Board allegedly ignores diagnoses of injured workers' doctors to cut costs
(Canadian OH&S News) — A new joint report from the Ontario Federation of Labour (OFL) and the Ontario Network of Injured Workers’ Groups has claimed that the Workplace Safety and Insurance Board (WSIB), Ontario’s workers’ compensation authority, has been ignoring the recommendations of medical professionals in order to close injured workers’ cases.
Released on Nov. 5, Prescription Over-Ruled: Report on How Ontario’s Workplace Safety and Insurance Board Systematically Ignores the Advice of Medical Professionals accused the WSIB of focusing more on clearing its caseload than on helping injured workers. The 16-page report was compiled with the assistance of more than 20 doctors who had decided to speak out about what they saw as the WSIB’s questionable practices.
“When an adjudicator doesn’t agree with what a family physician says, then they send it out for what we call a ‘paper doctor’ assessment,” explained OFL secretary-treasurer Nancy Hutchison, the report’s lead author. “So they’ll send it out to one of their consultants to do a second and third opinion on what the family physician and/or specialist is saying, and of course, nine times out of 10, it will come back differently.
“This really launches the injured worker into a greater sense of despair, because often, they are cut off based on the paper doctor’s new assessment of the claim,” continued Hutchison. “So the family physicians and specialists, who have cared for injured workers, sometimes for decades, are overruled by these ‘paper doctors’ who really just take a look at the file, and they’re on the payroll of the WSIB.”
The report also included the stories of four anonymous injured workers who had shared their experiences. It concluded with five recommendations: a formal investigation into the WSIB’s approach to medical advice; publication of statistics on how often injured workers’ health providers’ advice is ignored; a protocol for deadlines on healthcare workers’ medical decisions; the elimination of “paper doctors” who never even meet the patients; and proper weight attributed to injured workers’ own personal doctors.
Although the WSIB declined to comment directly to COHSN, it did send out a news release in response to Prescription Over-Ruled on Nov. 5.
“The OFL report was not shared or discussed with the WSIB in advance, but we would be happy to review any files that they would like to bring to our attention,” the organization stated. “The WSIB values the relationships it has with thousands of healthcare practitioners across the province and relies on their professionalism and expertise.”
The WSIB also cited two recent studies by the Institute for Work and Health, which had concluded that the organization helped to keep injured workers out of poverty. “The WSIB may refer a case for an external expert medical review to assist our staff in understanding the available medical information, diagnosis and treatment plan,” said the WSIB. “A phone discussion with the worker’s treating physician often occurs to ensure a comprehensive understanding of the medical findings and recommendations.”
But Sudbury psychologist Dr. Keith Klassen, who had assisted with the report, said that the WSIB had made a regular practice out of ignoring medical opinions. “That’s the way they operate. They just sort of ignore it and do what they want,” he told COHSN.
“I’ve had cases where I’ve said that someone is unable to work, and they clearly can’t work, and a return-to-work plan would be detrimental to their health,” he added, “and they go ahead and call them up and say, ‘We want to start a return-to-work plan for you in a couple months.’”
Dr. Klassen speculated that the WSIB was trying to cut costs. “Five years ago, they had a huge multibillion-dollar deficit, and that has been reduced over the past years,” he said.
“If you cut enough people off benefits, it will reduce costs,” agreed Hutchison.
The WSIB’s alleged dismissal of workers’ healthcare professionals previously made headlines over the summer, when Hamilton doctor Brenda Steinnagel filed a lawsuit against the organization and her former employer, claiming that she had been pressured to change her medical opinion of a client (COHSN, Sept. 29).
“We’ve got a real problem at the WSIB,” said Hutchison. “We want a public system that works.”
Prescription Over-Ruled is available online at http://ofl.ca/wp-content/uploads/2015.11.05-Report-WSIB.pdf.