WCAT Decision Number:  
A2102416 (July 22, 2022)  
DECISION OF THE WORKERS’ COMPENSATION APPEAL TRIBUNAL  
WCAT Decision Number:  
A2102416  
WCAT Decision Date:  
July 22, 2022  
Introduction  
[1]  
[2]  
[3]  
On December 2, 2017, the worker fell from a ladder while working as a framer. He landed on his  
back and left side and sustained T6 and T7 compression fractures, a C7 spinous process  
fracture, and a left scapular fracture inferior to the glenoid.  
The worker filed a claim for compensation that was accepted by the Workers’ Compensation  
Board (Board)1 for the permanent conditions of T6 and T7 compression fractures and chronic  
thoracic back pain. The Board found that the C7 and left scapular fractures had resolved.  
The Board assessed the worker’s permanent partial physical disability as equal to 4.3% of total  
disability on a loss of function basis, consisting of 2.50% for chronic pain, effective June 2,  
2018, and 1.80% for loss of function at the T6 and T7 levels of the spine, effective August 19,  
2019.  
[4]  
[5]  
The Board has accepted that the worker is unable to return to his pre-injury employment but has  
concluded that he can adapt to the alternate occupation of social and community service worker  
(CSW).  
In a March 24, 2021 decision, a Board long-term disability officer granted the worker a  
permanent partial disability benefit, payable on a loss of earnings basis, effective August 19,  
2019. The award is based on the difference between the long-term wage rate established on the  
claim and the amount the Board has found the worker is capable of earning from full-time work  
in the CSW occupation.  
[6]  
In a July 19, 2021 decision, the Board accepted the condition of Other Specified Trauma- and  
Stressor-Related Disorder as a permanent condition on the claim, effective July 5, 2021.  
Assessment of the worker’s entitlement to a permanent partial disability benefit for this condition  
remains outstanding. The Board initially accepted this condition on a temporary basis in a  
November 5, 2019 decision.  
1
The Board operates as WorkSafeBC.  
1
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[7]  
[8]  
[9]  
On November 3, 2021, a review officer with the Board’s Review Division confirmed the  
March 24, 2021 decision (Review Reference #R0279846).  
The worker has appealed the Review Division decision to the Workers’ Compensation Appeal  
Tribunal (WCAT).  
I held an oral videoconference hearing of the appeal on May 10, 2022. The worker and his  
representative participated in the hearing. The employer is not participating in the appeal.  
Issue(s)  
[10]  
[11]  
The issue is: what is the extent of the worker’s loss of earnings benefit for his permanent  
compensable physical conditions, effective August 19, 2019?  
Jurisdiction and Standard of Proof  
This appeal was filed with WCAT under section 288(1) of the Workers Compensation Act (Act),  
which provides for appeals of final decisions by review officers regarding compensation matters.  
Section 308 of the Act gives WCAT exclusive jurisdiction to inquire into, hear, and determine all  
those matters and questions of fact, law, and discretion arising or required to be determined in  
an appeal before it.  
[12]  
This appeal is a rehearing by WCAT, which means that WCAT reviews the record from previous  
proceedings and can hear new evidence. WCAT has inquiry power and the discretion to seek  
further evidence, although it is not required to do so. WCAT exercises an independent  
adjudicative function and has full substitutional authority. It may confirm, vary, or cancel the  
appealed decision or order.  
[13]  
[14]  
The standard of proof in this appeal is the balance of probabilities, subject to section 303(5) of  
the Act. Section 304 provides that if WCAT is hearing an appeal regarding the compensation of  
a worker and the evidence supporting different findings on an issue is evenly weighted in that  
case, the appeal tribunal must resolve that issue in a manner that favours the worker.  
I am bound to apply the published policies of the board of directors of the Board, subject to the  
provisions of section 304 of the Act. The applicable Board policies for this appeal are set out in  
the Rehabilitation Services and Claims Manual, Volume II.  
Background  
[15]  
At the time of the December 2017 work accident, the worker was employed full time as an  
apprentice carpenter. He was standing on the third rung from the top of an eight-foot ladder and  
was pulling a sheet of plywood off. He thought the plywood would come off easily but was  
2
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
unaware that there was still one screw on. He exerted more force in pulling and the plywood  
gave way suddenly and unexpectedly. The worker lost his balance and fell backwards off the  
ladder and landed on his left side, on his left shoulder/back. He recalled hitting his head but he  
was wearing his hard hat.  
[16]  
The worker received emergency medical treatment for his injuries. After assessment by  
orthopaedic surgeon Dr. Krywulak regarding his scapular fracture and by neurosurgeon  
Dr. Goplen regarding his spinal fractures, it was determined that the worker did not require  
surgical intervention.  
[17]  
[18]  
In a December 14, 2017 decision, the Board advised the worker that his claim had been  
accepted for a left shoulder/scapular fracture as well as a “spinal/vertebral column fracture”2  
(later identified by the Board as “compression fractures of spine at T6 and T7”).  
After three months of rest, the worker participated in physiotherapy and an occupational  
rehabilitation 2 (OR2) program that included a graduated return to work. At discharge from the  
OR2 program on April 20, 2018, the worker had ongoing subjective reports of pain during  
functional activities. However, he reported that he was at about 80% of where he was before his  
injury, was happy with the progress he had made, and was doing 100% of his job duties at that  
point. The OR2 program provider concluded that the worker was fit to return to work without  
limitations and the worker returned to full-time work as a framer.  
[19]  
[20]  
In an April 25, 2018 decision, the Board concluded the worker’s wage loss benefits effective  
April 22, 2018. As well, the Board decided that the worker’s injury had not resulted in any  
permanent conditions and therefore, he would not be assessed for permanent partial disability  
benefits.  
Following this, there was no contact between the Board and the worker until early 2019, when  
the worker asked the Board to reopen his claim and assist him with changing career paths. The  
worker advised that his doctor had told him that it would take up to a year to see full recovery  
from his compensable injuries but, at just over one year, his condition had been getting worse.  
He said that he had a constant ache/pain in his back where the disc “was crushed”. It ached  
worse when he was doing manual labour, but the pain never went away; it was “brutal” and  
constant from the moment he got up until he went to bed. The worker was continuing to work at  
this time.  
[21]  
In an April 30, 2019 progress report to the Board, Dr. Parsons, the worker’s family physician,  
advised that the worker had developed severe depression. She prescribed Effexor. In prior  
reports dating back to 2017, she had also recorded that the worker was having psychological  
difficulties of varying degrees. Many of these were related to the pain from the worker’s back  
2
All quotations have been reproduced as written, unless otherwise indicated.  
3
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
injury, including that he was quite fearful of these symptoms. However, there were also other  
causal factors identified. In October 2018, when the worker was completing courses related to  
his apprenticeship, he was struggling with memory and concentration, having struggled for  
years with math, and he reported that his mood would go down thinking about his difficulties in  
school.  
[22]  
[23]  
In a May 7, 2019 consultation report, Dr. Ganesan, a physician with an interest in pain  
management, noted that the worker described his pain as a “constant dull ache” which  
worsened with activity.  
A May 19, 2019 CT scan of the worker’s thoracic spine showed a healed burst compression  
fracture at T7 with minimal anterior progression of height loss and a stable minor superior  
endplate compression fracture at T6.  
[24]  
[25]  
The worker went off work as of June 26, 2019 owing to pain and he applied for Employment  
Insurance benefits.  
As the worker was suffering emotional, mood, and other psychological issues, the Board  
arranged for him to undergo a psychology assessment with registered psychologist  
Dr. Gambouras. In an August 23, 2019 psychology assessment report, Dr. Gambouras  
concluded that the worker’s psychological difficulties could be directly attributed to the  
December 2, 2017 work injury and subsequent functional changes and pain. Based on the  
background information available to him, cautious interpretation of personality examination  
results overall, and clinical interview data, Dr. Gambouras diagnosed the worker with Other  
Specified Trauma-and Stressor-Related Disorder.  
[26]  
Dr. Gambouras concluded that psychological restrictions and limitations might be ongoing  
problems for the worker, as follows:  
… [A]s ongoing mood difficulties appear largely dictated by persistence of pain,  
functional problems, if the patient improves to a point, physically, pain-wise, that  
he can in fact return to some level of productive activity, it would be my  
impression that his mood levels would also have hopefully returned to close-to  
premorbid levels, and no or minimal psychological limitations or restrictions  
would therefore be necessary. With that said, it is my impression that, given the  
nature of current emotional and cognitive difficulties (i.e., poor frustration  
tolerance and anxiety with pain exacerbations), the patient will likely have an  
even further reduced capacity in parts of a job that involve a high degree of time  
pressures, sustained mental effort and concentration, or competing activities  
and/or outside distractions in particular on a more painful day. As he has worked  
for several months in carpentry post-injury (only having to stop working due to  
4
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
pain it appears), there does not seem to be any need, psychologically, for work  
restrictions.  
In terms of RTW [return to work] or vocational rehabilitation (VR), it is my  
impression that persistent physical issues, pain (v emotional) factors will serve as  
the primary barriers to sufficient engagement, participation, and benefit from any  
RTW or VR at this time. In this vein, psychologically, he seems reasonably ready  
for VR.  
[27]  
[28]  
In August 2019, the worker began working as a railing installer for a new employer where light  
duty work was available.  
In a September 13, 2019 decision, the Board advised the worker that, in addition to the  
previously accepted injuries, the Board had also accepted an undisplaced fracture of the  
spinous process at C7 and chronic back pain under the claim. The C7 fracture had resolved and  
did not result in any permanent conditions. However, the chronic back pain was permanent and  
so he was entitled to a referral to the Board’s Disability Awards Department. The Board  
concluded that the worker was able to return to his pre-injury job and restore his pre-injury  
earnings.  
[29]  
Neurosurgeon Dr. Faridi assessed the worker on October 29, 2019. He believed that the  
thoracic fractures the worker sustained on December 2, 2017 (a burst fracture at T7 and a mild  
compression fracture at T6) had healed, but booked the worker for an MRI scan to make sure  
the fractures had not affected the spinal cord. The worker was continuing to have pain and  
Dr. Faridi said that, as heavy work most likely would cause pain, the best thing for the worker  
would be to re-educate him in non-labour type work; the worker was currently unable to go back  
to work or lift anything heavy. Dr. Faridi assured the worker that the fracture had healed, that  
nothing needed to be done, and that he should be “okay.”  
[30]  
As noted, in a November 5, 2019 decision, the Board accepted Other Specified Trauma- and  
Stressor-Related Disorder under the claim. The Board also advised the worker that his claim  
had been reopened as of June 26, 2019 and a payment of wage loss benefits had been issued  
for the time he missed from work up to August 19, 2019. In addition, although he had declined  
to accept these services at this time, the Board remained willing to sponsor his participation in a  
pain and medication management program (PMMP) and to provide him with a block of  
psychological treatments or counselling. Further, his claim had been referred to the Disability  
Awards Department for assessment of his entitlement to a permanent partial disability award for  
the compression fractures of the spine at T6 and T7.  
[31]  
Dr. Dray, an external provider, medical examination for impairment assessment on  
December 12, 2019. The worker reported that his condition was worse than it was six months  
prior; he was continuing to experience pain, which seemed to be worsening. The worker’s chief  
5
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
complaints included: an inability to work in excess of a couple of hours before he experienced  
“intense” pain; the inability to participate in sporting activities; requiring pain medication (he was  
taking Tylenol No. 3); persisting “brutal” pain despite eating healthy and performing exercises;  
his neck aching at random times and frequently feeling stiff; cold causing pain that was  
“unbearable”; the inability to perform squats or heavy weights at the gym; and, constant low  
back pain which seemed to be extending into his neck. For financial reasons, the worker had  
moved back home and was living with his parents and he advised that, with respect to  
household activities, he was unable to lift anything in excess of 30 pounds. Also, working for  
long periods of time increased the intensity of his pain and, at that time, was working two to  
three days a week setting up safety railings on flat rooftops. This job was less physical than the  
job he was performing at the time of the injury. The worker also reported that his driving  
tolerance was 45 minutes, at which juncture he has to get out and stretch and sitting in a pub or  
restaurant aggravated his pain. He stated, “Practically everything has changed in a bad way”.  
[32]  
Dr. Dray reported that: the worker transitioned smoothly from sitting to standing and walked with  
a normal gait; he demonstrated the ability to walk on his toes and heels without difficulty;  
tandem gait was normal, and, he performed a full independent squat. Based on his examination  
findings, Dr. Dray reported that the worker had ongoing pain “in the area of accepted injury  
(thoracic spine) and neck, restricted range of motion in the thoracic spine but normal range in  
the cervical spine and lumbar spine, motor function was intact, and sensation was intact. There  
was no visible spinal deformity and alignment was normal, and there was no muscle wasting  
about the neck, shoulder girdles, or arms, and there was no scapular winging. The worker did  
have a mild palpable deformity at the T7 level and the T6 and T7 vertebrae were tender; also,  
there was tenderness of the paracervical musculature on the right. Dr. Dray concluded that  
there was less than 50% compression associated with the T6 compression fracture and over  
50% compression associated with the T7 compression fracture.  
[33]  
[34]  
[35]  
At the end of December 2019, the worker left his job with the new employer because the  
demands were much the same as those in his previous job.  
A January 6, 2020 x-ray of the worker’s cervical spine and left shoulder revealed no abnormal  
findings at the left shoulder, and no acute abnormalities at the cervical spine.  
On January 16, 2020, the worker saw physiatrist Dr. Rajasekaran regarding ongoing symptoms  
in his left shoulder. On examination, Dr. Rajasekaran found pain-free range of motion in the  
shoulder and full rotator cuff strength. However, impingement testing was positive and the  
shoulder was tender to palpation in the subacromial region. Dr. Rajasekaran said that the  
worker presented with a post-traumatic onset of left shoulder pain. Also, an  
ultrasound examination revealed an intact rotator cuff, but showed mild to moderate  
subacromial-subdeltoid bursitis. Dr. Rajasekaran encouraged the worker to continue with a  
structured exercise program.  
6
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[36]  
[37]  
On January 22 and 23, 2020, the worker participated in a functional capacity evaluation in order  
to identify his functional abilities and limitations and compare these to his pre-injury position as a  
framer. The assessing kinesiologist identified a number of physical limitations, including in the  
worker’s ability to: tolerate low-level work; engage in prolonged periods of bilateral reaching or  
overhead work; sit beyond one and one-half hours unless provided the opportunity for postural  
breaks every one to one and one-half hours; stand for prolonged periods of time; and, engage in  
fast-paced walking.  
The kinesiologist concluded that the worker was no longer physically able to perform the duties  
of this job; although the worker might be capable of more than what he demonstrated during the  
assessment, given his high levels of pain, poor pain management, and overall consistent  
presentation, he was likely not capable of work in more than a sedentary/light strength category.  
Regarding the worker’s overall working tolerance, the kinesiologist reported that, while the  
worker might be able to tolerate full-time work meeting the limitations identified during the  
assessment, he would have to demonstrate improved management of pain and his  
psycho-emotional status in order to maintain employment, as he became increasingly agitated  
with cumulative testing activity, as well as he presented with emotional distress (i.e. tearful,  
expressed frustration and low mood).  
[38]  
[39]  
The MRI of the worker’s thoracic spine that Dr. Faridi had ordered was performed on March 3,  
2020 and showed a remote stable compression fracture of T6 without evidence of cord  
impingement.  
The Board granted the worker the permanent partial disability awards for his chronic thoracic  
back pain and more recently accepted permanent T6 and T7 compression fractures in two  
separate decisions dated March 3, 2020. A review officer later confirmed these decisions  
(Review References #R0262618 and #R0262781, dated August 11, 2020).  
[40]  
As explained in the loss of function review memorandum that was enclosed with the second  
March 3, 2020 decision, when an anatomic and/or surgical impairment is present as well as loss  
of range of movement of the spine, the final impairment rating is based on the greater of the  
two. In the worker’s case, the loss of range of motion in the thoracic spine that Dr. Dray  
measured was equal to 1.80% of total disability. The evidence also supported that the worker  
had an anatomic impairment at the T6 to T7 level. As explained by the disability awards officer,  
this was also equal to 1.80% of total disability:  
Information in the December 2, 2017 [report for a CT scan] … showed that [the  
worker] has suffered a 50 - 60% loss of vertebrae height at the T7 level, and mild  
superior endplate compression fracture of T6 (although the medical documents  
do not show the percentage of T6 vertebrae height, it is rated at mild, and  
therefore I have given 30% loss of vertebrae height at the T6; the DAMA  
[disability awards medical advisor] report also mentions T6 compression fracture  
7
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
with less than 50% compression). The impairment for the loss of vertebrae height  
at the T6 and T7 level is rated at 1.80% of total disability.  
[41]  
[42]  
Because the award resulted in a payment of less than $200 per month, the worker received his  
permanent partial disability award in a lump sum payment.  
In a March 20, 2020 decision, the Board decided to reopen the worker’s claim for a further  
period of wage loss benefits from December 30, 2019 to March 22, 2020. The Board advised  
the worker that, as of March 23, 2020, he may be entitled to vocational rehabilitation benefits  
and that a Board vocational rehabilitation consultant (VRC) would contact him to explain this  
entitlement.  
[43]  
[44]  
The Board then began paying the worker vocational rehabilitation planning benefits. The worker  
identified the CSW occupation and, following psychovocational testing, in July 2020, the VRC  
approved the worker’s preferred plan to become a CSW.  
As of July 2020, the Board was covering the cost of mental health treatment for the worker with  
registered psychologist Dr. Williams. On July 20, 2020, Dr. Williams discharged the worker as  
he began participating in a PMMP.  
[45]  
[46]  
[47]  
The worker enrolled in a college community support worker-social services program that was  
scheduled to commence in September 2020. The course included a final practicum.  
At this time, the worker was receiving ongoing mental health support and was participating in a  
PMMP.  
In an August 11, 2020 discharge report, the PMMP provider reported that the worker was fit to  
return to work, subject to the following limitations:  
Lifting up to 20-30 lb. from floor to shoulder height on an occasional basis.  
Lifting up to 20 lb. each side (40 lb. total) overhead on an occasional basis.  
Carrying up to 50 lb. on an occasional basis over short distances.  
Pushing/pulling with LIGHT (NOC [National Occupational Classification])  
forces on an occasional basis.  
Reaching above shoulder level on an occasional basis.  
Reaching below shoulder level for up to a frequent basis.  
8
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[48]  
The program provider reported that, overall, the worker had progressed well and had shown  
good engagement and psychological gains:  
He has demonstrated increased use of pain and mood symptom management  
techniques and increased psychological flexibility and acceptance, which he  
shared has helped with decreasing the intensity of his pain catastrophizing  
thoughts, and occurrence of suicidal ideation. [The worker] has shown full  
engagement in the physical exercise component and demonstrated steady  
progress in his exercise regime, spine and shoulder girdle stability and mobility.  
[49]  
[50]  
Also, assessment using the Personal Assessment Inventory and Beck Depression Inventory  
revealed only minimal depressive and anxiety symptoms.  
The PMMP provider recommended that the worker continue with the functional and  
rehabilitation exercise program the PMMP had prescribed, continue to apply cognitive  
behavioural and self-management techniques in accordance with instructions the PMMP had  
provided, and continue to seek mental health support for his mood and pain.  
[51]  
[52]  
In an August 14, 2020 physician’s progress note, Dr. Parsons noted that the worker had stated  
his pain was the same, unfortunately with no improvement, but he was doing better mentally,  
which had made a difference.  
On August 25, 2020, the workers’ adviser asked the Board to adjudicate whether the worker  
had a permanent psychological condition. The adviser noted that, in the August 2019  
assessment, Dr. Gambouras had stated that:  
Around prognosis, as the patient’s emotional status appears largely related to  
such ongoing factors of pain and overall functional changes, and given that he  
reportedly continues to experience pain (and in fact believes he has gotten  
“worse each year”), it is not surprising that his mood levels have also not  
significantly improved. Accordingly, should the patient’s physical functioning, pain  
not significantly improve in the future (which is beginning to seem more unlikely  
now almost 2 years post-injury), it is difficult to envision his realizing  
improvements to pre-injury mood levels. In this vein, a PFI [permanent functional  
impairment] assessment might be useful after he has been afforded the  
opportunity to sufficiently participate in a Pain Management Program and  
additional MHT [mental health treatment].  
[53]  
The workers’ adviser noted that the worker had since completed the PMMP, but continued to  
experience significant psychological symptoms.  
9
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[54]  
[55]  
The worker began his college CSW program in September 2020. This involved attending online  
classes from 8:30 a.m. to 12:30 p.m. five days a week (Monday through Friday).  
Registered psychologist Dr. Doward reviewed the information in the claim file. In an October 15,  
2020 opinion, Dr. Doward said that, while it appeared that there had been significant  
amelioration in the worker’s accepted Other Specified Trauma- and Stressor-Related Disorder,  
it could be expected that further mental health treatment could yield further benefit. Therefore,  
the worker’s psychological condition was not at maximum clinical recovery.  
[56]  
Dr. Doward noted the following history: the worker was first diagnosed with the condition by  
Dr. Gambouras in August 2019, based upon the worker developing depressive and anxious  
symptoms as a consequence of the pain and consequential functional impacts of his injury;  
Dr. Gambouras recommended a referral to a multidisciplinary pain program with individual  
psychotherapy in follow-up; the worker had already been paying privately for several sessions of  
psychotherapy with Dr. Williams and the Board began sponsoring treatments with Dr. Williams  
for resiliency services and then standard mental health treatment; after completing only six  
further sessions with Dr. Williams, the PMMP was initiated; at discharge from the PMMP, it was  
noted that the worker had been free of passive suicidal ideation for some three weeks, but the  
PMMP report did indicate a need for ongoing mental health support in the community.  
[57]  
[58]  
Based on the PMMP recommendation, Dr. Doward recommended that the Board arrange for  
such support.  
In Dr. Doward’s view, the goal for the worker’s condition should be recovery, not plateau.  
Dr. Doward said that the current vocational rehabilitation plan took into account the  
psychological restrictions and limitations Dr. Gambouras had identified in August 2019.  
Dr. Doward noted that the worker had since substantially improved over this status and that,  
even at the time of Dr. Gambouras’ assessment, the worker was deemed capable of  
participating in vocational rehabilitation.  
[59]  
[60]  
On October 13, 2020, an occupational therapist whom the Board had retained to assist the  
worker reported to the VRC that the worker had told her that he was doing well in the college  
program and did not have any concerns.  
The Board initially established the worker’s long-term wage rate based on a gross annual  
earnings figure of $45,760. Based on this wage rate, the VRC concluded that the worker would  
restore his pre-injury earnings if he were to adapt to the new occupation of CSW. However, a  
review officer later directed the Board to further investigate and issue a new decision regarding  
the long-term wage rate (Review Reference #R0262883, dated August 20, 2020). Following  
this, the Board established the wage rate on gross annual earnings of $56,670. As the amount  
the Board considered the worker capable of earning over the long term in the new occupation of  
10  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
CSW were lower than this, the worker became eligible for assessment for a loss of earnings  
award.3  
[61]  
[62]  
On November 29, 2020, the worker began receiving mental health treatment from a registered  
clinical counsellor.  
On December 14, 2020, the VRC completed an employability assessment. Although the Board  
did not accept that the worker had any permanent medical restrictions as a result of his  
permanent physical impairments, the Board did accept that he has two subjective limitations:  
difficulty handling loads above light level; and, decreased tolerance for low-level work. As a  
result, his strength category was adjusted from heavy, as it was prior to his injury, to light. The  
VRC noted that:  
The worker had actively engaged with vocational rehabilitation services and had  
demonstrated an eagerness and determination to return to employment: “He researched his  
preferred occupation, including networking and contacting several schools.”  
The CSW occupation was the worker’s preferred plan.  
The psychovocational assessment had shown that his aptitudes and skills were  
well-matched to the CSW occupation.  
The worker had demonstrated the ability to seek and secure employment and was  
motivated to return to work in a full-time capacity.  
The worker was a young worker (currently 24 years of age), and had over 40 years  
remaining in the workforce; the CSW career would allow him to pursue an occupation that  
would restore his pre-injury earnings.  
[63]  
The VRC undertook labour market research and also reviewed the data maintained by the  
Board in its Employment Development and Placement (EDAP) system. Based on this  
information, the VRC concluded that the CSW occupation was physically suitable for the worker  
and reasonably available to him. Further, the VRC concluded that, with the supports included in  
the vocational rehabilitation plan,4 the worker would, within three to five years, be able to earn  
$24.85 per hour. The VRC also noted that, as the worker was a young worker, it would be open  
3
At this time, the Act required that, before undertaking a loss of earnings assessment, the Board had to  
first consider whether the worker was eligible for such an assessment. This eligibility requirement was  
removed from the Act with amendments to the Act that became effective on January 1, 2021. Since  
January 1, 2021, a worker’s entitlement to a loss of earnings benefit must now be considered in all  
cases where the worker has a permanent functional impairment.  
4
These included 12 weeks of job search allowance, the services of an individual job placement provider,  
and, in principle, a work assessment and training-on-the job sponsorship.  
11  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
to him to pursue further education for a bachelor degree in the future, which would allow him to  
earn higher earnings.  
[64]  
[65]  
In the claim memorandum documenting a January 15, 2021 telephone conversation with the  
worker, the VRC recorded that the worker agreed with the earnings she had recommended in  
the employability assessment. At the time, the worker was having difficulty identifying individuals  
who could act as references during his search for employment and he advised the VRC that he  
had contacted a local food bank to discuss the possibility of volunteering so that he could obtain  
a reference.  
In a February 2021 discharge report, the registered clinical counsellor stated that the worker  
had made little progress with his symptoms of depression, continued to have a negative outlook  
on his recovery and future employment opportunities, and had indicated that his main barrier  
was his pain, which impacted all aspects of his life. The worker reported that he was in constant  
pain and had constant negative ruminating thoughts about his workplace accident and about his  
future. The worker also reported that his main worry is that he was not going to be able to work  
an eight-hour day due to his pain/back injury and that no employer would hire him due to his  
injury. The counsellor felt that if the worker could find the right employer who was willing to  
accommodate his injury, he could have successful employment.  
[66]  
[67]  
[68]  
In a February 25, 2021 decision, the Board advised the worker that, as a result of the change in  
his wage rate, he had been paid an additional lump sum of $6,916.15 in addition to the previous  
lump sum payment he had received for his permanent functional chronic pain and thoracic spine  
impairment.  
On March 19, 2021, the worker called the VRC and advised that he had completed a three-hour  
volunteer shift at the food bank the prior week and his back was still causing him troubles a  
week later (he was still crying in pain). He expressed worry about how he would be able to  
complete his practicum, during which he would have to work eight hours a day for a month.  
In the March 24, 2021 decision, the long-term disability officer explained that, based on the new  
long-term wage rate, his pre-injury net earnings equaled $3,624.95. However, the VRC had  
recommended that, in the long term, the worker was capable of earning $3,183.13 net per  
month from full-time work in the CSW occupation.5 Therefore, he was eligible for a loss of  
earnings award based on the difference between the two figures. In current dollars, this was  
equal to $416.08 per month. The loss of earnings award replaced the prior functional award.  
However, as the worker had received lump sum cash payments of his loss of function award,  
which was equal to $143.95 per month in current dollars, he would receive a current monthly  
benefit of $272.13 ($416.08 minus $143.95).  
5
Both of these figures are in 2017 dollars.  
12  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[69]  
In an April 1, 2021 physician’s progress report, Dr. Parsons reported that the worker reported  
feeling better that week, but that things had worsened recently after he was doing some  
volunteer work at a food bank and bending over constantly made things worse. The worker  
reported that, with standing or walking, things worsened over one to two hours. He was able to  
sit for three to three and one-half hours, but then had to get up. The worker found that his pain  
could be depressing, but had stopped taking anti-depressants as they “just made him feel numb  
and [he] feels better off them.” Also, the worker admitted to “questioning his life” and what it  
would look like in the future, but he had no active suicidal plans or intent.6  
[70]  
On April 23, 2021, the worker advised the VRC that he was still passing all his courses at  
school, but he had to stop volunteering because it was painful even doing three to four hours of  
moving up and down boxing items. He again expressed concern that he would not be able to  
complete his practicum. The VRC suggested that the worker look for volunteer work that was  
not as physical and involved more interactions with people, such as at youth service centres or  
doing outreach work. The worker later changed his mind and, on April 29, 2021, advised the  
VRC that he had decided to continue working three shifts at the food bank and just tell them he  
could not do the physical aspects of volunteering.  
[71]  
[72]  
On June 2 and 5, 2021, the worker underwent a psychological assessment with Dr. Gambouras  
for the purpose of obtaining a current understanding of the worker’s psychological issues,  
particularly with respect to diagnosis, treatment, and return-to-work issues.  
In a June 8, 2021 report, Dr. Gambouras said that the worker reported that he was in constant  
pain that impacted all aspects of his daily life; he rated his average daily back pain as an 8 on a  
scale of 0 to 10, with 10 being the worst, and he advised that his pain increased with activity and  
decreased with lying down. The worker indicated on numerous occasions that he did not believe  
he would be able to work and that he had uncertainty/stress regarding his future. He also  
indicated a lot of anger towards the Board about how his claim was handled and that he had  
extreme low mood and suicide ideation. He estimated that he could walk for roughly 20 minutes  
before he needed to sit and he advised Dr. Gambouras that two neurosurgeons had said “I’m  
f…d”.  
[73]  
Dr. Gambouras found the worker to be polite and cooperative but said that his mood and affect  
were characterized by much distress (he frequently cried during the assessment in particular  
when discussing the ongoing pain and resultant functional limitations and he also often had  
intense outbursts of anger when discussing his injury and its impact on him). The validity indices  
on two psychometric tests he had administered suggested the presence of considerable  
distortion in self-report, as the worker may typically have attempted to portray himself in a  
particularly pathological or negative manner. Accordingly, Dr. Gambouras said it was possible  
6
Block capitalization was removed from quotations.  
13  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
that the current evaluation results served to overestimate, to some degree, the worker’s  
emotional difficulties at the time of the psychological assessment.  
[74]  
Dr. Gambouras concluded that the worker had realized significant emotional distress (that is,  
low moods and anxiety/stress) secondary to functional changes and pain that resulted from the  
December 2, 2017 work injury. He said it was difficult to provide a definitive opinion as to any  
reduced capacities in functioning secondary to psychological as opposed to physical/pain  
factors. He said that the most significant psychological symptoms currently interfering with  
function were the worker’s marked hopelessness and extremely negative outlook towards the  
future (sometimes even in the face of some positive changes or happenings). However, he felt  
that persistent pain and physical (as opposed to emotional) limitations and problems were the  
worker’s primary barriers to returning to work and it appeared that the worker’s ongoing mood  
difficulties appeared largely dictated by persistence of pain and functional problems.  
Consequently, if the worker’s physical condition and pain improved to a point that he could  
return to some level of productive activity, his mood levels would also hopefully return to close  
to premorbid levels. In that case, no or minimal psychological limitations or restrictions would be  
necessary. Due to the nature of his current psychological symptoms, the worker might have  
reduced capacity to “(1) persevere through (physical) set-backs in school or RTW or  
(2) appreciate or recognize increasing production and accomplishment or any positive  
happenings that might occur (school or RTW-wise, for example).”  
[75]  
[76]  
Dr. Gambouras also noted the worker’s accomplishments in the CSW diploma program and his  
experience volunteering and he said that, from a purely psychological (as opposed to physical)  
standpoint, there did not appear to be any specific tasks or activities that would result in harm or  
safety concerns that the worker should avoid.  
Dr. Gambouras noted that the worker did not appear to be open to any additional counselling,  
occupational therapy assistance, or psychotropic medications as he did not believe these  
treatments would be beneficial. Accordingly, in Dr. Gambouras’ opinion, additional talk therapy  
per se (even with a psychologist) would likely not result in significant improvements in emotional  
functioning for this patient over the next 12 months. Further, as the worker was so solely  
focused on his persistent physical symptoms and pain and resultant functional limitations,  
outside of pain and/or medicinal treatments or his realizing mood improvements secondary to  
future resolution of pain or physical problems, it was difficult to envision a mental health  
treatment that would serve to significantly improve his emotional status. Dr. Gambouras noted  
that the worker was awaiting a consultation regarding a possible spinal nerve ablation  
procedure and had also indicated that he was agreeable to participating in an in-person pain  
management program, both of which might improve his pain. Dr. Gambouras was hopeful that  
the worker would realize a return to better mood secondary to his return to work as a CSW,  
which was expected to occur in roughly September 2021. As he hoped that this return to work,  
the pending nerve ablation procedure, or participation in a pain management program would  
14  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
result in returning the worker’s mood to a better status, he believed that further (significant)  
change in the worker’s psychological function could be expected over the next 12 months.  
[77]  
[78]  
In the interim, Dr. Gambouras recommended that the worker’s loved ones and healthcare  
providers continue to monitor his suicidality.  
In a July 19, 2021 decision, the Board accepted the worker’s compensable Other Specified  
Trauma- and Stressor-Related Disorder as a permanent condition under the claim and referred  
him for assessment of his entitlement to a permanent partial disability benefit. Although  
Dr. Gambouras had indicated that there could be improvement in the worker’s psychological  
condition, this was contingent on reduced pain. However, to date, reduced pain had not  
achieved and the Board considered the psychological condition to have stabilized as of July 5,  
2021.7  
[79]  
[80]  
As the worker was currently involved in the vocational rehabilitation process, the Board  
postponed making a decision regarding whether the acceptance of this additional permanent  
condition under the claim entitled him to a separate referral for vocational rehabilitation services.  
In conjunction with the acceptance of this permanent psychological condition, the Board also  
accepted a new limitation under the claim: “Reduced capacity in parts of a job that involve a  
high degree of time pressures, sustained mental effort and concentration, or competing  
activities and/or outside distractions in particular on a more painful day.”  
[81]  
[82]  
A July 2021 transcript from the college where the worker was completing his CSW education  
shows that the worker obtained a grade point average equal to 86% and attended 98.4% of his  
scheduled classes. The worker began his practicum on July 27, 2021 and this ended on  
September 23, 2021.  
On August 30, 2021, the worker advised the VRC that he felt it was impossible for him to  
complete the job search requirements established under his vocational rehabilitation plan and  
that he was planning to apply for Persons with Disabilities (PWD) benefits as he only wanted to  
work part time for the time being. The VRC explained to the worker that he would receive job  
search assistance when he was ready to look for work and that the Board would also refer him  
to an individualized job placement service to assist him in identifying prospective employers.  
[83]  
On September 14, 2021, the worker confirmed that he planned to apply for PWD benefits and  
no longer wanted to pursue a job search. He said that, once his PWD benefit application was  
approved, he planned to search for part-time work as a CSW. In order to pursue his application,  
7
This conclusion was based on the medical advice Dr. Doward provided in a July 5, 2021 clinical review  
and opinion report.  
15  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
he needed a letter from the Board confirming he was not eligible for additional vocational  
rehabilitation benefits.  
[84]  
[85]  
In a September 21, 2021 decision, the VRC advised that his vocational rehabilitation benefits  
had been discontinued.  
In the request for review of the March 24, 2021 decision, the worker agreed in principle with the  
occupational goal of CSW. However, he argued that the Board “significantly overestimated his  
future earnings potential” and erred in deeming him to be capable of earning at the top end of  
the salary range. The worker submitted that it was likely that he would obtain employment at the  
bottom end of the pay range (which went from $16.00 per hour to $24.85 per hour) and so he  
was entitled to an increased loss of earnings benefit based on earnings of $16.00 per hour.  
In particular the worker submitted that:  
[86]  
His only prior work experience is in the construction industry and the proposed shift to the  
CSW occupation represented a very significant change in direction and something of a “leap  
into the unknown”.  
The psycho-vocational testing conducted in June 2020 concluded that his overall intellectual  
functioning falls within the low average range compared to age-matched peers and that the  
low average results for the verbal IQ scale indicated that he had difficulties in recognizing  
word meanings, reasoning, and applying his knowledge effectively; his results indicated that  
88% of his peers have scored better than him.  
While he had endeavoured to stay optimistic, there were many uncertainties ahead, and  
there was no logical basis for deeming him capable of earning at the highest end of the  
salary range for this occupation when, as yet, he has not even demonstrated the ability to  
gain employment.  
The VRC only considered the physical suitability of the occupation and disregarded the  
significant limitations resulting from his compensable psychological disorder, which were  
likely to have a substantial bearing on his future earnings potential.  
Although his psychological disorder was only deemed to have plateaued as a permanent  
condition on July 5, 2021, it was identified almost two years earlier after having been  
diagnosed through a psychological assessment report in August 2019.  
His psychological condition is likely to have a significant impact on his overall productivity in  
any work setting and the limitations resulting from it are not consistent with the finding that  
he is capable of earning at the highest end of the salary range for the target occupation:  
The now accepted limitation in parts of a job that involve a high degree of time  
pressures, sustain mental effort and concentration, or competing activities and/or  
16  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
outside distractions, in particular on a more painful day will limit his future  
employability.  
In addition to this, Dr. Gambouras noted that he may struggle at times to maintain a  
relatively “normal” work pace and to be productive in the expected manner over the  
course of a full work day or week, and anticipated that he would require short breaks  
as needed to “recharge”, thereby interrupting his work performance.  
[87]  
In Review Reference #R0279846, the review officer noted that policy item C6-40.00 stated that,  
in estimating what a worker is capable of earning after the injury, the Board considers the  
evidence, including the medical evidence, of the limitations imposed by the compensable  
disability and the fitness of the worker for different occupations. The Board also considers the  
evidence about the suitability of the worker for occupations that could reasonably become  
available. Following these considerations, the Board will arrive at a conclusion about suitable  
occupations that the worker could be expected to undertake over the long run that will maximize  
the worker’s long-term earnings potential, up to the pre-injury wage rate. In most cases, “long  
term” refers to three to five years.  
[88]  
[89]  
Given that the worker did not take issue with the occupational goal itself, the review officer  
found that it was not necessary to review the suitability and reasonable availability of the  
occupation. She noted that the Board agreed to sponsor the worker in this plan on the basis of  
the worker’s request for this plan and his own research into the occupation.  
The review officer was satisfied that the projected earnings of $24.85 (in 2020 dollars) was a  
reasonable estimate of what the worker could earn in this occupation in three to five years. The  
review officer acknowledged that the earnings potential within the range of earnings in the job  
postings the VRC relied on was at least partially dependent on a worker’s education and  
experience and that, in this case, the worker was starting out with no experience. However, the  
Board had sponsored him in a one-year training program that would assist him to get into the  
occupation and the review officer was satisfied that, after three to five years of experience,  
along with his certificate, the earnings estimate of $24.85 per hour was realistic.  
[90]  
The review officer also acknowledged that the worker’s employment history was limited to the  
construction industry; however, the Board agreed to sponsor the worker in a significant  
retraining program that would allow him to enter an entirely different field of work. It appeared to  
the review officer that many employers would accept the training program in lieu of related  
experience.  
17  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[91]  
With regard to the submission that the worker has a psychological disability as well as a  
physical one and this could affect his future earnings potential, the review officer concluded as  
follows:  
I acknowledge that the worker has further limitations with respect to his  
psychological condition; however, I find it noteworthy that despite the limitations,  
the worker did extremely well in his one-year formal training program and  
achieved outstanding marks and demonstrated excellent attendance.  
Specifically, a review of the worker’s July 2021 transcript revealed that he  
received a course average of 86% (GPA of 3.82) and his attendance was 98.4%.  
With evidence such as this to show potential employers, I am not persuaded by  
the Workers’ Adviser’s argument that the worker is far more likely to obtain  
employment in a lower paid, less demanding job at the bottom end of the pay  
range. I also note that the worker secured a practicum as part of his training  
program, which started on July 27, 2021, as well as participated in related  
volunteer work three days per week.  
[92]  
In addition, while the $24.85 per hour wage was noted by the VRC to be at the higher end of the  
wage scales in the job postings, the review officer found it noteworthy that the earnings amount  
was comparable to the occupational class average earnings for full-time workers in this  
occupation in 2017 ($3,940 per month) that were on the claim file. Further, the projected wage  
was also analogous to the earnings information obtained through the employer contacts the  
VRC undertook, as summarized in a June 12, 2020 document in which the VRC set out the  
results of her labour market information research.  
New Documentary Evidence  
[93]  
The worker obtained a January 31, 2022 letter from Dr. Parsons in support of his appeal.  
Dr. Parsons advised that the worker has very severe back pain as a result of his 2017 spinal  
fracture and, unfortunately, after many modalities of treatment, his pain remains as severe or  
worse. Dr. Parsons said that this limits the worker in his daily life in all aspects and, particularly,  
when it comes to employment. Dr. Parsons said that his back has a loss of mobility and his pain  
is significantly worsened by lifting, bending, sitting, and being in a flexed position. Dr. Parsons  
said that the worker is at a disadvantage when it comes to being able to perform almost any  
type of job. Furthermore:  
… this has understandably taken a very negative toll on his mental health -  
somethin[g] he has to reconcile with daily. The total of these two problems is a  
very significant burden for [the worker].  
18  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[94]  
[95]  
The worker also provided WCAT with a copy of his application for PWD benefits he completed  
on October 24, 2021.  
In the description of disability, the worker described the injuries he believes he sustained on  
December 20, 2017 as follows:  
On Dec 2nd 2017 I fell off a ladder and broke my neck in multiple places, I broke  
my spine (T6, T7, T8) vertebrae which the T7 was crushed over 60% while the  
T6/T8 was crushed 30% or more. I also broke my left side scapula affecting it  
negatively.  
[96]  
In the medical report section that Dr. Parson’s completed on November 17, 2021, Dr. Parsons  
identified the following diagnoses: T6 and T7 compression fracture causing chronic severe  
back pain (onset December 2017), depression stemming from the chronic pain (onset  
February 2019), and left subacromial/subdeltoid bursitis (onset December 2017). Dr. Parsons  
explained that the worker’s chronic pain limits all of his activities and noted that two attempts of  
nerve blocks, participation at an interventional pain clinic, physiotherapy, intramuscular  
stimulation, Celebrex, counselling, and exercise had all been unhelpful. She prescribes Tylenol  
No. 3 for the worker, “just to make things more tolerable”. Initially, the worker required a back  
brace and, although he did not presently require one, he might in the future.  
[97]  
[98]  
Dr. Parsons estimated that the worker’s tolerance for activity was limited in the following  
regards: two to four blocks of unaided walking on a flat surface; lifting under five pounds; and,  
less than one hour of sitting.  
Dr. Parsons said that the worker does not have difficulties with communication, but does have  
significant deficits with cognitive and emotional function. These have been listed below in my  
summary of the written submission the workers’ adviser provided to WCAT after the hearing and  
so will not be repeated here. Dr. Parsons said that, for the most part, the worker’s daily activities  
are very restricted and that he spends most of his day at home laying on the couch or in bed.  
Testimony  
[99]  
The worker testified that, other than working at a fast food restaurant while he was in high  
school, his only employment has been in the construction industry and doing labour. He started  
his apprenticeship right after he finished grade 12 and was a fourth year apprentice when he  
stopped working in construction. He had been attracted to work in this occupation because he  
liked being outside, liked hanging out with people, liked talking, and liked doing stuff with his  
hands. Overall, he liked his job and, looking back, even though it was intensive and hard work, it  
was great.  
19  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[100] The worker confirmed that he went back to work in construction for about eight months after his  
injury. He said that his neurosurgeon gave him the go-ahead to go back to construction, “for  
some reason,” although he did not know why. The neurosurgeon told him that his back would be  
fully healed by a year after the accident. However, his back was not getting better and, if  
anything, it is getting worse. He tried to do part-time work here and there at several places, such  
as driving a delivery truck with roofing parts. He did not have to lift anything and would just drive  
around in a truck, and he could not even do that. One day, he was crying from just driving the  
truck all day and he called his father and told him that he could not do this anymore. His father  
agreed, let him quit, and let him live in his basement for free. He said that he realized his  
neurosurgeon had no idea what he was talking about: “I broke my spine and I should have not  
gone back to work.” He decided not to work in construction anymore.  
[101] The worker said that, since then, he had not done much. He tried to work at the food bank,  
which involved lifting up cans of soup, pasta, and other items, but they made him work  
three-hour shifts. He said he would be crying after doing this lifting. That was all the work he had  
done in four years, up until a week prior to the oral hearing, when he worked a first shift in a new  
job.  
[102] I asked the worker to describe what he did during his practicum. He said that he found a  
position with a grocery delivery program and, basically, he was their “taxi boy” for a month and a  
half. He would drive around and take groceries to different places for delivery to people with  
mental health, disability, or drug issues. Employees at the shop would load them into his car  
and, when he got to the individuals to whom the groceries were to be delivered, they would  
come outside their homes and pick them up. He said that he got zero experience from the  
practicum, other than experience being a delivery boy.  
[103] The worker’s new job is a part-time position at a department store, working two to three shifts a  
week for 6 hours a day. He tried to get the employer to agree to only two shifts a week, but the  
employer said it would not hire him unless he agreed to work 12 to 18 hours per week. The  
worker said that he does not lift anything and all he has to do is walk around. He said he knows  
about motors and is responsible for helping customers who are looking for equipment such as  
lawnmowers or power tools. If anything needs to be lifted, he goes and gets someone else do  
this.  
[104] The worker said that he is working in his new job in order to keep his sanity and try to make a  
living. However, the worker also said that his sanity is gone. With the exception of the first 15 or  
20 minutes when he gets up in the morning, his back is constantly aching and hurts him no  
matter what he does, and it worsens throughout the day. He said that there is nothing he can do  
to get relief from the pain and this means he does not do much of anything other than sitting in  
at his house. He can lie down, but in reality that does not solve much.  
20  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[105] The worker understands that, because of his injury, he is missing three-quarters of one of his  
vertebra and 20% of a second vertebra and so his body does not have much to hold it up. He  
said that he has talked to the doctors who arranged for his imaging and they have basically told  
him his vertebrae “is grinding down every year.” It is getting worse and worse every year. In  
response to questions I asked him, he further explained that he believes that he has a broken  
cervical vertebrae, that his T7 vertebrae was crushed and is “about 60% shattered,” although it  
is probably a bit more now, and that his T6 and T8 vertebrae were “crushed about 40%”,  
although they are also likely worse now. He said that his spine is “absolutely destroyed”. He  
also noted that his left scapula was broken and he said that this causes him issues as he has  
bursitis there.  
[106] In response to his representative’s question as to whether he remembered the two-day  
functional capacity evaluation, the worker initially said that the two-day functional capacity  
evaluation he underwent was “kind of ridiculous” because it was online due to COVID-19.  
However, after clarification that this was the in-person assessment he attended in  
January 2020, the worker said that he vaguely remembered the assessment. He said that it had  
to be kept in mind that, at this point, he was at his lowest. He was trying to get back to work  
because he had no money, did not have any benefits yet and had no other disability funds, and,  
basically, if he did not work he would have been homeless. As a consequence, he had to push  
himself. Conversely, in the last couple of years while he has been receiving benefits, he has not  
had to push himself to try to get back to work.  
[107] The worker said that, since the functional capacity evaluation, his level of function has gotten  
worse, his pain is worse, and he can do less and less each year.  
[108] I also asked the worker about the activity levels the occupational therapist assessed during the  
two-day functional capacity evaluation and asked if these were things that he could still do. The  
worker said that he was currently unable to sit for periods of one and one-half hours at a time  
and his condition had absolutely worsened since then. He said that it was clear from his  
CT scans that his back is “degrading” and getting worse every year. He said that, during the  
functional capacity evaluation, because he did not have a job and had to get back to work or  
end up being homeless, he told the occupational therapist that he could work full time. The  
worker also told me that he was no longer capable of standing for between 45 minutes and up  
to one and one-half hours. At his current employer, he can sit down and take a break, and at  
least move around and stretch, but his sitting tolerance is also getting worse over time. His  
chronic back pain aches with standing and, as an example, he said that if he stands to do his  
dishes for 15 to 20 minutes, he has to go and lie down in his bed afterwards. In response to my  
question as to whether that was due to symptoms in his arms or his back, the worker said he  
does have issues with his shoulder and lifting and anything overhead is affected by that.  
However, this is not well-documented because everyone has chosen to focus on his back  
because it is the biggest thing and he always mentions this to his doctors and other health care  
providers. He said that, if the back pain was not there, he could probably go back and work full  
21  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
time, but his shoulder causes him issues every single day and whenever he lifts something up it  
“clicks” and is “brutal”. Although, he wakes up with pain in his neck in the morning and it also  
causes him excruciating pain, it is nowhere near the pain he experiences in his thoracic spine.  
[109] The worker said that the Board’s conclusion that his only limitations are difficulty with handling  
loads above light level and decreased tolerance for low-level work is “a complete lie.” He said  
that it is wrong to say he has trouble lifting only certain weights and that everything is affected:  
Every single thing in his life, from sitting down to going for walks to showering to just doing  
miscellaneous stuff like dishes and tying his shoes is more difficult.  
He was unsure of his maximum walking tolerance, but his back starts aching after 10 to  
15 minutes of walking and he can continue for maybe 30 minutes before he has to come  
home and lie down in his bed for an hour or so, and it is the same for everything he does.  
After sitting or standing for 30 minutes, his back is aching to the point where he has to go  
lay down for hours at a time, and that is every single time he does these activities.  
He can lift five-pound weights at a gym a couple of times a week, but that is the only  
physical thing he does.  
He cannot sit at a restaurant with his family without his back just aching the entire time.  
If he visits friends, he just ends up laying on the couch; they understand his situation and  
let him do that, but it is degrading.  
He can barely lift anything anymore, and could barely lift cans of soup for three hours at the  
food bank.  
Because of the pain, he does not push himself and he would rather keep stationary.  
[110] The worker described his claim experience as involving a four-year process to even get on  
disability benefits and that the scary thing is that the Board and everybody says, “Yeah, you are  
injured, but you’re screwed unless you want to go back to work.” He said that, no matter what,  
his doctors and everybody just keeps telling him to push it. He believes that a lot of his doctors  
do not know what is going on with him, and do not know what having a broken back means.  
They tell him he has to try to walk and push himself, because they think it will make him better  
and, even though it scared him, “me being stupid,” he would do what he was asked. However, in  
the last couple of years, because he has been receiving benefits, he has not had to push  
himself like this.  
[111] With regard to the occupational goal of CSW, the worker said that he had no knowledge about  
the occupation when the plan was established. He chose the occupation after speaking with one  
of his uncles, who worked as a CSW for years in the downtown Vancouver east side. His uncle  
told him that he never had to lift anything, and that the occupation would be fine. At first, the  
22  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
worker loved the idea of this occupation because it would mean he would get to help others  
and, because he is in a terrible space, it would make him feel better to help others. He was  
interested in the occupation and, at first, based on the online information about the course he  
enrolled in, he thought it would be a good fit for him. The course materials did not really mention  
anything about having to lift anybody in wheelchairs. It only said that CSWs work with disabled  
individuals and people with mental health issues.  
[112] The worker explained that he completed his one-year CSW course online and it was easy. He  
could just lay in bed for the most part, and his teacher understood. The course provider did not  
want the students coming in and doing anything physical, and the course did not involve any  
physical training. In order to transfer clients, doing CPR, and crisis intervention (including  
physical holds, which he would not have to do in any event), he would watch videos online. As  
he progressed in his education, he learned that CSWs are not social workers or anything like  
that. Rather, they are basically community support workers in the sense that they help  
individuals with basic stuff like living but, of course, they need to help people in wheelchairs.  
With regard to skillset, he drew an analogy between journeyman carpenters, who know all the  
intricate details of building houses, and labourers, who basically move lumber around and do  
not know anything; the CSW occupation is analogous to the labourer occupation and the social  
worker occupation requires a four-year social services degree.  
[113] The worker does not believe that he can meet the physical requirements of the CSW  
occupation. He said that he tried to apply for CSW positions but, if you cannot lift somebody out  
of a wheelchair, you cannot find a job. Over and above transferring clients, he said that he  
would have trouble with everything involved in the job. A lot of CSWs help clients “just do their  
life,” which includes washing dishes, washing their clothes, and helping them shower, and he  
does not believe he could do this. He said he has difficulty doing these things for himself, but he  
is able to force himself to do them notwithstanding his chronic pain because he does not want to  
get more depressed by living in an absolute trash pile.  
[114] The worker described his mental state as “just terrible in general”. He said he went into  
schooling assuming it would get better but, in reality, it has not. He wakes up every day with a  
broken neck and a broken spine, and he cannot do anything. His injury has affected his  
relationships, which have ended because his girlfriends do not want to be with a disabled  
person, and he cannot go to his family’s cabin because the long drive to get there eats at his  
mental state. Before his injury, he would work 12 hours a day, 6 days a week, and make his  
own living. In contrast, for 4 years, he was basically told he was useless to anyone and to “go  
be homeless.” He has had to deal with this every single day, no matter how good or bad his day  
is, and, while he would love to say he is getting better, he is “damn near suicidal every day.” He  
said that he will just be sitting or browsing on the computer, start thinking he wants to kill  
himself, and mutter that he just wants to die. This has happened in the presence of his  
stepbrother, with the VRC, and while he was taking his courses. When his stepbrother asked  
23  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
him what he was saying, he pretended he was playing a game and responded that he was just  
joking, but he was not joking and “I’m suicidal every ... day”.  
[115] The worker said that, as a CSW, he would have to watch over people practically the entire time.  
He thought he could do this but, in reality, even having worked for six hours at his new job, he  
had to go and lie down in his car after three hours because he was in excruciating pain; even  
after the first hour of work, he began thinking he had to get out of there. He doubts that he  
would be able to try and support other people in a position where he had to constantly talk to  
them because the pain eats at his mental state the longer and longer it goes on. He said that, as  
the day goes on, he gets anger from being frustrated, depressed, saddened, and anxious. He  
thought that no employer was going to hire him and he considers himself lucky to have found  
his current job. He told the employer about his disability and they were accepting of it, which is  
“crazy,” because they were nicer to him and more accepting of him than the people who work  
with people with disabilities at the employers where he applied for CSW work.  
[116] The worker said it would be great to be working with people in person as a CSW but, as time  
goes by in the day, it becomes problematic both emotionally and physically. Also, because he  
would have to be watching after a disabled person or a person who is mentally unwell as a  
CSW, he knew that his difficulties with concentration would be a problem. He said that, usually,  
CSWs have to work 8- to 12-hour shifts and there is a lot of overtime involved, as well as  
overnight shifts working with individuals who are struggling to live and the CSW has to watch  
them every moment. They could be in wheelchairs or doing drugs openly in front of you and, a  
lot of the time, they will not want to listen. He said it would be just terrible to lose track because  
of the terrible things that could happen. He said that he can barely even focus when talking at  
the dinner table with his family because, mostly, he is thinking about the fact that his back is just  
constantly aching. He said it is sad but, mostly, he thinks about himself rather than other people  
because he has a wide range of his own issues.  
[117] In response to his representative’s question as to why he felt unable to look for work at the time  
his vocational rehabilitation benefits were discontinued (September 2021), the worker provided  
several reasons. He had no references because he had not been working for three years, and  
so he started volunteering at the food bank. He worked 3 hours, 2 days, for a total of 6 hours a  
week and, after each shift, he would be crying in pain. He said that this “sounds absolutely  
ridiculous” and “sounds crazy,” but that is how much pain he was in from his back. He said that  
he realized he could not work 8-hour shifts, 5 days a week in the CSW position that would also  
sometimes require him to work overtime for 12 hours and lift people in wheelchairs. He knew  
there was no way he is ever going to be working full time ever again, and “that’s the sad reality  
of it.” He said he knows this now because, if he could not work at the food bank doing 3 hours a  
day, there is no way he is going to be working full time ever, it is just not going to happen, and it  
is going to worsen as he gets older. He decided to go onto disability benefits before he started  
anything.  
24  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[118] The worker said that he did apply for several CSW jobs but, basically, all of the potential  
employers told him that he had to get a doctor to sign saying he was physically and mentally  
well. His doctor knows that he is depressed all the time, knows that he is suicidal all the time,  
and knows about his physical injuries, and so that was an issue with every single one of his  
applications. He also said that only two of the employers he applied to for CSW jobs got back to  
him. They both asked him if he could lift people out of wheelchairs and, when he said no, they  
did not want to hire him.  
[119] The worker said he was sure that there were CSW jobs that do not involve lifting out there, but  
said he would not be able to obtain them. He believes he could be a CSW if he did not have a  
broken back; he has the personal attributes to do the job including that he is kind, good with  
people, and able to write reports. However, he has zero experience, he cannot work the long  
hours required, he cannot work on-call, and, while he would love to say that employers just like  
to hire disabled people out of the blue, that is not the case. As the CSW career involves looking  
after people with disabilities, employers just do not want to risk hiring a person with a disability  
to do that.  
[120] With regard to the projected earnings of approximately $26 per hour that the Board based his  
loss of earnings benefit on, the worker said that he was sorry, but he found this “complete BS”  
and that it makes him emotional because “it’s clearly plunked there just to mess with me.” He  
said that he is a hopeful guy and, when he was asked about his potential earnings as a CSW,  
he thought maybe he could work himself up to be a social worker. However, he said that the  
$26 per hour figure was absolutely crazy because, if you look up the salary of CSWs anywhere  
in Canada, they earn $16 or $17 per hour and you cannot make a living at that wage. Seeing  
that he is disabled, cannot work full time, cannot work long hours, cannot lift people in  
wheelchairs, has mental problems, and has a back that is deteriorating by the year, he guessed  
that he would probably only be able to get minimum wage, or $16 or $17 per hour as a CSW.  
He said that nobody will offer him a job that he cannot do and there is not a single employer  
who will allow him to work one eight-hour shift followed by a six-hour shift or the terms of  
employment he has with his current employer. He said that he has talked with CSWs who can  
actually lift people and are good CSWs. Most have said that they work full time, make in the  
range of $20 per hour, and make their money off overtime and overnight shifts. He said being a  
CSW is the “lowest of the low” in social work and, again, he applied the analogy of a carpenter,  
who gets $25 to 40 an hour to manage everything, and a labourer (equivalent to a CSW), who  
gets minimum wage or slightly more if the labourer is good at the job. He said he is clearly not a  
good fit for the CSW occupation because of his disability, and that leaves him at minimum  
wage.  
[121] The worker said that his application for PWD benefits was accepted on May 1, 2022 and he had  
worked his first shift at the department store on May 7, 2022. He is allowed to earn some money  
while receiving these benefits, but even with these additional earnings, he is making just above  
the poverty line.  
25  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[122] The worker does not believe that his current job or any other job is sustainable for him. He said  
that he does not know for how long he will be working but, as long as he is still can at least walk,  
he feels he should go out there and make some money and not just lie around all day on  
benefits. At the present time, his current job seems durable because the employer is not making  
him lift anything and, if he needs to take a break during his shift, he is allowed to do that he  
can ask if he can take 15 minutes to lie down or sit somewhere, and they will let him as long as  
he does not do this every half hour. However, he also said that, “When you look at somebody  
with a broken back that can barely stand for 30 minutes or sit for 30 minutes, no job is good”;  
everything requires standing or sitting, which he typically cannot do because of the excruciating  
pain he gets. He said that there is not a single job out there that you can say is for the “guy with  
the broken back” because, in reality, “there’s a guy out there who can do it better.”  
[123] The worker believes that it is inevitable that, some day, he is not going to be able to work. He  
does not how long that will be, and it scares him, but it is becoming more and more clear that  
his disability is not going away and nothing is going to make him better. He said that, at least in  
2020, or whenever the functional capacity evaluation happened, he was at least hopeful he  
could work hard and his back pain might get better, but it has just gotten worse, physically,  
mentally, and emotionally. He said that both of the neurosurgeons he has seen took about five  
minutes with him and told him that he is “F….d”. The have told him that, because there are so  
many organs that could be damaged, surgery is not an option.  
[124] As of the hearing date, the worker was taking Tylenol No. 3 three times a day. He said that he  
has been offered methadone and naloxone, but he turned these down because he has heard  
nothing but nightmares about these medications. He said it terrifies him that he could turn into  
an opioid addict during the opioid epidemic and he wants to put off using these medications as  
long as he can.  
Submissions  
[125] The worker seeks an increased loss of earning disability benefit, effective August 19, 2019.  
[126] In the notice of appeal, the worker submitted that he has not been able to return to work since  
his claim injury and his current partial loss of earnings benefit is based on the erroneous  
premise that he is capable of working full time as a CSW and earning at the highest end of the  
range for that occupation. He said that the combined effect of his physical injuries, chronic pain,  
and psychological limitations is such that he is unlikely to obtain work as a CSW and that he  
may in fact be competitively unemployable.  
[127] In the written submission the workers’ adviser provided to WCAT after the oral hearing, the  
worker acknowledged that he has recently started a part-time job at the department store,  
where he earns $17 per hour working 12 to 18 hours per week. However, this employment is  
part time and in a very different occupation than that envisaged in the vocational rehabilitation  
26  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
plan. He submitted that it is too early to say with any degree of confidence whether he will be  
able to continue working in that job for the longer term.  
[128] The worker submitted that the Board has significantly overestimated his future earnings  
potential.  
[129] First, the worker submitted that the true extent of his physical limitations is significantly greater  
than the limitations currently accepted by the Board relating to “difficulty with handling loads  
above light level” and “decreased tolerance for low level work” and his loss of earnings benefit  
should recognize this. He submitted that the Board appeared to have overlooked many of the  
findings in the functional capacity evaluation report from January 2020. He also relied on the  
fact that the provincial government has accepted his PWD benefit application and the new  
evidence from Dr. Parsons. He submitted that, although he initially agreed with the occupational  
goal of CSW, his subsequent experience while job searching led him to believe that there are  
few, if any, CSW jobs which would be within his actual physical limitations.  
[130] Second, although he submitted that his physical limitations were alone a sufficient reason to find  
that the CSW occupation is not suitable for him, the worker submitted that his psychological  
limitations also render that occupation unsuitable.  
[131] Third, he submitted that the overall weight of the evidence strongly suggests that he is only  
likely capable of working part time.  
[132] Fourth, while he takes the position that his physical limitations are a sufficient reason to find that  
the CSW occupation is unsuitable, his diagnosed psychological disorder presents another  
barrier to his employability in this occupation. He said that, irrespective of whether this  
diagnosed psychological disorder had stabilized as permanent, the Board was aware that it  
existed and that it would have an impact on the worker’s overall employability.  
[133] Fifth, as he had previously done in his submission to the Review Division, the worker noted that  
his only prior work experience has been in the construction industry and that the  
psychovocational testing conducted in June 2020 showed him to have lower overall intellectual  
functioning than age-matched peers. Therefore, deeming him to be capable of earning at the  
highest end of the salary range after taking a “leap into the unknown” was not reasonable.  
Rather, he is likely to encounter substantial difficulties and is far more likely to obtain  
employment in a part-time lower paid, less demanding job at the lowest end of the pay range.  
[134] The worker submits that, considering all of these factors, his estimated future earnings capacity  
should be based on him working part time (no more than 20 hours per week) at the lower end of  
the pay range of $16 per hour for the target occupation, which is broadly in line with the  
earnings from the part-time job that the worker has recently started, although in a different  
occupation.  
27  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
Analysis and Findings  
Law and Policy  
[135] Section 195(1) states that, subject to 196 of the Act, if a permanent partial disability results from  
a worker’s injury, the Board must estimate the impairment of the worker’s earning capacity from  
the nature and degree of the injury and pay the worker compensation.  
[136] Section 196(3) of the Act states that the Board is to determine the difference between the  
worker’s average net earnings before the injury and whichever of the two amounts the Board  
considers best represents the worker’s loss of earnings:  
(i) the average net earnings that the worker is earning after the injury.  
(ii) the average net earnings that the Board estimates the worker is capable of  
earning in a suitable occupation after the injury.  
[137] The worker is entitled to a permanent partial disability benefit based on the greater of the  
amounts calculated under the loss of function method and the loss of earnings method.  
[138] Board policy item C6-40.00, section B adds further detail to loss of earnings awards  
calculations. It sets out that the Board must consider both the worker’s actual post-injury  
earnings and its own estimates of a worker’s post-injury earnings when determining which best  
represents the worker’s post-injury loss of earnings. The medical evidence, the compensable  
limitations imposed on the worker, and the worker’s fitness for different occupations should also  
be considered. The Board also considers the evidence about the suitability of the worker for  
occupations that could reasonably become available. No loss of earnings benefit can be  
provided to a worker who is unemployed for reasons unrelated to the compensable injury or it is  
determined there will not be a potential loss of earnings.  
[139] Section C of policy item C6-40.00 confirms that a selected occupation must be suitable and  
reasonably available to the worker over the long term (generally, three to five years). It sets out  
that the worker must have the skills, education, and functional abilities that the target occupation  
requires and the occupation must be one that the worker is medically fit to undertake. The target  
occupation must also be reasonably available in practice, but if the worker has made all  
reasonable efforts to maximize the worker’s earnings, the job that they have actually obtained is  
generally accepted as being suitable. A reasonably available job is also usually within a  
reasonable commuting distance of the worker’s home and consideration should be given to the  
long term as well as the immediate job, including relevant economic conditions that are further  
outlined in policy. It is necessary to consider the “real likelihood”8 of the worker obtaining the  
8
Amos v. Workers Compensation Appeal Tribunal, 2015 BCSC 425 at paragraph 71.  
28  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
particular job selected and “if there are always numerous, better qualified applicants”9 available  
to employers.  
[140] Section D of policy item C6-40.00 sets out that a worker’s post-injury loss will be based on  
estimated earnings rather than actual earnings where the worker is employable but does not  
have a job, where the worker has a job but is not maximizing earnings capacity up to the  
pre-injury rate, where the worker has withdrawn from the workforce for personal reasons, or  
where the worker fails to cooperate with the rehabilitation process.  
Scope of the Appeal  
[141] In the current appeal, my jurisdiction is limited to considering the worker’s entitlement to a loss  
of earnings benefit as of August 19, 2019. I acknowledge that the worker’s description of his  
current level of function indicates that his condition has significantly deteriorated since that date.  
However, I have no authority to address the level of entitlement that may flow from any  
compensable worsening in the worker’s physical or psychological condition subsequent to  
August 2019. As noted, the Board has now found that the worker is entitled to a permanent  
partial disability benefit for his Other Specified Trauma- and Stressor-Related Disorder, effective  
July 5, 2021. Should the worker consider that additional consideration of his entitlement to a  
loss of earnings benefit for his chronic thoracic pain and permanent spinal condition at T6 and  
T7, it is open to the worker to discuss with the Board whether that entitlement should be  
reassessed, in accordance with policy item #40.32.  
[142] For clarity, I do not have jurisdiction to consider the extent of the worker’s entitlement to a loss  
of earnings benefit for his permanent psychological condition. During the oral hearing, I raised  
the concern that, because the worker’s psychological condition was not accepted as a  
temporary condition under the claim until November 5, 2019, which is after the plateau date, I  
would be unable to include consideration of any permanent restrictions or limitations resulting  
from that condition in my assessment of the worker’s entitlement to a loss of earnings benefit  
arising from his compensable chronic thoracic back pain and permanent spinal condition at T6  
and T7. The workers’ adviser submitted that, when considering the CSW occupation, the  
worker’s psychological condition should be considered in the same way the Board considers  
any pre-existing limitations. I invited the workers’ adviser to address this issue further in his  
written submissions, but he did not do so. I am satisfied that I do not have authority to consider  
the effect of the worker’s subsequently accepted and now permanent psychological impairment  
on his earning capacity as of August 19, 2019. As set out below, I did not consider whether, as  
of August 19, 2019, the worker had a psychological impairment that rendered the CSW  
occupation unsuitable for him. For the reasons provided, I have concluded that he did not.  
9
Young v. Workers Compensation Appeal Tribunal, 2011 BCSC 1209 at paragraph 64.  
29  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[143] I also confirm that, as I noted during the oral hearing, it remains open to the worker to ask the  
Board to consider whether he is entitled to acceptance of shoulder bursitis and neck and  
shoulder pain under the claim.10 While I do not have jurisdiction to consider entitlement in  
relation to these conditions, I have taken into account any restrictions and limitations that may  
result from these conditions in my consideration of the suitability of the CSW occupation for the  
worker.  
Nature of the Worker’s Permanent Physical Injuries  
[144] The worker’s presentation during the hearing was consistent with his presentation reported by  
Dr. Gambouras during the June 2021 psychology assessment. I also found the worker to be  
polite and cooperative, but that his mood and affect were characterized by much distress,  
including frequent crying when discussing his ongoing pain, his view of the resulting functional  
limitations, and his future. I am satisfied that the worker firmly and sincerely believes that he has  
a significant physical disability. As set out above, he understands that:  
The December 2, 2017 injuries resulted in his neck breaking in multiple places (application  
for PWD benefits).  
His T7 vertebra was “crushed” over 60% (application for PWD benefits), he is “missing”  
three-quarters of his T7 vertebra (hearing testimony), his T7 vertebra is “about 60%  
shattered” (hearing testimony), and the status of this vertebra is now likely worse.  
His T6 and T8 vertebrae were “crushed” 30% or more (application for PWD benefits), he is  
missing 20% of his T6 vertebra (hearing testimony), his T6 and T8 vertebrae were “crushed  
about 40%”, and the status of these vertebrae is now likely worse.  
His vertebrae are “grinding down”, “degrading”, and “getting worse and worse every year”,  
such that his spine is “absolutely destroyed” and there is very little of it left to hold his body  
up (hearing testimony).  
A lot of his doctors, including the orthopaedic specialists who have seen him, do not  
understand what is going on with him or what having a broken back means (hearing  
testimony).  
He faces a certain prospect, possibly imminent, when he will not be able to walk (hearing  
testimony).  
10  
In the August 11, 2020 Review Division decision (Review References #R0262618 and #R0262781),  
the review officer also advised the worker that it was open to him to do this but, to date, the worker has  
not raised this matter with the Board.  
30  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[145] Given this understanding, it is understandable that the worker is scared by his injury, is  
emotionally distraught to the point of thinking about suicide, and, when feeling pain, considers  
that his only option is to stop all activity and lie down.  
[146] Nevertheless, the medical evidence shows that the worker’s belief is not based on an accurate  
understanding of the nature of his injury.  
[147] First, the worker did not break his neck in multiple places. He sustained a single fracture at the  
C7 level. The January 6, 2020 x-ray of the worker’s left shoulder and cervical spine showed no  
evidence of an ongoing significant bone, joint, or soft tissue abnormality in the left shoulder. This  
means that the left shoulder fracture has healed and the worker’s scapula is stable. The x-ray  
also showed that the cervical vertebrae were normally aligned and there were no abnormal  
findings, including no evidence of significant disc space narrowing. This means the C7 vertebra  
is no longer fractured or broken and is stable.  
[148] Second, the worker’s T6, T7, and T8 vertebrae were not crushed or shattered, and no part of  
these vertebrae is missing because of the work injury. There is no record of an injury to the  
T8 vertebra. The May 19, 2019 CT scan showed that the compression fracture at T7 had healed  
and that the minor superior endplate compression fracture at T6 was stable. In the March 3,  
2020 MRI Dr. Faridi confirmed that the T6 fracture had healed. The T7 and T8 vertebrae are  
stable and there is no indication that they are degrading or grinding down.  
[149] Third, while the worker believes that his spinal injury is going to render him unable to walk, there  
is no indication in the medical evidence that this is a reasonably imminent possibility. Of note,  
the Board has accepted that there are subjective limitations on what the worker can do (tasks  
that cannot be performed due to the compensable condition either because the worker does not  
have the physical capacity to undertake the tasks or because the worker is unable to tolerate  
the symptoms associated with performing them). However, the Board has not accepted any  
medical restrictions (activities that should not be undertaken because they will place him at risk  
of substantial medical harm to himself or substantial harm to others) and the medical evidence  
does not support that he has any medical restrictions.11  
[150] It is apparent that the worker has misunderstood that the Board’s acceptance of 50% to 60%  
loss of vertebrae height at the T7 and 30% loss of vertebrae height at T6 refer to a loss of bony  
tissue in these vertebrae. This is not the case. Rather, these losses refer to a loss of the space  
(or height) between the T6 and T7 and T7 and T8 vertebrae. This loss of space or height is not  
caused by disintegration of the vertebrae but, rather, is due to change in the intervertebral discs  
that are between the T6 and T7 and the T7 and T8 vertebrae. These intervertebral discs are  
composed of fibrous pads of soft tissue, rather than bone, and function as interbody spacers  
11 The terms “permanent physical/psychological limitations” and “permanent medical restrictions” are  
explained in the Board’s Practice Directive #C6-1.  
31  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
and shock absorbers. Loss of intervertebral disc height can be caused by injury, as it was in the  
worker’s case, but also occurs through the normal process of aging. The medical evidence does  
not support the worker’s significant fear that the condition in his thoracic spine is deteriorating at  
a rapid rate, that his spine has reached a point where it can barely hold his body up, or that he  
faces the imminent prospect of not being able to walk.  
[151] The worker’s misunderstanding about the nature of his injuries is causing him excessive and  
unnecessary distress. I do not have authority to direct the Board to do so, but I strongly  
recommend that the Board arrange for a competent physician or other health care provider to  
provide the worker with a clear explanation about the nature of his injuries.  
[152] In the June 16, 2020 psychovocational assessment report, registered psychologist  
Dr. Tarasenco said that the worker was evidently deficient in retaining information that is  
verbally presented and that he will not assimilate new information from only listening and  
receiving verbal instructions. Therefore, I strongly recommend that this information be provided  
to the worker with reference to anatomical diagrams or pictures that will assist him to  
understand and process this information.  
[153] While I acknowledge the worker’s beliefs about the nature of his physical injuries, I have based  
my decision regarding the suitability about the CSW occupation for the worker, as of August 19,  
2019, on the medical evidence.  
As of August 19, 2019, was the CSW occupation physically suitable for the worker?  
[154] I accept that, as was argued by the worker’s representative, the criteria for PWD designation  
means that the provincial government has recognized that the worker has a severe physical  
and/or mental impairment. I also acknowledge Dr. Parson’s opinion that the worker is  
significantly restricted in his ability to perform daily living activities and requires help to perform  
those activities. However, I do not find that such a level of disability is consistent with the  
worker’s actual functional abilities as of August 19, 2019.  
[155] Although the worker’s subjective view of his physical tolerances appears to have diminished  
somewhat between August 19, 2019 and July 2020 (in December 2019, he told Dr. Dray that  
this was the case), I am satisfied that the findings of the kinesiologist who undertook the  
functional capacity evaluation in January 2020 and the findings of the PMMP in July 2020  
provide a reasonably accurate assessment of the worker’s level of physical function as of  
August 19, 2019.  
32  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[156] As was pointed out by the workers’ adviser in his post-hearing submission, the functional  
capacity evaluation noted limitations in addition to accepted limitations of “difficulty with handling  
loads above light level” and “decreased tolerance for low level work”. Specifically, the evaluating  
kinesiologist said the worker:  
would have difficulty performing job tasks requiring prolonged periods of bilateral reaching;  
was not suited to prolonged periods of overhead work;  
had sitting limitations estimated at 1 to 1.5 hours at a time and required the opportunity for  
postural breaks at regular intervals;  
was limited to standing for 45 minutes to 1.5 hours on an occasional basis, including short  
periods of static standing (10 to 20 minutes), with rest breaks to lie down;  
was limited to self-paced walking for short distances on an occasional basis;  
was limited to climbing stairs on an occasional basis and was not suited to repetitive and/or  
fast-paced climbing; and,  
has limitations in stooping, crouching and kneeling.  
[157] The PMMP provider also identified the following physical limitations:  
Lifting up to 20-30 lb. from floor to shoulder height on an occasional basis.  
Lifting up to 20 lb. each side (40 lb. total) overhead on an occasional basis.  
Carrying up to 50 lb. on an occasional basis over short distances.  
Pushing/pulling with LIGHT (NOC) forces on an occasional basis.  
Reaching above shoulder level on an occasional basis.  
Reaching below shoulder level for up to a frequent basis.  
[158] In the employability assessment, the VRC noted that the CSWs administer and implement a  
variety of social assistance programs and community services, and assist clients to deal with  
personal and social problems. CSWs perform a large variety of activities. The CSW occupation  
is identified as a limited strength occupation. According to the NOC, this means that, generally,  
the duties associated with the occupation do not require handling of loads weighing more than  
5 kilograms (or 11 pounds). The functional abilities demonstrated by the worker during the  
functional capacity evaluation and the PMMP confirm that he is capable of handling loads of up  
to 10 kilograms (22 pounds), which the NOC confirms is the upper end of the light strength  
category. I do not accept that, as was suggested in the post-hearing written submission, that, as  
of August 19, 2019, the worker was limited to jobs in the sedentary (or limited) strength  
category.  
33  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[159] The VRC undertook research by identifying current job postings, by calling a dozen employers,  
and by reviewing relevant NOC publications, job bank labour market information, information  
maintained by WorkBC, and the database maintained by the Board in its EDAP system. The  
VRC was satisfied that the CSW occupation is suitable for the worker in light of the limitations  
accepted under the claim and I am satisfied that it also suitable for a worker who demonstrates  
the functional limitations identified in the functional capacity evaluation and PMMP assessment.  
I acknowledge that, as the VRC stated, some CSW positions may require heavy lifting, but the  
VRC’s research demonstrates that, overall, the occupation would have many physically suitable  
job options for the worker.  
[160] I acknowledge that the worker’s belief that lifting people in wheelchairs is an essential  
requirement of CSW work comes from his search for employment and from having spoken with  
CSWs. However, CSW jobs are not limited to working with people who must be “lifted in  
wheelchairs”, or who require assistance transferring. I do not accept that his understanding  
provides a sound basis for rejecting the conclusion of the VRC that the CSW occupation was  
physically suitable for him. Although the worker indicated in his oral testimony that he had asked  
numerous employers about the requirements of the CSW position, he also confirmed that, of  
those applications he made for CSW positions, only two employers ever got back to him. The  
evidence does not support that the worker undertook an extensive search for employment as a  
CSW. Rather, he advised the VRC in September 2021 that he was discontinuing his search for  
this employment and, earlier that same month, advised that he had only applied for three  
positions as a CSW.  
[161] I also acknowledge that, based on his understanding of his current functional abilities, the  
worker may not be able to tolerate full-time employment as a CSW or working overtime hours in  
that capacity. However, for the reasons set out above, that understanding is based on an  
erroneous view of the severity of his permanent spinal impairment and is not consistent with the  
biologically plausible limitations on his function as of August 19, 2019.  
[162] I also acknowledge that, in the most recent psychological assessment Dr. Gambouras  
conducted in June 2021, Dr. Gambouras noted that the worker may struggle at times to  
maintain a relatively “normal” work pace and to be productive in the expected manner over the  
course of a full workday or week. Further, Dr. Gambouras anticipated that the worker would  
require short breaks as needed to “recharge”, thereby interrupting his work performance.  
Further, I accept that, as suggested by the workers’ adviser in the post-hearing submission, this  
may suggest that, from a purely psychological standpoint, the worker be limited to part-time  
work. However, I am not persuaded that the findings of the kinesiologist who conducted the  
January 2020 functional capacity evaluation supports that, as of August 19, 2019, the worker  
was similarly limited.  
34  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[163] As was noted by the worker’s adviser, the kinesiologist wrote as follows:  
In terms of overall working tolerance, while he may be able to tolerate full-time  
work meeting the limitations outlined above, he would have to demonstrate  
improved management of pain and his psycho-emotional status in order to  
maintain employment.  
[164] I do not interpret this comment as suggesting that, as of August 19, 2019, the worker was  
incapable of full-time employment. Rather, it was the kinesiologist’s view that, given his current  
inability to manage pain and his current psycho-emotional status, he would be unlikely to  
maintain such employment over the long term. The evidence supports that the worker’s  
psychological difficulties progressed after August 19, 2019 to the point where the Board has  
accepted that, as of November 5, 2019, the worker had a psychological impairment. As noted, I  
am limited to considering the suitability of the CSW position having regard to the worker’s  
functional status as of August 19, 2019. The subsequent impact of the worker’s psychological  
impairment on the suitability of that occupation is a matter to be addressed by the Board in its  
consideration of the worker’s entitlement to a permanent disability benefit for his compensable  
Other Specified Trauma- and Stressor-Related Disorder.  
[165] As noted, regardless of the fact that I cannot base my decision on the level of psychological  
impairment that has been accepted by the Board since August 19, 2019, I did consider whether,  
as of August 19, 2019, the worker had a psychological impairment that rendered the CSW  
occupation unsuitable for him and concluded that he did not. Of particular note, in the  
comprehensive psychology assessment report Dr. Gambouras completed on August 23, 2019,  
Dr. Gambouras indicated that, if the worker’s pain did not improve in the future, some minimal  
psychological limitations or restrictions would be necessary. However, he also noted that the  
worker had worked for several months in carpentry after his injury and said that, therefore, there  
did not seem to be any need for psychological work restrictions. Further, it was his impression  
that, at the current time, the worker was psychologically reasonably ready for vocational  
rehabilitation. In that same month, the worker began working for a new employer.  
[166] The Board has accepted that, as of July 5, 2021, the worker has a permanent psychological  
limitation of reduced capacity in parts of a job that involve a high degree of time pressures,  
sustained, mental effort and concentration, or competing activities and/or outside distractions in  
particular on a more painful day. However, I am not persuaded that, as of August 19, 2019, the  
worker had any psychological limitations or restrictions that created a barrier to his adaptation to  
the CSW occupation. This is particularly so given that the only expert to address this question  
was Dr. Doward. In his uncontradicted October 15, 2020 opinion, Dr. Doward concluded that the  
current vocational rehabilitation plan for the worker to adapt to the CSW occupation took into  
account the psychological restrictions and limitations Dr. Gambouras had identified in  
August 2019 and, moreover, that the worker’s psychological status had substantially improved  
since August 2019.  
35  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
As of August 19, 2019, was the worker reasonably capable of obtaining the skills and education  
necessary to adapt to the CSW occupation?  
[167] As noted, the worker has pointed out that the psychovocational assessment showed that he has  
some intellectual challenges and this means that some vocations will be unsuitable for the  
worker. There is further evidence that the worker has faced such challenges in the past. In an  
October 2, 2018 chart note that includes the first reference to the worker having mental health  
struggles that is on the claim, Dr. Parsons noted that the worker was struggling with  
memory/concentration and “had really struggled in math for years”. Dr. Parsons related these  
struggles to difficulties the worker was having with the schooling portion of his apprenticeship  
program, noting that the worker otherwise “loves his life”.  
[168] I accept that the psychovocational test results obtained during Dr. Tarasenco’s assessment  
support that there are some occupations to which the worker does not have the intellectual  
capacity to adapt. However, I am not persuaded that this means that he does not have the  
intellectual ability to adapt to the CSW occupation. As noted, the worker has now completed the  
Board-sponsored diploma with an overall average of 86% and the research the VRC undertook  
confirms that employers hire CSWs who have this credential.  
[169] In the June 16, 2020 report, Dr. Tarasenco noted that, owing to the effect of the worker’s  
constant pain on his ability to focus and retain information, there was a probability that the test  
results did not reflect his true abilities and knowledge. Nevertheless, Dr. Tarasenco concluded  
that the worker was a good candidate for a post-secondary diploma in the human services work  
area and that he had a variety of competencies that suit him to the CSW occupation. Among  
other things, the worker:  
Has excellent reading abilities, being able to pronounce words at a level greater than  
grade 12.  
Would be able to read and understand professional literature books, textbooks and  
content directed towards a more advanced reader audience with a comprehension skill  
achievement above grade 11.  
Has no difficulties producing accurately spelled written information. His spelling abilities  
are above grade 12 level.  
Scored at the moderate level for interest in work activities that are repetitive, structured  
and follow an established technique and in work that includes challenges and new  
experiences as well as interpersonal contact.  
[170] In addition, the worker has reported that he has good computer skills.  
36  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[171] The CSW training the Board sponsored for the worker was offered to him because it was the  
career option he identified as most desirable to him. During the oral hearing, the worker  
confirmed that he still believes that a career in this area would be rewarding. I am satisfied that,  
with completion of the CSW diploma program, the worker has the skills and ability to adapt to  
the CSW occupation.  
Is work in the CSW occupation reasonably available to the worker?  
[172] As noted above, I did not find the worker’s position that all CSW jobs have physical  
requirements that exceed his functional abilities persuasive. The worker has demonstrated that  
he is competent at seeking and maintaining employment. While he did not secure employment  
as a CSW, the file evidence confirms that he did not engage in a robust search for employment  
in that area.  
[173] The labour market research the VRC identified conducted supports that the CSW occupation is  
a high-demand occupation and, in the area of the province where the worker resides, had a  
forecasted growth of 1.4% between 2019 and 2024 and of 1.7% between 2024 and 2029. The  
information in the Board’s EDAP system confirms that, in the year prior to completion of the  
employability assessment, 28 workers with compensable disabilities had moved into positions in  
the CSW field, often with retraining assistance from the Board, four of these obtained  
employment in the region of the province where the worker lives, and five of these had  
sustained back injuries.  
[174] I note that, even with the limited efforts he made to obtain employment as a CSW before ending  
his job search in preference of pursuing his PWD benefit application, the worker obtained two  
interviews. Based on the evidence about the worker’s own experience and the employment  
information in the employability assessment and related research materials, I am satisfied that  
work as a CSW would be reasonably available to the worker should this be an option he wishes  
to pursue in the future.  
Over the long term (three to five years) what are the worker’s probable earnings from the CSW  
occupation?  
[175] The worker’s position that his likely earnings in the CSW occupation would be at the end of the  
pay range identified by the VRC is based on the same considerations identified at the review  
level, with the addition that he now seeks a finding that he could only work a maximum of  
20 hours per week.  
[176] For the reasons set out above, I am not persuaded that, effective August 9, 2019, the worker  
was limited to part-time work. I am also not persuaded that the worker’s earnings in the CSW  
occupation would likely be limited to $16 per hour. As noted, the worker has demonstrated the  
ability to obtain and maintain employment. He obtained the light-duty position he worked in  
37  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
commencing in August 2019 for three months, obtained and maintained a volunteer position at  
the food bank for several months, obtained and maintained his practicum position, and obtained  
two interviews after a minimal search for work as a CSW. The worker has the academic  
qualifications necessary to become a CSW and appropriate skills, including the ability to use a  
computer and sufficient literacy to be able to produce quality written work. The VRC felt that,  
with the supports provided in the rehabilitation plan, the worker would be able to achieve  
earnings of $24.85 per year, within three to five years of commencing in the CSW occupation.  
[177] In my view, based on the worker’s physical limitations as of August 19, 2019, even if he had  
been hired into a CSW position that paid at the low end of the pay range for CSWs, as he  
gained experience, he would have become eligible for employment in higher paying positions  
within the occupation and, with three to five years, been able to work his way up to a position  
that paid a higher wage.  
Summary  
[178] As noted, my decision is limited to considering the extent of the worker’s entitlement to a loss of  
earnings benefit as of August 19, 2019, at which time the only permanent conditions that had  
been accepted under the claim were his chronic thoracic back pain and the spinal impairment at  
T6 and T7. The Board has yet to consider the extent of the worker’s entitlement to a permanent  
disability benefit for his now-accepted permanent psychological condition and, while I have  
considered the worker’s psychological status as of August 19, 2019, none of the findings I have  
made in this decision are binding on the Board in its consideration of that matter. There is no  
question that, since August 19, 2019, the worker’s experience of pain and the psychological  
effects of his injury have significantly increased and there has been a significant decrease in the  
level of functional activity he is willing to tolerate. It is open to the worker to ask the Board to  
reopen his claim for reassessment of his permanent disability benefits, having regard to his  
current level of physical function. I find that the Board correctly assessed the extent of the  
worker’s loss of earnings benefit for his permanent compensable physical conditions, effective  
August 19, 2019.  
Conclusion  
[179] I deny the worker’s appeal and I confirm the Review Division’s November 3, 2021 decision.  
[180] I conclude that the Board correctly assessed the extent of the worker’s loss of earnings benefit  
for his permanent compensable physical conditions, effective August 19, 2019.  
[181] As noted above, my finding in this regard is not binding in the Board’s consideration of the  
worker’s entitlement to a permanent disability benefit that follows acceptance of his permanent  
psychological disability under the claim effective July 5, 2021.  
38  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  
WCAT Decision Number:  
A2102416 (July 22, 2022)  
[182] Further, as noted above and as the worker was initially advised in Review References  
#R0262618 and #R0262781 (August 11, 2020), it remains open to the worker to ask the Board  
to adjudicate whether he is entitled to acceptance of shoulder bursitis and neck and shoulder  
pain under the claim.  
[183] Finally, while I have no authority to direct the Board in this regard, I draw the Board’s attention  
to the recommendations I have made above in paragraphs 151 and 152 of my analysis.  
[184] There were no reimbursable expenses associated with the appeal. Therefore, I make no order  
in that regard.  
Deirdre Rice  
Vice Chair  
39  
150, 4600 Jacombs Road, Richmond, B.C. V6V 3B1  
Tel: (604) 664-7800 | 1-800-663-2782  
Fax: (604) 664-7898 | wcat.bc.ca  


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