Why a GTA woman is still fighting the WSIB for help a decade after her sister fell ill

As the director of internet marketing for a major hotel chain, Cynthia Vossah regularly flew long distances for work.

On July 11, 2011, a blood clot in her lung led to two heart attacks. It took paramedics 20 minutes to resuscitate her and she was left in a chronic vegetative state.

Over the past decade since, her sister Francine Vossah, and mother Ruth Vossah told CBC News they've had to quit their jobs and become full-time caregivers and advocates for Cynthia.

But more than 10 years after her sister's injury, Francine said she's still fighting the Workplace Safety and Insurance Board (WSIB) to modify her home so she can properly care for her sister while Cynthia is confined to a hospital bed set up in the family's living room.

"It's utterly ridiculous," said Francine. "There's no question about the claim, there's no question about her injury, yet simple things are becoming very difficult and time is stretching beyond what we think is fair."

A decade-long fight

In 2013, the WSIB was in discussions with the family to pay for home modifications so that Cynthia could live with Francine rather than in hospital. Francine said the WSIB told her that her apartment, which she rented, could not be modified. So Francine bought a two-storey house in Stouffville, Ont., about 50 kilometres outside of Toronto. They envisioned the unfinished basement as Cynthia's space.

But shortly after they closed the deal on their home, the WSIB said Cynthia should remain in hospital, where she had been since 2011, and the board would not pay for the modifications to the basement, including an accessible shower, bedroom, and elevator to the main floor.

In 2016, Cynthia was finally moved from hospital into Francine's house, and the following year, Francine took the decision to the Workplace Safety and Insurance Appeals Tribunal, which arbitrates disputes between workers and the WSIB. The tribunal ruled that it was reasonable for Cynthia to be cared for at home and the home modifications should proceed.

But the WSIB denied the family's basement modification proposal because it said the space was not accessible in the event of an emergency, according to documents reviewed by CBC Toronto. The WSIB wanted to make modifications to the main and second floor instead.

Then, when the WSIB's original main- and second-floor plan was eventually scrapped because it determined it would not meet Cynthia's needs, Francine said the board proposed an entirely new addition to the main floor of the house instead of a basement refinish like the family wanted.

That proposal runs counter to the WSIB's own policy on home modifications, which states that "wherever possible home modifications will be applied to existing structures."

"It's really unfortunate," said Francine. "We've been waiting for the board to do what we know the legislation, the law, the policies do."

Cynthia Soda, the designer who created the Vossahs' basement proposal, said having a proper space to care for their sister is about making the family's job easier and helping Cynthia feel more comfortable.

"The biggest thing is to create a space for her where she can heal properly and get some semblance of her life back," she said.

Francine filed a second appeal with the tribunal. It ruled in her favour and directed the WSIB to work with Francine and her mother to finish the basement space.

The WSIB did not respond to specific questions about Cynthia Vossah's case, but said it is currently "implementing" the most recent tribunal decision. The board told CBC News that it makes "every effort to provide necessary services, support and benefits as quickly as possible," but that in some cases "it may take longer than any of us would like."

The WSIB has been paying Cynthia's salary since the injury.

The 'ping pong effect'

Kathrin Furniss, a lawyer and advocate with the Injured Workers Community Legal Clinic, said when claims go to the appeals tribunal, it can take years before workers receive any compensation. Even after a favourable ruling, the WSIB and workers may have other disagreements, and it goes back to the tribunal. She calls it the "ping pong effect."

"I'm not entirely shocked," she said. "They want to save money, have control, not be worker-centred."

She said workers need documentation to prove everything, meaning many trips to doctors, psychologists or occupational therapists. These trips often create mental health issues on top of everything else, which then need further assessment.

"It is very stressful for workers to deal with the appeals process and to be continually re-traumatized," she said. "So they just end up giving up."

Gearing up for another appeal

Francine and Ruth are preparing to go back to the appeals tribunal for a third time. They claim the WSIB is not compensating them properly to provide Cynthia with adequate care.

An assessment from an occupational therapist found that Cynthia needs medical care 24 hours a day, seven days a week from both a registered practical nurse and a personal support worker (PSW), totalling 48 hours of paid help per day.

The WSIB only compensates her for 28 hours per day.

The WSIB would not answer a question about why it only agreed to 28 hours of care payments, and in an emailed statement, a spokesperson for the WSIB wrote that it does "not object to sharing claim documents, including design drawings, once the WSIB has had an opportunity to review them."

"There needs to be someone to make decisions about her medications, to interpret the vitals, interpret what's happening to her, and that's just not happening right now," said Francine.

Francine also said the WSIB has hired its own construction firm to build out the basement, and has stopped consulting her and her mother on the renovations. She told CBC News they're breaking ground on their own renovations out-of-pocket soon, because they're confident the WSIB will eventually be paying for them.

"Follow the [Workplace Safety and Insurance Act]. Provide the 24-hour nursing, 24-hour PSW and the home modifications that the Act says that an injured person at this level is entitled to," said Francine.

"That's all that we're asking for."

For more stories about the experiences of Black Canadians — from anti-Black racism to success stories within the Black community — check out Being Black in Canada, a CBC project Black Canadians can be proud of. You can read more stories here.