Evidence of meeting #52 for Veterans Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was worker.
A recording is available from Parliament.
NDP
Sheri Benson NDP Saskatoon West, SK
Right. I asked because someone could continue to work in those types of jobs and have experience and have PTSD and not know it.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
And not know it—or deal with it under another name. So we want to formalize it. In this legislation we try not to make it difficult for someone to make a claim, to accept their entitlement. That allows us to get to these individuals early and to get them the proper suite of care they require.
Most importantly, it allows us to try to integrate them back to the workplace early, because we all know that the longer you're off work for anything, the harder it is to get back to work. I had two weeks of vacation. I didn't want to come back to work.
NDP
Sheri Benson NDP Saskatoon West, SK
Right.
Can you talk about how you make the process of applying for a claim not a barrier to their following through? You sort of mentioned that—
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
They wouldn't have to prove that the diagnosis they have is related to their employment, because the nature of the employment has already been presumed to have caused, or has had the potential to cause, that type of injury.
NDP
Sheri Benson NDP Saskatoon West, SK
The other thing I wanted to ask about was the application process and the paperwork for people accessing WCB—I'm from Saskatchewan, so I'll keep saying WCB.
Is it difficult? Have you had feedback? Have you improved the process? That's often something we hear, not only from veterans, but certainly also from people trying to get access to government services generally.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
The requirement under our legislation is that the employer, upon hearing of a worker seeking medical attention or losing time from work, has a legal requirement to report to WSIB. That's the primary channel.
Second, if the employer is non-compliant or doesn't do what he or she is supposed to do, the worker can claim it at any time. If a worker goes to a physician in Ontario or to the emergency department, for example, and says, “I hurt myself at work,” that triggers a responsibility on that health care provider, under the law, to send us a form in which we set up a claim. Then we go to the other parties, the employer in particular, and ask, “Were you aware of this worker seeking medical attention?” We start the ball rolling right there.
That's typically not a large barrier.
NDP
Sheri Benson NDP Saskatoon West, SK
Right.
You didn't speak directly to this, and I'm not sure you have the figures close at hand, but how often would people appeal?
I like the process you talked about. If there is a disagreement about someone's abilities, when they need to return to work, or that kind of thing, there's an opportunity to work it out. How often do people appeal? I don't want to call it a success rate. I'm just curious as to how you feel the system is working in some ways.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
Ninety-two percent of all our workers get back to meaningful work within 12 months, albeit not always with the accident employer. If they're working for a chip truck and the latter goes out of business, we'll reintegrate them into the workforce in some capacity. We've come a long way.
Where we gain our success is, as I mentioned at the very beginning, in the case management approach. As soon as a case becomes available to us and the worker is off work, we truly do start a planning process that involves the worker and the employer at the very beginning.
We actually have first-day contact. When a case is referred to one of my case managers here in Ottawa, the expectation—although not always applied—is that they are to call both workplace parties and develop a comprehensive plan. That plan might not be a return to work, because we deal with some horrific accidents, but at least a medical plan is put in place. We keep the employer advised of what the plan is and where we're going.
At the very beginning, we develop a relationship with all parties. We are always on the lookout. We do an analysis of barriers and potential problems that have come down the flags, for example, if there is discourse in the workplace or a unionized environment and issues there, or “I don't like my supervisor,” or “I don't have a family doctor.” There are many things that we put into that assessment, and then we try to remove those barriers as we go along.
We try to involve both parties—particularly the worker, because that's our primary contact—with what we're doing and what the plan is, with the understanding that we're working towards recovery and a return to work from the very beginning.
We don't say, “It's tomorrow or Monday”, depending on the circumstances. It might be the next morning or Monday depending on the circumstances, but typically we say, “You broke your leg. Here's the treatment that you have. You're going to see the specialist next Wednesday. I will follow up with you the following Wednesday to make sure you're getting the proper physiotherapy, and I'll discuss your progress with you every two weeks with a view that we're going to try to get you back to your accident employer in some capacity.”
We lay the plan out at the beginning and we adjust the plan as we go along if things change medically. That's our approach.
Liberal
Alaina Lockhart Liberal Fundy Royal, NB
Thank you, Mr. Chair.
Thank you, Mr. Genise, for appearing today.
As you know, we're trying to compare the suite of services provided by VAC with many other jurisdictions'. One thing we have talked about quite a bit is the services offered by Veterans Affairs in the hope of helping people transition to different types of work. Do you offer such services for transition, and what services are included there?
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
Yes, we have work transition services. Their primary role is reintegration into the accident employer, where the worker was injured, but that doesn't always occur for a variety of reasons. After we've exhausted work with the accident employer, then we go to the worker's abilities outside the workplace they were working in. Again, it's a collaborative process in terms of planning. We do a detailed assessment of what their vocational characteristics are, what their skills and abilities are from the past. We try to use whatever skills they might have had in the past to formulate a plan with them.
We make that collaborative because of the success factor. If the worker feels engaged and they feel that yes, that's a plan, that they're interested in computers, for example, then we will try, within the scope of our entitlements, to get them into the field they want to go into. Now, if I want to become a helicopter pilot, that might not be appropriate. But we try to tailor it based on their earnings, because our plan is to mitigate their wage loss. So if you are a low-wage earner, and you no longer work with your employer, the plan might not be as fulsome. But if you are a high-wage earner and you can't go back to work with your employer, and you have limited skills, we'd probably spend more time trying to maximize your earnings potential outside of the accident employer.
But it's a plan that's developed with the worker, not the employer, in this case, because they're out of the picture, so to speak, and the medical community is involved in terms of the worker's abilities and strengths and weaknesses. We'll transition them through that plan. It could be going to school; it could be short, on-the-job training or whatever; but we involve them in that transition.
Liberal
Alaina Lockhart Liberal Fundy Royal, NB
When you say it could be school, do your services extend to paying for tuition and education programs?
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
Yes.
Liberal
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
We have all levels. We look for success, so we do a job market analysis of where employability is in Ontario and within the worker's geographic region. It has to be a viable plan. Many factors go into it in terms of workers' vocational characteristics. If they are approaching retirement and really have no interest in starting a new field and haven't been to school in many years, it may not be the best plan. So we involve them in that planning. For example, if they are relatively young and have just started in their career and are now unable to continue because of their workplace accident and their impairment, then depending on their earnings, we would put together a plan for them that might be more fulsome, depending on their earnings at the time.
Liberal
Alaina Lockhart Liberal Fundy Royal, NB
Do you extend any services to the families of those who are injured?
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
That's not part of our suite of packages. I know we have survivor benefits for workers who have been killed on the job. But in terms of the workers and their families, no, we wouldn't typically get involved in that.
Liberal
Alaina Lockhart Liberal Fundy Royal, NB
Okay. I think that with Veterans Affairs, part of reason is that we recognize that families are—
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
Absolutely, yes.
Liberal
Alaina Lockhart Liberal Fundy Royal, NB
—part of the recovery and the transition, so I just wanted to check on that.
What would you say your biggest challenge is in delivering your services?
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
I'll just stick to the stress and traumatic portion of it, because we have a large population of different types of claims.
Stigma is one. We found that access to medical care within the worker's community is quite difficult. Not everyone lives in Ottawa or Toronto. We had difficulty even getting a baseline assessment. Of course, you can see what I'm talking about: we need that assessment to build on and go.
We took it upon ourselves, and we're a larger insurer, so we have a little bit of opportunity to use our size. We have just been developing a provider network within the worker's community. We have a roster of psychologists and psychiatrists specifically for these cases.
It was a challenge with the medical community for sure. We've overcome that. We're trying to overcome that by facilitating care within the community.
Return to work is very difficult in most of these cases. There are so many factors, from transportation to and from work—again we talked a little bit about stigma—to cognitive load, and being able to manage screens. The other part of it is maybe the employer's reluctance, the front-line supervisor's reluctance or lack of understanding of what's required.
As to how we overcome some of that, again, at the very beginning, we try to do a fulsome plan, including even education of the workplace parties who are on the ground to say what the worker's abilities are. They can only work for two hours at time. They're going to need an hour of downtime. If we have a good plan upfront and the people understand the reasons for it, we have a better chance of success.
The last couple of things are these. We have a dedicated team for these cases alone. They have that economy of scale of working with people who have those challenges. It's not a claim for a back, then post-traumatic stress—you know what I mean—then a leg injury. They deal specifically with these cases, so we are able to skill them up in terms of how to communicate, including that they not take the typical responses you get from someone at face value. Maybe there are other things going on. They have a breadth of understanding, and we try to incorporate that.
Liberal
Alaina Lockhart Liberal Fundy Royal, NB
Do you mean that you have a case worker who dealt with, I don't know, back injuries?
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
Yes, dedicated to those.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
We have it for certain specialties. For this one we do. We have some others. We have a shoulder team here in Ottawa. We have some areas that are particularly medically complex, and we find it to our advantage to have people who are skilled with that.
It's the same with the dedication of the nurses. They're very helpful in our care of workers with post-traumatic stress disorder. They are kind of the liaison or the intermediary between the medical community and the worker. Oftentimes they don't understand what's asked of them in term of their doctors.
I think I'm talking a little too much. First time, probably last time.
