Appealing for WCB benefits was 18 months in the making, but we won.
I was more than relieved when the Appeals Commission decided in our favour, as was my client, a former detective with the
Calgary Police Service (CPS) for over 20 years. Together we walked a long winding road to reach this point, and after a rather arduous 18 months, finally we prevailed in overturning
WCB’s refusal to accept responsibility for my client’s complex PTSD.
It was a bittersweet moment however. It should never have been this difficult. Despite my repeated assurances to him that WCB would eventually see the error of its ways, the Board remained curiously resolute in its denial of benefits. And so it went, denial after denial, and as the failures mounted, my client’s despair deepened. How could they do this, he quietly pondered, when WCB is supposed to presumptively accept claims filed by first responders who’ve been diagnosed with a traumatic psychological injury?
What is presumptive coverage?
That’s a good question. First responders are bestowed with presumptive coverage as per WCB’s policy, meaning that psychological injuries in this context are presumed to be work-related unless proven otherwise by the Board. Injured workers normally bear the burden of proving work-relatedness, but presumptive coverage turns the tables. That is, to deny a first responder compensation for a traumatic psychological injury, WCB must show that occupational exposure played no role whatsoever in the development of a mental injury. And thus, the onus was never on my client to prove causation, but rather, it was WCB’s responsibility to disprove a presumed linkage between policework and his complex PTSD.
Short of a kitchen sink, I threw everything at WCB to force acknowledgement of section 03-01 Part ll of its own policy, where it’s stated that mental injuries sustained by first responders will be presumed to be caused by employment. I eventually appealed to the Dispute Resolution and Decision Review Board, WCB’s internal review division, in hopes that this body would overturn a seemingly obvious wrongful denial, but this hope was dashed too. And hence we forged ahead to the
Appeals Commission, a quasi-judicial tribunal that serves as the final level of appeal for workers and employers who disagree with a WCB decision. To their great credit, the panelists presiding over the hearing had no particular difficulty seeing that this veteran of law enforcement is manifestly entitled to benefits.
In retrospect
Reflecting on the journey, perhaps most disturbing was the dismissiveness exhibited by WCB when I described the trauma my client had experienced in his decades as a CPS beat cop and detective. Police officers are routinely spit on, bitten, punched, kicked, stabbed, and occasionally shot-at. Among those who arrive first on scene to countless gruesome suicides, officers then have the pleasure of informing family members of the tragic loss. Or how about scouring ditches in the dark with a flashlight for wayward body parts in the wake of horrific traffic accidents. Or perhaps apprehending sexual predators in the act of assaulting toddlers. If that’s not enough, what about getting grilled on the stand by defence attorneys who pick apart their every move. And all of this while working under intense political scrutiny that causes cops to second guess their training when there’s a split second to make a life-or-death decision.
Ask yourself, how might you fare after 20 years of risking life and limb, being subjected to all manner of horridness, especially amid the suddenly rabid, anti-police fervor and pervasive defunding of law enforcement agencies. Let’s face it, civilians like you, me, and your average WCB employee haven’t the faintest grasp of this crushing gravity. And yet, the Board dismissed all of this context with a cavalier wave of the hand. Let the officer eat cake, it would seem.
Is it always this bad?
In fairness, the level of apathy exhibited by certain workers within WCB in this particular case isn’t necessarily the norm. Suggesting otherwise would be an unfair characterization of the Board as a whole. After all, WCB consists of hundreds of adjudicators, case managers, and resolution specialists, each of whom have varying levels of experience and their own take on policy and procedure. Hence, one’s mileage with WCB will very much depend on the unique personalities assigned to their case. And yet, it bears mentioning that, while the adjudicative failures described here aren’t the norm, they aren’t exactly unusual either.
In the final analysis, the check and balance on WCB’s decisions ensured justice was served. Of course, I can’t help but wonder how many other first responders have been refused benefits despite the unambiguous meaning of presumptive coverage. But for this longtime police detective who’s done so much good in his life, he can finally focus on himself and his family, putting all the pieces back together with WCB’s support and resources.
Precedent setting
This case isn’t just about one individual’s struggle; it sets a precedent that could benefit first responders across the board. It highlights the importance of ensuring our systems fairly recognize and support the mental health challenges that come with public service. As we celebrate this victory, let’s also consider it a call to action to
safeguard the rights and well-being of those who put themselves on the line for our safety.