IAVGO publishes “Bad Medicine: the WSIB’s transformation of its health care spending”

It’s been my privilege to work with IAVGO Community Legal Clinic as a co-author of a report on how the WSIB has “transformed” its health care spending since 2010. We describe the effect that the WSIB’s transformation has had on the provision of health care benefits to injured workers, by analyzing the WSIB’s own data in the context of the changes the WSIB has made to its business model and the experience of injured workers during that time.

The evidence we present supports the following stark conclusions. Since 2010:

  • There has been a significant cut in prescription drug benefits that affects thousands of injured workers per year.
  • Health care spending has progressively shifted away from services whose sole focus is patient welfare, and into services that are structured to drive down the cost of benefits paid to injured workers.
  • The primary measures used by the WSIB as evidence of improved health outcomes (the reduction in the incidence and severity of permanent impairments) are the result of changes to the WSIB’s adjudication practices. They constitute a cut in benefits themselves, rather than a reflection of improved health care.

If you’re concerned about how the WSIB has been limiting entitlement to drug benefits, or rehabilitation therapy provided by physiotherapists, chiropractors and the like, or the WSIB has told you that you have recovered from your injury when you know you have not, I urge you to read the report. It covers these issues in detail, and a great deal more.

The report is available, for free, on IAVGO’s website. You can download it as a PDF by clicking this link.

You can also read about the report in an article in the Toronto Star, or listen to an audio clip of an interview about it on AM640’s Morning Show.

The good, the bad and the ugly: the WSIB’s draft chronic mental stress policy

After three years of delay, things are moving quickly on chronic mental stress in Ontario. Two weeks ago, the government proposed changes to the Workplace Safety and Insurance Act that remove the bar to chronic mental stress claims. Last week, the WSIB published a draft policy (PDF) and opened an expedited consultation on it, which closes on July 7, 2017.

It’s vital that injured workers make their voices heard in the consultation. This blog contains a preliminary analysis of the policy, which I’m happy for any injured worker or advocacy group to adopt or adapt (or reject or ignore!) when developing their submissions.

The Background Information (PDF) the WSIB published with the draft policy sets out “three key entitlement criteria for chronic mental stress,” namely “diagnostic requirements,” “injuring process,” and “causation standard.” I’ll go through all three, and then discuss a fourth issue, the lack of transitional provisions. Continue reading

Hidden treasure: the Ontario Workplace Tribunals Library

Recently I came across a flyer advertising the OWTL’s services, and it reminded me how few injured workers I meet know about the library—even though it’s a tremendous resource for self-represented workers and professional advocates alike. So I’ve taken it upon myself to do a bit of unsolicited promotional work for the library in this blog.

There are two things that make the OWTL a treasure.

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Chronic mental stress: the Minister speaks!

 

In previous posts, I’ve talked about the ongoing suffering caused by the government’s failure to respond to several WSIAT decisions stating that the exclusion of chronic mental stress from workers’ compensation in Ontario is unconstitutional. I’ve also speculated about the government’s motives for neither seeking judicial review of the decisions nor amending the legislation to fix the problem.

I decided that, rather than speculating, it would be fairer to the government and more helpful for injured workers if I simply asked Kevin Flynn, the Minister of Labour, about the issue.

In this post I provide readers a copy of our correspondence, and my commentary on it. Continue reading

PTSD update: good news and very bad news

In late February, the Ontario government announced that it is going to change the Workplace Safety and Insurance Act “to create a presumption that PTSD diagnosed in first responders is work-related.” The draft legislation hasn’t been released yet, but the government promises that it will “allow faster access to WSIB benefits and timely treatment, ultimately supporting positive recovery outcomes.”

This is, without doubt, good news for emergency response workers who develop PTSD, as it removes their cases from the WSIA’s exclusionary mental stress provisions, and treats their illness as an bona fide occupational disease.

However, the proposed amendments are carefully restricted to PTSD, so that emergency response workers who develop any other disabling mental illness (e.g. depression) will be left out in the cold. Worse still, the announcement implies that the government has no intention of providing any relief to other kinds of workers who develop a mental illness as a result of their work, who continue to be barred from claiming WSIB benefits. Continue reading

Who’s paying down the WSIB’s unfunded liability?

Elizabeth Witmer and David Marshall recently wrote an opinion piece in the Financial Post, in which they lauded the reduction in the WSIB’s unfunded liability under their leadership, asserting that it was achieved “all the while maintaining benefits for injured workers.”

Injured workers, and people who work with them, don’t believe that for a second: it’s clear to us that injured workers are effectively paying down the unfunded liability through denials of or reductions to benefits. I wrote a letter to the Financial Post’s editor, which I hoped would be published, but (imagine!) it was not. So here it is, for readers of my blog.

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