BC Looks at Broader Recognition of Workplace Trauma

The B.C. government is considering making it easier for some workers to access financial and medical help for mental trauma linked to their jobs, The Tyee has learned.

Documents obtained through freedom of information legislation show the province may expand the job categories where workers aren’t required to prove a psychological condition is caused by their jobs.

Firefighters, police officers, nurses and other first responders in B.C. already benefit from the presumption their psychological injuries are work-related, which saves them from what can often be difficult and traumatizing testimony at WorksSafeBC hearings.

A December briefing note says the province is now considering expanding that presumption to other workers who frequently submit mental claims, which could include teachers, bus drivers and employees at harm reduction sites for people who use drugs.

Labour Minister Harry Bains wouldn’t say which professions might benefit but confirmed government was examining the issue. He said workers who don’t benefit from that law often face a “very invasive” examination of whether a mental health condition is a result of their work.

“If you don’t have the presumption for mental health [injuries], it’s very difficult to prove it is work-related,” Bains said. “That’s why many people don’t report these types of injuries or they give up.”

A growing number of British Columbia workers say they suffer from depression, anxiety or other mental health conditions because of their jobs. In 2017, workers submitted a total of 3,643 psychological injury claims to WorkSafeBC, the province’s worker compensation system. In 2022, there were 5,914. Those numbers and others referenced in this article refer to claims that involved only a psychological injury, and not claims that also involved physical harm.

But relatively few of those claims are actually accepted. Of the 3,701 claims in 2022 that made it to a decision adjudication stage only 54 per cent succeeded, which is well below the rate of acceptance for physical injuries.

Kevin Love, a lawyer with the Community Legal Assistance Society, says that’s because it is much harder for workers with psychological injuries to prove their condition is a direct result of their jobs. Workers have to be diagnosed by a psychologist or other mental health professional. They also have to prove their condition is the result of either “a reaction to one or more traumatic events” or that it is “predominantly caused by a significant work-related stressor.”

Love says that means WorkSafeBC often goes through parts of a worker’s personal life to determine if there is another potential cause for a mental health condition. He said the prospect of that testimony has a “chilling effect” on workers, who have to demonstrate that their job contributes more to their mental health condition than other factors. “It’s really often hard to unpack and assign percentages to what caused what,” Love said.

In May 2018, the B.C. government changed the law so certain groups of workers no longer had to prove a mental health condition was related to work after a traumatic event. A December 2022 briefing note obtained by The Tyee indicates government was aware that process was harming some workers so much that some died by suicide.

“Government accepted that the process of applying for workers’ compensation for mental disorders was resulting in certain occupations being retraumatized in the process of establishing the disorder [and] its connection to work, including in some cases first responders taking their own lives as a result,” the briefing note said.

Today, that presumptive exemption applies to firefighters; paramedics; police officers and sheriffs; correctional officers; nurses and a number of other first responders and health-care workers.

But it doesn’t apply to social and community service workers; teachers or bus drivers, all of whom were among the most likely to submit mental health injury claims in 2022.

That year, 508 social and community service workers submitted mental health injury claims to WorkSafeBC, second only to nurses.

Those include workers at harm reduction and supervised drug consumption sites in B.C., who are often at the frontline of responding to the toxic drug and homelessness crisis.

CUPE 1004, which represents many of those workers in Vancouver, has pushed for its members to benefit from the exemption, according to internal government briefing notes. The union has proposed that include all workers who support clients or residents at safe consumption or drug injection sites, as well as workers supporting clients or patients who use drugs at residential or health-care facilities. The Tyee reached out to CUPE 1004 multiple times but did not hear back by publication time.

The Hospital Employees’ Association and Health Sciences Association of British Columbia have also asked government to expand coverage to other groups of health-care workers, the briefing notes said.

Not all claims came from first responders. Teachers and assistants submitted 251 mental health injury claims in 2022.

Workers in professions not covered by the presumptive legislation appear less likely to have their claims accepted. In 2022, for example, 84 per cent of the 363 claims submitted by paramedics were accepted. In comparison, the acceptance rate for teachers was just 49 per cent.

BC Teachers' Federation president Clint Johnston said the union was monitoring the issue.

“Teaching is a meaningful but mentally demanding profession, and British Columbia’s public educators work tirelessly each day under the added pressures of an understaffed school system,” Johnston said in a written statement.

Different provinces have taken radically different approaches to the question of which workers benefit from the presumption.

Ontario provides the presumption to 18 professions but limits it to workers diagnosed with post-traumatic stress disorder, not other psychological injuries. Saskatchewan and Prince Edward Island provide the presumption to any worker who experiences a traumatic event, regardless of what they do.

Bains would not say precisely which criteria government would use to expand the presumption, or when that might happen. But he did say he would look at jobs where employees “on a regular basis go to work and a face trauma as part of their work.”

Bains said he would also take the number of claims from each profession into account.

“If they fit the criteria, certainly they will be considered. But then we need to look at who else is out there,” Bains said.

Love says he supports any step to help workers access help. But he argues expanding it won’t do enough to address the central issue that mental health claims are not treated in the same way as physical ones.

A 2019 review of B.C.’s workers’ compensation system by labour lawyer Janet Patterson argued workers should not need to be diagnosed with a mental health condition to get compensation for injuries that kept them off the job for 10 days or less.

She also recommended that government remove the test that work-related stressors are the “predominant” cause of a mental health condition. And she said B.C. should replace the narrow term “mental health disorder” with “psychological injury.”

Love says that even workers who benefit from the presumption may still need to be exposed to one or more traumatic events, which he pointed out could be hard to define in the case of some jobs.

“They require for the stressors that it has to be unusual intensity and duration from what a worker in that position would normally experience. But a lot of workers experience inherently stressful occupations,” Love said. He gave the example of an educator who might not experience one traumatic event, but a series of stressors that eventually cause a decline in mental health.

“It’s not going to help the teacher who is day after day exposed to significant workplace stressors… unless there are some very broad changes,” Love said.

When asked about broader reforms, Bains said he wants to stay focused on injuries that clearly result from employment. “We need to work within the confines of the workers’ compensation system, which is to deal with injuries and illnesses that arise during the duration of the employment,” Bains said.

Love, though, argues the current definitions are too strict.

“A presumption is a good thing. But the concern is, it’s a good thing only for a certain category of workers, and that’s for something the board accepts as trauma,” Love said.