WSIB's 'devastating' compensation policy all about board's bottom line, lawyers charge
Some injured workers have had benefits cut by half since pre-existing conditions policy came into effect
Lawyers who represent people injured on the job in Ontario say a new policy introduced by the province's Workplace Safety and Insurance Board is having a "devastating" effect on their clients, and accuse the board of unfairly cutting injured workers' benefits in order to meet its own financial demands.
As CBC News reported Tuesday, injured Lanark County paramedic Dan O'Connor says he fears losing his home after the board slashed his benefits by half. O'Connor was ordered to resume a transitional training course despite debilitating back pain that makes it difficult for him to commute or sit in a classroom.
O'Connor's case has shed light on what many of those who deal with the board are characterizing as a larger, systemic issue: they claim the WSIB routinely blames pre-existing medical conditions for exacerbating workers' injuries, using that as an excuse to slash their compensation.
"It's ridiculous," said retired lawyer Ron Ellis, who served for 12 years as chair of the board's appeals tribunal.
I think we should be ashamed of the system. You have some of the most vulnerable people in our society being victimized by a corporate structure.- Ron Ellis, former chair of the WSIB's appeals tribunal
"It's a very large reduction in benefit entitlement with no change in the legislation," Ellis said. "I think we should all be ashamed of the system. You have some of the most vulnerable people in our society being victimized by a corporate structure."
Following a report by Ontario's auditor general showing the WSIB was short billions of dollars, the province ordered the board to clean up its financial mess before it jeopardized workers' benefits
In 2011 the WSIB's unfunded liability — the amount by which its future payment obligations exceeded its bank balance — hit an unsustainable $14 billion. Getting out of that financial hole required "radical and rapid steps," according to an independent report commissioned by the province.
Since then, the board has managed to reduce its liability to $5.6 billion, setting it six years ahead of schedule in its mandate to get in the black by 2027.
Board hired American consultant
In 2012, the board hired Hawaii-based consultant Dr. Christopher Brigham, paying his firm nearly $100,000 to review its policy on permanent impairment and create a tool to help staff rate cases.
According to the report submitted by Brigham and Associates, best practices within the industry "clearly identify that impairment due to an injury must be differentiated from impairment due to other health issues, including degenerative processes associated with aging or other pre-existing conditions."
Around the same time — and perhaps even earlier — lawyers who represent injured workers say they started noticing a dramatic shift away from a long-accepted principle known as the "thin skull rule."
Thin skull rule
The rule dictates that workers with thin skulls should be treated no differently than workers with normal skulls when bricks fall on their heads. The thin-skulled worker will suffer worse injury, but shouldn't be denied compensation just because their fragile cranium is a pre-existing condition.
It undermines the very core of the workers' compensation system. The results have been really devastating.- Maryth Yachnin, lawyer
Maryth Yachnin, a lawyer with the Industrial Accident Victims Group of Ontario, said the shift away from the thin skull rule began well before the board updated its official policy in 2014.
"They started cutting permanent impairment awards by half," said Yachnin. "[Workers are told], 'If you're still injured it's because you're older, you have pre-existing degenerative conditions, so we don't have to pay you anymore.'"
But the policy doesn't make sense, Yachnin insists, because in most cases the workers were able to perform their jobs without any problems — until they were injured.
"It undermines the very core of the workers' compensation system," said Yachnin. "The results have been really devastating."
'There's no malice here'
"There's no malice here. What we're trying to do is be fair, follow our policies and make the best decision possible," said John Genise, the board's director of service delivery in Ottawa. "The policy provided us with a little more guidance and rigour around how to approach those cases."
The board rejects the accusation that the policy was really about saving money. Nor is the WSIB's improved financial outlook the result of any one policy change, Genise said.
"There's a multitude of factors, from what I understand, that have put us in a better financial situation," he said, including a drop in the number of claims across Ontario, an early intervention approach that gets workers back on the job sooner and financial gains earned by the board's investments.
Class-action lawsuit
Nevertheless, Toronto lawyer Richard Fink launched a multimillion-dollar class-action lawsuit in 2014 against WSIB on behalf of injured workers who had their benefits cut due to pre-existing conditions.
An Ontario judge dismissed the case in July 2015, but Fink appealed. The case was heard Sept. 16 and he and his clients await the decision.
Retired lawyer Ron Ellis said the public often doesn't care about WSIB cases because there's a widespread perception that workers are abusing the system. He said in his experience, they form a small minority.
"I think it's true that the public has had very little sympathy with injured workers ... until it becomes their father, wife or daughter," said Ellis. "It's a system that we totally depend on and it's been totally undermined, and it's upsetting."
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