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.
4:15 p.m.
Liberal
4:15 p.m.
Liberal
Bob Bratina Liberal Hamilton East—Stoney Creek, ON
Well, thank you.
We've been talking about service delivery and the complexity of applications. How do you evaluate how well you're doing? It's probably not by what's printed in the media, because, like most of us, it's only the difficult things that show up publicly.
What about your evaluation? How well do you think you're doing?
4:15 p.m.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
We have a macro and micro type of approach. The macro level is our overall success, as I told you, in terms of return-to-work rates. Return to work is really our game. First of all, it's the worker's functioning, but it's return to work—and that's meaningful return to work. One of our primary measurements as an organization is do we get workers back to work? Is it meaningful work? Does it stick? A return to your normal life is paramount. That's one of our primary measurements.
Underneath that, we have a lot of checks and balances along the way. You heard me say that we plan at the very beginning. We have a system that requires first day contact. We assess the quality of those plans and the timeliness of them. We listen to phone calls of our planning discussions with our clients, in terms of their quality.
At the macro level we're looking at how the case is managed from all angles. We want to make sure there's a fulsome plan in place, that there are milestones. If the plan has changed, that's okay, but is there rationale for it?
We're pretty on the ground when it comes to how we manage individual cases. We also have the macro view of how we measure our success.
4:15 p.m.
Liberal
Bob Bratina Liberal Hamilton East—Stoney Creek, ON
The point you make is interesting from our perspective, because you want to get them back to work, and one of the big concerns we have is the veterans' loss of their career. Sometimes they feel, unfairly, “Just give me another chance and a little more therapy, and I could still do whatever.” That seems to be the a complexity of the situation—the transition from the regular armed forces to the veterans—and we're trying to work on that.
One of the issues that would come into play would be that you have contracted physicians—a roster of people—and I'm guessing some people will say, “He's there to make sure you save money by getting me back to work”, or something like that. You understand?
4:20 p.m.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
Yes.
It's not really my area, but we have a very elaborate FRP process, where they bid. There's a whole structure around how doctors are chosen, their credentials, etc. We try to align ourselves with some of the major treating facilities in the province. I mentioned CAMH, which is the centre of mental health in Toronto. That's our primary assessor for post-traumatic stress disorder. They do everything. So it's not just us. We're in Toronto Western hospital; we have most of the significant players in the medical field, and we buy time from them.
I'll give you an example of a worker who had a very significant ankle injury, whom we sent to Toronto to one of our specialty clinics. He said, “You're going to send me down to your doctor.” He sat in the chair beside one of the Toronto Raptors, who was going to see the same doctor. You know what I mean? It's not like we're buying our own doctor. It's like, “If it's good enough for the Toronto Raptors, maybe it's good enough for me.” We try not to segregate our own doctors to our own population, but we try to get the ones out in the community who are recognized.
In some areas, in smaller communities, it's difficult, but we expect our clients to travel if we can't get it in their own locale.
4:20 p.m.
Liberal
Bob Bratina Liberal Hamilton East—Stoney Creek, ON
Another issue we've seen with veterans is dealing with the complexities of the application and so on. Has that been worked out to your satisfaction, in your world?
4:20 p.m.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
We make it pretty easy. We don't make assumptions about the channel by which a client wants to use to come to us. It's easy to say everything is e-formula, etc., but most people don't have a printer or a computer, so we try to have a number of delivery channels. You can even start a claim with us by phone. We'll have someone there to take all the information down. We try to take that part of the stress away as much as we can. You can come to our office and sit down with someone to set up a claim. Typically the employer does, but we try to remove that administrative burden and get to the facts, so that we can move on with recovery and then return to work.
4:20 p.m.
Liberal
Bob Bratina Liberal Hamilton East—Stoney Creek, ON
Do you have an investigative component to your service?
4:20 p.m.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
It's light. It's more for the collection of information. If a worker comes to us and says they were injured in 2012 and their employer never reported it—they reported it to them and went to the hospital, but the hospital didn't...and there are gaps—then we'll send an investigator out to gather all the information.
We're not looking for false claims. That's not what investigations are for. We look for the facts of the case, and we make decisions based on what we find.
4:20 p.m.
Liberal
Bob Bratina Liberal Hamilton East—Stoney Creek, ON
When I was doing a little research, a fraud case cropped up.
4:20 p.m.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
That's part of society, and we manage our cases as we go along. If there are irregularities in the medical.... If the doctor says the worker has abilities, and the worker says they really can't drive anymore but the employer says they see them driving around, then we take steps. But it's not a large part of our work.
4:20 p.m.
Conservative
John Brassard Conservative Barrie—Innisfil, ON
Thank you, Mr. Chair.
Yesterday I had an opportunity to sit in on a Veterans Review and Appeal Board hearing. What was interesting to me, after talking to the appeal board members afterwards, was the issue of record-keeping. Oftentimes, injuries happen and illnesses happen, and they aren't reported to the employer. I guess I'm picking up a bit on where Mr. Bratina was going.
From a WSIB standpoint, what's an ideal situation for an employee and an employer in terms of keeping records? Are there best practices? Are there issues where you guide your employers? Maybe you can just speak to that a little as well.
4:20 p.m.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
Under our Occupational Health and Safety Act, which is not under the guides of the Workplace Safety and Insurance Board but the Ministry of Labour, if there's an incident at work, it must be recorded. In terms of retention of that incident, I'm not familiar with that exactly, but I'm suggesting it's five years, five to seven years, in terms of record-keeping.
That's not really where we get most of our claims in terms of that type of claim. We require an employer to report to us within three days of learning of lost time or of health care. There's an obligation on the employer. If the employer doesn't do that, we look at what the medical treatment was. In terms of medical records and the requirement for a physician in Ontario to keep medical records, I believe it's 10 years. I'm sure I can be corrected on that. The community at large retains much of this information, which suggests that if it's not with us, it will be out there for us by the time someone claims for it.
4:25 p.m.
Conservative
John Brassard Conservative Barrie—Innisfil, ON
You also said that you would do investigations as well. Would that be to fill in the gaps?
4:25 p.m.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
Yes.
4:25 p.m.
Conservative
John Brassard Conservative Barrie—Innisfil, ON
Would that be any claims that come forward where perhaps there isn't record-keeping?
4:25 p.m.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
Yes. Periodically we have to go back in time and piece together what occurred on the day of the alleged event. The worker will say that a witness was their co-worker at the time and that his name is so-and-so. He might not be working for the employer anymore, but that might be a linchpin for us to allow that claim. We'll send an investigator out to the employer to find that last record for that co-worker. We'll piece together the story as best we can based on the facts given to us.
4:25 p.m.
Conservative
John Brassard Conservative Barrie—Innisfil, ON
The other thing I want to bring up is the issue of modified work programs. There is case law about an employer's duty to accommodate. I think you mentioned that if an employee doesn't return after a year, there is a 7% likelihood that they may not come back to work at all. Within the military system and the Canadian Forces, there are issues of modified work. How forceful is the WSIB, in working not just with the employer but with the employees as well, in ensuring that there is a modified work program in place to get employees back to work, whether it's returning them to their job or to other positions?
4:25 p.m.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
It's embedded in our legislation that both parties have a requirement to co-operate in the return-to-work planning. The employer has an obligation, once they hear what a worker's abilities are, to review their workplace to determine what jobs and duties could be offered to that employee. The worker has an obligation, under our legislation, to co-operate in that return-to-work planning, so from the get-go, the expectation is there.
That doesn't always work, so we have collaborative planing. As I said at the very beginning, in any contentious case, one where we haven't had someone go back to work already, we'll get a work transition specialist or a return-to-work specialist to the job site, with both parties, to commence that planning. In terms of how forceful we are, with the co-operation provision, they have no choice. You have to come to the meeting. If you don't, we'll find you. If the worker says they're not interested at all, we'll say that if there's a job offered and we determine it to be good, then their benefits will be affected, because they're not co-operating and the job is custom-made for the type of accident or injury they had.
If the employer is not compliant, we have some means with which to find them, but we will also continue to pay the worker and perhaps go in a separate direction. Again, this is an insurance system, so they're paying more money because they have not had the wherewithal to bring their workers back to work.
In terms of how forceful we are, once there are abilities, there is a press for us to get the worker back to successful work. We're not looking for modified jobs that are pretend or—
4:25 p.m.
Executive Director, Case Management, Workplace Safety and Insurance Board (Ontario)
They're meaningful. That's why we have the on-the-job planning right there that's signed off on by everyone. Everyone knows what the duties are, and the hours, the responsibilities, and the barriers, and what the problems are. It's a form of about six pages or so that they fill out on the job with all parties to make sure it's comprehensive.
