The Ontario government recently passed legislation relating to
post-traumatic stress disorder (PTSD) diagnosed in first responders
(police, firefighters, paramedics, etc). Bill 163, Supporting
Ontario's First Responders Act, creates a presumption that
a PTSD diagnosis in first responders is work-related, thus allowing
for faster access to benefits.
The legislation, which amends the Workplace Safety and
Insurance Act (WSIA) and the Ministry of Labour Act,
has been welcomed by advocacy groups such as the Canadian Mental
Health Association because it means first responders seeking
disability benefits no longer have to prove their PTSD is the
result of their job.
However, there is one major problem. The presumption does
not include nurses among first responders. The Registered
Nurses' Association of Ontario (RNAO) noted it was
"dismayed with the exclusion of nurses in Bill 163" and
PTSD is a reaction to a traumatic event with long-lasting
symptoms that disrupt a person's life. It could lead to job
loss, relationship troubles and the deterioration of one's
overall health – among other things. Nursing professionals
– and this I know first-hand as a former nurse – are
exposed to violent and traumatic interactions all too
Like doctors and paramedics, emergency department nurses
repeatedly bear witness to trauma as a part of their day-to-day
work and may also experience physical violence from patients who
are cognitively or psychologically impaired1. Moreover,
these nurses are also routinely exposed to death and the resulting
grief expressed by family members and loved ones who must hear this
troubling news. According to the RNAO, "It is both offensive
and ludicrous to exclude nurses as first responders when they are
regularly among the first to assist during emergency
Ontario was not the first province to introduce a presumption
for first responders. Alberta introduced similar legislation in
2015, while Manitoba took the presumption one step further covering
"all workers," including nurses. Sandi Mowat, president
of the Manitoba Nurses Union, said "Nurses are often
misdiagnosed with occupational burnout or compassion
[burnout]."3 It remains to be seen which model
other provinces will take, the more narrow approach of Alberta and
Ontario or the more inclusive approach of Manitoba.
This omission means nurses who have been diagnosed by a
psychiatrist or psychologist with PTSD may still need to prove that
the cause of their PTSD is directly related to their work (and not
personal life) before they can access disability benefits.
Like other first responders, Ontario's nurses spend much of
their working lives dealing with traumatic situations while helping
us at our most vulnerable. They too should be able to access timely
medical and disability benefits when diagnosed with PTSD, without
the burden of proving the condition was related to their work, by
way of a disability-related presumption.
Unfortunately, reasonable accommodation for employees in the workplace continues to be the source of significant litigation and even today we continue to see outrageous examples of employers behaving badly.
We are now beginning to see reported cases involving charges and subsequent fines laid against employers for failing to provide information, instruction and supervision to protect a worker from workplace violence.
On October 13, 2016, the Supreme Court of Canada denied leave to appeal an Ontario Court of Appeal decision which ordered an employer to pay a former employee 37 months of salary and benefits following termination.
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