The large majority of WSIB claims are actually allowed. But we're talking about a couple hundred thousand claims a year, so for the small percentage that are denied, that's still a hell of a large number of injured workers for whom all those initial steps around immediate and accurate reporting, immediate layoff, seeking immediate medical attention etc take on a huge significance. Many injured workers don't have a clue how to do this, and in many non-unionized workplaces, there are also big risks to even reporting an injury much less bringing in a doctor's note requesting time off or modified work. Workers in smaller non-unionized workplaces also don't have the same access to long-term suitable work, and without an advocate they often don't know what to do to keep documenting their injury, their job search etc for the purpose of future litigation.
Story about WCB hostage-taking taken hostage by CBC jounalists
No no tricia, did not mean you were lulled, :D
i meant perhaps you were speaking with those speaking about their WCB current experinces.
Sloppy wording, I am so sorry.
canning while babbling
True story - years ago my brother worked as a tow truck driver for the AMA. ,,, "pre-existing condition" ..."bullshit"
Yes it is bullshit. And it's part of the long-running liberal-fascist bureacracy in Canada overall that extends to all three excessive layers of government bullshit. I have personal stories, too, from my family's experiences with the bastards. In the good old days after the war, my father was laid off from the mill countless times. He went north a couple of hundred miles to find work, because that's what they told him to do. Dad and mom pregnant in middle of winter left home for a year, and the VLA rents the house to a stranger in the meantime. Stranger wrecks the house in the meantime. But here's where the liberal-fascist end of it happens. The Liberal government at the time sends an agent from the capital all the way to Northern Ontario to where my parents were living to find out if they'd taken a table and set of chairs with them from the VLA home. They hadn't, but the federal agent of the Liberal government insisted on searching the apartment high and low for that table and chairs! They were small-minded bastards then and still today. More stories than that about the tiny minded pricks, too.
Good stuff from Triciamarie, Loretta, Tommy-Paine and all. Thanks.
I do some personal care work for a client on a WCB pension and she, too has horror stories. Fortunately she got NDP MLA Maureen MacDonal on her side and received the care she was due. And she, too could have been creamed for past deeds - who couldn't? - if her claim wasn't so clearly legitimate and her advocate so determined.
I have been worrying about what happens when she reaches retirement age. From what I've read in the above, it seems the WCB funds are cut off at age 65. Am I right? If so, she'll be poor and disabled.
Kathleen, in Ontario that would depend on the date of the accident. Workers' comp legislation is provincial though so you may want to try getting in touch with the Workers Advisors Program in Nova Scotia for specific advice about your client's claim.
our WCB laws here make pension awards to those disabled or ill (asbestosis being one example) however, those pensions cease at age 65. So, a WCB worker is making a "right" decision, according to the legislation when they tell an injured worker that their pension has stopped because they've turned 65 but is it "right" that the legislation is written this way?
The decision in any WCB case can be "right" according to the laws and policies but may be "wrong" because of the distortion of WCB by those politicans who shape it to be weighted in favour of employers.
Okay, it's good to have an example to think about.
Currently in Ontario, wage loss benefits are intended to replace the income that a worker is unable to earn due to the effect of the work accident. There is a separate payment for pain and suffering. Workers are compensated for 85% of their pre-injury after-tax income, less their post-accident earnings (or "deemed" earnings), up to age 65 -- whether or not the worker was planning to, or would have been able to, actually work until that age. Employed workers generally end up spending at least 15% of their net income and often more than that to attend work, between transportation, child / elder care, convenience food and all the rest of it. So in theory, an injured worker without those expenses should be able to maintain their lifestyle (ie referring to financial obligations only) and still have some extra money before age 65 that could be stuck away in a private pension. The Board also kicks in 5% on top of the 85% which is kept in a pension fund and paid out after age 65. The worker has the opportunity to get a further 5% taken off their wage loss benefits towards this pension, just as they often -- and not always -- would while working.
Workers with less serious injuries which don't eliminate their ability to work do lose some ground over their working life because their wage loss benefits (unlike full benefits) are not fully indexed to inflation. On the other hand, workers with good company pensions can often start drawing that pension while still receiving WSIB benefits, so they would in theory be earning more on compensation than if they were still employed (ie and not entitled to their pension), or if they retired on schedule before 65 (and were not receiving WSIB).
The workers who mainly lose out are those who would have continued working past age 65 out of financial necessity, as well as those who lost out on the chance to contribute to a good defined-benefit company pension because they were no longer working for the accident employer.
So in general then, taking all these factors into account, would you say it is right that wage-loss benefits get cut off at 65? Should workers continue to receive wage loss benefits after the age when the vast majority of them would have retired?
I think it is absolutely unconscionable that so many retired people are living in poverty, have to give up their homes, have to scrimp and save every minute of the day, may in fact be homeless or not know where their next good meal is coming from. That is completely heartbreaking to me. But it's hard for me to see how in most cases, injured workers of retirement age are on the whole that much worse off than everyone else -- assuming that they had been paid appropriately through the life of the claim, which is so often not the case, but that problem is unrelated to the issue of termination of benefits at 65.
I sometimes hear political demands for "lifetime pensions for lifetime injuries". I believe this is referring to the old practice of awarding lifetime pensions topped up with additional funds until age 65. The pensions continued past age 65, but the top-ups often did not approximate the pre-injury earnings. It's not clear to me what percentage of workers were actually better off under the old way.
Maybe injured workers themselves could tell me different.
In theory, it would make sense that, because of other programs kicking in, WCB pensions are no longer necessary. However, when a worker hasn't been in the work force for a number of years due to an injury, they can't contribute to CPP or their workplace pensions, should they have one. The result is that their income is lower in retirement than it would have been without the injury so losing the pension benefit is devastating.
As I was thinking about this, triciamarie, what happens to those folks who are injured on the job, and no longer able to work when they begin suffering the effects of aging in combination with their injury/illness? Does WCB assist them in terms of home care workers, extra medical costs, etc? Aging is very likely to exacerbate injury or illness -- is this taken into account? Somehow, I doubt it but it sounds as though you would have some idea of what happens in Ontario.
Diogenes, my comments re: seeking psychological entitlement were in respect of the Alberta man who is the subject of the news coverage.
Re fibromyalgia, this is just one of many nebulous if not spurious factors that carry a great deal of weight in a WC claim. This particula diagnosis, if extended by a rheumatologist, tends to be very persuasive in the eyes of decision-makers -- with differing effects for the claim, depending on for example, whether the diagnosis preceeds or follows the work injury. This is a window into the reading of tea leaves that takes place in WC adjudication -- but not only in WC adjudication; court litigation suffers from the same problem.
Sorry, triciamarie, after a more carefully reading of your post I came to realize that.
WRT your comments about Fibromyalgia and the Canadian Back Institute, well I am still left a bit speechless. CBI has a good reputation compared to others? And how could a diagnosis of fibromylagia be more persausive in the eyes of a decision maker over that of three other doctors who said the pain was the result of the accident, except for the sole purpose of denying a claim?
Beefing up security at WCB offices across the country was not the proper way to deal with the problems the WCB had Although I have had no dealings or expeience with them since, given what they have done with their offices, I can only assume things have not changed all that much.
No problem.
Back claims are problematic because back medicine is problematic. There is very little that most doctors can do to resolve or even to concisely diagnose a LB problem. Physiotherapy can help, but there is a broad range of competence between physiotherapists. CBI at least have a good grasp of the anatomy of the back and they do undertake the active physical therapy that is often associated with better results. Not by any means does it always work out.
Re weighing medical evidence, it's hard to comment on a specific claim without seeing the evidence, but I can generally say that there are a whole long range of factors that can come into play, including the question of whether the medical reports in question were solicited by one of the parties to the appeal. A report prepared for litigation purposes may be given less weight than a report from the worker's own treating physician. We use that argument all the time re reports obtained by the employer, who usually has a lot deeper pockets to "paper up the claim" like this than does the injured worker.
The thing is that in almost any given case, there are two possible ways to go -- allow or deny - and either one of them can be written to look like a fair and just decision. Decision-makers vary in their degree of openness to persuasion based on the evidence, and some of them are pretty set in their ways of looking at for example chronic pain, which in the past was never compensable over the long term.
Another point is that, while I'm not familiar with the policies of your Board or the facts of your brother's case, it could be that he got caught in a "usual healing times" policy that would allow eg maximum three months for a soft-tissue low back injury unless a permanent impairment appeared likely, which in your brother's case it sounds like he does not have. We don't (officially) have those UHT policies in Ontario anymore, and this makes it a little easier to show ongoing short-term work restrictions (supporting ongoing benefits) absent a confirmed chronic pain condition or permanent physical impairment. So if that is the case, this would be an area where injured workers in your province might decide to organize to put pressure on your Board to modify their policies.
I agree with you that the reason why WCB's require these extensive security systems is because some of their staff can be so high-handed and ignorant, not to say outright duplicitous in their dealings with injured workers. Their decisions may not take into account the real facts of the case, and workers have a hard time connecting with decision-makers to give them information. I can tell you that employers get much better service. On top of that, adjudicators usually don't explain their decisions very well, so the decisions can seem arbitrary and malicious. When people's livelihood and self-esteem are on the line it really behooves WCB's to do a better job of consistently interacting with workers in a respectful way at all levels of adjudication.
In Ontario I have also dealt with many decision-makers at all levels who are dedicated, professional, responsive and respectful of both employers and workers. So the possibility is there.
In theory, it would make sense that, because of other programs kicking in, WCB pensions are no longer necessary. However, when a worker hasn't been in the work force for a number of years due to an injury, they can't contribute to CPP or their workplace pensions, should they have one. The result is that their income is lower in retirement than it would have been without the injury so losing the pension benefit is devastating.
As I was thinking about this, triciamarie, what happens to those folks who are injured on the job, and no longer able to work when they begin suffering the effects of aging in combination with their injury/illness? Does WCB assist them in terms of home care workers, extra medical costs, etc? Aging is very likely to exacerbate injury or illness -- is this taken into account? Somehow, I doubt it but it sounds as though you would have some idea of what happens in Ontario.
Okay, but the problem you are identifying is really a problem with CPP, not worker's compensation.
I will explain it like this. Employers, who pay for WCB, would say that the vast majority of injured workers cannot be considered to be totally disabled as a result of their workplace injury. The injury disrupts their ability to work but does not remove it entirely. Assuming that the correct decisions are made in the claim, the accident-related portion of their reduced income as well as any lost pension opportunities are fully compensated through the WCB. The rest of the problem is either due to the general conditions of the labour market or in many cases, the worker's own decision not to return to work. Employers should not be required to indemnify workers against labour market conditions or the effects of workers' own personal decisions.
Workers may respond that the accident disrupted their working career and it was unreasonable to expect them ever to recover from that financial blow. A worker may have fully expected to have remained employed with the same employer up to retirement age. The WCB is assuming that they will be able to find another job that replaces the remaining income and pension and CPP contributions that the WCB is not covering. But after they lost that pre-accident job, particularly for older workers, their permanent physical restrictions made it unlikely that they would ever be able to find work in anything more than the most marginal employment. This is true even when the WCB spends hundreds of thousands of dollars on a lengthy retraining program, and it is certainly true when retraining is restricted to only a short literacy or GED program.
The latter is my position when I represent claimants who are requesting increased or full benefits over the long term. But I can not represent all claimants who ask me for help. A worker has to demonstrate that they did diligently and sincerely attempt to find work after their work accident -- not that they just sat back and put all their hopes in their compensation claim, or simply decided on their own, without medical support, that they were no longer able to work.
I guess what I'm saying here is that on the whole I am not able to characterize this issue as a cut and dry obvious "legitimate entitlement" WCB issue, unless the facts in a particular case establish otherwise. To me there is a cut and dry obvious deficit in the CPP program if it allows some seniors to subsist on income that is far below the minimum necessary. CPP is intended to support all Canadians, unlike WCB which by definition only compensates for the effects of work injuries.
Re work-related medical conditions that deteriorate over time, it is usually possible to get these medically reassessed, and if the injury is so severe that home supports are necessary then at least in Ontario the Board will pay for this.
All of a sudden he is not an injured worker, he is a wife beating crackhead who obviously doesn't deserve our sympathy or support. Regardless of the fact that he was injured at work and has been given the royal WCB runaround. It doesn't matter anymore, cuz he's a drug addict, not the poster boy we needed.
I didn't explain myself well the other day - I see people sharing these heartbreaking stories about how they were screwed over by the WSIB, and I'm thinking, maybe this guy isn't one of these. I totally admit that I sometimes err on the side of being too suspicious because I work with nasty people, but maybe this guy's claim got rejected because it's not a legitimate claim. After all, his drug use and declaration of bankruptcy predates the injury, and his history of wife abuse is a matter of public record.
One of my current patients is a guy who punched a wall, breaking bones in his hand in the hopes of getting Percocet. Several of my patients consistently refuse the free dentistry we offer because they want to continue to receive Tylenol #3 or Percocet. If their teeth get fixed, they don't have an excuse to get narcotics anymore.
Maybe this guy was trying to get money from the WSIB for drugs. I'm not trying to be worker-bashing or poor-bashing or classist - just saying, I've worked with addicts for a looooong time (maybe too long) and this behaviour would be consistent with what they do. It's the disease of addiction that makes 'em do it.
Maybe Clayton has a legitimate grievance. Then again, look at the behaviour: wife abuse, drug abuse, taking people hostage at gunpoint: adds up to antisocial personality disorder.
It's not being classist. It's looking at the evidence.
Sounds to me like this fellow had problems beforehand and his difficulties increased significantly after his work accident. If so, the pre-existing problems would not necessarily detract from his entitlement to compensation. This is the "thin skull" doctrine; a worker may have some characteristic that would predispose them to injury, but the predisposition does not eliminate WCB entitlement following a work injury as long as the accident also has an observable effect. The exception to that rule is known as "crumbling skull", when the predisposition is so significant that it renders the effect of the work accident inconsequential.
We know a lot of very personal information about this worker. This is offensive and may be very difficult for him, but I suppose he brought it on himself by deciding to take hostages and call the CBC. Nevertheless I think it would be a big mistake to conclude that we know anywhere near enough to be able to say that he does or does not have an allowable WCB claim.
Media usually avoid taking sides in individual cases, and as part of that, they tend to stay away from giving individual workers or employers a soapbox to proclaim the justice of their own case. This gentleman found a way around media circumspection using the threat of violence. That's where the stories of his past misfortunes may have some bearing. But the news story is, or should be, about the violence, and I guess also about workers' frustrations with compensation boards. I do not think that it is valid to draw conclusions about the merits of his specific WCB claim, or for that matter the legitimacy of the workers' compensation system, or general characteristics of injured workers -- 99% of whom in my experience do not in any way resemble this individual.
I would hope that any public policy discussions coming out of this would be informed more by the recommendations of injured workers' communities than the violent actions of one angry person.
Working aged people who fall ill, very quickly realise that the "systems" and "institutions" financed by tax dollars, and created by legislation are mere illusions. We have all the trappings of an advanced society, but it actually is each man for himsel.
Thanks tricia for the clear analysis, of what is legally doable, and indicating what is emotional reasoning based on not knowing the regulations, or details.
What I know for sure is he had been awarded some type of long term disability award, and he got 5000 a year from them, no matter what.
This indicates WCB has acknowleged his right to a claim award.
But that claim award appears, from the amount noted, to be the 1/4 of normal wages award, which is based upon their findings that they think perhaps at some point in the future said person may become employable, at 3/4's of regular full weeks.
Thanks remind, it's my pleasure. WC is a very complicated system to negotiate, but hopefully it can be made a little less so if injured workers are given information about the principles and practices underlying WC decisions.
You're right, I had forgotten that the Alberta worker said that the Board is giving him $5K a year. If so, that means that the Board did accept initial entitlement for a work accident and they determined that the worker has permanent restrictions that will impede his ability to work in some jobs.
At least in Ontario, ongoing benefits are calculated by "deeming" the worker as employable in a given specific job (eg "correspondence clerk")-- whether or not the worker can ever find this fictional job. The net earnings associated with that deemed employment are deducted from the pre-injury net earnings, and the remainder is covered by the WSIB, currently to the level of 85%.
Appeals usually argue that the specific deemed job decided upon for that worker (in Ontario currently called a "SEB", for "suitable employment or business") is not physically suitable and/or not reasonably attainable, taking into account all of the worker's physical restrictions and other personal characteristics. Job search records related to the SEB are a key piece of evidence. There is also a firm expectation that workers will try to find other employment outside of their SEB to mitigate their wage loss as much as possible. When the job search records are all in place it becomes a much easier proposition to persuade the Board that the SEB is unreasonable, and the resulting award is likely to be larger.
If Alberta uses a similar system, one thing to remember is that many lighter jobs require the ability to work with money. A person who is in bankruptcy is not bondable. That kind of thing can be used as a wedge to reopen a SEB decision, which could then be redetermined more carefully in an appeal situation, taking full account of all of a worker's physical restrictions and personal characteristics (ie those that predate the work accident, and those that are accepted as compensable under the claim.)
In these situations it might also be important to determine whether the Board would allow psychological entitlement under the claim. Ideally workers could obtain a referral to a psychiatrist who could provide a DSM diagnosis, a treatment plan and prognosis, as well as an opinion about any pre-existing psychological problems and whether the work accident contributed to worsening the problem. If a psychiatrist is unavailable the report could be written by a psychologist or even the family doctor. Psychological restrictions or precautions are often difficult to establish, so in some cases it might be best to see what the Board makes of the initial medical report first, then request a follow-up medical report outlining restrictions later on if necessary.
It might also be possible to medically clarify the extent of the worker's restrictions. Sometimes this is as easy as getting a report from the family doctor confirming that "no above-shoulder activity" (for a shoulder claim) also means that a worker can not work bent over with the arms extended more than 90 degrees from the body (or less, if the evidence supports this). Other times it may be necessary to ask that the Board reassess the worker's medical condition or recalculate the percentage impairment, eg if important aspects of the impairment were not captured, or if the rating schedule was not properly applied. Other secondary conditions can also be considered under the claim, eg an impairment that develops in the opposite arm or leg as a result of overuse, particularly if the worker is employed in work using that opposite extremity. Again there needs to be a clearly articulated and well-supported medical opinion, ideally backed up with the doctor's clinical notes to show how this condition arose.
If a worker's physical and psychological condition is severe enough, the worker may be deemed unemployable ("no SEB"), so that job search records would then be unnecessary. The bar is set pretty high for that determination though. Particularly for a younger worker, it is not helpful and may hurt the claim irreperably if a doctor writes a medical report saying that a worker cannot work at all, if the medical evidence supporting that conclusion is sparse.
However if a doctor believes that an injured worker is unable to work at all, that worker should consult with their doctor about filing a CPP Disability application. There are important time limits and other criteria for that application that should ideally be discussed first with a community legal clinic. When CPP-D is allowed, this would bring annual income well over $5K, particularly if the Board does not "offset" or reduce WC benefits by the amount of the CPP award. In Ontario our Board used to almost always offset the total CPP award but now, after concerted action by the injured worker community, in most cases our Board offsets CPP only from full WSIB benefits.
A CPP-D application sends the Board a clear message that the worker considers themself unemployable. If CPP is allowed related in large part to the compensable injury, this will often support a request for full WCB benefits. However if the CPP application is denied -- even if it is denied for administrative reasons, such as time limits -- or if the worker's and doctor's medical reports to CPP focus on issues that are not related to the claim, this could have strong negative consequences for an appeal for increased WSIB benefits.
For more information about these and many other issues in Ontario WSIB claims, there is an excellent resource on the Community Legal Education Ontario website. NB This document fills a large binder when printed but it is navigable online.
www.cleo.on.ca/english/wcManual/cover.htm
Wow, interesting the twist and turns, of the system. Thank you again, going to book mark this thread, for those I come across, so I can either direct them to read it, or copy and paste portions to print out.
Inside the systems knowlege is so important, it gives a fuller awareness of what is in play societal protection wise.
That is where your url also comes in handy as there must be something, if not most everything that has applications across provincial borders.
Much like every system set up in the social contract, it fills a binder if not more,....which in the end is a positive thing for the majority of workers...even though painful to experience, for others. It is protection they might not have otherwise had.
Thanks again remind.
I do need to emphasize the need for caution in relying too much on this kind of general internet information. Every province is different, every claim is different, and the law can and does change overnight. Injured workers should always seriously consider seeking assistance, whether from their union, their MPP, a community legal clinic, their provincial Ministry of Labour worker advisor service, an injured workers' group, or through the law society for their province.
You know why are there not classes in school, about the basics of this type of knowlege about the work place/force.
Youth are getting injured on the job in increasing amounts, it should be like getting a drivers license, classes and a occupational safety and awareness test before entering the work force
At WCB of BC, when Conservative Gordon Campbell came in, he looked at Alberta as a model of how to cut costs.
His first move was to slash employees by 40%.
I am sure there are hundreds of stories like this guy in Alberta, as well as BC now, sadly.
As for the dilemna as to whether or not to allow his grievances to be aired (as a result of a criminal act) - while they may be legitimate grievances, rewarding a hostage-taker with air time, can encourage others to do the same.
However, without an outlet with which they can air their grievances, what choice do these people have?
It's not as if there is a Toronto Star in Alberta or BC to give them a voice.
One solution is to work together with other injured workers to identify deficiencies in the system and make fixing those problems a priority for organized labour and the WCB's.
At root, one of the biggest problems with workers' compensation is that the premiums paid by employers are much too low. This affects injured workers because the law and policies are set in accordance with the total amount of money available to paid out. In Ontario, employer assessments have been slashed by 25% over the past 10 - 15 years. That is not an issue that any individual injured worker would be able to effectively address on their own, but working together, injured workers and unions can and do force WCB's to deal with systemic underfunding. For example in Ontario, the WSIB has recently established a new team of adjudicators who will be strictly reviewing all employer requests for claim cost forgiveness when their injured employees have pre-existing medical conditions. That program, called SIEF, has sucked a huge amount of premiums out of the system. It's not sustainable, and to the Board's credit they are now finally taking concrete steps to address this.
Injured worker communities can also help individual workers understand how their own claims might meet the criteria for acceptance, whether with respect to initial entitlement, wage replacement, or specific benefits (such as retraining or health care) sought under the claim.