CONTENTS
Thursday 16 September 1993
Workers' Compensation Board
Odoardo Di Santo, chair
Sam Van Clieaf, senior vice-president, client services
Linda Angove, project director, long-term facilities strategy and board secretary
Linda Jolley, senior vice-president, strategic policy and analysis
STANDING COMMITTEE ON GOVERNMENT AGENCIES
*Chair / Présidente: Marland, Margaret (Mississauga South/-Sud PC)
*Vice-Chair / Vice-Président: McLean, Allan K. (Simcoe East/-Est PC)
*Bradley, James J. (St Catharines L)
*Carter, Jenny (Peterborough ND)
*Cleary, John C. (Cornwall L)
*Curling, Alvin (Scarborough North/-Nord L)
Frankford, Robert (Scarborough East/-Est ND)
Harrington, Margaret H. (Niagara Falls ND)
Mammoliti, George (Yorkview ND)
*Marchese, Rosario (Fort York ND)
*Waters, Daniel (Muskoka-Georgian Bay/Muskoka-Baie-Georgienne ND)
Witmer, Elizabeth (Waterloo North/-Nord PC)
*In attendance / présents
Substitutions present/ Membres remplaçants présents:
Haslam, Karen (Perth ND) for Ms Harrington
Murdock, Sharon (Sudbury ND) for Mr Mammoliti
Owens, Stephen (Scarborough Centre ND) for Mr Frankford
Wilson, Gary (Kingston and The Islands/Kingston et Les Îles ND) for Mr Waters
Clerk / Greffière: Mellor, Lynn
Staff / Personnel: Yeager, Lewis, research officer, Legislative Research Service
The committee met at 1340 in the Huron Room, Macdonald Block, Toronto.
WORKERS' COMPENSATION BOARD
The Chair (Mrs Margaret Marland): We're meeting this afternoon following our three-hour tour of the Workers' Compensation Board offices at 2 Bloor Street East this morning. The purpose of having the tour this morning was so that we could ask questions this afternoon. As committee members will recall, we reversed the order, on the very wise suggestion of Mr McLean.
In my rotation -- well documented, I may add, for the purposes of the committee members -- we would start with Mr McLean. Mr Mahoney finished yesterday.
Ms Sharon Murdock (Sudbury): You didn't have to go through that preamble. We trust you, Margaret, at least on that kind of stuff.
Mr Allan K. McLean (Simcoe East): Mr Di Santo, I've had a question forwarded to me by Mr Runciman from Leeds-Grenville, and I want to read it so you'll have an opportunity. It's in regard to the scheduled workers' compensation assessment rate increases recently levelled at Ontario's homes for the aged.
"Workers' Compensation Board rates for this sector are to increase from $2.15 to $6.04 per $100 of payroll in 1994. For St Lawrence Lodge, a home for the aged located in the riding of Leeds-Grenville, the impact will mean that WCB contributions for the lodge will exceed $200,000, with no additional offsetting funding. This represents 3% of the lodge's operational budget or the equivalent of the salaries and benefits of five full-time workers. Ironically, the same day that officials at St Lawrence Lodge learned of the rate increase, the facility received an award from the Care-Givers of Ontario Safety and Health Association for achievement in accident prevention. The lodge is considered to be in the top 10% of Ontario hospitals, nursing homes, homes for the aged, for the least amount of lost-time injuries.
"Could you explain how the scheduled Workers' Compensation Board rate increases were determined for the homes for the aged sector, and do you actually reflect the past injury record of individual facilities such as the St Lawrence Lodge?"
Mr Odoardo Di Santo: I am at a disadvantage because I don't know the specifics of the case raised by the honourable member, so I have to ask you to give me that case and I will look into it. Your question was whether the rate reflects the performance?
Mr McLean: They've had a Care-Givers of Ontario Safety and Health Association achievement award.
Mr Di Santo: What the board of directors has done in the last two years is develop a new revenue strategy. We had 109 rate groups in Ontario, and employers were in those 109 groups. Of course, there wasn't a homogeneous match, because there were in the same group employers with a different level of risk but they were nevertheless paying the same rate. The board undertook a very large review of the revenue system and in 1991 approved a new system by broadening the number of the rate groups from 109 to 219.
The next question that was asked was that many employers would be moved from one group into another; for some of them there would be a sharp increase in their rates because the new group where they went was paying more, or some would experience a rather sharp decline.
Mr McLean: I understand that. I guess the bottom line of the question is, are the rates going to increase from $2.15 to $6.04 as of 1994?
Mr Di Santo: I have to look into that, because the budget we approved last year was basically that we would increase by 3% or decrease by 3%, no more than that. I have to look at this particular case.
Mr McLean: I find this rather difficult, because as we're aware, the last budget increased homes for the aged for seniors by some $372 a month, and here we are now having a substantial increase on the WCB for the homes. That's going to be reflected back on to the residents of those facilities.
Mr Di Santo: As I said, there must be some particular circumstances that I don't know. We are consulting on the 1994 rates and, as I said yesterday, we do not foresee any increase next year.
Mr McLean: But the directors have to make their recommendations by the 30th of this month, is that right? "The Workers' Compensation Board is scheduled to submit a formal recommendation to their board of directors by September 30, 1993."
Mr Di Santo: October.
Mr McLean: Oh, it's October. This letter indicates September. So you're saying there could be a change in that figure of $6.04.
Mr Di Santo: Are you talking about 1993 or 1994?
Mr McLean: In 1994.
Mr Di Santo: That has not been decided yet. Sorry, I misunderstood; I thought you were talking about 1993. No, 1994 has not been decided yet. We are consulting.
Mr McLean: "The Workers' Compensation Board rates for our sector are scheduled to increase from the current $2.15 per $100 of payroll to a 1994 target of $6.04."
Mr Di Santo: That's the target for that group. The board has decided that we will not go to the target immediately; last year, we decided that we would go gradually to the target. I don't know what the board of directors is going to decide.
Mr McLean: The indication is that there's going to be a substantial increase, in any case; that's for sure.
Mr Di Santo: That's very premature to say. There won't be a substantial increase; there will not.
Mr McLean: From $2.15 to $6.04; that's 181%.
Anyhow, I want to ask you some questions with regard to the tour we had this morning. You're quite familiar with it. On the 8th floor and the 12th floor, which we looked at, can somebody give me an indication of the staff turnover on those two floors?
Mr Di Santo: Sam will tell you that.
Mr Sam Van Clieaf: I'm Sam Van Clieaf, vice-president, client services. The staff turnover on the 8th floor and the integrated service unit on the 12th floor would probably be in the range of about 15% per year. Of that 15%, this year we would be running at about 4% or 5% where the employees actually left the Workers' Compensation Board for retirement or whatever reason, and the other 10% or 11% would be employees moving to another floor by way of promotion, transfer, that sort of internal staff movement.
Mr McLean: Could you give me an indication of the range of salary for those two floors? Would it be $30,000 to $40,000, or $20,000 to $40,000, or $20,000 to $30,000? Just a range: I don't want to know what the salary is, but it would be interesting to know what the range is that those people would be making.
Mr Van Clieaf: The range for adjudicators would be approximately $28,000 to $30,000 for a first-year adjudicator, and that would go up to about $55,000 for a senior adjudicator. There would be a comparable salary range for the various levels of vocational rehabilitation positions in the integrated service unit. In the management positions, the technical advisors and the managers, their salary range would be in the $55,000 to $65,000 range. The directors would be in the $70,000 to $80,000 range.
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Mr James J. Bradley (St Catharines): I'm in the wrong business.
Mr McLean: There was a little meeting we had this morning in that small room. To make some recommendations, I would suggest that the constituency staff perhaps have a tour such as we had, some dealing with them on a little-more-often basis, because they are our front-line workers and they're dealing with these people every day. I have a feeling that our constituency staff is just not up to speed on handling some of these cases, which would make it a lot better for our clients and make it a lot easier on our staff. I know we had some meetings here in this building last year, but seeing what I saw today and viewing what we viewed, I think it would be a real plus. I would suggest you could maybe do it in regions, too. They wouldn't all have to come to the headquarters, but I think there should be a little more communication.
Mr Di Santo: Allan, you remember that the attendance was quite overwhelming. We have in fact concentrated on training the constituency assistants, because we thought that would help both the members and us. But that's an excellent idea that we will consider.
Mr McLean: The other question I have is that yesterday you indicated that the property the new building's going to be built on is owned by the CBC.
Ms Linda Angove: That's correct.
Mr McLean: Are you getting a lease on that? Is it going to be a 99-year lease or will you own it?
Ms Angove: There is a 99-year lease from CBC to the co-owners, of which the investment fund is one of the co-owners.
Mr McLean: For how much?
Ms Angove: The ground lease is $5.25 a square foot.
Mr McLean: What would that amount to in a year?
Ms Angove: I'd have to get back to you on that. I'm sorry, I don't have that number with me.
Mr McLean: Why didn't you purchase it?
Ms Angove: It wasn't available for purchase.
Mr McLean: Just for lease?
Ms Angove: Yes. The project had already been leased by the Cadillac Fairview group when it developed the Simcoe Place project. When we tendered for projects, for design-build or existing buildings, that came in as a project that was already on leased property. But you must remember that it's a 99-year lease and our investment is in the building. Our return on investment is based on the building, not the land.
Mr McLean: So you're going to own 75% of the building.
Ms Angove: The investment fund will, yes.
Mr McLean: And who's owning the other 25%?
Ms Angove: The Toronto-Dominion Bank and the Cadillac Fairview Corp.
Mr McLean: The other question I have -- I've forgotten it. I will probably think of it again very shortly; it's slipped my mind. I know it was a very important question that had to do with the building; I know it did.
Anyhow, I think that's good for my round.
Mrs Karen Haslam (Perth): In the report of the Chairman's Task Force on Service Delivery and Vocational Rehabilitation, under B for principles, page 11, it says:
"Partnership and Accessibility.
"To ensure the success of its programs, the WCB must develop a solid, effective partnership with the stakeholder community: injured workers, employers, medical rehabilitation professionals and the board's front-line staff.
"The board must encourage and reflect stakeholder input in the development of policy."
I've been in contact with some of your stakeholders. I understand there are some questions that come out of the labour movement, and I'm interested in some of the answers. In particular, I have some information which I'd like to read and then maybe ask some questions.
"The non-economic loss provisions of Bill 162 would, if applied fairly, restore some of what was taken away by the abolition of permanent pensions. The board commissioned the largest, most scientific study of non-economic loss to test the American Medical Association's guides to impairment percentages against community perceptions of the seriousness of impairments. Over 10,000 people were surveyed.
"People surveyed did not agree at all with the AMA's percentages, especially in the area of minor to moderate disabilities. What was rated as 1% in the AMA guides was rated at 16% by the respondents. The board ignored its own survey and implemented the AMA guides anyhow."
Was this looked at seriously? It's my understanding that the workers' movement recognized some of the anomalies in the study data and suggested a compromise between the 1% and the 16%; that would have been a rating of 5%, which would have merged with the AMA schedule at about 55%. I'm asking, was this looked at seriously, and what were the criteria that made the 1% accepted over the other study? That's my first question.
Mr Di Santo: I'll let Linda Jolley, who is an expert and vice-president for policy, respond.
Ms Linda Jolley: Linda Jolley, vice-president of strategic policy and analysis. You're absolutely correct that we did a world-breaking study in terms of people's perception of what disability was. This information was provided to our board of directors, and it had asked us, especially from the employer point of view, to take it forward for peer review. They were concerned about some of the methodology that was taken; they were concerned about some of the findings etc.
I think there must have been three or four board meetings where this whole area was discussed, and it was finally decided that they would adopt right now the AMA guides but that they would reconsider this in the future. It was an issue also that I understand was put on the agenda by labour at the Premier's Labour-Management Advisory Committee, but I don't know where those discussions have gone.
Mrs Haslam: When you say you're going to look at it in the future, were there any time lines involved in that, or were you going to evaluate what you'd already put in place? What time lines were you looking at?
Ms Jolley: We're going to evaluate what we put in place. We had also been asked, as I said, to have the study peer reviewed and reviewed for methodology and accuracy etc. In fact, the 1993 AMA guides have been replaced now, so a discussion will have to take place at the board sometime in the next six months, I would suggest, about where we should go from here.
Mrs Haslam: My next question is around pensions. Those who suffer the most in the system are many of the workers who were injured previous to Bill 162 and received a pension for their disability. There are approximately 127,000 working-age pensioners, and it is estimated that 50,000 of them are unemployed. The bulk of these injured workers have pension percentages in the 10% to 30% range. If they were injured today, they would be entitled to reinstatement or rehabilitation.
My first question is, if they're on a 10% to 30% range of pension, can they not get into rehabilitation? Is there no program that allows them to examine reinstatement? Failing that, have you looked at increasing the pensions to these injured workers who were on pension pre-Bill 162?
Mr Di Santo: I think we are all familiar with the situation you are raising. In fact, there are also other negative aspects that impact on those older workers. For instance, at the time they were injured there was no possibility, as there is not today, for them to contribute towards Canada pension, so that's another negative aspect. If one of those workers was injured at age 45, when he reached age 65, his Canada pension would be much smaller because he has not been contributing from age 45 to age 65. Those workers are basically at the border of poverty because they've not been able to be re-employed because there were no provisions in law at that time. They cannot be reinstated now because reinstatement applies only to workers who were injured after January 1, 1990.
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Mrs Haslam: Is there any rehabilitative program looking at people who are already on pensions that they could take advantage of to be retrained to get back into employment?
Mr Di Santo: In terms of those 170,000 pensioners you spoke about, we have made several attempts. Especially the younger older-injury workers are those who come to us for rehabilitation, and we have tried, with not great success, for many reasons.
In many cases, as you know, you have injured workers who are immigrants who had a specific skill and worked in the construction industry. For them it becomes very difficult after many years of being unemployed to be retrained in another job, because in many cases there is not even the language skill.
I want to put the most extreme case: If we had legislation today that allowed or forced or provided for employment of people with disabilities of that kind, I think a large number of workers who were injured before 1990 could not be re-employed. The other avenue which is open to relieve those injured workers from their economic situation that, as I said, borders in many cases on poverty, and many of them are on welfare -- I think the only remedy is to try to reintegrate their package compensation.
Mrs Haslam: Are you saying that many of them cannot be retrained for work?
Mr Di Santo: Exactly.
Mrs Haslam: That's what you said. You said in terms of these people who collect a disability pension and then go to welfare and say, "This is all I've got and it's all I have to live on" -- I understand if you're saying, "We cannot retrain them; we don't have the facilities and we don't have anything to get them into rehabilitation," but what about Jobs Ontario Training, what about some sort of educational training? Are they so situated, at a 10% to 30% pension, that they cannot be retrained for other jobs?
Mr Di Santo: They cannot be retrained basically for two reasons: first, the objective reason, because the present situation doesn't allow us to retrain them; and secondly, for the subjective reason, because the further away you are from the accident, the more difficult it becomes to be reintroduced into the work pattern. In fact the board has adopted an early rehabilitation program because it is proved that if the worker is taken immediately after the accident and is brought to think about being retrained and being brought back to work, the rate of success is much higher. That's proved.
Mrs Haslam: I really find that very difficult. Let's take a look at society today, where we're talking about integrating disabled people. If we followed that thinking, then we would say, "You cannot integrate disabled people into the workforce because they've never been in a workforce and therefore they're not trainable in that workforce."
You say that a person on a disability pension, 10% to 30%, for loss of an arm, loss of a leg, is on that pension and a course is not available for them to be retrained because they've been out of work and away from the workforce too long. That would say to me that the permanently disabled person who was born with a disability could never be retrained to go into the workforce, and that is contrary to what you yourself were saying here earlier, that in the Workers' Compensation Board you were eager to bring injured workers into your workforce. I think those two things are opposite, and I'd like a clarification on that.
Mr Di Santo: No, I'm not contradicting myself. What I'm saying is that we have an objective situation where it has been very difficult; in fact, the rate of unemployment in this area is 39% among those 170,000, one of the highest rates of unemployment in the country. The major reason is that when those injured workers had an accident any time before 1990, the employer didn't have an obligation under Bill 162 to re-employ them. The board tried a number of avenues and eventually, in many cases, came to the conclusion that it was impossible to re-employ because there were not many avenues.
You are asking in absolute, theoretically, whether those workers could be re-employed. Well, I don't know; I cannot answer you. What I can tell you is that the experience we have in the system of rehabilitation is that the sooner you take the worker, the more success you have. The farther away you are from the job situation and the retraining pattern, the more difficult it becomes. But of course you can never speak in absolutes.
Mrs Haslam: Then let's go to the other side of that particular argument. I personally don't feel we should count them out and just increase the pension, but has the board ever considered indexing the pension or taking a look at the situation where they are only on a 10% to 30% disability pension? You've counted them out as being retrained and rehabilitated; they're on social assistance. This is a no-win situation for these people.
Mr Di Santo: Before I answer this question, I'd like to ask Sam to tell you the numbers. How many of those workers have come to us and, if you remember offhand, what is the rate of employment?
Mr Van Clieaf: I believe the group of injured workers you're referring to was also considered when the transition provisions of Bill 162 were introduced back in July 1989. At that time there were two subsections of the statute that were primarily designed to address that problem. It allowed for any unemployed worker who was receiving a disability pension from the board to apply to the board either for further vocational rehabilitation assistance or for a statutory amount which was equivalent to old age security. What has happened is that as these applications came into the board, each case was considered for one or the other of the provisions.
Mrs Haslam: What percentage uptake was there?
Mr Van Clieaf: In the initial startup with the applications that came in in 1989, I do not know the exact numbers, but I can give you a pretty fair estimate of totals since then.
Mrs Haslam: I'll take it.
Mr Van Clieaf: About 20,000 of these injured workers were reconsidered for vocational rehabilitation assistance on the understanding that there was a reasonable expectation that you could restore through a vocational rehab program the earnings capacity these workers had at the time of their injury. In fairness, as Mr Di Santo was saying, we have not had excellent success in actually restoring the earnings capacity of that group of workers; perhaps 15% to 20% of them were actually successful through voc rehab in returning to employment.
The other side was a much larger number of injured workers, probably in the 40,000 range, who have qualified to receive the equivalent of old age assistance. In fact, many of the 20,000, who, through best efforts by our vocational rehab people and the injured workers themselves, while the program wasn't successful, went from a full supplement and 100% benefits while with the voc rehab program, have since reverted to receive their 30% or 40% pension plus the equivalent of old age assistance. That is payable to age 65, when they would normally qualify for that benefit under the other social nets.
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Mr Di Santo: I want to say just briefly that from a rehabilitation point of view, we can do as much as we can do under the present circumstances. If we have a new legislation framework -- for instance, with employment equity, I don't know at this point how it will develop and will allow latitude for employing people with disabilities, including injured workers. Of course, there will be not only an incentive but also injured workers will seize on that opportunity.
But the real problem we have here is that despite subsection 147(4) that gives the old-age supplement to a number of those workers, and despite our efforts, the real situation is that you have a very large pool of workers who are living below the poverty line. That is a problem we cannot solve at the board. It requires a legislative change in the act. That's why I hope that the government, the legislators, will address that issue, because we cannot --
Mrs Haslam: Address the issue of employment equity? Is that what you're talking about?
Mr Di Santo: No, looking at the incomes of the older workers and the level of pensions, because right now we are stuck with a schedule we have to implement, and unless there is a legislative change we cannot do much on the level of pensions.
Mrs Haslam: Can I ask you a question? If a person is on a 30% disability pension and, through the changing culture we are living in, they are able to obtain a position with a company, what happens to their pension from WCB?
Mr Di Santo: They keep their pension.
Mrs Haslam: They keep getting it, so there is no disincentive; they won't lose that if they are able to get employment. I don't see it as a disincentive, but they will remain receiving that pension.
Mr Di Santo: Until 1990, we had one pension that compensated for both loss of income and pain and suffering, so to say. With Bill 162, we have a dual system. We compensate for wage loss and NEL compensates for non-economic loss.
Mrs Haslam: I want to go into my next question, being CPP offset. Some injured workers qualify for Canada pension plan disability pensions as well as benefits under the Workers' Compensation Act. The pre-Bill 162 legislation allowed injured workers who qualified to collect CPP disability benefits. Bill 162 gave the WCB the discretion to consider the amount an injured worker was receiving in CPP disability benefits when determining their future economic loss award. Under the previous administration, the board of directors decided to subtract the full amount of an injured worker's CPP benefits from their FEL award.
That's discouraged injured workers from applying for CPP benefits and added cost to the system. An injured worker should be entitled to at least 50% of their CPP benefits because that's what they contribute to the premiums in the first place. Can that be done? Have you looked at that and would it actually save money for the board?
Mr Di Santo: The board of directors has addressed this question on a number of occasions and has not come to a conclusion yet because there are some difficulties with the interpretation of the act. We asked for legal opinions and we had legal opinions that, quite frankly, came on both sides: "to consider" for some counsels meant to deduct; for others it meant only to give consideration and then decide according to a number of circumstances.
Until now, the board of directors has been unable to reach a consensus because -- I want to be very frank with the committee -- this is an issue that involves also large amounts of money, and of course it depends from what point of view you look at it. If you follow your reasoning, the board would save money. The other school of thought says that if we deduct and people still do not apply for Canada pension, then the board will lose money.
Basically, it is an issue that will be dealt with sooner or later, and I hope there is also some consensus between the employers and workers, not only at the board level but also at the Premier's council level.
Mr Bradley: I will begin. Mr Curling, I know, is anxious to ask some questions as a result of his tour of the facility, which was very intriguing to him, but I want to deal with a couple of issues. Ms Haslam has dealt, actually, with some of the issues I think we were going to explore.
I'd like to go back to the obligation of the employer nowadays, as of September 1993, where we are. The actual obligation of an employer to take back injured workers at a time when the company is downsizing: How strong is that obligation and how long does the employer have; or how long does the employee stay in limbo before the employee is, let us say, written off by the employer?
Mr Di Santo: That's for workers who are injured after January 1, 1990?
Mr Bradley: Exactly.
Mr Van Clieaf: There are reinstatement provisions within the statute, and the reinstatement provisions take a number of forms.
The employer has an obligation to take back a worker if the worker is able to do the essential duties of that worker's job. Those obligations are time-related and the worker must be taken back within a six-month period or the worker can apply to the board to hear his or her case in front of a hearing. The employer can receive a substantial fine and the worker can receive the equivalent of temporary compensation payments if the employer has breached its obligations.
The other parts of the provisions on the reinstatement provisions deal with the worker's right to an accommodated work site where, depending upon the nature of the injury, the employer is obligated to look at the worker's job site and, unless financial hardship would be imposed on the employer, they are required to take whatever steps are reasonable to make the changes, whether they be ergonomic or otherwise, to allow the worker to return. In those cases, the worker has the right to apply to the board where the worker does not feel that the employer has fulfilled the obligation. Again, it could proceed to a hearing to hear the case and there are penalties provided for in the statute to deal with the issue. In each case, though, they are time-related.
Mr Bradley: What happens if the employer deletes the position by, for instance, having a robot do the job? We used to smile at that years ago, but it does happen today. Today, it is a possibility that the robot can do the same job a person was doing. What happens in that event?
Mr Van Clieaf: I do not believe, under the provisions of the statute, that the employer can eliminate their obligation on that basis.
Mr Bradley: So they would have to give them another job other than the job --
Mr Van Clieaf: Yes, another job.
Mr Bradley: What if the company is "downsizing," as they like using? That's always a nice word. It doesn't sound so harsh when you say downsizing. But what happens if they are going from a company of 70 to a company of 50? How does the injured worker fit in then?
Mr Van Clieaf: Going from 70 to 50 does not eliminate their obligation under the reinstatement provisions. They must take the worker back or accommodate him.
Mr Bradley: What role does seniority play in this? In other words, if the worker has worked for 25 years for the company or 5 years, what if the company says, "When we're going from a workforce of 70 to 50, the people at the bottom end of the rung," in other words, the newest employees, "will go first, because we have a contract that deals with seniority"? How does that affect the person?
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Mr Van Clieaf: The worker's right under the Workers' Compensation Act would not deal with the seniority issue.
Mr Bradley: We talked a little bit about stress. I'm interested in psychiatric cases and how you deal with psychiatric cases who are no longer able to work. Any of us who have been members of the Legislature for any period of time have encountered individuals who believe that you have either planted a bomb inside them or have put a device inside their brain that's making them do things. It's very sad, because you're not going to convince the people differently. They say the WCB doctor did this or something of that nature. We know it doesn't happen, but those people are in that position and may not be able to be re-employed for psychiatric reasons. I had one fellow who gave me the diagram of his stomach, how you people in the WCB had planted the bomb in his stomach and you had a device that could have it exploded at any particular time. He was threatening to kill everybody. I was about sixth on the list, so I wasn't overly worried at the time.
But it is a matter of great concern when you have these psychiatric cases, because were I an employer, I would be saying, "Gosh, that's perhaps a dangerous person to employ and I don't know what the chances are of recovery." How does WCB kick in in that case, where it becomes a psychiatric disability as opposed to a physical disability?
Mr Van Clieaf: Are we talking here as it relates to reinstatement provisions?
Mr Bradley: Yes, reinstatement; that's what I'm thinking of primarily.
Mr Van Clieaf: In the example you've cited, if that was the worker's diagnosed condition, I don't think anyone could conclude that the worker was capable of doing the essential functions of the job, and therefore the reinstatement provisions would not apply in that sense.
Mr Bradley: What about the compensation provisions? The person may be physically fine to go back to work, in terms of being able to physically perform a task, but if the person has some significant psychiatric problems, that person could be quite disruptive to the workplace. It's a disability, but the disability is based on a psychiatric, as opposed to a physical, problem. How do you deal with that?
Mr Van Clieaf: The board will recognize a psychiatric component to a worker's compensable condition so long as there is a relationship back to the accident. It could be as a result of prolonged treatment or pain that such a condition develops, but so long as there is a link back to the injury that resulted in the claim in the first instance, those types of conditions are accepted and they are recognized.
Pensions will pay for not only treatment, if that's required for a period of temporary disability; we will also recognize that component of a worker's condition by way of a pension if it was a pre-January 1, 1990, case, and we will also recognize it as part of the reality in determining a future economic loss for a post-January 1, 1990, claim.
Mr Bradley: Would there have to be proof that the psychiatric condition was caused by the injury? It could be that the individual's son or daughter is driving him or her around the bend and that may have contributed significantly to the psychiatric problem. So it would have to be related?
Mr Van Clieaf: There must be a relationship between the psychiatric condition and the injury or the accident for which we've accepted entitlement.
Mr Bradley: I have a couple of questions about new rulings and how they might apply to you, and new legislation: first of all, the ruling that either a court or the Human Rights Commission has come out with recently -- I think it's a court ruling -- which says there must be accessibility. I don't imagine it affects you all that much, because you try for accessibility, but does that mean now that every WCB office has to comply with that? What is that going to mean in terms of capital improvements on your part, if anything?
Mr Di Santo: In our offices?
Mr Bradley: Yes. Are all your offices accessible now? They would meet that obligation now?
Mr Van Clieaf: We have accessibility guidelines that were approved a few years ago, and part of those accessibility guidelines and board policy states that if we currently have an office that does not meet those accessibility guidelines, the board will look to an alternative premise once the current lease comes due.
Mr Bradley: It's a little more difficult to deal with the other part of that. My guess is that probably enhances the re-employability of some of the individuals you try to help out, because it means that for reasons other than this, we have a situation where they're going to have to accommodate them in the workplace in any event. I suppose that helps your position a bit.
Mr Van Clieaf: It's certainly not going to hurt.
Mr Bradley: The other one I have is employment equity. How does employment equity affect somebody coming back to work? In other words, here you've got all these things, all these obligations on employers. What happens when the two clash? You're trying to achieve employment equity and you're trying to get the injured worker back in the place. Who wins? Who takes precedence?
Mr Van Clieaf: I would think that employment equity does cover people with disabilities. I don't think the two programs are necessarily in conflict, that they do work together.
Mr Bradley: So you have no concerns about the legislation, one way or the other, that the government has in place. It doesn't affect you.
Mr Van Clieaf: I don't believe so, no.
Mr Bradley: I'm going to pass to my colleague from north Scarborough in a minute here; yes, my colleague has some questions about the building.
Mr Alvin Curling (Scarborough North): It's Scarborough North. As my distinguished colleague has passed to me and woken me up about employment equity, you said you had been following the procedures, I presume, and seen the impact that employment equity may have on workers' compensation itself. You're saying that you don't see anything that would be in conflict at all or you're able to -- let me just put it this way. He had asked if all your buildings are accessible and you said they mostly are accessible. You said that if there's a building that is not accessible, when the lease runs out then you would comply.
Mr Van Clieaf: We would then look for quarters that did comply with our accessibility guidelines, which we also believe are in keeping with the other provisions.
Mr Curling: This may run in contrast to the objective of employment equity; in other words, if you set out an employment equity plan to say that this is what you would do and the employment equity plan asks that in three years you comply but your lease is beyond three years, the fact is that you may be in conflict with the employment equity legislation. I don't want to put you on the spot --
Mr Van Clieaf: Then we would have to comply with the law.
Mr Curling: Yes. What is happening here, I have found, is that the government sometimes requests more of the private sector than it's requesting of itself.
Mr Di Santo: I would like to reply to the member for Scarborough North, right, not north Scarborough?
Mr Curling: Scarborough North, you got it right.
Mr Di Santo: Mr Curling. Of course we will comply with the legislation. Not only that, but we have made, as we said yesterday -- you were not here -- one of our priorities to encourage employment equity within the board. In fact, we are encouraging not only injured workers but minorities in the other groups who are affected to have access to employment within the board. I can think now of only two of our offices: one doesn't comply completely with the access guidelines, and of course 2 Bloor Street East. Nobody should draw the conclusion that as, for instance, in Sudbury the office is not totally accessible, we will not comply with the employment equity legislation. If the legislation is passed, we will comply with it.
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Mr Curling: I see quite a lot of difficulty. I want to go on to another matter. I don't know how much time we have, since the Chair is not paying attention.
My colleague talked to you about seniority. Seniority is one of the biggest challenges the committee is facing, how to deal with seniority and call-back. He had put a scenario where the individual may be able, then get disabled and be laid off, and then he could be called back on seniority, because he or she is part of that seniority list and would be called back on seniority. You have been following the employment equity situation. Did you see, at any time when that has been discussed, that seniority may be a conflict in the principle of how you bring back your worker or promote that individual?
Mr Di Santo: I'm sorry?
Mr Curling: I'll ask it again. Seniority could be, and I think it is, in conflict with the principle of employment equity. When someone is laid off, for whatever purpose -- let's say in a case you'll be dealing with, a situation where someone has been injured, and when they're called back, they're called back according to their seniority. I'm asking you, following the employment equity legislation as it developed, do you see that in any way in conflict with the principles of employment equity?
Mr Di Santo: As Mr Van Clieaf said, it's written in the act that was passed in 1989 that when there is a conflict with the collective agreement, if the obligations of the employer under the Workers' Compensation Act enhance the re-employment chance of the worker, this act takes precedence over the collective agreement. This is not meant to operate in order to displace the collective agreement, but this takes precedence over the collective agreement.
Mr Curling: I have to say I'm fully confused in the sense that when I read the legislation -- to say that takes precedence but again it is not to work against a collective agreement.
Mr Di Santo: No, no, no. The Workers' Compensation Act doesn't nullify an existing collective agreement, but if a worker is in these circumstances, is under section 54 of Bill 162, then section 54 takes precedence over the collective agreement.
Mr Curling: I don't want to go into that in more detail, because it's unfair of me to pursue employment equity too much with you. I would just like to say to the WCB to follow that act very closely as we develop this act and see where you can comply, because I think you're going to have extreme difficulty in complying if it proceeds in the manner it's going now. It's unfair of me to ask you questions in that regard when of course they will be listening and changing it, and when it is changed, it will be different.
I just want to say to you that accessibility is going to be a chief concern in regard to complying with the regulations. I notice in your new building you're going to have day care. I notice carefully that you said you're not quite sure who is going to fund that while the government is not funding day care, which is also part of employment equity. Again, that is being developed and hopefully more space will come about. I will just back off employment equity.
Mr Di Santo: I don't know the employment equity legislation that you are obviously discussing in another forum, but as far as we are concerned, I can reiterate that we are committed to employment equity because that's the policy of the board at this point in time. I think the Workers' Compensation Board should make an effort in employing injured workers, because this is an institution that was created because there were injured workers. I think it should reflect our society, because workers belong to every group in Ontario and therefore we should encourage employment of the other groups that are disadvantaged in our society.
Now, under the present legislation, we can deal with workers who are injured on the job after January 1, 1990, and their right to re-employment. In places where there is a collective agreement, those workers have precedence in re-employment because the Workers' Compensation Act clearly states that the act supersedes only collective agreements, but the act also says we do not intend to deny collective agreements; in other words, collective agreements are their life, but if a worker gets injured, he has precedence because of the Workers' Compensation Act.
Mr Curling: This is my last --
The Chair: No, no.
Mr Curling: Just a little statement then. I think it's appropriate, Madam Chair, just as a statement.
I have no doubt that you are committed to employment equity. I would say to you that the definition of disability and all that should be watched very carefully on what is disabled and what are severe disabilities.
Mr McLean: I have a question and I'm curious about the answer. Due to construction being down in Ontario -- there are a lot of people out of work -- what percentage have your claims been down in the last year?
Mr Di Santo: In 1992 we had 377,000 injuries on the job and in 1991 we had a little bit more than 400,000.
Mr McLean: What's your anticipated projection for this year? Fewer still?
Mr Di Santo: Projected for this year is 373,000.
Mr Van Clieaf: Within 1%.
Mr Di Santo: Yes, just a small percentage.
Mr McLean: I remember the question I had earlier that slipped my mind: It was the question we had asked in committee this morning about the offices, where they are located. During the discussion this morning, it was noted that while regional offices of the WCB increase the perception of accessibility to services, delivery of services from smaller regional offices is more expensive than from head office due to lower efficiencies of scale. The difference in that cost would be what? And how much does the decentralization cost?
Mr Van Clieaf: I don't have an up-to-date answer for you. I know that when we took a look at this issue -- I think the most recent time that we looked at it was about 1989 -- the dollar figure that comes to mind is about $4.5 million more to deliver the service out of a regional setting than it was at head office when the work was about 50% regional office, 50% at the office in downtown Toronto. What those numbers are today, I do not know.
Mr McLean: Give me the locations of the regional offices.
Mr Van Clieaf: We have regional offices in Hamilton, London, Windsor, Ottawa, Sudbury and Thunder Bay.
Mr McLean: And you have some smaller offices in what locations?
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Mr Van Clieaf: We have area offices in Sault Ste Marie, North Bay, St Catharines, Kitchener and Kingston.
Mr McLean: Is there not one in Barrie?
Mr Van Clieaf: Not an area office, no. There might be another one, but it doesn't come to my mind at the moment.
Interjection: Timmins.
Mr Van Clieaf: Timmins; there it is.
Mr McLean: What are the other offices you have? You have three different types of offices. You have the main offices, area offices, and what's the third one?
Mr Van Clieaf: The third one would be described as work bases, where we would have field vocational rehabilitation staff. In other words, our employees who live in those areas would work out of office space that was rented in that area. It gives the board a small presence in those communities and primarily provides interviewing space and rooms where we can interview workers, employers or others, set up appointments and organize our work out of those bases. They are numerous throughout the province.
Mr McLean: They would be where the adjudicators would probably work out of, in some cases?
Mr Van Clieaf: No. They are primarily where vocational rehabilitation staff would work out of, as opposed to adjudicators. Adjudicators essentially work out of regional offices and Toronto's head office.
Mr McLean: So if an adjudicator comes to my area, I would anticipate that individual would come and visit more than one person to review their file.
Mr Van Clieaf: That would be a case worker, yes.
Mr McLean: That would be a case worker. Do they travel the province regularly?
Mr Van Clieaf: Yes.
Mr McLean: What about the people from your regional office, or your area office? Do they then request these people to come to see the individuals?
Mr Van Clieaf: No, they're essentially performing that function. They could either come from a regional office or head office or they could be working out of one of the work bases; it's a combination of the three. But if you had a case worker stationed in Barrie, say, you usually wouldn't send somebody from Toronto to manage that case. It would be managed by a case worker in Barrie.
Mr McLean: In northern Ontario, do you have an office in Sudbury?
Mr Van Clieaf: Yes, we do.
Mr McLean: An area office?
Mr Van Clieaf: No, we have a regional office in Sudbury.
Mr McLean: What's in Thunder Bay?
Mr Van Clieaf: A regional office.
Mr McLean: And in Timmins?
Mr Van Clieaf: An area office, much smaller, with far less of a service base than an area office. Timmins, for instance, would not register new claims for the board. Timmins would not adjudicate entitlement. Timmins would not authorize payments or produce cheques for injured workers. Timmins would have, perhaps, vocational rehabilitation, case workers or specialists who have assigned case loads of injured workers in the Timmins area, and those claims would be attached to the Sudbury office. It would be an adjunct to the Sudbury office, where the adjudication is done in Sudbury and the voc rehab is done in Timmins.
Mr McLean: What office do you have in Barrie?
Mr Van Clieaf: We would have a work base in Barrie.
Mr McLean: What would that work base cover?
Mr Van Clieaf: That work base would cover vocational rehabilitation activity for the area around the city of Barrie, and Barrie would be attached to the Toronto North ISU working out of head office here.
Mr McLean: Would they take their directions mainly from head office?
Mr Van Clieaf: They would take their direction from the director and the managers working out of the ISU in Toronto if they were in Barrie.
Mr McLean: Would there be anybody in Barrie who would contact that office for any purpose, or is that strictly like a satellite office from here, where everything goes through here to that area office?
Mr Van Clieaf: Basically, that's correct. Everything would go through Toronto to Barrie.
Mr McLean: There would be no constituency staff that would phone that office for any reason?
Mr Van Clieaf: If the constituency staff knew that a worker was receiving voc rehab assistance and they knew the case worker and they knew the case worker worked out of that Barrie work base, they might well phone if their question was associated with vocational rehabilitation. If it was associated with policy or adjudication, they would usually phone head office. I wouldn't be opposed at all to them phoning the Barrie work base, and they would relay the information to Toronto and get it and go back to the inquirer.
Mr McLean: But what you're promoting is, "Phone this office in Toronto and it'll be handled from there."
Mr Van Clieaf: Yes.
Mr McLean: How many stories is the new building going to be?
Ms Angove: I'm Linda Angove, director of the facilities strategy project. It'll be 30 stories, which includes two mechanical floors.
Mr McLean: And what corner will the chairman's office be located in?
Ms Angove: We haven't determined that yet.
Mr McLean: It will be on the top floor?
Ms Angove: No, it will not.
Mr Di Santo: Do you suggest it should be a penthouse?
Mr McLean: They usually have a top corner suite in the southwest corner of buildings, and I thought that would be a beautiful spot.
Ms Angove: If I could clarify, Mr McLean, the upper floors will be speculative office tenants, so the WCB will occupy the lower 70% of the building.
Mr McLean: Oh, so the tenants are going to get the satisfaction of the view at the top and the opportunity to pay a higher rate of square footage?
Ms Angove: That's correct.
Mr Curling: If Bob Elgie was here, they would have given him the top floor.
Mrs Haslam: That's fiscal responsibility.
Mr McLean: What is the square footage of the building?
Ms Angove: It's 755,000 square feet, approximately, for the whole tower, of which we will occupy 525,000.
Mr McLean: And how much footage do you have rented now?
Ms Angove: I should have mentioned this this morning on the tour. We have a number of locations outside of 2 Bloor as well: We have operations at 121 Bloor, at 80 Bloor and at 2 Bloor West, and we have our computer centre at Manulife just down Bloor as well, so we occupy close to 470,000 square feet, not all of which will be relocated. We will not be relocating our mainframe computers. I think Mr King mentioned yesterday that we were, but we will not be; they'll remain in what is a computer centre. The rest of what is located in the Bloor Street area will be relocated.
Mr McLean: What hours would those staff people we saw this morning work? How many hours a day?
Ms Angove: Seven.
Mr Van Clieaf: The normal work day would be 8:30 to 4:30, but if the work schedule allows it, we are reasonably flexible with people. Some of them will work from 8 to 4, some of them from 7:30 to 3:30, some from 7 till 3. It's fundamentally an 8:30 to 4:30 shift.
Mr McLean: I happen to believe it would have to be a real tough job to be doing that. What percentage of people, with the stress, just can't hack that any more? I would think it would have to be a high number. That's why I wanted to find out what your turnover rate was. I wouldn't want to do it. It's got to be a tough job.
Mr Van Clieaf: We are very interested in improving the morale of our own people by improving the quarters in which they will work.
Mrs Haslam: I would like to go into another topic called "experience rating." Experience rating programs were designed to provide a financial incentive to employers who have above-average safety records by lowering their assessment rates compared to other employers in their rate group. Unfortunately, experience rating programs sometimes encourage, as I understand, the hiding of claims, and do little to improve the workplace health and safety. Experience rating prompts employers to appeal workers' claims if the smallest doubt exists. Was the impact of a flat-rate assessment system or a two-tiered high-risk/low-risk rate investigated, and if so, what was the decision of that investigation?
Ms Jolley: Presently, we are considering the whole issue of our role in health and safety incentives in our strategic planning with the board of directors. Right now I have to say to you that the board of directors is not considering a flat rate or a two-tiered rate at the present time. It has been discussed from time to time, but not in a serious discussion.
What we are looking at, both in strategic planning and at the board of directors' meeting in October, is whether or not we should extend experience rating to all of the industries in Ontario or whether we should look at changing the systems of incentives for prevention. There is evidence to indicate that they do reduce the incidence and frequency of injuries, but we have evidence to indicate, as you've said, that it can also be done by other means. There is evidence that it does produce what we would like it to do, but how it's done is not always through health and safety prevention.
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Mrs Haslam: I'd like to get into extending the coverage a little later, but let's go back to the health and safety. If you developed a single rate, would health and safety enforcement and audits and education be left more to the Workplace Health and Safety Agency in the Ministry of Labour, therefore alleviating some of your work?
Ms Jolley: If you had a flat rate, you could either deal with incentives as we do in experience rating, where we would give rebates and penalties based on their experience, or we could look, as Brian King suggested, to other alternatives. You can look at enforcement of the Occupational Health and Safety Act through administrative penalties through the workers' compensation system; that's something the Attorney General is exploring right now with us. You can look at the agency taking over a workplace auditing system through its accreditation, where it could go in and inspect workplaces, and then it could also use experience rating as a part of that as well.
There are a number of options. Our board of directors is looking at that. We are now working with the agency so that we will not be duplicating its efforts when it develops its accreditation system.
Mrs Haslam: This was an interesting fact when I read it. Do you know the percentages -- I don't know if you would or not -- of businesses which really would do that, which would say, "I don't want a WCB claim because it hurts my rates"? How prevalent is that?
Ms Jolley: We don't know that for sure. We did a study. As a result of our looking at experience rating in 1990-91, Peat Marwick actually did a study for us where they identified some of these unforeseen behaviours like hiding claims. What we've discovered is that often they don't report non-lost-time claims, so the claims mix is changing. Indeed, I think the resources development committee of the Legislature in 1987 found that in the mining industry, for example, there was some of that happening as a result.
We did a study where we tried to ask employers about this kind of behaviour. As you can imagine, it's very difficult to get at it because in fact the behaviour is illegal. You are required by law to report accidents. We found that about 20% of employers -- and I can give you the exact figures -- had other programs they could use, for example, sickness and accident benefits etc.
They indicated that they encouraged people to come to work, to stay at work. There are a lot of good reasons why you want to keep people at work. There may be some negative ones too, but there are good reasons to keep people in touch with their colleagues and workmates and things like that.
We explored that, but we can't get at that, as I say, because it is illegal behaviour and it's very difficult to get people to admit.
Mrs Haslam: I guess we all know it happens; it's just hard to put a percentage on it.
Ms Jolley: Yes.
Mrs Haslam: Right. You were talking about coverage, and I was reading again that approximately 430,000 workers are not protected by WCB. Is that correct? Would that be an accurate reading?
Ms Jolley: Approximately one million are not covered.
Mrs Haslam: It's that many?
Ms Jolley: Yes.
Mrs Haslam: Okay, because the information I had was taking a look at the fact that some employers have to pay, some don't. Am I correct in saying that it covers some workers and not others, just whether that industry is covered by WCB?
Ms Jolley: Right.
Mrs Haslam: Am I correct in thinking that you are looking at adding new sectors to WCB?
Ms Jolley: As part of our strategic planning at the board of directors, coverage is one of the issues. The board has agreed that there seem to be aberrations in coverage, but there is no consensus as to whether or not all of industry in Ontario would be brought under. It has also been discussed at the Premier's Labour-Management Advisory Council.
Mrs Haslam: When you're talking about industries, one thing I see is that when you're looking at a reduction of your manufacturing base and your resources base but you're looking at an increase of your knowledge-based industries -- banks in particular was the one that caught my eye; I just love to read about banks -- how can we justify the exclusion of banks and insurance companies from WCB? We're looking at a new kind of injury and a new prevalent kind of injury. Are you looking at including these two sectors? Let's put it that way.
Mr Di Santo: The Workers' Compensation Act in Ontario covers only 60% of all the workers. We have come to that situation gradually, because of course when the act was enacted in 1914 the number of workers covered was very much smaller. The question you're posing is a very serious one, and in fact other provinces in Canada --
Mrs Haslam: Excuse me. Madam Chair, I'm talking about workers and I'm talking about benefits for workers. I'm not talking about a building, I'm not talking about concrete items, and I can barely hear Mr Di Santo's answers because of the noise in here.
The Chair: All right. Both the government caucus and the Liberal caucus are having side conversations, and the problem this afternoon is that we have a lot of overhead noise from some system in this building which has been elevated; earlier in the week that noise was there but it is worse this afternoon, so we will consider Ms Haslam's ability to hear Mr Di Santo. Thank you for your consideration. Would you like to proceed?
Mrs Haslam: Thank you, Madam Chair.
Mr Di Santo: I was saying that in the other provinces situations vary, but most of the provinces cover most of the workers. As you know, in BC, where 85% of the workers were covered, now virtually every worker has been covered with the act introduced this year.
In Ontario, as we've said in the last four days, we have a situation where the workplace has changed dramatically since the moment the act was enacted in 1914. At that time, Justice Meredith had to deal only with accidents on the job that affected the body because of a fall, because of machinery that broke the back or part of the body. Today we are dealing with a complex situation where there is a whole area, the occupational diseases, that was totally unknown. It's becoming a very big issue because of the scientific and medical knowledge that is increasing, and therefore we have an obligation to compensate those disabilities.
There is another major factor: that because of that situation, a disequilibrium, an unbalance is developing within the employers presently covered. In the mining industry we are compensating now, for instance, occupational diseases that developed a number of years ago with employers that do not exist any longer. Also, we told you that 75% of our revenues come basically from the three major sectors, but we have a restructuring of our economy and manufacturing is not as important a sector as it used to be a few years ago. But we have an obligation to compensate workers who have been injured or who are developing occupational diseases, because in some cases of asbestosis and other diseases the latency is very long.
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So we have to think, is this system adequate to deal with compensation? Of course the answer is, obviously not, and it comes not only from workers but also from the present employers. But this is a question that has to be dealt with by the political world, possibly with the consensus of the workplace partners.
Mrs Haslam: So if the decision was made to include or add additional sectors, it would be a political decision to do that?
Mr Di Santo: It's a decision that has to be made by the Legislature, ultimately.
Mrs Haslam: Do you not include sectors on your own? Are you not entitled to add various new sectors?
Mr Di Santo: No, we can't. The act must be amended.
Mrs Haslam: Okay, it was my misunderstanding.
Mr Di Santo: Let me add that the act must be amended or it can be by regulations also.
Mrs Haslam: Thank you for clarifying that, because I was under the impression that you could do it and it was done by regulations. That's what I understood.
Mr Di Santo: But you know who passes the regulations.
Mrs Haslam: Yes, I know who passes regulations, but I needed that clarification that it can be done without changing the act.
Section 93 removes WCAT's independence by allowing the WCB board of directors to overrule its decisions. Is that correct, and how often has that been done?
Mr Di Santo: We've had a section 93 in very few, a handful of cases.
Mrs Haslam: Okay. Since I see that there are no other questions from anyone else --
Mr Rosario Marchese (Fort York): I'm on the list.
Mrs Haslam: Oh, you are on the list? I thought you wanted me to stop.
Mrs Marland: There's only five minutes left. Would you like to give it to Mr Marchese?
Mrs Haslam: I would yield to Mr Marchese.
Mr Marchese: Thank you, Ms Haslam. I had a question with respect to physicians and the decisions that are made by the board's doctors versus opinions that are given by not just general practitioners but by specialists. They are often in conflict, of course. Ms Jolley or Mr Van Clieaf, I don't know which of the two of you would like to address the issue.
The specialist gives an opinion and says, "Yes, this is related to the accident," and gives an opinion as to why the worker should be covered. It goes to the doctors at the compensation board and, in their opinion, they give a different conclusion. I'm sure this is an ongoing problem that needs to be somehow addressed, because not only does it lead to frustrations from the employee, who says, "All the doctors I see say this is compensable, but you go here and it's denied," and of course they keep on appealing and they're frustrated, but I presume some physicians are frustrated as well.
I've had many experiences where some physicians in the past were very, very angry, where they in fact have gone to the appeal process themselves to defend the injured worker and said, "This person is 100% disabled and should get whatever is deemed to be appropriate," and they leave frustrated because the case is denied in the end. How do you deal with that, either of you?
Mr Van Clieaf: I think it's important that we do understand the role of both WCB physicians working for the board and physicians who are treating injured workers as family doctors or consultants brought in to do it. In the decision-making process, physicians, either externals or physicians of the board, do not make the decisions. They are adjudicative decisions. The adjudicators receive the advice of the physicians and then make the ruling. Adjudicators will not usually question a physician, especially the external, when it comes to diagnosis or to a treatment program; they will seek advice.
Where sometimes the conflict will arise occurs in cases where the worker might say, "My doctor says I can't work." That is really not a medical decision; that's an adjudicative decision. What we hope to get from our own physicians and from the external physicians would be, what are the restrictions the worker has, what can or cannot the worker do, and you would then use that to reach your adjudicative decision. I'm not sure if I'm answering what you asked for, though.
Mr Marchese: I'm not sure you did either. I was saying that the specialist gives an opinion of the accident and says, "This is compensable," and gives medical reasons as to why that is so and the board's doctors come to a different kind of conclusion. How do we deal with this ongoing medical conflict that exists in their different ways of interpreting things? Is it just a fact of life that we have to deal with? The ultimate say, of course, is with the board, and yes, there are appeals, but ultimately the opinions that seem to be the strongest are the ones given by the doctors at the WCB.
Mr Van Clieaf: I don't want to be argumentative, but I would suggest that usually the adjudicator will take a look at the discipline and the specialty of the physician who is making the diagnosis and, normally, if a specialist has reached a diagnosis, they will go with that diagnosis as opposed to the general practitioner or the opinion of the board's internal physician, unless they're of equal rank. Frankly, if there are reasonable grounds for doubt on either side, they would ask a third physician to give you a ruling.
Mr Marchese: But on the whole it's the internal physician that the adjudicator goes to for final adjudication. That's what I understand happens at the board.
Mr Van Clieaf: One of the things that's been very interesting in the last few years has been the discipline that has been brought to this whole process by the external appeals tribunal, for instance. In days gone by, an internal board physician might simply look at a request for an opinion on, is there a relationship between the diagnosed condition and, say, the work an individual is doing? You might have seen in days gone by the word "allow" or the word "reject" and the internal board physician signing it. That is not the case any more, especially with this move to the physicians having to give the adjudicators advice. We are looking for explanation and rationale to support that decision, and that's gone a long way to removing some of that medical conflict to which you refer.
The Chair: Before we adjourn, I want to place on the record what we will expect to happen next. I had a discussion at noon with Mr Waters, who said it might be the wish of the committee to discuss at the next meeting the Premier's council report, and perhaps its recommendations, if they're available. I said that would be something he might like to discuss with the opposition parties.
In light of the fact that some people are not able to be here this afternoon -- one case in particular I know is a funeral -- I'm suggesting that perhaps the committee can't give direction to Mr Yeager for the writing of the report because at this point you haven't really completed all those matters which you wish to consider, namely, for example, the one Mr Waters mentioned at noon. Perhaps we could have an understanding, obviously, that when we return to this subject, there will be other matters still for consideration.
Mr Curling: Are we going to discuss the Premier's council's report?
The Chair: That will be a decision of the committee. We're not in a position to make that decision right now. I'm just stating that it was something Mr Waters mentioned.
Ms Murdock: Mrs Witmer mentioned that she has had ongoing conversations with some of the members of the PLMAC and that its report is not due out until October some time, in which it's discussing workers' compensation issues, that is, other than the other things it discusses; there is a specific report on workers' compensation issues. As long as the committee is of the understanding that it probably won't come up until then.
The Chair: It's going to be October very quickly.
Anyway, I thank you, Mr Di Santo, and please thank Mr King -- he's not able to be here this afternoon -- on behalf of the committee, and we certainly appreciate the cooperation and the attendance of all of your staff. I think it's been a productive week, and we appreciate the attendance and cooperation of everyone involved. I thank the members for their help and cooperation also.
Mr Di Santo: Thank you. I also must mention that Ms Lynn Mellor has been instrumental in organizing and helped us very much in bringing all of us together.
The committee adjourned at 1512.