Effective date: December 20, 2016
Application: All psychological injury claims, regardless of injury date.
Policy subject: Decision making - Injuries
To establish adjudication guidelines for psychological injury claims.
DSM, means the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. The fifth version to be used as prescribed by The Workers’ Compensation Miscellaneous Regulations. The DSM does not include guidelines for treatment of any disorder.
DSM diagnosis, for the purposes of this policy, means a diagnosis that meets all diagnostic criteria for a disorder in accordance with the DSM, completed by a psychologist or psychiatrist licensed to practice and make diagnoses.
Mental Health Assessment (MHA) is a psychological evaluation completed by a Workers’ Compensation Board (WCB) accredited psychologist or psychiatrist and includes:
Psychological injury, for the purposes of this policy, means any psychological disorder or condition that meets DSM diagnostic criteria and has arisen, or is presumed to have arisen, out of and in the course of employment (Section 28.1(1)(a)).
Traumatic event means a single or series of events or incidents that arose out of and in the course of employment that may result in a psychological injury. This includes, but is not limited to:
Diagnoses and Mental Health Assessments (MHA)
Traumatic Events – Acute and Cumulative
Incidents – Workload and Interpersonal
Permanent Functional Impairment (PFI)
Critical Incident Response Information Sessions
The Workers’ Compensation Act, 2013
Sections 2(1)(r), 2(1)(ff.1), 2(1)(ff.2), 2(1)(ii), 19, 20, 25, 26, 28.1, 44, 46, 49, 187(1)(e.1)
The Workers’ Compensation Miscellaneous Regulations
(1) 20 December 2016. Bill 39, an amendment to The Workers’ Compensation Act, 2013, came into effect, which established a rebuttable presumption for all forms of psychological injuries. The amendment applies to all current and former workers eligible for coverage, regardless of injury date.
(2) POL and PRO 01/2009, Injuries – Psychological (effective 01 May 2009 to 19 December 2016).
(1) 01 January 2014. References updated in accordance with The Workers’ Compensation Act, 2013 (Bill 58).
(2) 21 October 2013. Policy and procedure reviewed.
(3) POL 02/92, Stress Claims (effective 28 January 1992 to 30 April 2009).
PRO 02/2017 Injuries – Psychological
POL 07/2021 Arising Out of and In the Course of Employment
POL 12/2017 Pre-Existing Conditions – Aggravation or Acceleration
POL 23/2010 Permanent Functional Impairment (PFI) – General
PRO 02/2021 Medical Fees – Psychologists
POL 04/2013 Date of Injury
POL 21/2013 Appeals – Claims
POL 22/2013 Appeals – Board Appeal Tribunal
POL 03/2021 Second Injury and Re-Employment Reserve
PRO 03/2021 Second Injury and Re-Employment Reserve
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