Showing posts with label workers compensation system. Show all posts
Showing posts with label workers compensation system. Show all posts

Monday, December 12, 2016

WSIB's 'devastating' compensation policy all about board's bottom line, lawyers charge


Toronto lawyer Richard Fink launched a multimillion-dollar class-action lawsuit in 2014 against WSIB on behalf of injured workers who had their benefits cut due to pre-existing conditions.

An Ontario judge dismissed the case in July 2015, but Fink appealed. The case was heard Sept. 16 and he and his clients await the decision.

Source/more:
http://www.cbc.ca/news/canada/ottawa/wsib-injured-worker-benefits-1.3803300



WSIB gives corporations millions while doctors, injured workers outraged


TORONTO, ON--(Marketwired - October 31, 2016) - Despite growing public attention surrounding the Workplace Safety and Insurance Board's (WSIB) treatment of workers who get injured on the job, the WSIB announced Friday that they will further reduce employers' premium rates that fund the system.
Source/more:

http://www.marketwired.com/press-release/oniwg-wsib-gives-corporations-millions-while-doctors-injured-workers-outraged-2170921.htm



Tuesday, May 26, 2015

Adding insult to workplace injury

Injured workers: It’s the kind of story journalists hear about a lot and sometimes dread, because if you look into one case, you’ll hear from 10 more people in the same or more serious situations. Did I say 10? It’s sometimes 20. And the sheer number means not only is there something clearly wrong, but that it’s systemic.

http://www.capebretonpost.com/Opinion/Columnists/2015-05-09/article-4140845/Adding-insult-to-workplace-injury/1

Tuesday, March 31, 2015

Mike Spencer and struggles on WSIB

Ever been injured at work? Think if you are you’ll be looked after and made whole? Many injured workers in Ontario are living another reality after being injured and then entering the Workplace Safety and Insurance Board – WSIB – system.

According to a website for Ontario injured workers, the “compensation system is meant to protect workers, their families, and the broader public against both the harm and the costs of work-related injuries. This system was created to provide injured workers with prompt and secure benefits that compensate them for as long as they are disabled. Workers’ compensation is supposed to be no-fault, prompt, and non-adversarial. Perhaps most importantly, the workers’
compensation system was designed to ensure that employers collectively pay the costs of workplace injuries, instead of foisting those costs on injured workers, their families, and the rest of us.

If unchecked, recent initiatives by the Workplace Safety and Insurance Board, will spell the end of workers’ compensation as we have known it. The Board’s management, with the full support of the provincial government, have instituted changes that will limit workers’ entitlement to benefits to a short period after the injury. Instead of a system that compensates workers for injuries, we will be left with system where most workers’ claims are denied and the few workers whose claims are accepted will be forced either back to work or into poverty.”

With me was local activist Mike Spence, himself an injured worker, and we had a discussion on the reality of life for injured workers in the WSIB system:

 Comments

Fred Palmer November 1, 2013 at 1:36 pm #
 
On August 30, 1979, I was thrown from, dragged, and crushed, by three rail cars. Company negligence caused the derailment that hurt 6 men. I am still standing. Barely. Since then I have been subjected to the most horrendous neglect and tortured by it. I was shattered from head to toe. Suffering a brain injury and moderate to severe Chronic Pain ever since. Pain so severe I nearly died of a stroke. Crippled so bad I cannot walk or stand for very long. Partially paralyzed on the right side of my back, frozen shoulder, twisted spine, herniated disks, crushed ankle, and if I walk or stand too long will develop blood clots. I was not told this and nearly died of blood clots. I was put back to work totally disabled from employment then slandered when I quit to see my doctor. For 34 years now I have lived in the utmost fear, depression, anxiety, and anger, at having my whole life stolen from me. I have nothing, exist with the charity of food banks and friends. A little over a year ago WSIB cut off my pension. I think because they say I am dead. Every crime has been committed against me, every insurance fraud, including fraud on the Supreme Court of Canada for disobeying a court order to treat patients in pain. The WSIB is killing its patients because of this neglect. I am one of its many victims. We only have government to blame for this mess they have created. The WSIB operates with a “get out of jail free” card. Two actually. If any Canadian accepts workers compensation insurance in this country, they are automatically classed as an “injured worker” and excluded from the Canada Health Act. You are then left at the mercy of a criminal insurance company who will cut off the most serious claims and leave the person in pain and poverty and stress. To make matters worse (can it get worse than having a criminal insurance company control your medical care and financial benefits?) you also lose your legal rights. Oh yes you heard that right. You have no legal rights. Each Workers Compensation Act in each Province removes an injured workers legal rights. Maybe it is time healthy Canadians ask why is this removal of rights taking place? I never gave up my rights. Did you? It appears to me the WSIB, and other Workers Compensation Boards, are using these Acts to commit every crime imaginable, including cutting off the most seriously injured and disabled citizens. Crimes for money. Leaving the injured workers and their families in absolute misery having to beg off family and friends to survive. And pain so severe they can’t even sleep. A life, a family, ruined by deceit, fraud, slander, theft, neglect, and discrimination. We need a National dialogue on the issue of workers compensation in this country. Too many are suffering needlessly by being denied medical care. Too many losing all they worked hard for. Too many committing suicide or dying from the stresses of being denied medical care and being forced into poverty. Wake up Canada. For our children’s sake, our families, friends and neighbours. For all of us.

Source: http://windsorshakeup.com/2013/11/01/oct-25-2013-mike-spencer-and-struggles-on-wsib/

Ontario’s workplace safety board tries to muzzle online commenter

Windsor’s self-described defender of injured workers fights peace bond

Mike Spencer walks out of Ontario Court of Justice, Tuesday, March 17, 2015. A WSIB security manager is seeking a peace bond against Spencer to stop him from posting allegedly derogatory and threatening comments online. (DAX MELMER/The Windsor Star)Mike Spencer walks out of Ontario Court of Justice, Tuesday, March 17, 2015. A WSIB security manager is seeking a peace bond against Spencer to stop him from posting allegedly derogatory and threatening comments online. (DAX MELMER/The Windsor Star)



A man who sees himself as a champion of injured workers grew agitated and emotional on the witness stand Wednesday as he tried to stop an arm of the Ontario government from muzzling his online comments.

The Workplace Safety and Insurance Board is trying to get a peace bond against Mike Spencer to stop him from posting what it considers threatening comments against employees on Facebook.

But Spencer testified he never intended to threaten harm against anyone. He said he was trying to be a voice for injured people who have been “harassed,” “abused,” financially ruined and even driven to suicide by WSIB employees and practices.

“They can see me there defending them,” said Spencer, 54, originally from Pennsylvania. “It gives them hope. Maybe they won’t go and kill themselves next week.”

The WSIB has been monitoring Spencer’s online activity since 2011.

They take issue with numerous online comments, including “you are going to hell with all your murdering ilk. If I can do anything to expedite that I will.” Another post stated “the time for talking is over. I’ve had enough. I think you all need a lesson and I can’t think of anyone more qualified to give it to you than me.”
Another claimed “the consequences of your actions are long overdue but they are coming scum. They are coming.”

WSIB repeatedly tried to get him to stop posting comments. When sending letters didn’t work, they called Windsor police. Officers met with Spencer and gave him a warning, but the comments didn’t stop.

Sgt. Gary Williams testified he felt there was enough evidence to charge Spencer, but the Crown attorney said a peace bond would be a better way to go.
“There is a level of freedom of speech,” said Williams. “But you can cross that line.”

Spencer, who worked in mechanical and steel fabrication, was hurt Sept. 11, 2008. Under questioning from his lawyer, he didn’t go into the details of the accident, but said his leg was snapped in three places.

After fighting for benefits and having WSIB cut off paying for painkillers, Spencer said he has a $610 monthly pension. He said the constant fighting with WSIB caused him to sink into depression.

“They made me feel like killing myself,” said Spencer. “They made me wish I was dead.”

A friend directed him to some Facebook pages where people in similar circumstances commiserate online. Spencer said that was where he realized how widespread the problem, as he sees it, has become. He claims the stress from dealing with WSIB and receiving inadequate benefits, combined with the pain of injuries, cause people to have heart attacks and strokes. He said some have even killed themselves. Spencer, calling it the “silent genocide,” said he hears from a few people a week contemplating suicide.

He claims his comments are not meant to be threatening or incite violence. Spencer said much of what he posted was meant to get him sued or otherwise hauled into court so he had another public forum to express his views.
“This is all to humiliate and demean them so disabled workers can see and they won’t be afraid,” said Spencer.

He said he doesn’t want to hurt WSIB employees. He wants them in jail.
“I want these people criminally charged, I want them tried, I want them convicted and I want them punished,” said Spencer.
twilhelm@windsorstar.com

MORE:


A two-day hearing began Tuesday with Frank Brunato, WSIB’s corporate safety manager, seeking a peace bond against Windsor’s Mike Spencer to stop him from posting allegedly derogatory and threatening comments.

http://blogs.windsorstar.com/news/ontarios-wsib-tries-to-muzzle-online-commenter



Monday, February 9, 2015

Meet the man injured Ontario workers ‘love to hate’

David Marshall will steer the perpetually challenged Workplace Safety and Insurance Board for another two years.

Critics say David Marshall's job "is to disqualify injured workers from receiving their rightful benefits." A spokesman for the labour minister, however, says he is "improving outcomes for injured workers."
Richard J. Brennan / Toronto Star Order this photo
 
Critics say David Marshall's job "is to disqualify injured workers from receiving their rightful benefits." A spokesman for the labour minister, however, says he is "improving outcomes for injured workers." 

David Marshall is a man who is both praised and reviled.

As the reappointed head of the perpetually challenged Workplace Safety and Insurance Board, the 69-year-old Marshall acknowledges he is not about to win a personality contest.

“Everybody loves to hate the WSIB . . . but we are doing a lot for workers,” the president and CEO, who is paid $400,000 a year, told the Star after his appointment was recently extended by two years.

The WSIB is a vast provincial government bureaucracy that takes in premiums from employers and distributes disability payments to injured workers.
Since taking over in January 2010, Marshall has met the challenge of reducing the unfunded liability — money owed to injured workers that it doesn’t have — by several billion dollars. That has made the bookish former senior federal bureaucrat, auditor, banker and diplomat the darling of the debt-ridden Liberal government.

Injured workers and labour leaders are far less complimentary, accusing Marshall of cutting costs on the back of workers struggling to get benefits.
“The combination of fewer injuries, better return to work, better management of our investment fund and higher premiums than we need for day-to-day . . . we are well ahead of our schedule that the government has set in order to become fully funded (by 2027),” Marshall, former Canadian ambassador to Barbados and the Eastern Caribbean, told the Star, insisting his organization is the best of its kind in North America.

Among other things, the board is concentrating on getting injured workers back to health with “tailor-made” programs with flexible recuperation deadlines.
“Our research shows that if you don’t get a worker back within 90 days of their injury, the chances that they ever go back to work drop by 50 per cent,” said Marshall, adding the WSIB hired 300 additional staff to help those injured “negotiate” their way back. 

The unfunded liability has been shrunk from a high of $14.2 billion to just over $9 billion in five years, the number of workers not back to work after a year has dropped by more than half and lost time claims have dropped by 17 per cent — from 50,667 in 2009 to 41,987 in 2013. All the while employers are paying the highest premiums in Canada.

On average there are 200,000 claims made each year to the WSIB. The vast majority — 60 per cent — are dealt with without any work time being lost.
“Over the last five years, David Marshall has led the WSIB through a significant transition toward improving outcomes for injured workers and returning the board to financial stability,” a spokesperson for Labour Minister Kevin Flynn said in an email statement.

“He has refocused the board’s objectives in helping injured workers return to work, diversified the WSIB’s investment portfolio, and transformed its medical strategy, work transition and return-to-work programs,” he said.
Ontario Federation of Labour president Sid Ryan calls Marshall “the equivalent of the modern day bounty hunter.” 

“His job is to disqualify injured workers from receiving their rightful benefits . . . The $400,000 is his bounty for his work over the last year,” Ryan said.
Catherine Fenech, of the Ontario Network of Injured Workers’ Groups, said since Marshall arrived, “we’ve seen a steady decline in the number of claims being accepted . . . and an increase in workers being told the board thinks they can go back to work no matter how badly injured they are.”

Marshall counters that about 45 to 46 per cent of claims now are getting approved automatically using “computer logic,” which then allows us more time to focus on the others who need additional help.

John McKinnon, executive director of Injured Workers Consultants community legal clinic, said that under Marshall the WSIB no longer publishes statistics on claims denied, forcing him to make requests through the Access to Information act.

“That may explain how they are reducing their expenses,” he said.
In 2009 the WSIB paid out $3.2 billion in benefits. By 2013 it had dropped by 22 per cent to $2.5 billion. 

McKinnon said the WSIB insists the workplaces are safer, which the corporation claims contributes to the reduction in lost time claims.

“But the number of traumatic fatalities has actually gone up by 43 per cent between 2009 and 2013,” he said, noting that there were 68 on-the-job deaths in 2009 compared to 97 in 2013.

McKinnon claims there has also been a reduction in the board’s recognition of permanent impairment, adding those numbers have gone down by 37 per cent, since 2012. 

At the end of Marshall’s two-year-old term, which will round out a seven-year stint, he will be rewarded with an additional nine months pay for ostensibly helping with the transition to the new head.

Sitting in his perch, high atop Toronto in the WSIB’s Front St. boardroom, Marshall, former assistant auditor general for Canada, says he was brought in to snatch the WSIB back from the brink of financial ruin yet make sure injured workers are looked after, which he says is being done despite what the critics say.

“If a worker is injured, they get 85 per cent of their wages and if they can’t go back to work until age 65 they get a pension plan that we fund completely. They get medical care that is in excess of what OHIP provides . . . and they are entitled to retraining for a new job if they can’t (return to) their old job. The spouses are supported, their children are supported if there is fatality, so this is a very comprehensive system,” he said.

NDP MPP Taras Natyshak (Essex) said despite what Marshall says, his office is deluged with WSIB complaints.

“I say that strictly from the sheer volume that we see coming to our office in terms of injured workers, who are in crisis mode . . . people are falling through the cracks. We get calls all the time — non-stop — and it is not getting any better,” he said.


Source: http://www.thestar.com/news/canada/2015/01/31/meet-the-man-injured-ontario-workers-love-to-hate.html
 

Sunday, January 4, 2015

Injured, disabled workers stage rally calling for WSIB changes

Injured workers gathered outside the office of MPP Michael Gravelle to advocate for changes to the WSIB system.
Matt Vis, tbnewswatch.com
 
Injured workers gathered outside the office of MPP Michael Gravelle to advocate for changes to the WSIB system.
 
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THUNDER BAY – A system designed to aid people injured on the job is failing those who need it, say local injured workers.

A number of injured and disabled workers gathered outside the constituency office of local MPP Michael Gravelle (Lib., Thunder Bay-Superior North) Monday afternoon, advocating for changes to the Workers Safety and Insurance Board system.

Greg Snider, president of the Thunder Bay and District Injured Workers Support Group, said total WSIB payments are down while the percentage of denied claims are increasing.

“We’ve had people who have had injuries for extended periods of time and people who haven’t gotten benefits that were approved in the past. They go back to get that same benefit because of a recurring injury they have and they’re being denied,” Snider said.

“That kind of stuff is extremely frustrating because the injured workers seem to have no control over it which adds to stress and just adds to the injury.”

Snider said the number of denied claims has increased from nine per cent in 2010 to about 24 per cent by the end of 2013.
He said the total annual benefits paid by the WSIB has dropped 28 per cent from 2009 to 2013.

“The purpose of the WSIB existing is for injured workers and it seems to be not working for them at all,” he said.

The demonstration was one of several taking place across the province, coinciding with an address from Minister of Labour Kevin Flynn in Toronto.

In addition to the increased denials, injured and disabled workers are protesting cuts to long-term benefits and changes to the recognition of a permanent impairment.

They are also looking for the end to time limits for injured workers and enhancements to health care coverage.

Eugene Lefrancois, chair of the Ontario Network of Injured Worker Groups, said issues with the system goes beyond WSIB and need to be addressed by the provincial government.

“I think what they have to do is talk to injured workers and roll up our sleeves and work on this,” Lefrancois said. “We are not going away.”


Source: http://www.tbnewswatch.com/News/365581/Injured,_disabled_workers_stage_rally_calling_for_WSIB_changes

Wednesday, December 31, 2014

How the WSIB is failing the injured workers of Ontario

Injured workers advocates gather June 1, 2013 at Queen's Park to celebrate the 30th Injured Workers Day.
Injured workers advocates gather June 1, 2013 at Queen’s Park to celebrate the 30th annual Injured Workers Day.

On Jan. 1, 1915, a worker in Kearney, Ontario, employed by a lumber company, suffered a hand injury on the job. He was the first worker to receive benefits under the Workman’s Compensation Act, which came into effect the same day. The Workman’s Compensation Board–now named the Workplace Safety and Insurance Board of Ontario (WSIB) – was established in 1914 to administer benefits to injured workers in Ontario through a system modelled on William Ralph Meredith’s “historic compromise,” whereby workers are denied the right to sue employers in exchange for compensation, benefits, and the facilitation of a timely return to work.

Because workers cannot sue their employers, they depend on the WSIB to administer justice. Is the WSIB living up to this task?

In 2013, 243 workers died of workplace injuries and occupational diseases in Ontario. Tens of thousands more are injured yearly on the job.

Today, the WSIB is funded 100 per cent by employers and is overseen by the Ontario Ministry of Labour. This year, the WSIB is celebrating what it’s calling “a century of serving Ontario.” Yet now more than ever, the WSIB has been the target of widespread criticism for its failure to adequately compensate workers, process claims fairly, accurately assess medical opinion, and facilitate employees’ safe return to work.

The WSIB is theoretically an independent organization. Yet critics argue the WSIB is heavily biased towards employers. The past few decades have seen inadequate premium rates imposed on employers. Workers have seen cuts to compensation and benefits while the board’s management receives bonuses. Perhaps most concerning is the WSIB’s relentless drive to push workers back into the workforce despite the medical assessment of a worker’s injury. The WSIB appears to be more concerned with meeting the labour needs of employers than providing healthcare to workers.

Denying medical expertise

According to the Workplace Safety and Insurance Act, injured workers have a legal right to “necessary, appropriate, and sufficient” healthcare for their work-related injuries.

Many Ontario injured workers receive health coverage under the Ontario Health Insurance Plan (OHIP). However, OHIP does not usually provide coverage for medications, assistive medical devices, physiotherapy, medically-related travel expenses, and mental health.

The WSIB is required to cover these expenses when they are related to a worker’s injury on the job, but the Injured Workers Action for Justice (IWAJ), which advocates for fair compensation from the WSIB, say that the WSIB is steadily reducing benefits related to healthcare. It reports that the WSIB has cut $77 million in healthcare-related spending since 2009.
IWAJ
Jessica Ponting, a community legal worker with the Industrial Accident Victims Group of Ontario, says that almost 20 per cent of the WSIB’s healthcare budget is allocated towards “specialized clinical services,” or WSIB-run assessment centres.

As funds for doctor-recommended treatments are being cut, the WSIB is increasing funding for assessment centres.

The IWAJ claim that these assessment centres are known for predicting early recoveries and can facilitate the denial of claims, as well as a premature return to work.

“They [the WSIB] say benefits are being cut because they are providing healthcare and getting people back to work, which is not true,” says Ponting.
Instead, she says, workers are being sent back to work before they’ve recovered because of predicted recovery dates that often don’t correspond with reality. 
She says, “The WSIB ignores reports from family doctors that state that a worker is still injured.”

“These centres can provide useful information, that’s fair, but the WSIB requires them to say when they will predict the worker will recover. In most cases, they meet the worker once and make a prediction. Then the WSIB says they have a relatively comprehensive medical report and they end benefits based on that expected recovery date,” says Ponting.

The painful side of WSIB assessment centres


Daniela, who requested that her last name not be disclosed, is an injured worker and member of IWAJ.

Daniela says, “Many workers come to me and complain. They are afraid to ask for their rights. They do not know they have rights.”

She says workers are afraid of losing their jobs if they report workplace injuries. They come to her to share their stories and ask for advice.
Daniela’s workplace injury was caused by repetitive movements combined with lifting weight. She was sent to a rehabilitation centre for WSIB claimants, following five months of physical therapy.

The WSIB approved her repetitive movement injury, but did not approve another injury she reported. She says it is not easy to have injuries approved.
She explains that following the workplace injury, the WSIB assigned a recovery time to her, and pressured her to push herself physically beyond her limits. She says the WSIB pushes workers to return to work before they are fit to do so.
She says the centre told her, “In four weeks, you will be good to work again.”
“They try to push you. They increased the amount of weights that I was using. They claimed it was the right thing to do, but I was constantly in pain. They see it but they ignore it.”
She says that during her time in the program, she met many injured workers and heard their stories. “They were in pain. They were forced to work by their case managers.”

The WSIB can cut off benefits from workers by deeming them “uncooperative.” For this reason, workers are sometimes fearful to resist directives from the assessment centres.

“One woman was clearly in pain. She really could not perform her job, but she needed to cooperate. She had to go to work. She had a fixed treatment and then she was sent back to work. And then she received more treatment, and was sent back to work.

“It was like that for a year.”

The Marshall Plan


Since 2009, the number of denied claims have increased by 50 per cent, and benefits to injured workers – which can include, for example, loss of earning benefits – have been reduced by 631 million. These cuts have come alongside the appointment of international banker David Marshall as the WSIB’s president. Marshall, well known to both Wall Street and Bay Street, has presided as vice-chairman of CIBC and as a managing director of New York leading investment bank, Bankers Trust.
Under Marshall, whose five-year contract exceeds 2.4 million, the WSIB has laid off hundreds of staff and slashed benefits for injured workers. What’s worse, Marshall has been promised a $400,000 bonus if he is able to achieve particular financial goals, including increasing “administrative efficiencies” and reducing “unfunded liability.”
Unfunded liability is understood as the discrepancy between the funds required to pay the benefits of injured workers and the amount of money collected into the WSIB’s insurance fund. The provincial government passed legislation requiring the WSIB to eliminate its billions of dollars of “unfunded liability” by 2027. Under Marshall’s austerity model, workers are being forc
ed to bear the brunt of cuts to benefits, rather than requiring emcompensationployers to increase premium contributions. In fact, premium contributions were frozen at current rates for the year 2014.
Even more shocking, the WSIB is providing millions of dollars in rebates on premiums to employers convicted under the Occupational Health and Safety Act (OHSA), as revealed in an excellent report released by the Ontario Federation of Labour on Nov. 24. According to the report, between the years 2011 and 2013, 78 (58 per cent) of 135 employers convicted of offences under the OHSA received almost $15 million in rebates during the same year that offences were committed, and oftentimes, these rebates were greater than the fines designated for violations of the act.

The WSIB is determined to get the worker back into the Canadian job market as soon as the predicted recovery date is over, says Ponting. “‘The WSIB will say, you may or may not be permanently disabled. But we think you could do a job as a customer service rep, or a parking lot attendant.”
“It’s a dehumanizing, intensive process,” she says.

Do labour unions make workplaces safer?


While the WSIB deals with claimants that work in unionized environments, Ponting says collective agreements can improve healthcare access for workers, particularly where agreements provide long-term or short-term disability insurance through a private provider.

The reality is injured workers are confronting two powerful forces against them: the government and the employer.

“They both want to protect the bottom line,” says Ponting. “These are two very powerful institutions. You have the economic incentive of, effectively, an insurance company, coupled with the power imbalance between you and your employer.”

“Unions help to offset that power imbalance between worker and employer, and an insurance company that wants to deny them benefits,” says Ponting.
Daniela has worked in a unionized workplace before, and says she saw a difference in the level of workplace safety between it and the workplace where she obtained her injury.

“The [unionized] workplace was super safe, we were aware. We were aware of how to report this. I wonder why it can’t be like that elsewhere. Because if you are aware, you prevent yourself from getting injured.”
“My experience is unionized workplaces are safer.”

In Part two, R&F.ca examines how the WSIB affects Ontario’s migrant workers, and we will discuss needed reforms to the WSIB system.

Source: http://rankandfile.ca/2014/12/03/how-the-wsib-is-failing-the-injured-workers-of-ontario/
 

Friday, October 3, 2014

Mental Stress Claim Upheld By Workplace Safety And Insurance Appeals Tribunal

In a ground-breaking decision, the Workplace Safety and Insurance Appeals Tribunal has found that a provision in the Workplace Safety and Insurance Act (the “Act“), which denied benefits to workers suffering from non-traumatic mental stress, is unconstitutional.

Background

The Act is designed to provide benefits to employees who have sustained personal injury in the course of their employment. However, the Act provides that employees are not entitled to benefits for mental stress unless the stress is “an acute reaction to a sudden and unexpected traumatic event” in the course of employment.

This is seen by many as unjust. The Ministry of Labour has indicated that approximately 30% of disability claims involve mental illness. Nevertheless, employees suffering from workplace stress, unlike employees who have suffered physical injury, are denied access to workers’ compensation benefits.

The Decision

This decision involved a claim by a nurse who worked at the same hospital for 28 years. For 12 of those years she claims she was subjected to mistreatment by a doctor who worked with her. She claimed the doctor yelled at her and made demeaning comments to her in front of both colleagues and patients. Coworkers brought her mistreatment to the attention of management, but no steps were taken to deal with the issues and the doctor’s behaviour continued.

After a particularly difficult incident, the nurse complained to management about her treatment by the doctor. The hospital responded by demoting her. The worker was so distressed that she sought medical attention. She was diagnosed with an adjustment disorder with anxiety and depression attributable to the stress she suffered in the workplace.

The WSIB denied the claim because the nurse’s condition was not the result of an “acute reaction to a sudden and unexpected traumatic event.”

The case was appealed to the Workplace Safety and Insurance Appeals Tribunal. The Tribunal concluded that the nurse would have been entitled to benefits but for the restriction on awarding benefits as a result of mental stress.

The Tribunal went on to find that the provisions of the Workplace Safety and Insurance Act which deny benefits for mental stress violated the guarantee of equality under the Charter of Rights and Freedoms.

Implications of Decision

Although the Workplace Safety and Insurance Board is not bound to follow the decisions of the Tribunal it is expected that this case will form the basis of a new policy by the WSIB to accept claims based on mental stress.

In 2011, the WSIB allowed 677 claims for traumatic mental stress. The potential claims arising out of “non-traumatic” mental stress will no doubt greatly exceed this number. The Government of Ontario has stated that 1 in 5 Canadians are affected by mental illness every year. Certainly not all mental illness arises because of workplace stress. However, if the WSIB allowed 677 claims for traumatic mental stress in 2011, it is a reasonable assumption that there are many more “non-traumatic” claims for workplace mental stress.

Concerns have been expressed that the increased number of claims expected as a result of this ruling will result in sky-rocketing increases in WSIB premiums at a time when employers are already complaining about the high cost of WSIB coverage.

The Appeals Tribunal addressed those arguments. It noted that there was little evidence regarding the cost of mental stress claims in Ontario. It also noted that any argument that people with mental stress claims would put an unjustified burden on the workplace insurance system merely served to “exacerbate the historical disadvantage faced by persons with mental disabilities” because it assumes that they are not deserving of benefits and places the burden on society.
It is likely that the Ontario government will challenge this ruling in the Divisional Court. In the meantime, applications for benefits based on non-traumatic mental stress are likely to be entertained.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

Article by Elizabeth J. Forster
http://www.ilstv.com/mental-stress-claim-upheld-by-workplace-safety-and-insurance-appeals-tribunal/
 

Tuesday, September 30, 2014

Ontario's workers' compensation system is under attack

To save money, the fairness at the core of Ontario's workers' compensation system is being undermined.

If WSIB President David Marshall succeeds, he will save the workers' compensation board money, but at what cost? asks Oduardo Di Santo.
YouTube screen grab 

If WSIB President David Marshall succeeds, he will save the workers' compensation board money, but at what cost? asks Oduardo Di Santo.
I had the great privilege to serve as chair of what is now called the Workplace Safety and Insurance Board (WSIB) in the early 1990s. As an immigrant from Italy and then a member of Ontario’s Provincial Parliament, I had observed firsthand the difficult circumstances of injured workers and the important role of the board in helping them get back on their feet.
As chair, I did my best to strengthen the WSIB’s support to those workers, especially around rehabilitation and return to work. So I have a personal stake in the changes now underway at the board — changes that are undermining decades of progress and that all Ontarians ought to oppose.
These changes were well illustrated by two recent articles in the Star. One showed that many of the criteria used by WSIB to justify surveillance of inured workers unfairly target those who are new immigrants or whose injuries seem to be taking too much time to heal.
Another recounted two cases of injured workers who were denied compensation because the WSIB maintained that x-rays found evidence of degenerative disc disease (a “pre-existing condition”) in their spines. Never mind that both of these workers had been able to work for many years before their workplace injuries.
These stories represent a historic and unfortunate departure from established WSIB practice.
The board has no policy or legal authority allowing it to deny benefits because of pre-existing conditions. In fact, current policy and many years of appeal decisions make clear that the board should pay benefits to workers who were able to work before their injury and unable to work afterwards.
Recently, the WSIB proposed a policy to overturn the long-standing approach, which, if approved, would undermine the basic principle upon which the system was based.
Ontario’s workers’ compensation system has always required balance between the contribution of the employers and the benefits paid to the injured workers. It was built with fairness at its core.
And yet, since the 1970s, successive governments have kept employers’ contributions artificially low, allowing an “unfunded liability” to develop. The WSIB doesn’t have the money to fund likely future benefit claims.
In the early 1990s, the board concluded it needed to raise employers’ contribution to 3 per cent of payroll to eliminate the unfunded liability by 2014. Unfortunately, when Mike Harris took power, his government lowered the contribution to 2 per cent. And though it also reduced payouts to injured workers, the unfunded liability skyrocketed.
To deal with this problem, the McGuinty government appointed as WSIB president David Marshall, an accountant, who was granted a stipend of $400,000 a year plus a performance bonus of 20 per cent.
In 2010, Marshall told the legislature he had to cut costs. He said he would develop a plan that would have “some tough, tough proposals in it. I mean you can’t recover this amount of money without … pain somewhere in the system … I don’t get any bonus unless I can meet this target.” Not one word about the revenue side.
Instead, under Marshall’s watch, denied claims increased by 50 per cent. Benefits to injured workers have been reduced by $631 million; the rehabilitation program has been decimated; long-term wage loss benefits have been reduced by 28 per cent; hundreds of WSIB employees have been laid off; and injured workers’ pensions have been reduced by 31.3 per cent.
This is not only having a devastating impact on injured workers; it is also downloading costs onto our social assistance and health care systems. And the workers’ compensation system has been brought to a stall, with thousands and thousands of appeals and lengthy and unacceptable delays in dealing with them.
That’s not all. In 2011, Marshall was granted the unprecedented authority to change autocratically most WSIB policies without board approval.
The Star has documented how Marshall is exercising this power. If he is allowed to implement the infamous policy on “pre-existing conditions,” this will allow the WSIB to deny benefits because of, say, age.
In fact, the board has already begun illegally implementing the policy. The WSIB routinely writes to workers, warning them: “please be aware that … the WSIB may determine that the current condition is more likely related to the natural aging process or to the progression of an underlying pre-existing condition.” So the worker is zapped despite the long-standing policy that compensation will be granted if the injury is a significant factor in causing the worker’s disability.
Injured workers, the medical profession, community groups, and many others have decried the absurdity and unfairness of what the WSIB is doing. So far, to no avail. If Marshall succeeds, he will surely reduce the unfunded liability, but at what cost?
The destruction of our workers’ compensation system will create bitterness and polarize workers and employers. After a century of progress, we will once again have thousands of injured workers desperate and deprived of justice and the means to support their families. Rather than going down this harmful path, we ought to work together instead on the prevention of workplace injuries and diseases, and the re-employment of injured workers.
Odoardo Di Santo is a former Ontario MPP and chair of the workers’ compensation board.

Source: http://www.thestar.com/opinion/commentary/2014/06/27/ontarios_workers_compensation_system_is_under_attack.html

 

Monday, September 29, 2014

Workplace Safety Insurance Board steps up spying on clients, documents show

Internal documents show the WSIB considers psychological conditions or language barriers to be "red flags" for fraud and may order surveillance.

Jennifer Williams is a WSIB client who was tailed by a private investigator and cut off from benefits.

Lucas Oleniuk / Toronto Star Order this photo

Jennifer Williams is a WSIB client who was tailed by a private investigator and cut off from benefits.

Jennifer Williams is sitting in the darkened board room of a legal clinic watching a video shot by private investigators as they follow her down the aisles of Honest Ed’s and up the stairs which, because of a fall at work, she takes slowly — one by one — using her cane.
The former personal support worker, injured on the job in 2005, can see her grainy image through the window of a Shoppers Drug Mart as investigators wait outside, and more clearly as she loads small packages into the back seat of a van.
The video is the work of a private investigator hired by the Workplace Safety and Insurance Board which, internal documents suggest, was suspicious that Williams was secretly working and faking her psychological illness. Williams was followed a month after a board-ordered medical assessment by doctors at CAMH determined she was in pain, depressed because of her injury and a poor candidate to return to work.
This type of surveillance by the WSIB used to be a rarity, typically ordered when the insurance board received a tip from a caller, according to legal experts.
But documents obtained by the Star suggest the WSIB is spying on clients claiming to be seriously injured, now more than ever and often without cause.
“Now that we are conducting more surveillance related to misrepresentation of level of disability where we don’t have an actual allegation, e.g. call record, there have been lots of questions from compliance specialists around what constitutes sufficient grounds to warrant surveillance,” states a 2011 internal email from Bob Thomas, an employee in the WSIB’s regulatory services division.
Those “sufficient grounds,” according to the email, include dozens of indicators such as chronic pain, language barriers and problems speaking to an injured worker directly, frequent change of phone number or address, recovery times that are inconsistent with usual healing times, anti-social behaviour or overreaction and psychological problems.
Other “red flags” for fraud, as the board refers to them, include forms returned by someone else or not signed, an unreasonable distance travelled by the worker to see a doctor, a worker who is “never home, returns calls after hours, noise in background” or who has a “first medical treatment from chiropractor.”
The email written by Thomas says that although it may look like he is applying some kind of “voodoo science” in making his decisions to approve surveillance, “I actually have specific things I look for before making a request.”
The documents were obtained by the IAVGO Community Legal Clinic through a freedom of information request after surveillance was used to reduce the benefits of eight clients.
“We believe that the WSIB’s internal guidelines mean that the most vulnerable and precarious workers — those with limited English, psychological problems, lack of stable housing, temporary employment — are being targeted for covert surveillance,” said Maryth Yachnin, the IAVGO lawyer who is representing Williams in her appeal.
The WSIB couldn’t comment on Williams’ case because of privacy issues, but a spokeswoman said they do not target injured workers.
“Like any large insurance system, the WSIB does need to investigate potential compliance issues brought to our attention,” Christine Arnott wrote in an email. “These represent a small handful of claims, approximately 0.075 per cent of total claims received annually. Surveillance is used as a last resort only after considering all relevant information about a case.
“If it is considered necessary, we ensure that privacy is respected and protected.”
More on thestar. com:
Michael Green, an independent lawyer who began working on appeals for injured workers as a law student before he was called to the bar in 1984, is currently dealing with nine surveillance cases.
“The one that gets me is the psychological condition,” said Green of the WSIB’s checklist. “If you talk about workers with permanent impairments, the incidence of psychological conditions — depression — is extremely high.”
Green said long-term injuries often affect a worker’s family life, income and social connections and can lead to isolation. Depression is common.
“The fact that one of the reasons you may be surveilling someone is because there’s an indication of a psychological problem — to my mind that raises questions about discrimination,” said Green. “They’re not supposed to discriminate based on the type of disability. Mental disabilities are supposed to be treated the same as physical disabilities.”
Green also said at least half of his clients would raise several “red flags,” which leaves case workers with a huge amount of discretion in deciding who should be followed.
Yachnin said the WSIB targets clients who have injuries that could entitle them to long-term loss-of-earnings benefits, which adds more financial pressure to the already underfunded insurance board.
Williams was followed in 2011, six years after her initial injury, which is the time period when benefits usually lock in until age 65.
The WSIB receives more than 200,000 new claims annually and pays out $2.6 billion to injured workers each year, according to Arnott.
The WSIB’s insurance fund takes in less money than it needs to pay the benefits of injured workers, leaving it with billions of dollars in what is called “unfunded liability.” The Ontario government passed legislation requiring the board to get rid of that liability by 2027.
Green said the insurance board has been underfunded since then Ontario premier Mike Harris cut employer premiums by about 30 per cent and workers’ benefits by 15 per cent, leaving a gap between what the board took in and paid out.
The lawyer said investments helped the board cover the shortfall until 2007, when the market crashed. WSIB documents show their investments went down slightly that year followed by a drop of 15.5 per cent in 2008.
By the end of 2013, the WSIB’s unfunded liability was $10.6 billion, down from $14.2 billion at the end of 2012, the result of fewer injured workers, higher employer premiums, stronger investment earnings and “improved return to work and recovery outcomes for injured and ill workers,” said Arnott.
Green said the average client he represents typically receives full loss-of-earnings benefits for a year. After that, injured workers are told they are fit for some type of minimum wage work and their benefits are reduced accordingly.
According to Arnott, 92 per cent of all injured workers are back at work, with no loss in wages, within a year.
In mid-2012, the board created a branch called Secondary Entitlement, which deals with chronic pain disability and psychological trauma, which the board says are secondary conditions related to the original work injury.
As of April 2014, the branch has denied close to 35 per cent of claims, according to internal WSIB documents obtained by IAVGO.
Williams, the former personal support worker, was injured after she fell one Saturday in the dining room of the nursing home where she worked.
“I didn’t take it for anything,” the soft-spoken Williams said of the injury, until the pain increased overnight. On Monday, she went to the doctor who diagnosed a sprain and gave her medication.
When the injury failed to heal, Williams was sent for an MRI, which showed a large degenerative tear in her meniscus, the cartilage that works as a shock absorber in the knee.
The 54-year-old woman returned to work at the nursing home where she had been employed for four years, but even light duties such as delivering meals proved a problem.

“I got so depressed and frustrated,” said Williams.
Her doctor recommended she take more time off work and that’s when she said her “life turned upside down.”
Williams said she was tormented and bullied by her case worker, who asked her at one point if “she saw the WSIB on her pay stub.”
“That’s when I started getting depressed,” said Williams, a college grad who held down several jobs to support her family after emigrating from Jamaica.
“That’s when I started getting lost, when I started dealing with her, and it went on and on,” she said, breaking down.
Her marriage fell apart. In 2007, she began seeing a psychiatrist.
The WSIB ordered surveillance in September 2011, a month after the psychiatric assessment by CAMH, ordered by the injury board, determined Williams was unfit for work.
An investigator tailed Williams after a meeting set up by a case worker and followed her for a total of 52 hours during a seven-day period.
The 30-minute tape that was later handed over to Yachnin shows investigators also sat outside a home where Williams used to live, taking extensive video of an unknown woman unloading groceries from a car. The vehicle’s licence plate is clearly visible.
“The fact that the WSIB did not notice this breach of a third-party’s privacy suggests that the WSIB adjudicator or regulatory services branch did not actually properly review the surveillance evidence,” Yachnin contends.
According to internal documents, the injury board ordered the covert surveillance to confirm if Williams was secretly working as a personal support worker and to determine the “true” depth of her psychological and physical distress. The documents also say “the surveillance could also provide evidence of offences” under the Workplace Safety and Insurance Act.
The board used the video as proof that Williams was employable and ordered a workplace assessment, which was never completed because the injured woman was extremely upset and uncooperative, according to WSIB files.
In January last year, the board cut off her benefits because of her 
non-cooperation and estimated she could make the top salary of a customer service employee at $26 an hour.
“Ms. Williams’ most disabling impairment is psychological and cannot be seen on videotape,” said Yachnin.
Williams is now on welfare. Her appeal will be heard this month.
Green, the injured workers’ lawyer, said that process can take up to a year and a half. If the first appeal to the board fails, an outside tribunal may hear the case, which adds another year to the outcome.

source:  http://www.thestar.com/news/gta/2014/06/16/workplace_safety_insurance_board_steps_up_spying_on_clients_documents_show.html

Ontario's workers' compensation system is under attack

To save money, the fairness at the core of Ontario's workers' compensation system is being undermined. 

If WSIB President David Marshall succeeds, he will save the workers' compensation board money, but at what cost? asks Oduardo Di Santo.
YouTube screen grab

If WSIB President David Marshall succeeds, he will save the workers' compensation board money, but at what cost? asks Oduardo Di Santo.

As chair, I did my best to strengthen the WSIB’s support to those workers, especially around rehabilitation and return to work. So I have a personal stake in the changes now underway at the board — changes that are undermining decades of progress and that all Ontarians ought to oppose.
These changes were well illustrated by two recent articles in the Star. One showed that many of the criteria used by WSIB to justify surveillance of inured workers unfairly target those who are new immigrants or whose injuries seem to be taking too much time to heal.
Another recounted two cases of injured workers who were denied compensation because the WSIB maintained that x-rays found evidence of degenerative disc disease (a “pre-existing condition”) in their spines. Never mind that both of these workers had been able to work for many years before their workplace injuries.
These stories represent a historic and unfortunate departure from established WSIB practice.
The board has no policy or legal authority allowing it to deny benefits because of pre-existing conditions. In fact, current policy and many years of appeal decisions make clear that the board should pay benefits to workers who were able to work before their injury and unable to work afterwards.
Recently, the WSIB proposed a policy to overturn the long-standing approach, which, if approved, would undermine the basic principle upon which the system was based.
Ontario’s workers’ compensation system has always required balance between the contribution of the employers and the benefits paid to the injured workers. It was built with fairness at its core.
And yet, since the 1970s, successive governments have kept employers’ contributions artificially low, allowing an “unfunded liability” to develop. The WSIB doesn’t have the money to fund likely future benefit claims.
In the early 1990s, the board concluded it needed to raise employers’ contribution to 3 per cent of payroll to eliminate the unfunded liability by 2014. Unfortunately, when Mike Harris took power, his government lowered the contribution to 2 per cent. And though it also reduced payouts to injured workers, the unfunded liability skyrocketed.
To deal with this problem, the McGuinty government appointed as WSIB president David Marshall, an accountant, who was granted a stipend of $400,000 a year plus a performance bonus of 20 per cent.
In 2010, Marshall told the legislature he had to cut costs. He said he would develop a plan that would have “some tough, tough proposals in it. I mean you can’t recover this amount of money without … pain somewhere in the system … I don’t get any bonus unless I can meet this target.” Not one word about the revenue side.
Instead, under Marshall’s watch, denied claims increased by 50 per cent. Benefits to injured workers have been reduced by $631 million; the rehabilitation program has been decimated; long-term wage loss benefits have been reduced by 28 per cent; hundreds of WSIB employees have been laid off; and injured workers’ pensions have been reduced by 31.3 per cent.
This is not only having a devastating impact on injured workers; it is also downloading costs onto our social assistance and health care systems. And the workers’ compensation system has been brought to a stall, with thousands and thousands of appeals and lengthy and unacceptable delays in dealing with them.
That’s not all. In 2011, Marshall was granted the unprecedented authority to change autocratically most WSIB policies without board approval.
The Star has documented how Marshall is exercising this power. If he is allowed to implement the infamous policy on “pre-existing conditions,” this will allow the WSIB to deny benefits because of, say, age.
In fact, the board has already begun illegally implementing the policy. The WSIB routinely writes to workers, warning them: “please be aware that … the WSIB may determine that the current condition is more likely related to the natural aging process or to the progression of an underlying pre-existing condition.” So the worker is zapped despite the long-standing policy that compensation will be granted if the injury is a significant factor in causing the worker’s disability.
Injured workers, the medical profession, community groups, and many others have decried the absurdity and unfairness of what the WSIB is doing. So far, to no avail. If Marshall succeeds, he will surely reduce the unfunded liability, but at what cost?
The destruction of our workers’ compensation system will create bitterness and polarize workers and employers. After a century of progress, we will once again have thousands of injured workers desperate and deprived of justice and the means to support their families. Rather than going down this harmful path, we ought to work together instead on the prevention of workplace injuries and diseases, and the re-employment of injured workers.
Odoardo Di Santo is a former Ontario MPP and chair of the workers’ compensation board.

source:  http://www.thestar.com/opinion/commentary/2014/06/27/ontarios_workers_compensation_system_is_under_attack.html

Class-action lawsuit aims to help Ontario injured workers

Toronto lawyer launches multimillion-dollar lawsuit on behalf of Ontario injured workers who had payouts reduced due to pre-existing conditions.

Former Brampton sewer worker Pietro Castrillo, 61, is part of a multi-million dollar class action lawsuit against the Workplace Safety and Insurance Board (WSIB) for discounting non-economic loss awards due to pre-existing medical conditions.
/ Laurie Monsebraaten

Former Brampton sewer worker Pietro Castrillo, 61, is part of a multi-million dollar class action lawsuit against the Workplace Safety and Insurance Board (WSIB) for discounting non-economic loss awards due to pre-existing medical conditions.

A Toronto lawyer has launched a multimillion-dollar class action lawsuit on behalf of injured workers against Ontario’s Workplace Safety and Insurance Board.
The lawsuit, filed in Ontario Superior Court last month, alleges the board acted in bad faith and “with public malfeasance” when it reduced benefits for pain and suffering for thousands of injured workers with medical conditions that weren’t causing impairment before their workplace accidents.
“For 22 years, the board has calculated non-economic loss awards based on a point system that recognized the impact of injuries on degenerative disease,” said lawyer Richard Fink.
“But several years ago, the board instructed case managers to deduct for pre-existing conditions without any formal changes in policy, regulations or law,” he said in an interview Friday. “What they are doing is illegal.”
As reported by the Starlast week, injured workers’ advocates are alarmed by a proposed board policy on pre-existing conditions they say would legitimize this practice.
Before the election call, they wrote an open letter to Premier Kathleen Wynne, saying the change would contravene the “historic compromise” behind Ontario’s 100-year-old no-fault insurance plan, which saw injured workers give up their right to sue in exchange for fair and just compensation for as long as a workplace disability lasts.
A WSIB spokeswoman said the board considers Fink’s lawsuit to be “completely devoid of merit and will vigorously defend all allegations.”
“We are committed to ensuring that every injured worker receives the appropriate level of benefits,” Christine Arnott said in an email. “The WSIB is proud of its record in providing service to injured workers in Ontario.”
Non-economic loss awards are granted by the Workplace Safety and Insurance Board (WSIB) to cover pain and suffering for injured workers who suffer permanent physical and psychological impairments from a work-related injury or illness.
Fink’s lawsuit, which still has to be certified by the court, seeks damages from the board for its alleged behavior, including expenses incurred by workers challenging decisions on their claims.
“The Board moved aggressively to reduce its costs by clawing back legitimate awards to injured workers, forcing them into lengthy and costly legal battles to win back what they should never have lost,” said Fink. “The lawsuit seeks to right this wrong and hold the board to account for its actions.”
Pietro Castrillo of Brampton is just one of the many injured workers whose non-economic loss award was wrongfully reduced by the WSIB due to a “secret policy” the board adopted to cut costs in 2011-2012, Fink alleges in the statement of claim.
The 61-year-old man tore his rotator cuff and permanently injured his shoulder while working for a sewer construction company in 2011.
He was eligible for a non-economic loss award of about $2,500. But since medical tests found evidence of osteoarthritis in his shoulder, the WSIB reduced his award by half to $1,230, according to the lawsuit. Castrillo appealed and won because this pre-existing condition had never impaired his ability to work in the past. However, Castrillo is still out more than $600 he had to spend in legal fees to fight the case, the lawsuit says.
“Personal-injury awards have increased dramatically over the years, but WSIB awards have stayed the same or gone down,” said Fink, whose firm, Fink & Bornstein, has represented injured workers for more than 30 years.
“I don’t think it’s constitutional to rob people of reasonable damages within the WSIB system,” he added.
Fink’s firm is holding public meetings in Mississauga and Toronto later this month to find other injured workers to join the class action.

source:  http://www.thestar.com/news/gta/2014/05/12/classaction_lawsuit_aims_to_help_ontario_injured_workers.html