In July 2012, WorkSafeBC amended the Workers Compensation Act to more clearly define coverage for work-related mental illness. In April 2018, the provincial government introduced presumptive legislation for five groups of first responders in the province, and a year later, expanded the eligible occupations to include:
- Firefighters (paid and volunteer workers assigned to fire suppression duties).
- Police officers.
- Emergency medical assistants, including paramedics.
- Corrections officers, including wardens.
- Emergency dispatchers for firefighters, police, ambulance, and 911.
- Nurses regulated by the British Columbia College of Nursing Professionals, including RNs, RPNs, LPNs, and NPs.
- Health care assistants (care aides) registered with the BC Care Aide and Community Health Worker Registry.
If anyone in these occupations experiences one or more traumatic events at work and develops a mental disorder, the disorder will be presumed to have been caused by their work. This allows for the claims decision process to move more quickly and with less investigation than in the past. WorkSafeBC’s Mental Health Claims Unit (MHCU), a multidisciplinary team managing the claims, continues to grow to meet the increasing demands of accepted mental health injury claims.
Implications for family physicians
Physicians treating patients who work in the included occupations and who have been exposed to traumatic events and present with mental health symptoms should submit the usual physician’s first report (Form 8) to WorkSafeBC. The MHCU team values and relies on clinical information provided by community primary care providers in their physician reports (Form 8/11), as well as requested clinical records that are submitted. Information that is particularly helpful for the MHCU team includes:
- Work history including any known recent or remote trauma/stressor exposure.
- Mental status examination.
- Generalized Anxiety Disorder 7-item (Gad-7) and Patient Health Questionnaire (PHQ-9) scores.
- Concerns about safety such as suicidal or homicidal ideation or substance-use issues.
- Psychiatric history (this is not an exclusion for coverage since claims may be accepted for exacerbation of pre-existing mental disorders).
- Important considerations or recommendations for treatment, including referrals already made to local health services.
Various treatment options designed for trauma-related mental disorders are available for patients with an accepted mental health claim. Physicians wishing assistance for a patient with a pending or accepted claim should make this request on their Form 8/11.
Trauma-specific treatments available at WorkSafeBC
WorkSafeBC’s Occupational Trauma Response (OTR) service model offers two new services, one for intervention and the other for transition. OTR intervention is an early response to exposure to trauma at work for those diagnosed with a trauma-related condition such as PTSD or acute stress disorder. The goals are for the injured worker to learn skills to manage symptoms and engage with supports, and to assist in stabilizing and preparing those workers who require further, more intensive interventions or identify those who are ready to transition back to work. The intervention service lasts a maximum of 6 weeks or up to six sessions while providers normalize the trauma reaction, assist in strengthening natural resilience, build supports, and provide skills that can help prevent worsening of mental health symptoms.
OTR transition is intended for those who have recovered or reached a plateau from the trauma-related psychological condition but require additional support during the critical periods of return-to-work or vocational rehabilitation. OTR-transition lasts a maximum of 4 months or up to 10 sessions and is designed to assist the individual to maintain and apply the skills acquired in treatment.
WorkSafeBC has contracted providers to deliver these services to injured workers as close to their home community as possible. At the moment, the services are provided in 37 locations across the province.
For further information or assistance with a patient who has a work-related mental health injury, please contact a medical advisor in your nearest WorkSafeBC office or call the Physician Hotline at 604 276-3049 or toll-free at 1 855 479-3049.
—Tanya Fairweather, MD, CCFP, FCFP
WorkSafeBC Medical Advisor
This article is the opinion of WorkSafeBC and has not been peer reviewed by the BCMJ Editorial Board.