Highlights of Noteworthy Decisions

Decision 129 23
2023-02-13
J. Dimovski - C. Sacco - M. Tzaferis
  • Psychotraumatic disability
  • Non-economic loss {NEL}
  • Permanent impairment {NEL}
  • Post-concussion syndrome
  • Rehabilitation, medical (cooperation)
  • Suitable employment (suitable for worker's capabilities)
  • Loss of earnings {LOE} (eligibility) (impairment)
  • Adjustment disorder
  • Major depressive disorder

The issues at dispute in this appeal were: a) whether the worker had entitlement to a permanent impairment (PI) and entitlement to a Non-Economic Loss (NEL) determination for a head injury/concussion; b) ongoing entitlement to psychotraumatic disability; c) whether the worker had failed to co-operate or was non-compliant in healthcare assessments; and, d) whether the worker's pre-injury job was suitable as of February 17, 2020.

The appeal was allowed.
It was found that the worker's post-concussive injury persisted beyond February 2020, resulting in a permanent impairment. Accordingly, the worker had entitlement to a NEL determination. The evidence also supported that the worker had an ongoing psychotraumatic condition from the time of the accident. The worker was found to have continuing entitlement.
The Board had concluded that the worker was non-compliant because he refused to wear a mask at a scheduled functional capacity evaluation (FAE). There was a medical opinion provided, noting a link between the worker's treatment and his anxiety involving face masks. The Panel was satisfied that the worker's decision not to wear a mask arose out of the worker's anxiety and compensable condition, and did not amount to an act of non-cooperation.
The Panel found the worker had entitlement to ongoing benefits as of February 19, 2020. As the worker had ongoing symptoms which prevented him from working in his pre-accident employment prior to February 2020, and as his injuries persisted beyond February 19, 2020, the Panel was satisfied that his pre-accident job continued to be unsuitable as of February 19, 2020. The worker had entitlement to ongoing benefits as of February 19, 2020.