For workers, the wins in Bill 105 are a Trojan horse—and the surprise inside will degrade worker protections for decades to come

Since it was elected in 2018, the Ford government’s approach to the WSIB has heavily favoured employers, reducing premiums by a cumulative amount of $18.6 billion while paying out employer rebates of $1.5 billion in 2022 and $2.5 billion in 2025.

Recently, a government announcement made it seem that the pendulum was finally swinging towards workers: it promised new legislation that would increase wage loss benefits from 85% to 90% of a worker’s pre-injury earnings, and would loosen the strict age-related cut of benefits to compensate older workers who, but for their injury, would have worked beyond age 65.

But as soon as the text of Bill 105 was published, we saw that the swing toward workers was an illusion.

In exchange for the changes favorable to workers—which, as we will explain, are not all they are cracked up to be—Bill 105 makes fundamental structural changes to the compensation system that will seriously degrade the protection it provides workers, allowing the WSIB to supervise disabled workers’ lives until they reach age 65, and imposing an effective marginal tax rate of 100% on any other benefit or income that a permanently disabled worker has the temerity to receive before they turn 65.

The outside of the Trojan horse

The outside of the Trojan horse is made up of apparently positive changes for workers, which induced some labour groups issue statements supporting the legislation before it was published. Let’s examine those changes now.

The first and best of the two changes is an increase in rate of Loss of Earnings benefits, which are currently set at 85% of a worker’s pre-injury net average earnings. Bill 105 increases the rate to 90%.

But before we applaud the government for its benevolence, we should recall that this change is just restoring benefits to the original level set when the wage-loss system of workers’ compensation came into effect. That reduction happened in 1998, and was imposed to control the unfunded liability, which largely arose from a decade of freezing and reducing of employer premiums, and the “off-balance” of the WSIB’s experience rating schemes.

So, positive as that change may be, Bill 105 is not an amazing step forward for working people, as the government announcement would have us believe. It’s more a situation where a burglar steals your children’s gifts from under the Christmas tree, returns them to you on Christmas day twenty years later, and somehow expects to be celebrated as Santa Claus.

Except it’s worse than that, because Bill 105 doesn’t give back everything that was taken from workers in the first place (for example, the contribution to the retirement benefit was halved in 1998 and not restored by Bill 105). Turns out our burglar returned some of the gifts and kept rest for himself. Merry Christmas.

The second of the two positive changes relates to the age-related cut-off to LOE benefits. Unfortunately, the benefit of this change is largely illusory for workers, and manifestly self-serving for the government.

By way of background, the current Act provides that wage-loss benefits must cease when a worker turns 65 (or, if the worker is 63 years or older on the day of the accident, two years after the accident occurs).

That age cut-off causes significant hardship for low-wage workers, and newcomers to Canada, who don’t have sufficient savings or pension contributions to retire at age-65, and who therefore would, but for their injury, have continued working into their late 6os and 70s. Our current system doesn’t compensate these workers for the true extent of their loss.

But Bill 105 isn’t a meaningful solution to this inequity. It leaves everything important to the discretion of the WSIB in individual cases. We predict that the number of workers who benefit from these changes each year will be counted on the fingers of one hand—while at the same time the government has insulated the legislation from an age-discrimination Charter challenge.

The inside of the Trojan horse

The inside of the Trojan horse—the provisions of Bill 105 that were not announced and came as a nasty surprise to worker groups—are two sets of amendments that degrade the protection that the WSIA provides permanently disabled workers (in other words, the most vulnerable people in our compensation system).

The first is a major structural change: the elimination of the statutory “lock-in” of benefits, to be replaced by regulations that will enable the WSIB to supervise workers right through to age-65.

Under the current Act, the WSIB can review a worker’s wage loss benefits on an annual basis, and whenever it decides there is a “material change” in the worker’s circumstances, during the first six years of a worker’s claim. These reviews can result in a reduction or termination of benefits (for example, if the WSIB decides the worker is now capable of working, or if the worker starts receiving Canada Pension Plan disability benefits). However, the current Act says that the WSIB may NOT conduct such a review if more than 72 months have passed since the date of the accident. We call the 72-month mark the “lock-in date,” and the worker is assured that whatever benefits they are receiving at the time of the lock-in will continue until they reach age-65, indexed for inflation.

The lock-in is an important, original structural component of our current wage-loss system, which replaced life-long permanent disability pensions in 1990. It gives the WSIB and employers plenty of time (six years!) to assist workers with their recovery and vocational rehabilitation (and even allows for a two-year extension if such activities are still happening at the 72-month mark). But, like the PD pension it replaced, the lock-in recognizes that some workers’ injuries leave them with life-changing, life-long disabilities. It protects those workers by finalizing their entitlement under their claim after 72 months, which gives them financial stability, allowing them to plan their lives, knowing that they can rely on receiving a set amount of compensation from the WSIB until they reach age 65. The adjudicative finality relieves them of the psychological stress of being subject to the WSIB’s scrutiny and having to satisfy the demands of WSIB staff in order to maintain their income. In short, the lock-in allows permanently disabled people to move forward with their lives, despite their difficult circumstances.

Bill 105 will strip all that away. It removes the lock-in protection from the legislation, and allows for regulations that would in turn empower the WSIB to conduct both regular reviews (limited only by an undefined “prescribed frequency”) and “material change” reviews (which are entirely unlimited) for years, even decades, after the injury.

Workers will be continuously subjected to the WSIB’s scrutiny and will have to report any changes in their health, or income from other benefits or from working, until they reach age 65. Their benefits could be reduced or terminated by the WSIB as a result of any one of these reviews, all the way to age 65. There will be no finality, and no stability, for permanently disabled workers under the Bill 105 regime.

The second change is a cap on the total amount of income a worker can receive from the WSIB and non-WSIB sources throughout the life of their claim. The cap is set at 100% of the worker’s pre-injury net earnings, and the other sources of income that the WSIB must consider (which will be set by regulation) will include payments made “under another Act or an Act of Canada” and “payments made… by, or on behalf of, the worker’s employer.”

In practice, that means that once the worker’s other income makes up the difference between LOE benefits and their pre-injury net income, their LOE benefits will be reduced dollar for dollar to ensure they receive not a penny more than earned before their injury. That’s effectively a marginal tax rate of 100% (a rate that no wealthy people in this province have ever been subjected to, but which is all too familiar to the Ontarians on ODSP).

The new cap is grossly unfair. It will mean that WSIB benefits, which are supposed to compensate for employment earnings lost as a result of a work injury, could be reduced when an injured worker receives a benefit that is neither employment income nor intended to compensate their injury. For example:

  • If a 60-year old worker, to make ends meet, decided to take his CPP retirement benefits or an employment pension early, those payments would be deducted from WSIB benefits—even though pensions are the workers’ savings, and not employment income.
  • If a worker were to receive government benefits aimed at assisting with raising children or to affording housing, those payments could be deducted from the WSIB benefits, even though those support programs have other objectives and are not compensation for the workplace injury.

The new cap on income works hand in glove with the removal of the lock-in. The receipt of any new source of income will be considered a “material change” that must be reported to the WSIB, so that benefits can be reduced accordingly, regardless of how many years have gone by since the injury occurred. There can be no getting ahead financially if you were permanently disabled by an accident at work.

The government has offered no public justification for these changes. The sad truth is that they’re another instance of government policy being captured by the owners of capital (employers) to advance their interests over those of ordinary people, fuelling the growth in inequality rather than reducing it. In summary:

  • Permanently disabled workers—largely people who are living close to, or in, poverty—will be subject to continuing WSIB scrutiny, and any attempt to better their situation will be met with a reduction of benefits.
  • Meanwhile, employers will continue to enjoy their half of the historic bargain (immunity from workers’ lawsuits) at discount prices, with ongoing premium reductions and multi-billion dollar rebates paid to them out of the insurance plan.

It’s not too late to stop this. Call and email your MPP and the Minister of Labour. If you’re in a union, talk to your union reps. Make contact with advocacy groups who are organizing around this, and join in their activities. Take action!

A letter to Ontario’s Attorney General, Doug Downey

The Ford government has imposed massive cuts to the funding of legal aid, which will cause serious hardship and disruption throughout Ontario’s legal system.

Injured workers will be hit particularly hard. Three Community Legal Clinics that do vitally important work for injured workers have had their (already incredibly lean) operating budgets cut by 22 to 30%, and new rules have been imposed on the kind of advocacy work they’re allowed to do with their remaining funds.

I’m one of a group of private-bar lawyers who wrote to Attorney General expressing our concerns about this terrible situation. Our letter is below (or you can read it as a PDF).

 

July 23, 2019

 

Hon. Doug Downey, Attorney General
Ministry of the Attorney General
11th Floor, 720 Bay Street
Toronto, ON M7A 2S9

 

Dear Mr. Downey:

RE:      Restoring funding to legal aid

Congratulations on your appointment as Ontario’s Attorney General.

We’re writing about the most pressing issue before you: the cuts to legal aid imposed by your predecessor, Ms. Mulroney.

Reversing the cuts should be your top priority as Ontario’s chief law officer, responsible for the administration of justice in our province.

Who we are, and why we’re writing to you

We’re a group of six private-bar lawyers who practice workers’ compensation law.

None of us are employed by, or receive money from, Legal Aid Ontario. But we have close ties to the Community Legal Clinic system, and we understand the impact that the cuts to legal aid will have on ordinary people in Ontario.

We want to make you aware of that impact too.

More specifically, we want to make you aware of the devastating impact that the cuts will have on three Clinics that have been publicly identified by Legal Aid Ontario as “worker-focussed” and targeted for especially deep cuts accordingly.

The clinics are the Injured Workers Community Legal Clinic (IWC), the Industrial Accident Victims Group of Ontario (IAVGO) and the Workers’ Health and Safety Legal Clinic (WHSLC).

The cuts and their immediate effects on client service

The cuts to the three clinics are substantial. IWC and IAVGO have had their operating budgets cut by 22%, and WHSLC by 30%.

While other clinics were given two years to absorb their budget cuts, the three worker-focussed clinics’ cuts were imposed in full retroactively to April 1, so the impact on their ongoing operations for the remainder of 2019 is especially severe.

To cope with the cuts, IAVGO’s staff voluntarily took a 20 percent cut in their pay and the time they spend working. IWC is laying off four of its ten staff. WHSLC, which suffered the largest cut, will obviously have to reduce staff too.

Because of their reduced capacity, all three clinics are no longer taking on new clients.

So, as result of the cuts, the clinics find themselves turning away disabled people who desperately need legal help but cannot afford a lawyer. Some of these people will go to the Office of the Worker Adviser, which has long waiting lists for service, further drawing out their hardship. Others will give up on the WSIB and end up living in poverty on OW or ODSP benefits — thereby transferring responsibility for their disabilities from employers to Ontario’s taxpayers.

That shouldn’t be acceptable to a government “for the people.”

New restrictions on the use of funds and how they stack the deck against ordinary people

When it cut their budgets, Legal Aid Ontario imposed a new restriction on how the three clinics may use their remaining funding: they have to spend all their money on individual clients’ cases, and are not to spend a penny of their funding on broader advocacy.

That means that the clinics can no longer do important law reform work that benefits thousands of ordinary people, like advocating for policy changes at the WSIB, participating in public consultations, or making submissions to select committees and the government about changes to legislation.

That’s going to leave a huge gap, with no one to represent the interests of ordinary people and counterbalance the lobbying done by the well-funded business lobby.

Lawyers in private practice, like us, do our best to contribute to this kind of work on a volunteer basis, but there’s a limit to what we can do. Only paid Community Legal Clinic staff can put in the work necessary to ensure the voices of ordinary people are heard — and now they cannot do it.

Again, that shouldn’t be acceptable to a government “for the people.”

What we’re asking you to do

We ask you to immediately reverse the cuts to legal aid and remove the new restriction on the clinics’ use of funds.

Doing so should be a matter of honour for you:

  • As Attorney General, whose role includes safeguarding the administration of justice in our province
  • As a member of the Progressive Conservative party, who promised to govern “for the people,” and
  • As a recipient of the Sam Delmar Award, which we understand is given to lawyers who share the qualities possessed by Sam: dedication of effort, humility and courage.

We trust you will respond to our letter quickly, setting out your plan to restore the funding to legal aid and strengthen the Clinics’ ability to help ordinary people.

Yours sincerely,

 

PETER BIRD
Workplace One Complex
340 King Street East, 2nd floor
Toronto, ON M5A 1K8
bird.peter.d@gmail.com

 

MICHAEL GREEN
103-1415 Bathurst Street
Toronto, ON M5R 3H8
mgreen@workerscomplaw.ca

 

JACQUELINE KOTYK
302-658 Danforth Avenue
Toronto, ON M4J 5B9
jacqueline@asingletonlaw.ca

 

ELLEN LIPES
2000-393 University Avenue
Toronto, ON M5G 1E6
elipes@wsiblaw.ca

 

GARY NEWHOUSE
103-1415 Bathurst Street
Toronto, ON M5R 3H8
gnewhouse@sympatico.ca

 

ANTONY SINGLETON
302-658 Danforth Avenue
Toronto, ON M4J 5B9
antony@asingletonlaw.ca

 

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Chronic mental stress update: IAVGO publishes the details on the 94% denial rate

Last week I published a post (Ontario: open for harassment) commenting on the revelation, in the Toronto Star, that during the first five months that the chronic mental stress the legislation was in effect, the WSIB denied 94% of CMS claims.

The Star article was based on information from an internal WSIB audit of adjudication under its chronic mental stress policy.

That internal audit was obtained by IAVGO Community Legal Clinic as part of a freedom of information request.

IAVGO has now made the WSIB’s full audit document available on its website, along with an excellent analysis of its contents, written by IAVGO lawyer Maryth Yachnin: “Adjudication of Chronic Mental Stress Injuries by the WSIB: A Farce, But We’re not Laughing.

The details of the audit are just as disturbing as the headline number of denials. As IAVGO explains, the audit shows that, in the great majority of cases, the WSIB is doing little, if any, investigation of circumstances that gave rise to the claim – or even gathering basic medical evidence.

Indeed, the details of the audit thoroughly justify IAVGO’s conclusion that:

“The WSIB is not treating chronic mental stress claims as real injuries. It is failing to do basic investigations, gather documents, or investigate complex workplace risk factors for mental health injuries. The result is the near-total exclusion of workers with mental stress injuries from health care, return to work and compensation support when they are hurt on the job.”

I encourage you to visit IAVGO’s website and read IAVGO’s analysis, and obtain a copy of the WSIB’s audit, for yourself!

Ontario: open for harassment

This week the Toronto Star revealed an internal WSIB audit showing that, in the first five months of the year, the WSIB denied 94% of claims for chronic mental stress.

That’s a bombshell revelation. Without urgent reform, the WSIB will turn a significant human rights victory for Ontario workers into a major step backward, leaving them more vulnerable than ever to harassment in the workplace. Continue reading

What’s the purpose of the entitlement presumption? There isn’t one, if we fail to tell the WSIAT about it.

Recently I revisited a WSIAT decision from last December whose interpretation of the “entitlement presumption”—a fundamental principle of workers’ compensation law—caused consternation among worker advocates when it was first released.

It’s a case that’s still worth discussing, not just because of the importance of the “entitlement presumption,” but also because we can draw a broader lesson about advocacy from it. Continue reading

The reward for paying down the WSIB’s unfunded liability? Permanent austerity, if you’re an injured worker.

With great fanfare (including breathless tweets) the WSIB announced it has eliminated its unfunded liability, ten years ahead of schedule.

But the fanfare didn’t end there. We also learned who would enjoy the dividend of full funding: employers, who received a massive reduction in premiums: 29.8% on average, amounting to almost $1.5 billion per year.

Our new Minister of Labour celebrated this cut as “just one part of our plan to lower taxes, reduce the regulatory burden, protect and grow jobs, and send a message to the world that Ontario is open for business.” For workers, she had nothing to offer but an anodyne assurance that “workers and their families” can now have “peace of mind” the WSIB will pay them the benefits they’re entitled to under the law.

That the Minister could so openly disregard workers and celebrate giving the entire dividend of full funding to employers is testament to the way employers have captured the narrative about the unfunded liability (UFL). Continue reading

Reminder: the deadline for filing 2014-2017 mental stress claims is July 1, 2018

Recently I blogged about the transition rules for the new mental stress provisions in the Workplace Safety and Insurance Act.

One of the transition rules allows workers who sustained a mental stress injury before January 1, 2018, to file a claim and have it adjudicated by the WSIB under the new mental stress provisions, provided that

  • You have not filed a mental stress claim before, and
  • Your injury occurred on or after April 29, 2014.

The limitation date for filing those claims is almost upon us: the deadline is July 1, 2018. Continue reading

A plain language guide to the mental stress transition rules

[Note: this is a slightly revised version of a paper I presented to the OBA Workers’ Compensation Section’s 2018 annual conference, A New Era in Workplace Safety and Insurance Law.]

In 2017, the Ontario government removed the bar against mental stress claims under the WSIA, replacing it with a new provision ex­press­ly allowing workers to claim benefits for mental stress injuries.

These amendments came into force on January 1, 2018, but they also have a limited retroactive effect. The government enacted a set of transition rules setting out how the WSIB and the WSIAT will deal with the claims and appeals of workers who suffered a mental stress injury before January 1, 2018.

The transition rules are written in dense technical prose. This post is an attempt to untangle them and explain them in plain language. Continue reading

The WSIB’s internal documents on adjudicating mental stress claims

We entered a new era in the compensation of work-related mental disorders on January 1st this year:

After less than five months of the new regime, I still don’t know a great deal about how the WSIB is applying these policies in practice.

To increase my understanding, in April I made a freedom of information request for all of the WSIB’s internal documents giving its decision-makers advice, guidance or direction about adjudicating claims under the new policies.

In May, the WSIB granted my request, and disclosed over 400 pages of documents.

I haven’t had time to go through the material in detail yet. When I do, I’ll  publish a post (or two) analyzing the most important documents.

However, I want to make the documents available immediately to any injured worker or advocate who may be interested in them. Therefore, I’ve bundled them into a .zip file which you can download by clicking this link. (Note: it’s a 19 MB file that downloads automatically.)

Enjoy responsibly!

This blog contains general information and should not be relied on as legal advice in an individual case. If you need advice about a WSIB claim or appeal, please visit the website of my law office, asingletonlaw.ca, and book a consultation.

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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.