (CMS)
- Post-traumatic stress disorder (PTSD) in First Responders and Other Designated Workers
A worker may be entitled to benefits for work related mental stress arising out of and in the course of employment. However, a worker is not entitled to benefits for work-related stress caused by an employer’s decisions or actions that are part of the employment functions, such as:
- Changes in working hours
- Productivity expectations
- Terminations
- Demotions
- Transfers
Overview
Filing a Claim
You must file a claim with the Workplace Safety and Insurance Board (WSIB) as soon as possible, but no later than six (6) months from the date you became aware the condition was related to work or a work incident.
Diagnostic Medical Requirement
Before any work-related stress claim is considered, there must be a diagnosis in accordance with the Diagnostic and Statistical Manual for Mental Disorders (DSM) from an appropriate health care professional. Sometimes a work-related stress claim may be denied due to pre-existing or non-work-related psychological factors.
Return to Work
Regardless of the type of injury/illness, a worker has an obligation to participate in the return-to-work process. The employer will likely initiate a modified work offer outlining their intention to accommodate your medical condition. The modified work offer should be communicated in writing. For more information, refer to WSIB Fact Sheet # 4 Return to Work (RTW).
Alternative Income Sources and Accommodation
In the interim, if you have been denied benefits from WSIB and you are medically unable to return to work, you may be able to access your Short Term and/or Long-Term Income Benefits, if applicable. If you do not have benefits or have exhausted your benefits, you may qualify for Employment Insurance Sickness Benefits or Social Assistance Benefits.
If Your Claim is Denied
You have a right to appeal a negative WSIB decision. You must submit an Intent to Object form (ITO) to WSIB no later than six (6) months from the date of the written decision (RTW decisions have 30-day time limits). For more information, refer to WSIB Fact Sheet # 2 Appealing a Workplace Safety and Insurance Board Decision.
Traumatic Mental Stress (TMS – for accidents on or after January 1, 2018)
A worker must have suffered or witnessed the work-related traumatic events first-hand or heard the work-related traumatic events first-hand through direct contact with the traumatized individuals. In addition, there must be a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) which may include, but is not limited to:
- Clearly and precisely identifiable (who, what, where, when and how)
- Objectively traumatic
A worker must have suffered or witnessed the work-related traumatic events first-hand or heard the work-related traumatic events first-hand through direct contact with the traumatized individuals. In addition, there must be a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) which may include, but is not limited to:
- Acute stress disorder
- Post-traumatic stress disorder
- Adjustment disorder
- Anxiety or depressive disorder
Cumulative Effect
A worker may be exposed to multiple traumatic events over time. A final reaction to a series of traumatic events is considered to be a cumulative effect. A worker may be entitled to benefits because of the cumulative effect, even if the most recent event is not the most traumatic.
Exclusions
A worker is not entitled to benefits for TMS caused by decisions or actions of the worker’s employer that are related to the worker’s employment, including:
- A decision to change the work performed
- The working conditions
- Disciplinary Action
- Termination of employment
However, a worker may be entitled to benefits for TMS due to employer’s decisions or actions that are not part of the employment functions such as violence, threats, or conduct that a reasonable person would perceive as shocking or abusive.
Chronic Mental Stress (CMS – for accidents on or after January 1, 2018)
A worker is entitled to benefits for Chronic Mental Stress (CMS) arising out of and in the course of employment. Work-related CMS is a diagnosable mental disorder that has been predominantly caused by a substantial work-related stressor or a series of stressors. A work-related stressor can be considered substantial if it is excessive in duration and/or intensity in comparison to the expectedpressures and tensions of the job. This includes being subjected to bullying or harassing behaviour at the workplace, which is known, or ought to be reasonably known, to be unwelcome.
Consistent exposure to a high level of routine stress over time may be considered a substantial work-related stressor only in jobs with a high degree of routine stress. Routine high level stress can be found in jobs that typically have responsibility over matters involving life and death and/or involve routine work in extremely dangerous situations.
To be entitled to benefits for work-related Chronic Mental Stress, all the following criteria must be met:
- A regulated health care professional has provided a diagnosis based on the Diagnostic and Statistical Manual of Mental Disorder (DSM). In complex CMS cases, WSIB may require a diagnosis from a psychiatrist or psychologist.
- The worker has experienced substantial work-related stressor, like workplace bullying or harassment.
- The work-related stressor was the predominant cause of the appropriately diagnosed mental stress injury.
Exclusions
A worker is not entitled to chronic mental stress caused by an employer’s decisions or actions that are part of the employment functions such as:
- Changes in working hours
- Productivity expectations
- Terminations
- Demotions
- Transfers
Interpersonal conflicts between workers and their supervisors, co-workers or customers are not generally considered to be a substantial work-related stressor, unless the conflict amounts to workplace harassment and/or results in conduct that a reasonable person would perceive as shocking or abusive.
Post-Traumatic Stress Disorder (PTSD in First Responders and Other Designated Workers)
If a first responder or other designated worker is diagnosed with Post-Traumatic Stress Disorder (PTSD) and meets specific employment and diagnostic criteria, a first responder or other designated worker’s PTSD is presumed to have arisen out of and in the course of employment, unless the contrary is shown.
Transitional Claims
There are special criteria for pending claims prior to April 6, 2016. Please refer to WSIB Operational Policy Document 15-03-13.
Who is Covered?
Refer to Section 14 of the Workplace Safety and Insurance Act for covered occupations. On May 8, 2018, Bill 31 amended Section 14 of the WSIA to expand the presumption of work relatedness for PTSD to add six additional categories of workers: including nurses (which directly provide patient care), provincial bailiffs, and probation officers.
Diagnosis and Rebutting the Presumption
The diagnosis of PTSD must be made by a psychiatrist or psychologist and must be consistent with the description in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5). Your employer has the right to challenge the presumption if they believe they can demonstrate that the employment was not a significant contributing factor in causing PTSD.
Exclusions
A first responder or other designated worker is not entitled to benefits for PTSD caused by decisions or actions of the worker’s employer relating to the worker’s employment, including:
- A decision to change the work performed or the working conditions
- Disciplinary Action
- Termination of employment
Contact Us
To contact OPSEU/SEFPO Worker Safety Unit, email [email protected] or call 1-800-268-7376.
This publication contains general information and is intended as reference only. It is not intended as substitute for independent legal advice regarding your particular situation.