Injured workers advocates continue call for WSIB investigation

On November 5, labour rights activists and community members joined in Victoria Park to mark the ten year anniversary of the release of “Prescription Over-Ruled”, a whistleblower’s report by the Ontario Federation of Labour (OFL) and the Ontario Network of Injured Workers Groups (ONIWG). 

The report includes several allegations from healthcare professionals about the Workplace Safety and Insurance Board (WSIB), including failing to heed medical advice regarding readiness to return to work, insufficient treatment, blaming ‘pre-existing’ conditions for ongoing illness, and using independent medical reviews which proclaim patients to be healed, despite the evidence of treating practitioners.

Many critics have argued that these practices are detrimental to healthcare coverage of injured workers.

“The report reveals all the things that have been happening to me for 26 years. And how many other countless people have been forced into poverty?”  said Kevin Jones, an injured worker who suffered a workplace injury in 1998 that resulted in a chronic pain disability. “We must continue to fight for justice.”

Injured Workers’ Compensation 

The workers’ compensation system has been in place for over 100 years in Ontario. The Workplace Safety and Insurance Act mandates loss of earnings and healthcare coverage for injured workers, who in turn, are unable to sue their Employers for workplace injuries. In the 1990s under the Harris Conservative provincial government, austerity measures were implemented and the system shifted from a social program to an insurance company. 

The result was a reduction in wage loss coverage from 90 to 85 per cent and a reduced cost-of-living adjustment. While 5 per cent may not seem significant, the pay cut for injured workers can be very materially significant. It also reduces pension contributions, and for injured workers with more permanent disabilities, there are even longer term impacts. 

These benefits reductions are for claims that are actually granted entitlement. During the “Marshall years” from 2010 to 2015, WSIB CEO David Marshall instituted cost-cutting measures and was awarded a bonus of $400,000. These measures included reducing total benefits paid to injured workers, increasing the claim denial rate, slashing the duration of vocation training, cutting awards for permanent injury impairments, and reducing WSIB staff by 200 employees.

At the end of Marshall’s tenure in 2015, the OFL and ONIWG report included detailed descriptions about how the cost-cutting had impacted injured workers’ physical and mental health and social well-being, “through WSIB’s improper interference with medical care and bad faith decision-making.”

For the past decade, there have been calls on the provincial government to investigate WSIB on the basis of the allegations made in the report. 

When workers are denied compensation, healthcare costs shift from Employer-funded WSIB to the individual injured worker and the publicly-funded OHIP system. An article in the Canadian Medical Association Journal raised concerns about public healthcare system costs for workplace injuries as early as 2007. There are also ongoing concerns about claims suppression, as researchers have uncovered thousands of workplace injury reports that were filed but not assigned claim status. 

“We have to keep spreading awareness,” added Jones about the Nov. 5 rally. Jones organizes with Occupy WSIB and regularly sets up pickets in London to “keep the focus on injured workers.” 

WSIB continues cost cutting

Last month, WSIB announced an additional $2 billion in Employer rebates. Like other insurance companies, WSIB collects premiums for coverage. These rebates return some of the money paid into WSIB by Employers. Referred to as ‘surplus’, the money comes from unpaid benefits and adds to the cumulative $21.5 billion Employer savings in the past ten years.

In September, the WSIB announced it was cutting the average premium rate for the seventh time in the past 10 years. The average premium rate is now less than half of what it was in 2016 and is at its lowest point in more than 50 years. 

As another cost saving measure, WSIB has also continued the controversial practice of deeming (also called ‘determining’). This is when a worker is considered fit to work, even if they are not working and the jobs do not exist. If a worker is ‘deemed’, their benefits are reduced accordingly. 

The OFL and ONIWG report raises many issues that injured workers continue to navigate with WSIB today; chief among them are inadequate healthcare services and ignoring the opinions of treating medical professionals. 

Delays in approving healthcare services, denying referrals, too narrow of treatment options for injuries, and cutting off services before injured workers have recovered were all reported by healthcare professionals in the report. Claim denials often rely on file reviews by physicians who have never treated the injured worker, and the primary whistleblower Dr. Brenda Steinnagel was allegedly fired for refusing to lie in favour of WSIB claim denial. Return-to-work specialists reportedly push injured workers back to work against treating physicians’ recommendations and then deny coverage when injured workers are unable to work as directed by WSIB.  

Injured workers continue to fight for systemic changes

WSIB legislation cuts off benefits at age 65, but “A lot of people nowadays work past age 65 because of the economy. Cutting off benefits then puts people into pure poverty,” said Liz Garant, Vice President of ONIWG for Southwestern Ontario.

Garant was injured at work in 2006. When she was no longer able to work due to the injury, she had to try to access benefits through WSIB. Although she worked an average of 40 hours a week for 11 years, WSIB deemed her able to work 2 hours per day despite her functional limitations.

“I’m living in poverty now only getting paid for 20 hours. But when I turn 65, I’m going to be in worse poverty,” added Garant.

On Nov. 25, advocates are planning for a Queen’s Park lobbying day to address age discrimination in the workers’ compensation legislation.