Access to Workers’ Compensation Benefits and Other Legal Protections for Work-related Mental Health Problems: A Canadian Overview

Abstract

M ental health problems are a significant source of disability in Canada, 1-3 and many mental health problems are attributable, in whole or in part, to stressful working conditions. 1 Workplace violence, notably in health care facilities, [4][5][6] the hospitality industry and schools, 7 is a significant cause of disability, both physical and mental. 8,9 Psychological harassment 10,11 and organizational factors 3,10,12 have been linked to an increase in mental health problems but also to physical violence. 6 Women are disproportionately affected by psychosocial risk factors, 3,12 including psychological harassment. 13 Some mental health problems are attributable to acutely traumatic, stressful events, often associated with workplace crime or violent accidents, hereinafter referred to as "acute stress" claims, whereas others develop more insidiously over time, hereinafter referred to as "chronic stress" claims. As we shall see, the nature of the stressful situation has a significant impact on access to economic support in many Canadian jurisdictions.This paper addresses major policy issues governing protection for people who may be work disabled because of mental health problems arising from stressful work situations or conditions. It relies on classic legal methodology to examine the application of legislation, in Canada, that provides economic support for workers with mental health problems attributable to work-related stressors; 1 it then describes regulatory frameworks recently introduced to provide protection and recourse for workers who are harassed at work. 2 Workers' compensation in CanadaGovernment, society and the business community have long accepted the legitimacy of regulatory interventions to protect work-ers' health from risks attributable to working conditions. Employers are required to assume the costs of disability attributable to work-related hazards, as they control working conditions and are in the best position to redistribute those costs to the consumers of their products. In Canada, 14 as is the case in other OECD (Organisation for Economic Co-operation and Development) countries, workers' compensation systems are the oldest social security programs, dating back to 1909 in Quebec 15 and 1914 in Ontario. 16 Canadian workers' compensation legislation is said to be the subject of a historic compromise: workers have access to benefits regardless of evidence of fault, and employers are protected from law suits brought by their workers. This legislation thus replaces civil liability rules and was originally designed to remove litigation and blame laying from the workplace. 15,16 In Canada, workers' compensation is governed by provincial legislation, with the exception of coverage for workers who are employed by the federal government or federal agencies, whose claims are governed by the Government Employees Compensation Act. a Federal legislation provides for coverage of employees according to

Gender differences in occupational injury incidence

“…Gender difference in mental disorder claim rates have been less well documented than differences in physical injury claim rates. Workers' compensation claims data are not ideally suited for determining the total burden of mental health disorders related to the workplace, because of limited access to workers' compensation for mental health problems resulting from working conditions [Lippel and Sikka, ] and barriers to claim acceptance[Guthrie and Jansz, ]. In our study setting, the worker first has to demonstrate that the work was the predominant cause of the condition before being eligible for compensation for the mental health condition, and claim acceptance rates are still relatively low.…”

An international comparison of occupational health guidelines for the management of mental disorders and stress-related psychological symptoms

“…For example, in the Netherlands sickness and disability compensation is provided regardless of the cause of disability, but in Finland only mental disorders are eligible for compensation and symptom diagnoses (such as stress and burnout) are not 9. In addition, in Canada,51 Australia52 and the USA53 no mental health conditions are covered. These differences in systems may impact the content of guidelines; for instance interventions may be successful in one country but totally inappropriate in another given the differences in roles of caregivers and other stakeholders and the legal protections available to workers.…”

Burnout: the legal perspective

“…British Columbia joins six other jurisdictions -those being Quebec, Saskatchewan, Alberta, Northwest Territories, Nunavut, and the Yukon -none of which have exclusions to chronic mental stress claims in their workers' compensation legislation (Lippel and Sikka, 2010, pp. S17-S18).…”