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.

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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