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Editorial: PTSD rules need more work

The province’s labour minister, Harry Bains, is making it easier for some employees with post-traumatic stress disorder to be compensated by WorkSafe B.C.

The province’s labour minister, Harry Bains, is making it easier for some employees with post-traumatic stress disorder to be compensated by WorkSafe B.C. In the past, anyone filing a claim for PTSD had to prove the disorder was due to work-related causes.

Now police officers, firefighters, first responders, sheriffs and correctional officers are being exempted from this requirement. They will still have to show they suffered a trauma on the job, but they will not have to prove this was the cause of their PTSD.

That is a significant easing, because it can be difficult to identify the specific origins of this disorder. PTSD is defined as a mental condition caused by suffering or witnessing a traumatic event. The symptoms can include flashbacks, distressing memories, nightmares and personality changes.

But “trauma” is a vague term. Beyond physical violence, it can also include bullying or a toxic work environment that leads to psychological stress.

The ambiguity shows up in existing failure rates for PTSD claims. In 2017, before the new regulations were enacted, more than half the claims by police officers were rejected. A similar proportion of claims by firefighters and first responders were turned down. Now it seems probable the door will be opened wider.

Not surprisingly, other workers have come forward insisting they, too, should be covered. The B.C. Nurses Union held a rally last week in Vancouver to ask for equal treatment. They point out that nurses are just as likely to experience violence and stress on the job.

Something of the sort happened in Saskatchewan. There, employees in every occupation are eligible for compensation if they suffer any work-related psychological injury, not just PTSD. They are also relieved of the need to prove that workplace trauma caused their illness.

The B.C. minister has said the regulations leave room for additional occupations to be added. But there are several issues that need clarifying.

First, it’s a virtual certainty that the new policy will increase compensation claims and sick leave. Taxpayers will foot that bill, since the occupations involved are all public-service related.

Second, there is an element here of letting management off the hook. If employees no longer have to prove their PTSD is work-related, where is the incentive to maintain and improve workplace safety?

Most important, there is a degree of arbitrariness in the occupations selected. Nurses certainly appear to have a case. They have to witness death, console distraught family members and suffer violence at the hands of patients. That sounds like trauma.

Then again, what about social workers, childcare staff and employees in long-term care facilities? They often have to deal with hostile and occasionally violent clients.

Going further afield, there are numerous jobs that are far more hazardous than those the minister is concerned with. Among the top 10 most dangerous occupations are logging, roofing, power-line maintenance and working on a fish boat. None of those jobs make the list.

And curiously, the only occupations being given this special status are in the public sector. Why are there no private-sector jobs? Long-distance trucking is clearly stressful. So is construction work on highrise buildings.

No one would disagree that employees who are genuinely traumatized on the job should be eligible for aid and compensation. But Bains is essentially establishing two levels of proof for the same disease.

Part of the explanation might be that there is little research on the prevalence of PTSD in blue-collar occupations. Almost all the studies have focused on white-collar, public-service jobs. But is this a reasonable basis for discriminating in favour of one group?

Before Bains expands his list, he needs to commission research that provides a more equitable foundation for decision-making.

His heart might be in the right place, but as it stands, the minister is basically making it up as he goes along.