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Index October 2007
Answers on WSIB insufficientSir: I recently received a response (see below) to my letter published Aug. 23, 2007 in The Observer ("Candidate stances on WSIB important") from Liberal incumbent MPP Maria Van Bommel, along with the as-promised answers by WSIB Chair Hon. Steven W. Mahoney PC. ("Chairperson defends record of WSIB," The Observer, Aug. 29, 2007) Ms. Van Bommel's own numbers show that injured workers have fallen 26.1 per cent behind the inflation rate over the last 12 years and the sitting government has seen fit to offer 155,000 injured workers a 7.5 per cent increase in benefits over a year-and-a-half. How generous of them for that. Let's not forget that same Liberal government voted themselves a 25 per cent pay increase during their last term as well. In Mr. Mahoney's letter, he called the issues I raised in my questions unfounded and unsubstantiated. Take question No. 19 for instance. I asked of the candidates, "Did you know an injured worker can be cut off benefits without cause at anytime, then be made to appeal those decisions on terms dictated by the WSIB, not in accordance to the laws of Ontario and Canada?" Mr. Mahoney provides a long eloquent answer but the bottom line he provides is that there are 350,000 claims and that 16 per cent are abandoned and four per cent are denied. If so, then there are a potential 70,000 claims that do not receive compensation. That's 70,000 families that are potentially plunged into poverty in Ontario alone. It's all how you spin the stats. Still inflammatory and unsubstantiated? Injured workers write to and tell injured workers support groups the abuses and unfair treatments they suffer at the hands of the WSIB. Families of deceased-by-suicide injured workers have also written to injured workers support groups asking for justice. These nonflammable and substantiated reports are the basis for my asking the candidates of the upcoming Ontario election my query. I have already apologized publicly to Mr. Mahoney for misquoting his salary (The Observer, Sept. 11, 2007), but I won't take back anything else. It's a fact injured workers in Ontario are penalized 15 per cent of their net pre-injury earnings just for being injured and on a WSIB claim. That means, a worker earning minimum wage $8/hr or $320/wk as pre-injury wages will receive, post injury, approximately $244.80/wk, the WSIB deemed salary cap (85 per cent of $320 minus 10 per cent for taxes). The answers Mr. Mahoney gave MPPs to my questions all look nice and rosy but within those roses are where we find the thorns. I won't be forgetting that when it comes time to vote. Pete Clare Lambton Shores http://www.theobserver.ca/ArticleDisplay.aspx?e=721514An Answer from Two Politicians:Dear Mr. Clare: Thank you for taking the time to write. Please find attached answers to your WSIB questions and concerns from the Hon. Steven W. Mahoney, Chair of the Workplace Safety and Insurance Board. I would like to note that the McGuinty government is committed to creating a brighter future for injured workers. We have taken action to put more money into the hands of injured workers through benefit increases and announced reforms to the Workplace Safety and Insurance Act (WSIA). For the past 12 years, erosion of inflation protection under the Friedland Formula (1994) and modified Friedland Formula (1998) saw injured workers' benefits increase by only 2.9 per cent, while inflation rose by 29 per cent. Changes in Budget 2007 will address this situation by enhancing the benefits for more than 155,000 injured workers by 2.5% on July 1, 2007 and on January 1st in each of 2008 and 2009. This exceeds the current rate of inflation. Our proposal for a 7.5 per cent increase would, in just one year and a half, more than double the increase seen over the last 12 years. We have also proposed a regulation-making power so that injured workers don't have to wait for the WSIA to be reviewed again for future increases. Thank you again for bringing your concerns to my attention. Sincerely, Maria Van Bommel Lambton-Kent-Middlesex Attachment: 1. Did you know that all Canadian WCB's including the WSIB are being run as the American Model, of giant, corporate, private insurance company? The WSIB is a not-for-profit trust agency of the Ontario government and is not in the business of making corporate profits for stakeholders. The WSIB's number one priority is to improve the lives of injured workers while remaining fiscally responsible. As you know, the Workplace Safety and Insurance Board began as the Workmens' Compensation Board in 1915 through an Act of the Ontario Legislature. The legislature adopted the new system, based on recommendations by Sir William Meredith in 1914. Fundamental to the system was (and still is) an historic compromise in which workers give up the right to sue for their work-related injuries, irrespective of fault, in return for guaranteed compensation for accepted claims. Employers, for their part, receive protection from lawsuits in exchange for financing the program through premiums. This system of collective liability provides fair compensation for injured workers and their families, while spreading individual costs among employers. The WSIB's prevention mandate and return to work programs also sets it apart from private U.S. companies that do not offer these services to injured workers. 2. Did you know that right now, the WSIB is not accountable to anyone, including governments? As you are aware, the Workplace Safety and Insurance Board (WSIB) is an agency of the provincial government responsible to the Ministry of Labour for administering the Workplace Safety and Insurance Act (the Act). The WSIB is fully accountable to the Ontario Government. Its operations are subject to public scrutiny by a variety of independent parties including the Ontario Legislature, the Provincial Auditor, the Ontario Ombudsman and the Fair Practices Commission. We have also been the subject of numerous audits and appeared before the Standing Committee in February/March 2007. 3. Did you know the WSIB creates their own legislation and policies? The WSIB does not make laws; that responsibility rests wholly with the elected representatives of the Ontario Legislative Assembly. As an agency of the provincial government, the WSIB is responsible to the Ministry of Labour for administering the Act. We develop and update policies in accordance with the Act and through consultation with stakeholders. We are committed to consulting on policy issues with all interested stakeholders; however the policy consultation process that we decide to follow depends on the complexity and scope of the policy issue. Since 2005, management at the WSIB have had over 1,400 meetings, consultations, presentations and information sessions with workers, employers and associations on a variety of issues. Action items arising from those meetings have been identified and are being followed-up to ensure they are being addressed. Recent consultations have included: Return to Work Policies (two rounds of public consultations including a request for written submissions and over 30 meetings with various employer and worker groups) Bill 187 policies Schedule 2 Administrative Rate How to integrate CPP disability benefits with workers' compensation benefits Confidentiality Policies 4. Did you know that big employers of this province commit fraud by misrepresenting their payrolls in order to pay cheaper premiums than what they should actually be paying? We have fostered a very successful partnership with the Canada Revenue Agency (CRA) to address compliance issues and help create a level playing field. The CRA and the WSIB share information on businesses to ensure that all Ontario employers who are required to register with either organization are, in fact, registered. Exchanging information also helps the WSIB ensure that employers are accurately reporting their payroll to us. In the last two years, this has resulted in the registration of 17,000 non-compliant employers. 5. Did you know that an injured worker loses all their rights as a Canadian citizen when they go on a WSIB claim? The WSIB is bound by several pieces of legislation including the Human Rights Code as well as the WSIB Code of Business Ethics. In addition to complying with legislation, the WSIB does everything possible to ensure that injured workers and their families receive the best possible service and that benefits are at adequate and secure levels. In making decisions about worker benefits, the WSIB uses policies contained in its Operational Policy Manual (OPM) which is derived from the current legislation. We are committed to supporting the injured workers of this province through: Comprehensive multilingual support to workers in over 60 languages The creation of an Adjudicative Best Practices Working Group comprised of WSIB staff and external stakeholders that continue to identify ways that we can be better and more efficient Staff training in areas of occupational disease, return to work and worker sensitivity Creation of a Serious Injury Program Working Group with external stakeholders to identify ways that this program can improve service to most seriously injured workers of this province A review of the WSIB's Service Delivery Roles as part of our commitment to service and organizational excellence Funding of U*.5 million for Occupational Health Clinics for Ontario Workers Numerous benefit improvements over the last few years including removal of the cap on burial expenses and the extension of monthly benefits for dependent children from 25 to 30 years of age. 6. Did you know fraudulent claims submitted by workers is a total of .01% of all WSIB claims submitted by injured workers? Despite the small percentage of those who try to take advantage and cheat the system for their own benefit, we're doing all we can to crack down on fraud to create fairness in the system, including a verification audit to ensure full and appropriate reporting of all injuries and illnesses. 7. Did you know the WSIB is not subject to the laws of Canada or Ontario and are free from prosecution of those laws when they break them? The WSIB is fully accountable to the Ontario Government and its operations are subject to scrutiny by the Fair Practices Commission. The WSIB places the highest value on the integrity of the organization and its employees. The core drivers of an ethical organization are people, integrity and commitment. In addition, all staff including the Board of Directors, advisors, officers, management, employees, retirees and those on early leave are bound by the WSIB's Code of Business Ethics which also governs our relationship with agents, consultants, independent contractors, business partners and suppliers of the WSIB. 8. Did you know the WSIB can refuse to provide medical treatment that the injured workers health care professionals order? The WSIB does not provide medical treatment, but it is responsible for determining the necessity, appropriateness and sufficiency of the health care provided as outlined under sections 32 and 33 of the Workplace Safety and Insurance Act. The WSIB generally allows treatment or appliances that are prescribed by the treating health professional for a work-related injury/disease. In determining if a health care product, treatment or service is an allowable benefit, the WSIB decision-maker considers if the prescribed health care is "necessary, appropriate and sufficient". Factors considered include whether the treatment is required as the result of the work-related injury, whether the need is supported by medical reports, and whether the outcome will promote health recovery and result in early and safe return to work. 9. Did you know the WSIB will cut an injured worker off their prescribed medications? The WSIB will not cut an injured worker off their prescribed medications for no reason. Based on the worker's entitlement, the WSIB will pay for medications prescribed by a physician. Where the medication is not usually prescribed for the work-related condition, the WSIB will review the situation to determine whether the medication can be paid as an exception. 10. Did you know the WSIB will force injured workers back into the labor market while still injured or ready to re-enter the labor market, for the sake of clearing case files? Improved return to work (RTW) outcomes for injured and ill workers is a major strategic business objective for the WSIB. Improving early and safe Return to Work outcomes is a core value and the WSIB has a robust set of RTW and Labour Market Re-entry (LMR) policies in place designed to help injured workers return to work in a timely manner following a workplace injury or illness. WSIB claims and cost data and feedback from staff, employers, workers and their representatives indicate that RTW policies, services, processes and outcomes need to be improved at the claim, workplace, program, and system levels and in establishing a disability management baseline for Ontario workplaces. In the fall of 2005, the WSIB introduced a set of draft RTW policies that are reflective of evidence-based RTW best practices and aligned with disability management principles. The policy improvements were necessary because experience has shown that the current direction of RTW policies were not working as expected. It is also hoped that more effective RTW policies and programs will help to address the system's funding challenges by fostering better RTW outcomes. The policy improvements addressed issues of fundamental fairness for both workers and employers, clarity of roles of all workplace parties and legal compliance (such things as expected behaviour, circumstances of a RTW breach and how penalties would be applied). The first round of consultations brought a number of improvements and changes to the draft policies based on the valuable feedback received from our stakeholders. The policies were streamlined and simplified to ensure better clarity in their intent and direction and the number of policies were also reduced. The revised policies were made available for further consultation until February 15, 2007 and additional refinements will be made. Those proposed revisions will be shared at the end of this year. The draft policies have also been tested in the RTW demonstration pilots, which began in September 2006, to ensure that they are clearly understood and can be effectively applied. The testing period concluded in spring 2007 and feedback is being gathered from test participants, including workers, employers and WSIB staff, on any problems that arose with the draft policies and any suggestions for improvement. The WSIB is committed to having subsequent discussions with stakeholders to share with them the results of the public consultation, the findings from the testing process, and the implementation plan (including education and training). The final policy revisions are being analyzed with the results of the policy testing. Once complete, the WSIB administration will be seeking the approval of the WSIB Board of Directors in order to proceed with the implementation of the final version of the policies. The WSIB will integrate this analysis with some of our other key organizational initiatives on our Road to Zero. 11. Did you know that the Chairman of WSIB is salaried at more than ?,000.00/year? The WSIB Chair's salary is not ?,000 per year; not even remotely close. I do this work because I am passionate about eliminating the carnage that occurs in Ontario workplaces every year. In fact, the position of Chair of the WSIB is a part-time appointment by Order in Council of the Provincial Government. But I can tell you without fear of contradiction, I and everyone at the WSIB work on a more than full-time basis to help make Ontario's workplaces the safest in the world. 12. Did you know that injured workers are given salary caps, deemed by the WSIB and the WSIB will take the injured workers earned CPP disability benefits so the injured worker does not exceed the WSIB deemed salary? As you know, on March 22, 2007, the Ontario Government introduced Bill 187, the Budget Measures and Interim Appropriation Act, 2007, which includes several amendments to the Workplace Safety and Insurance Act. Bill 187 removes the word "deemed" from the Workplace Safety and Insurance Act. Instead, the Act now uses the word "determined". This means the concept of "deeming", the practice of estimating an injured worker's earning potential for benefit-setting purposes in cases where the worker has not yet found employment, has been changed in an effort to compensate workers more fairly for their real wage loss. The WSIB considers employment that is both suitable and available when determining a worker's post-injury earnings or determining if a labour market re-entry (LMR) plan is required for the worker. Previously, the WSIB only had to consider employment or business that was suitable for the worker, but whether or not the employment actually existed was less important. Also, in cases where injured workers have secured employment but their earnings remain below their pre-incident level, the WSIB will consider their actual earnings in setting and paying further wage loss benefits. With respect to CPP benefits, the WSIB approved new and revised policies in 2005 that changed the way the WSIB calculates benefits for workers and survivors who receive both WSIB and CPP/QPP benefits as the result of a work-related injury/disease or death. The policy changes help ensure that the WSIB is providing fair compensation to workers, and in cases of work-related deaths, their survivors. 13. Did you know the WSIB puts a strain on the provincial health care system when work related claims are denied there by forcing IW's treatment to be provided by OHIP? It is not accurate to say that claims denied by the WSIB puts a strain on the provincial healthcare system. It is only within the mandate of the WSIB to pay for health care and benefits for injured workers for approved claims. In allowing a claim, evidence must show that the injury was related to work or a work exposure made a significant contribution to the development of a disease. The Ontario worker's compensation system is an investigative, rather than an adversarial process and it is the WSIB's responsibility to make an entitlement decision based on information that is impartial and informed. Of the total claims registered with the WSIB each year, 80% are allowed, 16% are abandoned and only 4% are denied. 14. Did you know that OHIP can refuse to pay for treatment of a work-related injury? We cannot comment on the policies of OHIP. If an injury is adjudicated to be work-related, the WSIB pays for health care. 15. Did you know there is an advisarial attitude that exists within the WSIB towards injured workers? WSIB claimants are treated with dignity and respect. All adjudicators are required to participate in the WSIB's award winning worker sensitivity training program which helps them better understand the issues and challenges facing injured workers. We are sensitive to the fact that every claim is more than a piece of paper. We understand that there's a human being with a family within the pages of every claim file. I am very proud of the staff of the WSIB and their dedication to the work they do - at every level of the organization - is unparalleled. We strive for service excellence and most of the time we get it right. But when stakeholders tell us we're not doing a good job, we take it very seriously and we take appropriate action. 16. Did you know that WSIB uses fear and threats to close case files? This is purely speculative and unsubstantiated. It is only with the continued hard work and dedication of our adjudicators and front line staff that we are able to adjudicate over 350,000 new claims and make over 1 million appealable decisions every year. The WSIB's main objective with respect to decision making has always been on making timely decisions, without sacrificing quality. Adjudicators work as part of a multi-disciplinary team to ensure that injured workers receive timely and effective access to health care and to assist them in achieving optimum recovery and return to work. All adjudicators go through an extensive 6 month training program and are required to participate in the WSIB's worker sensitivity training program. This helps adjudicators better understand the issues and challenges facing injured workers. We also have many vehicles and processes for injured workers to share their feedback and concerns. The Adjudicative Best Practices Working Group, which includes labour and injured worker representatives (OFL, OWA, Legal clinics), regularly meets to discuss issues around decision making and processes. Their work has resulted in the creation of advice or best practice documents to ensure a common understanding of decision making processes. We work collaboratively with the Fair Practices Commission to identify solutions to systemic or recurrent issues that have been identified by workers and employers. All of these changes in recent years have resulted in all-time highs in worker satisfaction levels. Our 2006 Ipsos-Reid Customer Satisfaction survey reports that 70% of injured workers are satisfied overall with the WSIB (with 45% very satisfied, the same as 2005). The overall satisfaction is up from 69% in 2005. 17. Did you know the WSIB causes further psychological damage to injured workers then refuses to compensate the injured workers for this further damage they cause? This is purely speculative and unsubstantiated. All WSIB claimants are treated with dignity and respect. With respect to stress, the Workplace Safety and Insurance Act covers work-related traumatic mental stress, but does not cover chronic stress that develops over time due to conditions in the workplace. In 2002, the WSIB revised its policy on work-related stress to clarify coverage for workers who have been exposed to multiple traumatic events in the workplace. 18. Did you know injured workers can NOT sue WSIB for unjust decisions nor can they sue their employers for the neglegence that may have caused the injury, in a court of provincial or federal law? (Historic Compromise, Merideth Principle) *Did you know the WSIB is the root cause for many injured worker's suicides? The WSIB is committed to assisting injured workers to regain a meaningful and productive life. To suggest our efforts are responsible for injured worker suicides is both inflammatory and preposterous. If someone tragically takes their own life we all lose. I can assure you, WSIB claimants are treated with dignity and respect and effective internal and external appeals processes do exist should they wish to see the decisions of our adjudicators reconsidered. If the WSIB renders a decision that a worker disagrees with, there are multiple avenues of appeal available, beginning with providing more information to the adjudicator for reconsideration, to launching a formal appeal with the WSIB, and finally appealing to the Workplace Safety and Insurance Appeals Tribunal (WSIAT). WSIAT is separate from and independent of the WSIB and is the final level of appeal to which workers and employers may bring disputes concerning workplace safety. 19. Did you know an injured worker can be cut off benefits without cause at anytime, then be made to appeal those decisions on terms dictated by the WSIB, not in accordance to the laws of Ontario and Canada? An injured worker cannot be cut off benefits without cause. The Workplace Safety and Insurance Act designates the WSIB as having the role of gathering information from workplace parties in order to adjudicate work-related injury and illness claims. If the WSIB renders a decision that a worker disagrees with, there are multiple avenues of appeal available, beginning with providing more information to the adjudicator, to launching a formal appeal with the WSIB, and finally appealing to the Workplace Safety and Insurance Appeals Tribunal (WSIAT). The WSIB receives and adjudicates over 350,000 new claims each year while paying some form of benefit in over 600,000 existing claims (covering all 3 benefit schemes) each year. We administer 230,000 employer accounts and front-line staff makes over 1 million appealable claims & account decisions each year. The appeals process was streamlined in 1995 and by 2000, annual appeal volumes fell from 19,901 at its peak to 10,000 and have remained below 10,000 through 2006. This represents less than 1% of those 1 million appealable decisions made at the front lines. In 2006 the WSIB resolved 9,375 appeals and the average timeframe for a resolution was 5.9 months. In terms of WSIAT the yearly volume of appeals has gone down 21% in the past 6 years. In 2005 the WSIB received 3,753 appeals & 1,287 of those were allowed by WSIAT. 20. Did you know anyone in this province no matter how large the salary can be subjected to the unfair practices of the WSIB and driven to poverty? Don't believe me? Suffer a work place injury which results in a permanent disability and it won't take long to see for yourself. As I've said above, the WSIB is committed to assisting injured workers to regain meaningful and productive lives. I can assure you, WSIB claimants are treated with dignity and respect and effective internal and external appeals processes do exist should they wish to see the decisions of our adjudicators reconsidered. In addition, all of the WSIB's operations are subject to scrutiny by the Fair Practices Commission. The unfounded and inflammatory statements made by P.C. Clare do nothing to help the cause of injured workers in Ontario. We all need to do more to eliminate workplace injuries and fatalities and to accomplish this we need to be honest. My door is always open to assist anyone in understanding the value the WSIB brings to Ontario's workers, injured workers and the employers who fund the system. At the end of the day, we want to ensure that workplaces are safe and that all workers return home to their loved ones without injuries or illnesses. I am committed to make sure that happens. Sincerely, The Hon. Steven W. Mahoney P.C. Chair Workplace Safety and Insurance Board POSTED BY: Pete Clare London Free Press HISTORY: Aug. 23, 2007 - injured worker asks questions about the WSIB to Ontario provincial election candidates in newspaper: - Letter to the editor from P.C. Clare, "Candidate stances on WSIB important" - (The Observer, Aug. 23, 2007) - Aug. 29, 2007 - WSIB responds negatively in letter to same newspaper: - Response to P. C. Clare from WSIB Chairperson, Steven W. Mahoney, "Chairperson defends record of the WSIB" (The Observer, Aug. 29, 2007) Aug. 29, 2007 - the CIWS responds to both letters: - Response from the CIWS to the Sarnia Observer Editorials re: Mr. Mahoney (WSIB) and Mr. Clare's Letters - sent August 29, 2007 - (Published in the Sarnia Observer Set 5 2007) Sept. 11, 2007 - PC Clare's response: All Injured Workers Need Fair Treatment October 4, 2007 - PC Clare receives answers from Steve Mahoney and responds: Answers on WSIB insufficient Back to Article Index |
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