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WCB Psychological Claims: A Cautionary Tale for Employers

Posted in: Mental Health,Workplace | Posted by Rebecca Ingram on April 28, 2021

Once upon a time, there were very strict guidelines for the Alberta Workers’ Compensation Board (WCB) to consider a psychiatric or psychological injury claim. Essentially, there needed to be a clear correlation to a work-related incident such as a head injury, organic brain damage or an emotional reaction to a traumatic event. Workplace interactions, conflicts and relations were considered to be part of a normal work environment that all workers are subject to. It was further felt that all workers had the option of leaving their job if they were unhappy with their work environment.

Prior to November 2000 the WCB defined normal employment pressures and tension as follows: interpersonal relations and conflicts, health and safety concerns, union issues and routine labour relations actions taken by the employer, including workload and deadlines, work evaluation, performance management (discipline), transfers, changes in job duties, lay-offs, demotions, terminations, and reorganizations, to which all workers may be subject from time to time.

In late 2000 changes were made to WCB Policy 03-01, Part II, Application 6 that broadened the scope of psychiatric and psychological claims to include mental stress and chronic onset stress conditions. At the same time it tightened the eligibility criteria by requiring a confirmed psychological or psychiatric diagnosis as defined in the most current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Since then, the definitions, criteria and conditions have been modified and that may have serious implications for employers, especially after the changes made in November 2020.

Workplace bullying and harassment are now identified as possible acceptable psychiatric or psychological WCB claims while interpersonal relations and conflicts are no longer listed as normal pressures and tensions of employment. Based on WCB Policy 03-01, Part II, Application 6 as it stands now, interpersonal relationships between co-workers and/or between superiors and their subordinates present a safety risk that can result in a WCB claim.  

According to Alberta Occupational Health & Safety (OHS) Legislation, employers are required to help prevent workplace violence and harassment and to take action when incidents occur. No one would argue that addressing bullying and harassment, especially in the workplace, is a priority but now employers need to take greater preventative measures to avoid WCB claims.

Many of these incidents are really personal issues between co-workers or between a worker and their superior that go beyond the scope of employment. Whether it is a personality conflict or a harmless situation gone awry, a worker who does not have good resilience or is seeking retaliation could submit a claim to the WCB.

In a number of cases, text messages and pictures sent between co-workers started out innocent enough but went sideways. As a result, one worker would put in a claim, even if the interactions were sent outside of work hours. The benefit of cell phones at work is gaining traction from a communications and safety perspective however, social media interactions have opened up a new dimension of workplace harassment and bullying.

Emails, text messages, Instagram, Facebook, Snapchat, and other similar applications have blurred the line between work and leisure allowing employees to freely share conversations, comments, photos, and videos not only during but outside working hours. What may start out as innocent fun and games can become a real problem if dynamics change. The ability to save and keep all these forms of communication means it can be stored indefinitely and then used as evidence to support or refute claims of harassment or violence. Once information is shared there are no restrictions over how far it can be shared or with whom, leaving victims and often employers vulnerable. 

So what can employers do?

  1. Awareness of actions – employers, supervisors, managers, and those in positions of authority need to be extremely careful in their interactions with staff. Subordinates may be uncomfortable expressing how they honestly feel. They may have preconceptions that it will undermine their credibility, cause disruption and/or jeopardize their employment or they may not be able to articulate what they are experiencing. 
  2. Check-In – regular contact with your employees to see how they are doing can identify issues before they develop into serious problems and allow early intervention. A performance review doesn’t cut it, quarterly or monthly check-ins will catch many concerns while they are still manageable.
  3. Employee Assistance Programs (EAP) – ensuring there are resources in place that is easily accessible for workers if they are struggling, feeling insecure, or need to discuss a confidential matter. Encouraging staff to take advantage of mental wellness programs will help workplace stress balance.
  4. Develop and enforce HR policies that address:
    • standards of behaviour such as bullying, harassment, and violence; how it is defined, how to report it, and how it will be dealt with.
    • cell phone and social media use at work including periodic reminders to use discretion and warnings about negative implications and repercussions.
    • interoffice or workplace romances and include periodic check-ins with the parties involved to ensure workplace boundaries are respected. 
  5. Educate, broadcast, and publicize – workplace posters, pamphlets, emails, and texts are effective ways of reminding staff of standards of behaviour, company policies, and available resources. Sensitivity awareness training, workshops, and periodic refresher courses are also excellent ways of making and keeping everyone aware of the implications and risks their actions may have. 
  6. Hire a Human Resources (HR) Consultant –  open professional communication and availability to fair and unbiased mediation may be great first steps in understanding and managing situations. A qualified HR consultant can review or help create company policies around sensitive issues or areas of concern, research training resources and identify potential problems.

Despite employers taking all the preventative actions possible, they may still be subject to a WCB claim. Claims management and early intervention in the claims process can allow for thorough investigation of a claim, provide the opportunity to challenge an entitlement decision or bring the claim to conclusion as quickly as possible. 

Even if a claim is accepted there are measures that can be taken to manage claims costs. For instance, WCB Policy 03-01 clearly states that ongoing compensability for stress claims only lasts while medical evidence shows that the work or work-related injury is the predominant cause of the claimants current symptoms. Monitoring medical reporting can help identify the point where WCB responsibility for a workers condition ends and bring the claim to closure more quickly.

Sounds complicated? It doesn’t need to be! 

Claims consultants specializing in WCB matters can provide the knowledge and expertise necessary to efficiently navigate the workers’ compensation system and a Current Claims Management Program is one of the best ways to contain costs and mitigate the impact on WCB premiums. 

For further information on WCB stress claims, you can visit WCB Alberta Psychiatric and Psychological webpage or  check out WCB Alberta Fact Sheets for employers and workers.

As always, we are available to answer your questions and/or address your concerns to the best of our ability. You can reach us directly at [email protected], [email protected], by phone at 1-844-377-9545 or you can connect with us on Facebook, Twitter, or LinkedIn.

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