New occupations covered in B.C. meant to speed up diagnosis, treatment and return to work, says labour minister
“Mental health... is probably one of the most common workplace injuries and sometimes one of the most difficult to deal with."
So says Dianne Rideout, in discussing B.C.’s expanded list of recognized occupations falling under a presumption of work causation for mental disorders.
The presumption fast-tracks the claims process with WorkSafeBC and provides certain workers with faster access to treatment and workers’ compensation benefits, says the partner in the employment and labour group at Cassels in Vancouver.
In June 2024, the presumption was expanded in B.C. to a wider range of occupations, including community-integration specialists, coroners, harm-reduction workers, parole officers, probation officers, respiratory therapists, shelter workers, social workers, transition house workers, victim service workers and withdrawal-management workers
"If you are in one of the identified occupations and you develop a mental health illness that's diagnosed, you no longer have to show that there's a connection between that illness and the work — it’s presumed to have arisen in the course of your employment,” says Rideout.
And the list could further expand, as there are ongoing efforts to evaluate whether additional occupations should be included under the presumption, says Harry Bains, minister of labour for B.C.
"If they fit the criteria, they can be added on," he tells Canadian HR Reporter.
Going beyond physical to mental injuries
B.C’s act and regulations outline specific cancers, heart injury and diseases that impact firefighter groups with respect to presumptions. And in 2018, the province added mental-health disorders to the list of presumptions for federal and municipal firefighters, as well as police, paramedics, sheriffs and correctional officers.
Before that time, in order to get compensation, an employee had to prove they had a recognizable injury with a medical diagnosis, says Rideout.
“You also had to establish — through evidence, either medical or scientific — that the illness you had was related to the workplace, or the terms that typically are used in WorkSafeBC language: it ‘arose out of and in the course of the employment’… which sometimes can be challenging, particularly when you’re dealing with a mental health illness."
Every worker is protected for mental health injuries under the WCB act, but they must prove that it's work-related which “can be almost impossible, if not very difficult,” says Bains.
These roles on the expanded list in B.C. share a common thread of frequent exposure to traumatic events, such as drug overdoses and fatalities, he says.
"Because of the type of work that they do, the trauma is part of the job, and they take it home and they become ill, so they're suffering. We have seen some devastating results, at the end of the day, [such as] suicides,” he says.
Speeding up diagnosis of mental illness
"It is very, very important to make sure that they get a speedy acceptance, which means speedy treatment and a speedy return to work,” says Bains.
The burden of proof, even under the presumption, still requires proper medical documentation such as a formal diagnosis from a psychologist or psychiatrist, says Rideout.
"You still have to show that you have a diagnosed mental health [issue].”
Bains says that access to specialists, particularly in rural areas, remains a challenge but WorkSafeBC has measures in place to expedite treatment, such as psychologists or psychiatrists on contract.
And there is a built-in safeguard so that WorkSafeBC can begin treatment should a person’s situation deteriorate before the claim is fully processed, he says.
"It's recognizing that these are serious cases and we need to provide them care in a timely fashion.”
Speeding up return to work
With timely access to treatment, enabling a faster return to work, there is a dual benefit for both employees and employers, says Bains.
"With the presumption now that they can apply for a workers' compensation claim, and it's presumed to have happened at the workplace, they don't have to relive that trauma... which means, in return, now they are recovering faster, and they're going back to work faster and earlier."
While employers will “definitely see an uptick in claims,” which will impact premiums, says Rideout, “overall, I would view it as a plus in the sense of helping employees get back to work quicker.
"It may be easier for them to get access to benefit they need in a quicker manner and get on the road to recovery and getting back to work," she says.
New rules for handling employees on leave
It’s always been best practice to keep in touch with employees away on leave, to make sure you have updated medical information and can accommodate any return to work. Plus, it's part of the accommodation process that would be expected under human rights legislation, says Rideout.
But there are also new rules under the WorkSafeBC legislation that require the employer to keep in touch when someone's away from work with a disability, she says.
“There's two new duties that came in effect as of Jan. 1. And so it's a duty to cooperate, which basically, for employers, is a duty for the employer to keep in touch with the employee and cooperate with them in terms of obtaining information and making inquiries as to whether there may be suitable work for them to return back to work.
“And then there's also a duty to maintain employment… when they come back from the leave… it's almost codifying obligations that exist under the human rights legislation as well.”
Employer support for mental health
Often, employers are unaware that an employee is suffering from a mental health illness, leaving them “a little bit behind the eight ball,” says Rideout, until WorkSafeBC reaches out after an employee has filed a claim.
Mental health injuries continue to carry a social stigma, says Bains, so workers may hesitate to come forward.
"When you compare physical injury versus mental health injuries, stigma still is there, and people don't want to come out; you're seen to be weak, you’re seen to be not able to handle stress," he says.
Employers have a role to play in addressing mental health in the workplace, says Bains, though he admits “when you are police officer, when you're a paramedic or firefighter, it's very, very difficult to put in preventive measures.”
But training programs can definitely help.
"The employer should be... providing awareness about how to handle trauma, and after they handle trauma, how to provide [employees with] support," he says, along with confidential workplace programs, such as Employee Family Assistance Programs.
