04/12/2018
Narrative of Mr. L - WSIB Matter
The following summary of Mr. L’s WSIB claim, is a disturbing narrative which highlights the essential deficiencies in the adjudication process of the WSIB, and may be of interest to you.
In March 2004 at the age of 22, Mr. L was a construction worker who was severely electrocuted at work, after only one week of employment. At the time he was injured, Mr. L was earning $1,000.00 gross per week. However, the WSIB has stated his earnings are $342.00 per week. The reason for this WSIB determination was that the Accident Employer, 12 years after the accident, said workers like Mr. L, only work from June to September each year. However, as one can see from the above, this contradicts the fact the Worker started work in March!
The Worker did not understand the WSIB’s Decisions, and did not appeal the earnings decision, due to his cognitive deficits from the accident. Additionally the Worker’s right to appeal this decision was refused. The Worker’s lawyer spent 7 months in the Appeals process, to secure the Worker the right to appeal the decision. The calculation of the Worker’s pre-accident earnings is now currently before the Appeals Services Division.
The WSIB routinely imposes strict time limits, which are the shortest legal time limits in the Western World (let alone Canada). The uneducated and mentally suffering injured workers cannot meet these time limits, and thereby the WSIB defeats a worker’s ability to appeal decisions.
Following the work accident, the Worker was given psychological treatment for 10 years. According to law, s.44 2.1 of the Workplace Safety and Insurance Act (WSIA), the Worker’s full LOE entitlement should have been locked in by 2011, and the Worker should have been paid full LOE to age 65, unless he was involved in: retraining, health care measures, or early and safe return to work communications with the Accident Employer. As the Worker was receiving medical treatment when the lock in was to be done, the WSIB deferred the lock in. According to the law, the lock in could only be deferred for up to 24 months following the lock in deadline. This is where the WSIB violated the section of the WSIA and law, as the WSIB did not lock the Worker within 8 years from the date of his accident.
However given the passage of time, surely by 2013, 10 years post accident the worker’s benefits should have been locked in and he should have been saved from the following:
The Worker’s benefits are terminated in 2016, which is explained below.
After treatment at Homewood in 2014, the Doctors there determined that the Worker’s depression was in remission, but were worried the Worker may regress. The WSIB Case Manager interpreted this to mean that the Worker no longer had depression. It was further suggested the Worker have intense and continuous psychiatric treatment, while he participated in the Work Transition Process. Such treatment was not available from Homewood, and the Worker received no treatment while in his Vocational Retraining.
The point to note from the above is two fold:
The WSIB routinely misinterprets medical doctors, to allow the WSIB to refrain from considering the injured worker’s complete disability. Additionally, the WSIB routinely provides inadequate psychological support.
The career of Office Clerk is chosen for the Worker by the WSIB. In June 2015, the Worker began the retraining program consisting of: academic upgrading, computer training and file clerk training (such as Quick Books), and it lasted one year. The duration of the program was extended several times, due to the Worker’s slow progress. Complete, verifiable, and independent testing was not done, to determine whether the Worker completed all the modules of the retraining program. The testing that was done was not accurate, because the Worker was assisted in answering the questions of the tests by his teacher (according to the Worker).
The WSIB does not routinely monitor the efficacy and quality of Return to Work Vocational Training.
The Worker was given a subsidized placement for 6 weeks at Shoppers Drug Mart, where he was to work 6 hours per week, in order to learn the job of office clerk. Instead the Worker spent the entire time of the placement stocking shelves, and learned no clerking skills, nor did he thereby advance his resume.
The WSIB routinely provides completely inadequate on the job training, to allow an injured worker the skills and resume background, that will make an injured worker employable.
In July and August of 2015, the Worker worked with March of Dimes to find an office clerk job. No such job could be located, so March of Dimes located a factory assembly line job for the injured worker, which involved physical labour. This job of factory labourer was not deemed acceptable by the Vocational Assessors retained by the WSIB (1644), because the Worker has chronic back and leg pain.
The WSIB routinely ignores the professional opinion of its own vocational assessors, in order to expedite terminating injured workers from benefits.
Five medical experts retained by the WSIB indicate the Worker has chronic pain in his back and leg, on a psychological basis on account of the work accident, which originally involved back and leg trauma.
The above noted 5 medical experts were ignored by the WSIB’s Case Manager, on the basis the Worker’s psychological problems were accepted under cognitive difficulties category, and thereby bypassed any consideration of psychological chronic pain, because a Pension can be awarded for only one or the other (and not both).
The WSIB routinely uses technical arguments, to ignore the true merits of the universal disability suffered by the injured worker.
The Worker did the factory job for 6 weeks, but in October of 2016 he was unable to continue. He has received no benefits from the WSIB since, and it took the Worker’s lawyer 16 months to arrange a Hearing to review of the WSIB’s decision making. The results of same are currently pending.
The WSIB Appeals Process is lengthy, and procedurally more resembles a Court procedure than an expedited opportunity to have the Worker’s argument heard.
Thus we have 9 patent defects in WSIB adjudication illustrated in Mr. L’s claim. The conclusion I draw is that a wholesale change of case management needs to be made at the WSIB.
