DECISION NUMBER:

20250061

OBJECTING PARTY:

REPRESENTED by:

RESPONDENT PARTY:

HEARING:

HEARD by:

DATED:

SEPTEMBER 29, 2025

The worker objects to the Case Manager (CM) decision dated June 8, 2021, communicating their date of injury is January 5, 2020.

The worker seeks the date of injury to be changed to 2018.

In April 2021, the worker submitted a WSIB mental stress claim. The worker indicated they encountered multiple traumatic events throughout their 14-year career as a first responder. They stopped working on in January 2020. The worker was diagnosed with Posttraumatic Stress Disorder (PTSD) on March 15, 2021.

The decision letter dated June 8, 2021, communicated entitlement to benefits were in order for PTSD under Operational Policy 15-03-13 – Posttraumatic Stress Disorder in First Responders and Other Designated Workers. The letter communicated the date of January 5, 2020, was determined to be the date of injury as this was the last day the worker was at work, and the last day of occupational exposure.

The worker was determined to have a permanent impairment for PTSD. In February 2023, the worker received a 10 per cent non-economic loss (NEL) benefit in recognition of their PI. The worker returned to work performing accommodated work duties within their permanent restrictions.

The worker objected to the date of injury determination. They submitted their date of injury ought to be adjusted to 2018, when their PTSD symptoms commenced. The operating area reconsidered and upheld the decision dated June 8, 2021, confirming the date of injury remained unchanged. The date of injury determination is now the matter before the Appeals Services Division.

Workplace Safety and Insurance Act (WSIA), 1997, as amended

Operational Policy Manual

Published

11-01-04 Determining the Date of Injury

15-03-13 Posttraumatic Stress Disorder in First Responders and Other Designated Workers

April 9, 2021

September 7, 2018

I have carefully considered all of the available information, legislation and relevant operational policies in reaching this decision. For the reasons that follow, I find the date of injury is January 28, 2019.

It should be noted my review and assessment does not include an all-inclusive summary of all the evidence submitted to the record, and there has been no attempt to reference every document in the claim file. I have included a summary of the pertinent evidence and testimony in relation to the issue in dispute.

Review of the Evidence

The record contains email correspondence from the employer Superintendent, dated July 5, 2018, addressed to the Deputy Chief, indicating they met with the worker that day who was quite upset and requested the next 3 shifts off as personal leave days. The worker reportedly informed the Superintendent they were working too much for too many days in a row, and it was making them crazy. As per the Superintendent’s email, the worker indicated they heard something upsetting and brought the matter to the union. The Superintendent relayed the worker explained there was a lot going on in their personal life as well as their professional life. The worker informed the Superintendent they went to Employee and Family Assistance Program (EFAP).

The record contains an EAP Client Intake/Assessment dated January 28, 2019, completed by J. Alaska. The session notes indicated the worker presented with job-related concerns and they expressed feeling overwhelmed and frustrated with management, lack of resolution, and minimization of concerns. The worker indicated they had a history of concerns with getting shifts, harassment, being put on the part-time list, as well as personal non-work-related concerns. The worker indicated part of their concern was in respect to taking calls. The record contains a progress note from J. Alaska dated February 20, 2019, indicating the worker cancelled their 1pm appointment last minute.

The record contains an email from the worker to the employer dated February 21, 2019, requesting to be scheduled only 60 hours for the upcoming schedule. As per the worker’s submission, the worker requested to lower their contractual hours because they were suffering from undiagnosed PTSD, and they could not handle the amount of shifts that were scheduled.

The record contains clinical chart notes from Dr. J. Cole, the worker’s primary care physician. The following was gleaned from the worker’s chart:

September 26, 2019 – introduction appointment – no mental health concerns raised with Dr. Cole
January 30, 2020 – presented with mental health concerns
- Worse over the last 1.5 years, worse over last few months with additional stressors
- Needs time off from first responder duties, had a rough year, personal family-related stressors
- Dr. Cole provided a note for work, worker provided with counselling materials

Dr. Cole submitted an undated report to the record, citing the worker’s concerns regarding their mental health preceded the initial visit on January 30, 2020. It was noted the worker’s symptoms were present for 1.5 years to the extent they sought out external counselling in January 2019 through Clinic A. The record contains a letter from Clinic A dated October 24, 2023, confirming the attended (1) session of psychotherapy on January 28, 2019, with J. Alaska. As documented in memorandum A0078, the CM contacted Clinic A and confirmed J. Alaska was a registered Psychotherapist; however, they were no longer in their employ.

On October 30, 2020, Dr. Cole sent a referral to Dr. D. Whitney, Psychiatrist, seeking a consultation for the worker. It was noted the worker was off work due to work stressors and office conflicts. The referral note indicated the worker was currently engaged in counselling, and they were resistant to taking medication.

Dr. Whitney assessed the worker on March 15, 2021, for the purpose of completing a psychiatric consultation. The report indicated the worker had been off on stress leave from their first responder position for approximately 1 year. It was noted the worker was concurrently employed with another employer on a part-time basis. The worker described a change in the work environment over the past 3 years. They expressed frustration with not receiving debriefing sessions after attending traumatic calls. The worker indicated they were targeted by their employer after they began taking more frequent absences from work due to personal reasons, and they reported being harassed, bullied and intimidated at work. The worker advanced they attended to many disturbing calls throughout their career as a first responder. The worker endorsed having a depressed mood over the past 2 to 3 years, increased irritability, and decreased motivation in previously enjoyable activities. The worker indicated they were currently receiving counselling through Clinic B, and they previously attended counselling through the EFAP and a virtual program (April to July 2020).

Dr. Whitney submitted a Health Professional’s Report (Form 8) dated April 12, 2021, indicating the worker was diagnosed with PTSD secondary to workplace trauma as well as Adjustment Disorder with anxiety and mildly depressed mood. The worker was recommended to engage in cognitive behavioural therapy (CBT).

The record contains progress reports prepared by Dr. S. Sinclair, Psychologist. The assessment form dated July 19, 2021, indicated the approximate date of onset of psychological symptoms was January 2019. Dr. Sinclair submitted a letter of support to the worker dated February 29, 2024, indicating the worker reported their PTSD-related symptoms commenced in the summer of 2018, and escalated to the point where they were significantly distressed in January 2019. At that time, the worker reported they were more dysfunctional and started cutting back on their work hours as they were unable to continue full-time employment.

The record contains a letter of support from X, the worker’s co-worker, dated February 3, 2025. M.S. indicated they have known the worker since 2008, and they could personally attest the worker’s mental health began to decline in 2018, continuing through 2019 and 2020. They submitted in September 2018, the worker’s behaviour, work habits and demeanor changed in that their attendance declined, they became withdrawn and distant, and they were irritable and emotional.

Assessment of the Evidence

Operational policy 11-01-04 states, in part:

Determining the date of injury

The date of injury (also known as the date of accident) varies based on the type of claim and can refer to the date:

of the actual incident
on which an unexpected result of working duties occurs
of first medical attention, or
of diagnosis.

As enumerated in operational policy 15-03-13,

The first responder must have been diagnosed with PTSD by a psychologist or psychiatrist:

on or after April 6, 2014, and
no later than 24 months after the day he or she ceases to be employed as a first responder if he/she ceases to be employed as a first responder on or after April 6, 2016.

The first responder must be diagnosed by a psychologist or psychiatrist with PTSD as described in the DSM-5.

The worker submitted the date of injury of January 5, 2020, fails to accurately reflect the onset of progression of their mental health symptomology, which they submitted commenced sometime in 2018. The worker indicated at that time they experienced an unexpected change in their regular scheduled hours. They indicated they were a part-time employee that worked nearly full-time hours, and their hours were unexpectedly reduced in 2018. They submitted the date of injury should reflect the date when the cumulative stress first became apparent or disabling. The worker submitted they slowly began decreasing their hours at work as they were unable to continue their regular duties, and even had to find new employment. The worker submitted they did not have a family doctor for many years and faced significant barriers to accessing mental health services. They indicated that each time they reached out for help or showed signs of deterioration, they were misdirected. For instance, the worker submitted they were brushed off by the employer and they were directed to EFAP instead of being referred to WSIB. The balance of the worker’s submission is in reference to matters and concerns that are outside the scope of this decision, and I make no findings on such matters involving hours owed, medication approval or general management of the claim file.

I appreciate the worker’s anecdotal and documentary evidence indicating they were experiencing PTSD- related symptoms in 2018, which led to a slow reduction in hours and I also appreciate X’s written statement of support that the worker’s mental health began deteriorating in 2018; however, this evidence is insufficient to support the determination of the date of injury. While I acknowledge the worker was likely experiencing mental health challenges in and around 2018, there is no contemporaneous medical evidence to substantiate these claims. In the absence of such, I am unable to accept the date of injury is sometime in 2018.

The medical evidence in the record supports the worker initially sought medical attention for work-related stress on January 28, 2019, as per J. Alaska’s EAP intake assessment. As per the chart note, the worker presented with a host of concerns on this visit. It was noted the worker was feeling overwhelmed and frustrated with management, shifts, and personal issues. The chart note indicated the worker expressed concerns with taking calls, which I find is in keeping with responding to calls as a first responder. The worker was not diagnosed with PTSD until January 2020, when they saw Dr. Whitney. As per the worker’s submission, they did not have a family doctor for many years and they faced significant barriers to accessing mental health services. While I appreciate the worker was not diagnosed with PTSD until they were assessed by Dr. Whitney, I accept the date of injury in this case is January 28, 2019, as it is the date of first medical attention which led to the eventual PTSD diagnosis.

CONCLUSION

I conclude the worker’s date of injury is January 28, 2019. The worker’s objection is allowed-in-part.

DATED SEPTEMBER 29, 2025

L. Mansueti

Appeals Resolution Officer Appeals Services Division

Worker v. Employer, 2025 CanLII 123889

Case Summary

Review of the Evidence

Assessment of the Evidence

Determining the date of injury

CONCLUSION

DATED SEPTEMBER 29, 2025