LABOURERS' INTERNATIONAL UNION OF NORTH AMERICA
UNITED BROTHERHOOD OF CARPENTERS AND JOINERS OF AMERICA
CONTENTS
Wednesday 5 June 1991
Workers' Compensation Board
Labourers' International Union of North America
United Brotherhood of Carpenters and Joiners of America
Adjournment
STANDING COMMITTEE ON RESOURCES DEVELOPMENT
Chair: Kormos, Peter (Welland-Thorold NDP)
Vice-Chair: Waters, Daniel (Muskoka-Georgian Bay NDP)
Arnott, Ted (Wellington PC)
Cleary, John C. (Cornwall L)
Dadamo, George (Windsor-Sandwich NDP)
Huget, Bob (Sarnia NDP)
Jordan, Leo (Lanark-Renfrew PC)
Klopp, Paul (Huron NDP)
Murdock, Sharon (Sudbury NDP)
Offer, Steven (Mississauga North L)
Ramsay, David (Timiskaming L)
Wood, Len (Cochrane North NDP)
Clerk pro tem: Manikel, Tannis
Staff: Luski, Lorraine, Research Officer, Legislative Research Service
The committee met at 1633 in committee room 1.
WORKERS' COMPENSATION BOARD
Resuming consideration of the designated matter, pursuant to standing order 123, relating to the Workers' Compensation Board.
The Chair: We have two groups making presentations today. The first is the Labourers' International Union of North America, Local 183; the second is the United Brotherhood of Carpenters and Joiners of North America.
I should remind these people and others listening that the scope of this review is a limited one. It is a review of procedures of the Workers' Compensation Board that impede the provision of efficient services to workers and employers. I would ask that people making presentations restrict themselves hopefully to 10 minutes, maximum 15 minutes, to leave sufficient time for some healthy discussion.
LABOURERS' INTERNATIONAL UNION OF NORTH AMERICA
The Chair: We have Dan McCarthy with us from the Labourers' International Union of North America. Please start and we will listen carefully. We have a written submission from you. Then please stay so we can ask some questions and get some answers.
Mr McCarthy: On behalf of the 14,000 members of Local 183 of the Labourers' International Union of North America, I thank the standing committee on resources development for the opportunity for input on the issue of service at the Workers' Compensation Board.
Rather than read from the text you have in front of you, I would like to outline the perspective I bring to the standing committee. As in-house counsel at Local 183, 90% of my work is with the Workers' Compensation Board. As we are principally a construction union, it means I deal almost exclusively with integrated service unit 4 and have been for the past year and a half.
I think if you have looked at my comments, you will notice that they are perhaps a bit technical. Rather than making sweeping statements about the board and its agenda, I have tried to focus on roadblocks that I have noticed within unit 4 and the others with which I deal.
The comments, therefore, come from a familiarity with the personalities in a unit and with the number of times that case loads are switched. I can go through any number of files and realize that I am dealing with my third or fourth case worker in the course of six months. I am also privy to offhand comments from board employees, because we have built up a rapport over the last 18 months, so that I usually know when someone is carrying over 200, or sometimes 300, files. Unfortunately, that is all too often.
With regard to staff placement, I think the last one I got was a May telephone listing, and I was told it was obsolete when I got it. That gives you an idea of how people are moving around, even within a particular unit.
In terms of technology, I am sure you have heard a lot about the imaging, which I refer to on page 2 of my submission. The thing I would like to highlight is that what is good in one aspect, multiple access, is terrible for decision-making. I am sure that when people in your constituency offices are preparing submissions, you can see them with remnants of a WCB file, where they have pulled out the three most important medical, the four most important memoranda, the previous decision, and perhaps an assessment from vocational rehabilitation. They have them lying out in front of them, and they refer to them constantly as they prepare the appeal on behalf of your constituent.
Now imagine you have a screen in front of you and you can only have one of those pages at one time, and each of those pages comes from a different category. Because everything is on machinery, it can often take you three to four minutes to get that one page in front of you to visualize it, and then you try and memorize those pages so you can compare the conflicting evidence on memo 5 and memo 15. It will give you an idea of what an adjudicator is up against in terms of using the imaging system to make a decision.
Further, my understanding is that we are still at a point with imaging where you cannot directly image on to the screen. All paper has to go through a different department to be scanned to be back on the electronic file, so if a worker writes a memo in the morning and sends it off to be scanned, he may not get the memo back for 48 hours. If you happen to call in, they will say: "I just did something on that. I remember it. I wrote a memo. You're going to have to call me back in a day and a half when it is back on the screen and I can tell you what it is," and that is reasonable. When you are working with hundreds of files, you cannot remember everything you have done on each one.
You have probably heard more than enough on the answering machines. I think my small comment on the answering machines is that the implementation is probably more important than the technology. What came in with telephone answering machines was the introduction of adjudicative assistants, who were all brand new and returned the phone calls. They knew nothing about how the board works, and they knew nothing about the file. There is nothing more frustrating than getting an adjudicative assistant and trying to say, "Well, no, you have overlooked A, B and C," and they go on: "Well, I don't really know this. Let me get back to the adjudicator," so you just have one more go-between. You not only have a machine; you have a person answering the calls you leave on the machine who does not understand the file. I think if you are going to introduce technology, you are going to have to have methods of implementation well thought out.
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My comments on communication are simply that I do not think interiorly they work very well between those who make policy and those who implement it. It is the same with the implementation of decisions. The hearings branch is at 80 Bloor Street West, and sometimes it can take months to get a decision that is made there implemented back at 2 Bloor Street East. When a worker hears that he has money after a two-year wait to get to a hearing, it is spent. I would like to close the file myself. I would like to say, "We finally got this done," and close it and put it away, and not be dragging it out from the closed-file section to fight about getting the money through.
With regard to rehabilitation, I speak particularly from a construction point of view, where our membership develops special skills that do not transfer out of the construction field. When it comes to rehabilitation, they are often facing extreme obstacles of limited education, language difficulties, and little understanding of alternative employment. They are accustomed to working in an environment where they can speak their language, where they work with their friends, where they know what they are doing, and this leads to innumerable problems. If you ask them, "Can you work?" they can only think of one thing, building forms again, or climbing bridges, or being on scaffolds, and they will say no. They will not understand that the question is meant, "Do you think you could do modified work if it existed and you had been retrained for it? Therefore we can give you money if you say yes." They do not understand that, nor should they. They know what work is. They have done it all their lives, and they know they cannot do what they did before.
I think when you are looking at somebody who has worked for 20 or 25 years in construction and you send him off to a functional evaluation, where he is doing tests or he is told he cannot do tests because there is too much ethnic bias in the tests, or he does not have the rudimentary skills or sophistication in English or mathematics, what message are you sending to that kind of person? It seems to me the problem is that the board has set up steps A, B and C, and step B is this functional evaluation. Everybody goes through it. There is no streaming. There is nobody saying: "This person is 57 years old. He worked in construction for 30 years. He has no education. He does not have the command of the English language. He is going to need specialized treatment." What are we doing sending them off to put pegs in a board? All it is going to do is exacerbate the feelings that they have about not being able to work. It is going to lower their self-esteem even more, and it is not the time to do it, so I would suggest that there has to be some streamlining.
I have made these points, I think, in greater length in my submission, but I will just leave it there and try to answer your questions.
Mr Huget: I noticed with interest your comments on the vocational rehabilitation process in its current situation. In terms of if we had a perfect world here, what would you specifically like to see in that vocational rehabilitation process as it applies to construction workers?
Mr McCarthy: I would like to see a form of streamlining so that immediately upon vocational rehabilitation they do some kind of initial assessment in person, some kind of contact with the person who assesses, just roughly up front, what their particular skills are and what their needs are. If you are dealing with somebody who is 61 or 62 and is financially in good shape, then I think you want to approach that construction worker much differently than you approach someone who is in his late 30s or early 40s who, in terms of education and language skills, is in the same position as the person who is 62, but of course is looking at 20 years in the workplace, so that right off, you do not send the 62-year-old person to the functional evaluation. You try and say, "Now with what kind of training can we get them back into work?" Protecting their pension is going to be important, those kinds of things, for the person nearing the end of his working career. So you identify needs up front and then you stream them accordingly.
Mr Huget: Would it be your experience, or your view at least, that construction workers have a much more difficult time for some of the reasons you mentioned in terms of thinking about the concept of rehab and alternative vocations? Is there enough emphasis put on the human side of that, understanding the stress that these people are under in comparison to other industrial workers, for example, when there is a threat made on their livelihood in terms of an injury and being able to make informed decisions about alternatives for the future?
Mr McCarthy: I think the construction workers face problems that are worse than those of industrial workers. With industrial I workers think there is a better chance of reinstatement because the principles of accommodation are more thoroughly understood in the industrial area, that you can actually change a physical workplace. There seems to be the impression that construction is slugging it out and it has always been that way, and that there are not that many ways of accommodating workers. We have seen photographs of U-shaped shovel handles so you do not bend over, but I do not think I have ever driven down a street and seen one in action on any crew.
In answer to your question, I think the construction worker faces more difficulty because there is less chance of getting back to the trade with accommodation. He is aware of that and feels that his life as he knows it is gone. Unfortunately we begin to see the development of a lot of psychological problems, a lot of chronic pain problems which in the long run are far more expensive to employers and to the system.
Mr Huget: Would expanded, specialized counselling in your view go a long way to help in that situation?
Mr McCarthy: I think the early intervention thrust of Bill 162 is good, but it has to be meaningful; It has to be human. It is not talking to somebody through his 15-year-old son and saying: "Well, what about these jobs? What about assembling something in a factory?" and then writing it in on the form and sending the form in and they don't hear back for six weeks.
Mr Dadamo: I have a question that quite possibly I should have asked when we met with the first group on Monday. We talk about imaging. We talk about trying to make it a little bit easier for the adjudicator or whoever else handles the files at WCB. What would we do if we did not have the imaging system? Have you ever toyed around with the idea of another system?
Mr McCarthy: The advantage of the imaging system that you do not want to lose is multiple access, the fact that a pension adjudicator can be dealing with a pension issue at the same time as a claims adjudicator is dealing with a claims issue, so there is no doubt that having multiple access is a good thing. It would seem to me that what would expedite the decision-making would be if you could print parts of the file that an adjudicator might need. For example, they could review the file and say, "In making my decision, I am going to need the following memos, the previous decision, and these four medical reports." Then somebody else produces hard copies and brings them to the adjudicator's desk so that they are dealing with the imaged file but they have also got the key documents in front of them. They are not carting tons of paper around, and they can just dispose of them once they -- I suppose there is a certain waste to the environment, but we are dealing with human beings, who are easily more important.
Ms S. Murdock: I am interested in the upgrading aspect. I know what it has been like in my riding of Sudbury both pre-Bill 162 and post-Bill 162, and I am wondering what your observations are.
Mr McCarthy: Which specific aspect of upgrading?
Ms S. Murdock: Specifically, my riding has a fairly high number of second-language Canadians. They have difficulty, so that a lot of them end up in the upgrading program, where they basically start from whatever level they are at and they are trained. Now pre-162, of course, it went on for a fairly lengthy time; post-162 it is now limited. I do not know how my experience has been. It has not been all that beneficial, depending on how the teaching was being done. But I do not know what other areas are like and I would like your opinion on how it has worked with construction workers.
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Mr McCarthy: By and large it has not. Upgrading is working best with those who have managed to pick up a fair amount of English already. My experience in this is that I have had several younger workers in their 30s who have had quite severe accidents, but because socially they tended to mix more in and out of the specific ethnic community, they have picked up much better English skills and they seem to do well in upgrading. Post-Bill 162, it is a bit of a fight because they are not giving them enough time to really get their skills up so they can take a course at George Brown. It is a problem.
Mr Wood: Most of my questions have been asked by George there. But just briefly on page 2, revolutionary and expensive innovation by imaging is delaying the process of adjudicators without a hard copy where you can lay out the hard copies and compare them all on a desk without having to fight among them on the screen individually?
Mr McCarthy: That has been my experience, yes, and these are comments and discussions I have had with individual workers at the board.
Mr Cleary: First of all, I would like to thank you for your presentation, Mr McCarthy. The one thing that I had circled here Mr Huget had already answered. I agree with what you said on number 6, especially with the older workers because I have dealt with a number of them. I guess my second question would be on Bill 162, your opinion on that. Is that workable? We have heard all kinds of different comments in this room. Some say it should be scrapped; some say it should be reworked. I would just like to get your opinion on it.
Mr McCarthy: With regard to Bill 162, the most positive thing I can say is that the emphasis on early intervention and on a sports model of medicine, where you get to workers early and you make them understand that rehabilitation in terms of physical rehabilitation may cause some pain, as opposed to the old system of treating it conservatively, giving them drugs, letting them stay at home and having the desertion sort of psychological affects move in, I think that is its most positive part. Where I find Bill 162 unworkable is that the deeming aspects of the future economic loss awards are problematic, particularly when you look at the ideal type I have just given you of a construction worker who has limited education, limited language skills.
It is going to be years before you assess what future thing they can get into and whether or not they can get into it. They have ridden past all those checks -- check at two years, check at three years. The person is still in school. How can you say how much they are going to lose at the end? How can you say if they are going to be able to pick up a second language successfully? We do not even know that, so it is going to be pretty hard to give reasonable and reasoned future economic loss.
The other thing is the people who got caught in the interim under subsection 135(2), the hurdle that you have to show that after retraining you can make 90% of your previous salary. Construction workers make good money. You are not going to come out of George Brown and start at $35,000 or within 90% of that. That is just a reality. So anybody who, because he worked hard in a unionized sector and had a good wage, is penalized, and you are penalized twice. First of all, they do not collect 90% of their salary when they go on compensation because they are beyond the limit, and then, because they are a high-wage earner, they cannot come out of a course that would give then a decent living. They cannot get retraining for it because they cannot get over the hurdle. So in terms of Bill 162, I think the retraining aspects need some drastic reworking. I think the thrust towards the early intervention and the sports model of medicine is positive.
Mr Cleary: One other short question: What would be the first step that you would take to try to improve the workers' compensation?
Mr McCarthy: The first thing I would do is spend my energy on vocational rehabilitation, because my understanding of statistics is that 75% of claims are still handled relatively efficiently and people get their money and they are off it for two or three weeks or two or three months, and then they get back to work. The biggest expense in terms of human beings has to be those who cannot return to their previous occupation.
I think the retraining has to be where you spend your money, where you put your most qualified people, and you try to get people who speak a variety of languages working up on the front lines. I think I made that comment at some point in my paper, that the problem with the wage scale of the WCB is that the more proficient you become and the more you show you are a worker of stature, the more quickly you are removed from the front lines.
When you walk in as a worker, you talk to the telephone clerks who are brand new -- the highest turnover -- or you talk to the initial adjudicator who is brand new because the senior one has moved up to a better position. There has to be a way of rotating senior people with experience through the front lines so that there is some kind of training going on, on the job, as a problem solver, as a trouble shooter who is right up on the front lines and has the experience.
The Chair: Thank you, Mr McCarthy and Mr McCleary. I said Mr McCleary, Mr Cleary. I got McCarried away. My apologies. Mr McArnott.
Mr Arnott: Thank you, Mr McChairman. Mr McCarthy, I want to thank you very much for your McPresentation. I appreciate your comments and I would like to ask a question about the vocational rehabilitation suggestion you had.
My family has been in the construction business for, I guess, about 62 years and I worked my way through university spending summers on construction. I never saw a serious accident; I saw a few close calls. I think I know something about construction workers and that sort of thing.
I would like to submit that your suggestion that voc rehab counsellors be more sensitive to the individual needs of their individual clients might be expanded to include not just construction workers, but also I can think of mining, heavy primary manufacturing, timber extraction, which all may employ individuals who have limited education, lack of language skills, little understanding of alternative employment. Would you agree with that?
Mr McCarthy: Yes, the resource sector would certainly fit in with the same needs.
Mr Jordan: I am sorry, I came in late and did not hear the prelude to this discussion, but something that seems to be following through is the problem with the adjudicators being overworked with too many cases, with up to 300 sitting on their desks waiting to be dealt with. I do not understand the operation of the Workers' Compensation Board that well, but I would like to know what special abilities an adjudicator has, so that the doctor at the home location where the person lives cannot do an assessment and fill in some forms and send them in. What is the problem with that?
Mr McCarthy: The problem is that the compensation board is there to compensate for work-related injuries. The issue is not exclusively, "Is there an injury?" but, "Did the injury happen at work?" So if you are asking what a doctor cannot provide that an adjudicator has to provide, it is that it is more than you had an injury; it is the determination of, "Did it happen at work?" There is the whole problem with proof of accident where somebody was on a work site working alone when the incident occurred. Did it happen at home? Did it happen on the way to work? Did it happen at work? Those are the kinds of issues that adjudicators get caught up with endlessly.
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Mr Jordan: Do you see a solution to this funnelling everything into this one point?
Mr McCarthy: I think you are right that adjudicators are overloaded, and that always exacerbates things. It develops what I would refer to as a "squeaky wheel" principle, in which those who have representatives -- I know that I am one who calls and says, "I am a lawyer," and you are listened to a little more quickly, I think, or I am dealing with one unit and have several hundred files on the go and they know me quite well, or it is an MPP's office who is calling. My own sense of justice is, what about the workers who do not have somebody and are not a squeaky wheel and are not being greased? That is the real problem.
Mr Jordan: That is the part that I resent. I had an occasion last week in the constituency office where an individual came in and he had been waiting for three months for a $4,500-and-some-odd cheque. After a phone call, he had the cheque the next day or within two days. Just because the phone call came from the member's office, I do not think should be a reason.
The Chair: Ms Murdock, is there something that is very urgent and fast?
Ms S. Murdock: Everything is urgent in the WCB. In case conferencing, do you get any case conferencing in terms of service areas, where your case worker will discuss certain files with you on a regular basis?
Mr McCarthy: I do not do it on a regular basis, no.
Ms S. Murdock: It is done, though?
Mr McCarthy: Not that I know of.
Ms S. Murdock: Okay. It is done in some areas around the province. I just wondered whether in your experience it was.
Mr McCarthy: No.
The Chair: Thank you very much, Mr McCarthy, for coming here this afternoon. Your comments are undoubtedly going to be of great value in preparing this committee's report. You will undoubtedly, or at least hopefully, be among the first people to get a copy of that report. Once again, thank you and we look forward to the next time we have to talk.
I would like to mention, and the committee and people joining us here this afternoon should know that Steve Mantis, who is one of the newest appointees to the Workers' Compensation Board, is with us this afternoon as a spectator from Thunder Bay. We are pleased to have him here and appreciate the interest he is showing. We thank him very much for dropping in and saying hello and seeing what is going on.
Ms S. Murdock: And the vice-chair.
The Chair: The vice-chair has been here almost daily, and that is almost needless to say. The Chair was here quasi-daily and the vice-chair has been here almost daily. But in particular today, we have Steve Mantis from Thunder Bay, and we really appreciate that.
People should make themselves coffee if that is their wish.
UNITED BROTHERHOOD OF CARPENTERS AND JOINERS OF AMERICA
The Chair: Perhaps we could have the United Brotherhood of Carpenters and Joiners of America. Tell us who you are, please.
Ms Crimi: I am Olga Cardile Crimi and I am from the carpenters' Local 27 in Toronto. I assume you have all got a copy of my submission.
The Chair: Yes, ma'am.
Ms Crimi: I would even be happy to continue with the questions that were already asked -- they were quite interesting -- but I will start with my statement and we will take it from there.
I will say though that I have been with the carpenters for about four months, so I am just starting to get a feeling of what is happening on the outside. I was a claims adjudicator at the board for about three years, so your question over there is quite interesting as what goes on internally and maybe we can talk about that too.
I have been asked to appear before this committee to discuss and comment on the procedures of the Workers' Compensation Board which impede the provision of efficient services to employers and particularly to injured workers.
As the co-ordinator of workers' assistance programs, part of my job involves preparing and representing members of the Carpenters and Allied Workers -- Local 27 in dealing with the Workers' Compensation Board.
In order for me to remain abreast of the policy and procedures of the WCB, I subscribe to its operational policy manual. According to policy 01-01-05 of the manual, this section discusses the board's operation policy on decision-making.
The policy adopts four basic principles: (1) determine a worker's entitlement to compensation; (2) determine classification and assessment issues; (3) communicate such decisions to the relevant parties; (4) communicate reasons for delays to the relevant parties.
These four principles are to be used by the claims adjudicators and the hearings officers in order to make entitlement decisions. Decision-makers, and I quote, "are required to make decisions as quickly as possible. These decisions must be based on all pertinent and available evidence from employer and worker (if applicable) but prompt decision-making is not to be sacrificed for the sake of complete documentation. Entitlement decisions are therefore to be made as quickly as possible, but in no case later than 12 weeks after the registration of new or reopened claims, or after the receipt of the objection."
Simply put, the 12-week criterion is not being met, and in most cases the adjudicator does not communicate relevant information to the relevant parties.
If I ask myself, as an injured workers' representative, what "efficient" means when dealing with the Workers' Compensation Board, "efficient" means prompt and fair decision-making.
Training decision-makers in interpreting the WCB Act is essential in providing efficient service. Last year, the WCB did increase the number of staff by hiring case assistants. At the same time, they did in fact reduce the number of decision-makers. My understanding is that there were 339 claims adjudicators. They were reduced to 226 and replaced with about 113 case assistants. The problem with that is the reduced number of decision-makers. The case assistant is not in a position to respond to entitlement issues.
When I call to speak to the claims adjudicator, I either get meridian mail or, in some ISUs, I get the general telephone clerk. I spend five minutes with the general clerk simply trying to explain what I am calling about and then leave a message. If the case assistant calls back, I find I just repeat what I have told the telephone clerk, because it is the responsibility of the claims adjudicator to respond to entitlement issues.
As a workers' representative, I have taken the liberty of introducing myself by letter to the unit director, stating that I will be representing the carpenters of Local 27. The claims adjudicator will still not release information unless a signed consent form is on file. This definitely impedes efficiency, given that the injured worker may have to come in to see me and sign a release form before I can proceed. It is not always possible for the injured worker to come to our office if he or she is disabled.
Another recurring problem I am facing regarding telephone inquiries is that in some cases, where I have made several attempts to contact the claims adjudicator or have been awaiting a decision for a prolonged period, I will usually try to contact the manager in charge. They also have meridian mail and in many cases, even though I have left a message that I have had difficulty resolving the case through normal channels, the manager does not necessarily call me back directly, but has the claims adjudicator call back. This defeats the purpose of contacting the manager, and I feel it demonstrates a lack of responsibility and professionalism on the part of the managers who do not return their calls.
In terms of correspondence, I will usually wait two to three weeks for at least a letter of acknowledgement, only to find when I follow up the case that no one has reviewed the file or seen my letter. The letter may be as simple as requesting access to the injured worker's file. From the time the WCB receives my letter and refers it to the access specialist, I may wait between six and eight weeks before obtaining the claim file. If I am presenting an objection to the decision review specialists, I may wait a further eight to 12 weeks for a decision. Access to an injured worker's file must be quicker to obtain in order for us to be effective in assisting injured workers.
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Given the limited time I have today, I simply wish to state that the other areas of concern I have, and which I feel impede the efficiency of services provided to workers and employers, are:
1. Entitlement is delayed because the claims adjudicator waits several weeks to obtain a medical opinion from the unit medical adviser.
2. Files listed for investigations can take up to six weeks before the claims adjudicator sees it again, and at that point he or she still needs to rule on entitlement to benefits.
3. Files which are in the process of being reviewed by one claims adjudicator get reassigned to another adjudicator even before the decision has been completed.
4. There is a lack of communication between the case worker and the claims adjudicator. If the WCB is serious about rehabilitating injured workers, then the use of retraining must be more positive. The role of the case worker is to look at the vocational rehabilitation aspect, but at the same time the claims adjudicator rules on entitlement. The vocational assessment by the case worker has a strong impact on benefits; therefore, the case worker and claims adjudicator must work together. With the introduction of Bill 162 yet another level of adjudication has been introduced in the form of an FLE -- future loss of earnings -- adjudicator. This is another area which must be addressed in terms of how they will collaborate with the case worker and claims adjudicator.
5. Pension ratings, especially for chronic pain, are taking months to schedule. The rating for non-economic awards are not being considered until a policy has been established. The imminent arrival of Bill 162 was known for some time prior to its becoming law. However, the Workers' Compensation Board administration did not provide adequate training and has still not established a policy on how to assess these awards.
Now let me retract a little bit here. There may be a policy but the adjudicators whom I have spoken to so far who have claims for injuries that were sustained in 1990 have no idea what the policy or procedure is about, the ratings for the economic and non-economic loss awards. They are just sitting there.
On a final note, I wish to be somewhat constructive in my criticism today. No doubt there have been major changes at the Workers' Compensation Board in the last few years which have affected the quality of service we receive. The impact of technology, the changes in legislation brought about by Bill 162, the introduction of evening shifts and the numerous pilot projects have impeded efficiency in service.
One must look at both the service delivery and the administrative process to understand what is hampering service delivery. The complex administration impedes decision-making partly because of the lack of communication between policy and operations. The ergonomics involved in looking at imaged files eight hours a day affects the thoroughness involved in making intense decisions.
In conclusion, I hope I have generated some discussion by addressing some of the problems injured workers and employers are faced with every day when dealing with the Workers' Compensation Board.
Mr Ramsay: Thank you very much for your presentation. I find it fascinating that you used to be an adjudicator at the board?
Ms Crimi: Yes.
Mr Ramsay: We are hearing consistently, through many of the presentations, presenters saying that the board does not put its most experienced people on the front line and therefore this is why we are getting many appeals and that down the line these things are corrected through the appeal process. I am wondering, is there some sort of unofficial maybe quota system at the board, that it has some sort of bell curve and says: "Listen, at the first take there is no way we would approve more than 66% in general. Be cognizant of that when you are making decisions. You can't go approving all these things"? Is there some sort of quota, do you think, out there?
Ms Crimi: Not at this time. When I started at the board, the adjudication strategy that was introduced in 1989 did, I think, address the problem that the new people coming into the board are given the responsibility of looking at initial entitlement. It is true it is a problem, when you are not experienced, to nip it in the bud. If you do not adjudicate the claim properly from the beginning, it just snowballs into a problem.
They seem to have tried to look at putting more experienced adjudicators at the front line. That does not seem to be happening. The intent was there; I do not see it happening, though. That is part of the problem that I see. The monitoring too that is supposed to be going on by the technical advisers or the manager does not always seem to happen.
So far, I mainly deal with the construction unit. I have been pretty pleased with the callbacks and the answers I have been getting from the managers. In other units, I cannot seem to get through to them that all I want to do is call to resolve the problem and I cannot seem to get across the idea that I am not just calling to cause trouble or to give someone flak. Each unit seems to be different on how it operates and who it puts in certain positions. There is not a co-ordinated effort.
Mr Cleary: You have been on the inside and are now working on the outside. What do you feel the biggest problem is at the Workers' Compensation Board?
Ms Crimi: First of all, I would say it is poor training initially and who they hired initially as trainers. Now I understand the training happens outside of the board, at George Brown College, and I have to question how effective that is and what the intent was in doing that. I certainly think they should have people from the inside who have gone through the ranks, the positions, and are qualified then to be instructors. Part of the other problem is training when changes occur, such as Bill 162. Staff do not seem to be kept abreast of the changes that are happening and how you adopt those changes when adjudicating a claim. That is another problem. I really have to stress the problem of training staff at this time.
Mr Cleary: Since you mentioned Bill 162, what is your opinion of it?
Ms Crimi: I have concerns about reinstatement for those in the construction industry. It does not exist. It should have been there primarily for injured workers who are in high-risk jobs, such as those in the construction industry, and it does not exist at this time. Yes, it is harder to close a file where one is requesting vocational rehabilitation services. At one time, you would close the file if they were not co-operating. It is harder in that sense. It is a lot harder to get the benefits and the retraining.
Retraining still seems to be a dirty word at the board. It seems that the case worker, for whatever reason, has somewhat of a tunnel vision, that you first start with a job search and use what you have. Sometimes you have to look at the economic situation before saying, "Look for a job." If there is nothing out there for those who are fit to work, how can you ask an injured worker to continue to conduct a job search? Why not take advantage of the situation and consider training at a time when things are pretty dead in terms of the job market? There does not seem to be that flexibility in looking at the individual. It is a very general outlook on how you deal with an injured worker when they are fit for modified work.
Mr Jordan: I would like to refer to the last page. In the third to last paragraph, you point out that, "The complex administration impedes decision-making." Could you enlarge on that a bit?
Mr Crimi: I will look at one of the things I have looked at, the policy -- just looking at the beginning, at my introduction -- about a 12-week guide to adjudicate claims to make a decision. Operations may have come down and funnelled down to the unit that, "This is what we want." Is it realistic? Is 12 weeks even appropriate? Is it too long? Is it too short? That is coming from operations, which may not really know what is going on in the front lines. My understanding, from speaking to people at the board, is that the hearings officers refuse to even abide by that policy, that it is unrealistic to follow this 12-week policy where it includes the hearings officers. Here is an example of a procedure that is being completely ignored. Are they collaborating at the management level and operations when making these policies?
Mr Jordan: It would seem difficult to deal with cases in a numerical manner -- that is to say, "I can deal with 12 this week" -- when they could be so varied in their complex nature that numbers, to me, would not be a very good way to measure. However, thank you very much for your comment.
Mr Arnott: I would like to thank you also for your presentation. I sometimes wonder if all of us who try to advocate on behalf of workers do not have a jaded view of this. Do you think anybody is getting decent service from them?
Ms Crimi: Yes. I certainly do not want to be all negative today. Yes, there are adjudicators out there who are doing a thorough job. It is unfortunate that morale is as low as it is right now at the board, for numerous reasons, and that the turnover has been as it has, but yes, there are qualified people there. You have to realize adjudicators are interpreting a legal document day in and day out and if there is not the proper training you are going to run into problems. That is one of the comments I wanted to make today.
Yes, I do not want to be completely negative. There may be managers in certain units who are not encouraging their staff to a certain --
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Mr Arnott: Would you mind telling us what was the extent of your training prior to your assuming a position as a claims adjudicator, and what time frame was this?
Ms Crimi: It would have been in October 1988. It was an 11-week training course and the expertise of the trainers at the time was questionable.
Mr Arnott: You would have questioned the extent of the training even at that time?
Ms Crimi: Yes.
Mr Jordan: And the quality?
Ms Crimi: The quality.
Ms S. Murdock: I have just a comment and a question at the same time. I want to thank you very much. It is a pleasant surprise to unexpectedly see a female. I expected a male. It is my own bias, I guess.
The comment I want to make is that the CUPE local for the Workers' Compensation Board has put out a questionnaire to its membership. One of the things was with regard to information that you have been giving us today about the feelings of the adjudicators, both on pensions and claims, who have to implement Bill 162. In their questionnaire, they have found that 19% of the people who have to work with it felt they did not know enough about Bill 162 and 43% felt uncomfortable with using it and not sure of the information they were having to use. It goes along with what you were saying earlier. That is over half of the people at the board who are not comfortable.
In terms of your point 5, on pension ratings, how would you expedite assessments? If you were able to go into the board and change it, in terms of expedition of pension assessments, how would you go about doing that?
Ms Crimi: I think one thing may be to rely a little bit more on the treating physician, not so much maybe the family doctor but the specialist. A form does go out, on occasion, to the injured worker which his specialist is to complete. If there is not time to have individuals come in to be assessed, maybe it should at least start as a paper review. You cannot appeal something you do not have a decision on and you are waiting and waiting, but maybe that will be the initial assessment and rate at that level.
Ms S. Murdock: It is interesting, but I do not know how one would go about it. In that instance, I know that in Sudbury, my riding, they tried to inform doctors how to simply fill in a form properly, because that is another major problem we have been having. Only two doctors showed up out of hundreds in the city.
Ms Crimi: So far, I understand only amputated claims get a paper review in terms of assessing a pension award. Maybe we will have to expand that. I do not think the solution is always increasing staff or getting more doctors. Maybe they do need some more unit medical advisers, but there will never been enough, so we will just have to change how they review them.
Mr Waters: You were talking before about the morale of the board and the adjudicators and you mentioned the assistants. Do you see any value to having assistants or should they all be properly trained and be adjudicators?
Ms Crimi: In my opinion, I think they should be adjudicators. My understanding is that the claims adjudicator is quite leery to accept the information the case assistant gets over the phone because the final responsibility lies on the claims adjudicator and that adjudicator is going to have to use that information. Maybe it is a matter of time, where attitudes will change and experience in terms of the case assistants will change, but the way it stands right now, the claims adjudicators have a hard time accepting their information. They are only the information gatherers. They are not in any position to make decisions. It all lies on the claims adjudicator, so I have to wonder, is there duplication there? Yes, the person may be calling the doctor, but that file still has to come back to the claims adjudicator to make a decision.
If they are still not happy with the information the case assistant got, that case assistant will get the information again, will have to recall that doctor or employer or injured worker. That can also be frustrating on the outside. What is the doctor to say? "You just called me two days ago. What else do you want? I don't have time. I have an office full of patients here." So I have to question if there is duplication in having a case assistant. They are only responsible, at this time, for clerical duties, but at the same time they reduce the number of claims adjudicators, who are the decision-makers.
Mr Waters: I have seen files everywhere from about that thick. I have never seen them under that thick, though. I guess I have a problem with the duplication or the waste, because we seem to go back to the same people for the same information and they write it up at the same time. Is that standard?
Ms Crimi: Seeing memos repeated over and over again?
Mr Waters: Or you need a doctor's report and it seems the doctor says the same thing -- bang, bang, bang, bang -- churns out the same thing. Obviously, in a lot of cases, it is not going to change.
Ms Crimi: Are you talking in terms of initial entitlement, or are you looking at someone who is trying to appeal and trying to get information from his doctor in support of his compensable injury? There is a difference in how one interprets, and there is a problem with the doctors providing the information the adjudicator needs to determine entitlement.
Mr Waters: Do you have any idea how to deal with the doctors so they understand the information the WCB needs?
Ms Crimi: That is a good question. How do you encourage doctors to sit down and write thorough, concise reports and not just fill out a form that says "mechanical back strain"?
Ms S. Murdock: It is not by paying them $25.
Ms Crimi: It is not. Exactly. How do you encourage them to provide the information the board needs? That is a good question. I do not know. Is it always the dollar sign? I do not know. Again, we are talking in generalities. There are doctors out there you would phone, and no problem, they will give you whatever you want and be very clear and supportive and answer any question you have. There are others and it is just a, "Don't bother me," kind of attitude.
Mr Waters: In your experience -- and I know you said you started in 1988, so you probably do not have personal experience but probably had contact with people -- was the training of the adjudicators ever any better? It seems they feel that they are not, as you said, kept off the --
Ms Crimi: Before I got there?
Mr Waters: Yes.
Ms Crimi: I think things were, from my understanding, a lot better. The major changes started to happen when the integrated service units were developed and everyone got funnelled into different units. That is when a lot of the problems started to happen. That is not to say it was not a good idea. In the end, to have doctors, the rehab counsellors and the adjudicators on the same floor was a good idea.
Maybe the problem was too many changes at one time -- meridian mail, Bill 162, night shift, pilot projects regarding medical strategy, revenue strategy, adjudication strategy. It was just too many major changes at one time.
With Bill 162, the time I was there we had a two-day course at a hotel and most of the questions the adjudicators were trying to ask the instructor which -- no fault of the instructor; they were senior adjudicators at one time. Because it was a new bill, they just did not have the answers because the policy had not been created. There was no policy, no procedure, and we were just told: "Hold your questions for now. We will get back to you." That is in the time I was still there and then I went on maternity leave, so I cannot really say what happened afterwards. What was the point of that? I do not know. They just did not have any answers.
In terms of imaged files, as Mr McCarthy from Local 183 indicated, certainly it is a good idea to have imaged files but it is a good idea to have them while they are, in my opinion, small files. As more complex documents come into the file, maybe they should have a blended case load on their desk, some hard files and some imaged files. Is that an option? You find when the system goes down, which is frequent enough, you are twiddling your thumbs there. I am sure the adjudicators are going crazy knowing, "I have 300 files to work on and I am sitting here doing nothing because the system is down."
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Mr Huget: We have heard several presentations that have stressed a morale problem within the board staff, and certainly suggest that many staff members are somewhat less than happy campers, if you will. What, in your view, other than case load, is contributing to that morale problem?
Ms Crimi: One of the problems was definitely the introduction of the night shift, working a shift of 2:30 to 10:30 at night. While I was there, the attitude of the board seemed to be that if you were not willing to take this night shift you were not going anywhere. Any promotions that would come up would be for those who were willing to take an evening shift, and any available job that came up during the day -- somebody would leave or there was a promotion -- the understanding was that it would only be considered if the person had worked the night shift, and not the person who may have been more qualified who had a day position and had applied for the job.
Certainly that was quite demoralizing. When the adjudication strategy came into place, even though the title of the job changed from initial adjudicator and senior adjudicator to junior entitlement and junior benefit, your work essentially did not change, but in some aspects you were demoted because of the structural change. That can be demoralizing when you have been told, and been patted on the shoulder, that you have been doing a wonderful job, but you are being demoted. "However, if you will take the evening job, we will give you back your job."
Mr Huget: Is there anything else you can think of that comes to mind?
Ms Crimi: That is it for now.
Mr Huget: Just to close it off, in your view, how much of an impact does employee morale have on the client relationship and the service to the client? Many times we have heard general statements like low morale and all those things, but in your view and in your experience, how much is that impacting on the services to clients, and in what ways?
Ms Crimi: I do not think it does fall upon the client. There are some wonderful, loyal, intelligent people at the board who take their job very seriously. The frustration comes maybe with the volume and the attitude internally, and the directors not being given the autonomy they think they should have in each unit, but I do not think the claims adjudicator takes it out on the clients or the stakeholders out there.
Mr Huget: So you would say that really is not having a negative impact on a claimant?
Ms Crimi: It is more because of the technological changes that impede the efficiency, but it is not intentional.
The Chair: Ms Murdock, real fast.
Ms S. Murdock: Real quick. Actually, when you were there, had shift work started?
Ms Crimi: It was just being introduced. We had completed a questionnaire about that.
Ms S. Murdock: I visited four board offices in the province, and of them, only with one has the director overlapped the two shifts so the adjudicators on each shift can conference for an hour and a half, they are together for an hour and a half. It involves a little bit of juggling in terms of desk space and so on, but what do you think of that idea in terms of shift work, if shift work has to be a given?
Ms Crimi: You are asking my personal opinion. I am sure there are --
Ms S. Murdock: In your experience at the board.
Ms Crimi: There are people who are single and for whatever reason do not mind working an evening shift, but there are a lot of people in my situation, my age bracket with young families, who really do not want to work. Safety may be another factor.
Ms S. Murdock: No. Make it a given that there is a shift, and if there is a shift, what I am asking you is, in terms of the servicing of the case load, what do you think of the idea of an overlapping shift?
Ms Crimi: Where the case assistant and the claims adjudicator meet for about an hour?
Ms S. Murdock: Yes.
Ms Crimi: I do not think that is sufficient time to discuss what work the case assistant has to do and what information they are to gather. When the claims adjudicator comes in the next morning and the case assistant leaves him that particular information to continue adjudicating the claim, I have to wonder if that can work.
The Chair: We appreciate your coming here and the time you have spent with us. It has been, of course, valuable, and will be useful. Like others who have appeared, all things being equal, you should be among the first people to get the report, but Murphy's Law is one of the few laws around here that is kept consistently. All I can say is, we will do our very best.
Now to the committee, before we head back to the chamber, the subcommittee met very briefly prior to this committee meeting. The reason for meeting was to discuss at least one contact that had been made, and that was additional persons who yet want to appear. All of the time period, as everybody knows, is restricted to 12 hours gross time. That is the rule. This is not a usual type of inquiry. It is not dealing with legislation; it is standing order 123, which means a maximum of 12 hours. The subcommittee and committee had already made decisions about the amount of time to be spent on debate and deliberations, which was three hours. That would allow one hour to each caucus, and I think that is appropriate and fair.
The decision of the subcommittee was -- in view of the fact that we are this far along and that this is not a wide-open hearing process; it is a very narrow, time-restricted process -- that it would not be possible, unfortunately, at this time to let more people join the list of presenters. That would cut into the debate, deliberation and discussion time set aside. So we propose, subject to what anybody might say now, to advise those people and others who might subsequently indicate a desire, that unfortunately, this particular type of process, this standing order 123 process, is not the type that accommodates an open-ended list of participants.
The other interesting thing, of course, is that there has been a remarkable consistency so far in the types of things we have heard, notwithstanding what part of the spectrum the presenters have come from. Those were the sorts of things the subcommittee -- and I trust I have put it fairly -- considered very briefly today, and its decision was, with regrets, to advise any of these people or groups that they could not be accommodated at this point.
Has anybody any comment on that? It is unfortunate, but again this is a special type of process where there is a maximum of 12 hours. That means we have to be very careful with our time, and the committee has obviously tried very carefully to balance the people appearing before it, so there is representation from all parts of that spectrum of interested people.
Thank you very much, people. See you on Monday. Thank you to those people who are here again this afternoon, Mr Biggin, among others, for their interest, and we hope to see you again during the course of these hearings. Take care.
The committee adjourned at 1738.