Presumptive Coverage: First Responders take Heed

Presumptive Coverage for First Responders and WCB Policy

We all recognize the physical dangers first responders face daily. However, the less visible but equally harrowing psychological impacts often go undiscussed. This article delves into a complex facet of WCB policy: claiming compensation for psychological injuries rooted in occupational trauma, especially when workplace bullying and harassment (B&H) also play a contributing role.

Understanding Presumptive Coverage

For the uninitiated, WCB’s policy on compensating psychological injuries is rooted in ‘presumptive coverage.’ In simple terms, if you, as a first responder, experience a traumatic event at work leading to PTSD, it is presumed that your PTSD is work-related. This presumption, however, isn’t ironclad. It can be countered by specific circumstances and evidence.

The Nuance of B&H: A Double-Edged Sword

Here lies the delicate complexity. B&H can indeed form valid grounds for compensation if they arise out of and during the course of employment and encompass grave degradation, public humiliation, or threats of violence. But, and this is crucial, if the B&H cannot be verified, the WCB often relegates it to the realm of “Non-traumatic and non-compensable normal pressures and tensions of employment.” Consequently, the claim is denied.

 The Uphill Battle of Proving B&H

While B&H can technically be compensable, getting it recognized as the chief or primary cause of a psychological injury is a Herculean task. Remember, it’s not what you know, it’s what you can prove. The criteria for claim acceptance.

  • A confirmed psychological or psychiatric diagnosis as per DSM criteria.
  • The events or stressors at work being the “predominant cause” of the injury.
  • These events must be “excessive or unusual” compared to pressures faced by the average worker in a similar role.
  • Objective confirmation of these events.

Eric’ Story: The Reality of Not-so-Presumptive Coverage

Eric, a veteran police officer, patrolled the streets of Edmonton for over 20 years. These weren’t just any years; they were filled with sights of bloodshed, violence, and other harrowing experiences that would shake the very core of most individuals. He wasn’t just a passive observer either; he had been at the receiving end of violent assaults, having been punched, kicked, stabbed, and even shot at. Among the myriad traumatic episodes, the gut-wrenching moment that stood out was witnessing the death of his partner in the line of duty.

One day, the weight of it all became unbearable. Visiting his doctor, Eric unraveled a narrative bearing all the hallmarks of chronic trauma. Acting on the doctor’s advice, Eric submitted a claim to WCB. Crucially, he also highlighted an ongoing clash with his sergeant, which further amplified his distress.

It seemed straightforward: decades of traumatic exposure would surely be recognized. But the complexities of WCB policies emerged when an adjudicator, initially accepting the claim, reversed the decision. The crux of the contention? It was unclear whether the primary cause of Eric’s trauma stemmed from his two decades on the streets or his tumultuous relationship with his sergeant.

Eric, leaning on the tenet of ‘presumptive coverage’, questioned the denial, only to be met with a convoluted rationale. He was told, “You mentioned a toxic workplace, a mechanism of injury that isn’t presumptively acceptable. Since the alleged bullying and harassment couldn’t be verified, it’s considered a chronic-onset, non-work factor. Given the presence of both non-work and work-related factors, determining the predominant cause becomes murky, leading to the claim’s denial.”

Eric’s story reflects the complexity first responders face when trying to seek acknowledgment and compensation for their psychological injuries. It’s not just about traumatic experiences but also about navigating a policy maze that often doesn’t align with the lived reality of our brave frontline heroes.

Shows like Law & Order merely scratch the surface in portraying the intense pressures and split-second decisions officers like Eric and his peers regularly face. Nullifying presumption due to the inherent turbulent workplace dynamics unique to first responders sets a disconcerting precedent. It implies that no first responder, irrespective of their experiences or dedication, can anticipate compensation for psychological injuries if they’ve encountered interpersonal conflicts on the job.

A Call to Action

To our first responders, this article isn’t merely an academic exploration. It’s an attempt to unravel the plethora of details that determine your entitlement to WCB benefits. Blue Collar Consulting’s mission? To champion your cause and help you navigate this slippery slope.

Call (780)-340-5727 to speak with our 541 Eagleson Wynd, Edmonton T6M 0Y4 team for free.
Ben Barfett

Ben Barfett

Ben Barfett, Principal and Consultant, has spent his life in the construction sector, specifically heavy civil, enviro, commercial, and energy. Having held senior roles in business development, technical advisory, and regional management, he earned his stripes in the field and in head office. Conscious of the interplay between commercial, legal, and execution aspects of construction, his business insights are informed by expertise in WCB policy and enhanced with disability-specific training.

Ben Barfett

Ben Barfett

Ben Barfett, Principal and Consultant, has spent his life in the construction sector, specifically heavy civil, enviro, commercial, and energy. Having held senior roles in business development, technical advisory, and regional management, he earned his stripes in the field and in head office. Conscious of the interplay between commercial, legal, and execution aspects of construction, his business insights are informed by expertise in WCB policy and enhanced with disability-specific training.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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