CANADIAN ASSOCIATION OF REHABILITATION PERSONNEL
CONTENTS
Wednesday 12 June 1991
Workers' Compensation Board
Canadian Association of Rehabilitation Personnel
Odoardo Di Santo
Brian King
Organization
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)
Substitution: O'Connor, Larry (Durham-York NDP) for Mr Kormos
Clerk pro tem: Freedman, Lisa
Staff: Luski, Lorraine, Research Officer, Legislative Research Service
The committee met at 1546 in committee room 1.
WORKERS' COMPENSATION BOARD
Resuming consideration of the designated matter, pursuant to standing order 123 relating to the Workers' Compensation Board.
CANADIAN ASSOCIATION OF REHABILITATION PERSONNEL
The Vice-Chair: I would like to call the committee to order. I guess we are starting off a bit late, so we will move right into it. The first group is the Canadian Association of Rehabilitation Personnel. Would you please identify yourself for Hansard?
Ms Scott: I am Viki Scott.
Ms Baptiste: I am Barbara Baptiste. I am the president of the Canadian Association of Rehabilitation Personnel.
The Vice-Chair: The tradition has been so far that you try to have a short presentation, try to keep it as brief as possible, and then we move into questions and answers or at least allow time at the end for questions and answers if possible. The floor is yours.
Ms Baptiste: Okay, I will start. You have asked us to address efficiency of service in the Workers' Compensation Board. Specifically we will be addressing rehabilitation.
Ms Scott and I wish to congratulate you for allowing us to participate, as this is the first time in 21 years that our organization has been asked to be involved in the legislative process.
I will briefly review what CARP is, what accreditation and certification are, the definition of rehabilitation, and the purpose of vocational rehabilitation as a health and social service program and as a service delivery mechanism.
What CARP is not is the Canadian Association of Retired Persons. That is the other acronym, so we may be changing our acronym. When I saw the headline that CARP members got lower prescription rates, I was pretty excited, but that is not what we are. We are the Canadian Association of Rehabilitation Personnel. It is a 21-year-old, non-profit, federally chartered organization, initially organized by vocational rehabilitation specialists working with the industrially injured. It now encompasses professionals who work with the congenitally, acquired and traumatically disabled.
The board is a volunteer board and consists of national and provincial boards. Ontario is approximately 50% of the membership of the national board.
Over the past few years there has been decreased involvement of the rehabilitation personnel at the Workers' Compensation Board in CARP. This began with the new hiring of rehabilitation personnel over the past two to three years. These new rehabilitation case workers do not meet the experiential or educational requirements of accredited rehabilitation workers and most certainly do not meet the requirements of certified rehabilitation counsellors. This is a major concern of our association.
I will explain to you what accreditation is and what certification is. Accreditation is offered to all CARP members who meet the educational and experiential criteria set by the national association. This is all gone into in more depth in our brief; this is just a review. Certification is more involved and includes examination and a code and canon of ethics for working with persons with disabilities and injuries. I have included, as an exhibit, the code and canon of ethics. It invokes greater consumer protection and accountability by the professionals. Certification was implemented in Canada in September 1990 and the first exam was written in April 1991. Of the many hundreds of rehabilitation personnel at the board, I believe one Workers' Compensation Board worker wrote the exam in Toronto.
Vocational rehabilitation is an integral part of the health care team. Masters' degrees are offered in vocational rehabilitation in the United States and more and more books are solely dedicated to this profession. Vocational rehabilitation counsellors have substantial impact on the cost-containment portion of an insurance policy, as well as substantial impact on the future direction of the life and work of persons with disabilities and injuries. Returning an injured worker to his pre-injury status of work is intrinsic to the rehabilitation service of the Workers' Compensation Board, and this is the process of vocational rehabilitation.
For a system to be efficient it must also be effective. Effectiveness is ensured by the quality of personnel. We recommend that all rehabilitation workers within the WCB be able to meet the requirements of accreditation and that all vocational rehabilitation counsellors meet the requirements of certification.
I should give a definition of rehabilitation. I think it is important. It is on page 6, but I will just refer to it to give Viki some framework.
Rehabilitation -- and this is looking at the much larger picture than vocational rehabilitation -- is a facilitative process enabling a person with a limitation to attain usefulness and satisfaction in life. Rehabilitation, then, equalizes opportunity for life attainments as a human right and societal obligation. Rehabilitation is more than medical and vocational. The mandate of rehabilitation is to attain usefulness and satisfaction in life.
It is the largest component part of insurance systems within the US as well as the workers' compensation boards within the US systems. The Canadian system is so far behind within the Workers' Compensation Board that it is quite embarrassing even to deal with our counterparts in the US. We are asking for a lot of changes here.
Ms Scott: Basically what I am going to go through for the next few minutes is what vocational rehabilitation programs were provided prior to Bill 162 and what vocational rehabilitation programs are being provided post-Bill 162 under the present Ontario Workers' Compensation Board system.
In the voc rehab division manual of November 1982, the following definition of rehabilitation was offered: "A very acceptable but sweeping definition of rehabilitation in the broad sense is that it is the cultivation, restoration and conservation of human resources, assisting those who are handicapped by disease, disability or social maladjustment to achieve a state of maximum well-being."
The goal of rehab for the board, before the new strategy was developed, was to provide the injured workers with the means and opportunities to achieve the most effective restoration of earning capacity and assume their place back in their own community. It did not mean just vocationally, but meant socially, on the family level, economically etc. It was a more comprehensive process than it is today.
To implement this goal, the board set out to "develop and promote understanding and the active participation of industry, unions, treatment agencies, medical profession, government agencies and ministries, community groups and the public at large in the vocational rehabilitation process." At one time the board would go out into the community and have employer fairs, where it would pull all kinds of employers together and the case workers would go and market their injured workers. A lot of employment was gained through those types of employment fairs.
To maintain a progressive and responsive vocational rehabilitation service, as their 1982 rehab manual stated then, is to "undertake the responsibility of helping the industrially injured worker to help herself/himself toward the restoration of renewed confidence, independence and the achievement of self-realization." Again, it used to be a very personal, individualized program that was developed in the old days, as we put it, at the board.
It is clearly evident that there is some recognition by the board that the injured workers were affected by their surroundings. Thus, the perceived need to assist the injured worker adjust to the injury and the need to enlist the co-operation of the community in the process. Anyone knows that to successfully place or integrate someone back into the community you have to have the community support and the mechanism there. It can never be separated, but under Bill 162 it seems that there is the community and there is the injured worker and never do they come together at any given time.
This brief review clearly indicates that the WCB understood the needs of injured workers with respect to rehabilitation -- medical, social and vocational. Unfortunately the implementation of these goals falls immensely short today. Over the years injured workers and their representatives have too often told the WCB that too many injured workers are abandoned with little or no service from the voc rehab division. It seemed that any time anything of any contention seemed to occur through the history of the Workers' Compensation Board, the voc rehab services were the scapegoat. In essence it appeared to be a lot of our rehabilitationists who were under the gun or the attack.
From a lot of pressure through the years, in 1986 the then Honourable Bill Wrye appointed the Minna-Majesky task force to study voc rehab services. The Minna-Majesky task force report ended up being, as everyone knows, entitled An Injury to One Is an Injury to All. That was announced in August 1987. There were 84 recommendations to the Minister of Labour on how the voc rehab services of the WCB could be improved. Among these recommendations, the three points were:
"1. Rehabilitation as a right to injured workers who have not returned to work within 30 days of their accident.
"2. Mandatory rehiring.
"3. The establishment of a separate vocational rehabilitation division with its own vice-president, and renaming the board the Workers' Compensation and Rehabilitation Board."
It is evident from what has transpired since Bill 162 came into effect that the services to injured workers from the WCB with respect to voc rehab are very restricted. The focus now is on getting the worker back to the accident employer and doing so at the least cost possible. For this reason we see many injured workers being denied services because the board has, in its wisdom, deemed them to be non-rehabilitative and therefore they cannot be considered to be worth the effort to be provided with this service. It is very crass but very true.
The implementation of the new voc rehab strategy, along with the changes in the board's policies for subsection 45(5) in November 1987, the adoption of integrated service units and the more restricted access to rehab services clearly indicate that the board has gone overboard in its effort to save money. It is very difficult to work on rehabilitative programs when there is no team effort there. When you have two or three rehab case workers assigned to one unit where before there would be one general division which would employ over 100, you are not getting the comprehensive rehab services process that an injured worker should have, because in some integrated service units you have three greenhorns, you might have a combination of greenhorns and experienced, or you may have an ISU that has all experienced people. So you are not having consistent rehab provided by the board in this province today.
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Sections 54a and 54b of the Workers' Compensation Act, as amended under Bill 162, remove from the board the following power: "To aid in getting injured workers back to work and to assist in lessening or removing any handicap resulting from their injuries, the board may take such measures and make such expenditures as it may deem necessary or expedient."
The act and the policies of the board establish windows for opportunity as to when voc rehab services will be provided, and if such services will in fact be provided. It is not generally mandatory that someone have rights to rehabilitative services today, even at the worker's request.
To receive voc rehab services and supplementary benefits, the board has to be satisfied that a voc rehab program will help increase the worker's earning capacity to such an extent that the sum of the worker's earning capacity after voc rehab and the amount awarded for permanent partial disability approximates the worker's average or net average earnings, as the case may be, before the worker's injury. If this criterion is not met, the injured worker is provided with a supplementary benefit which is equal to the federal old age security pension. This supplement is called wage loss, permanent supplement and older workers' supplement. Part and parcel of this is the integration of CPP and QPP benefits in the calculation of supplementary benefits. This is not rehabilitation at all.
To establish the vocational needs of an injured worker, today's rehab case worker has the option to utilize limited testing tools. Some of those tools are dated. They do not recognize new technology that is coming forward daily. As Barbara said earlier, we are behind our American counterparts in research and policy development in workers' compensation. When we have the Americanization coming forward to our country private rehabilitationists are utilizing these new tools and techniques in order to assist an injured or disabled person to fit back into the community; unfortunately the board is not. It basically states very clearly in its policies which testing tools case workers are allowed to use, and in order to have those testing tools changed, you have to have a policy change. By the time the policy is changed, there are new tools available on the market.
CARP strongly recommends that the independent firms that the board contracts testing out to have accredited, certified rehabilitationists within their employ. Professional standards are required to provide rehabilitation to impaired and disabled citizens of Ontario. This would include certification of all professionals providing case management and vocational rehabilitation, specifically certified rehabilitation counsellors.
I am going to talk a little bit about the functional abilities evaluation or, as everybody understands the term, the FAE. Functional abilities evaluations are a common tool of a rehabilitationist and a major tool in preparing a program plan or direction for an injured worker or a disabled citizen in the insurance industry, the private industry or the industrial industry. What makes CARP very nervous about the FAE process is that the board "may" provide an FAE. Again, there is no guarantee that an individual will have a functional ability evaluation conducted.
The board's FAE involves a range of assessment procedures to identify an individual's functional abilities and limitations as they relate to work. Assessments are classified as either specific or general. We agree with the definition the board uses of functional abilities and limitations as they relate to work, but unfortunately an injured worker does not have a statutory right to this assessment. In practice, the board is only interested in obtaining a list of a person's restrictions. The board's FAE concentrates on one's restrictions; it does not present one's abilities clearly. A case worker is not provided with the information required to assist an employer in returning an individual to work.
A definition of a worker's abilities provides criteria to allow an employer to accommodate the worker. The structure of the board's FAEs today presents a design of criteria for elimination from a voc rehab program. Functional abilities evaluations are intended to be assistive; that was the entire reason for their creation.
Inappropriate job placement can result in employee frustration, lower productivity, higher production costs and a greater potential for reinjury and injury of co-workers. An accurate functional abilities evaluation would provide objective evaluations of workers' traits, aptitudes, functional capacities and skill sets. An effective FAE would provide an employer with specific information to assist in the accommodation process. We all know that under the act today, accommodation by the employer is mandatory, and the employer needs assistance in that process. Functional abilities evaluations as interpreted by the WCB must be reformed to the level of general consistency and recognition of certified rehabilitationists.
Under the Ontario task force on the vocational rehab services of the WCB in relation to CARP, we recognize that rehabilitationists were under attack during the process, specifically those who were employed by the Ontario WCB. CARP agrees with the findings of the task force in principle. The recommendations referring to case management, rehabilitation service providers, qualifications of counsellors, case loads and employment specialists are all supported by CARP.
We strongly suggest to the committee that it obtain a copy of this report and review it thoroughly. CARP would be interested in providing resources to the board to allow and assist in the implementation of the task force recommendations.
CARP is indebted to the dedicated rehabilitationists who were employed by the WCB 20 years ago. The association was initiated by these pioneers of industrial vocational rehabilitation. A few of them are still part of us. When you talk to them about the past and what they are faced with in the future, they are disillusioned and a lot of them have left the board to work in another area of rehabilitation, which is a major loss to the board itself. These individuals had the foresight that our profession needed to be recognized, united, educated and standardized.
In the past, the WCB supported its employees in these efforts by providing financial, physical and moral assistance. The Ontario WCB supports CARP as a professionally recognized organization by placing a clause in the labour contract with its employees which provides CARP membership dues payment as a benefit. As recently as 1988, a voc rehab counsellor who was employed at the board had to meet the basic requirement for employment by being "willing to proceed to accredited status" with CARP. For your benefit we have enclosed exhibit II, which is a copy of a rehab counsellor's job spec from 1988.
CARP was excited to learn that the WCB was going to employ many more rehab case workers as recommended by the Ontario task force. This excitement soon was deflated when we learned that the case workers were not going to be as qualified as our rehabilitation counsellors were. We further learned that the rehab counsellors had been declared redundant and the union was being forced to launch class-action grievances. A posting for a WCB case worker as it appeared in the Globe and Mail of 20 November 1989 is enclosed for your benefit as exhibit III.
As mentioned earlier, CARP Ontario has well over 500 members and represents 50% of the national association's population. Last year, 20% of the Ontario membership represented the Ontario WCB. Even though there has been an increased staff in the rehab department at the board, our membership representing the Ontario WCB has dropped to less than 10% this year. Why? The answer is very simple. The new employees do not meet our academic or practicum criteria in order to become members or accredited, and certainly do not meet the criteria to become certified.
A baseline to ensure efficient and effective services to the injured and disabled citizens of Ontario is having qualified professionals to work with them.
In conclusion, CARP Ontario does not endorse the WCB rehab strategy as it is being administered today. We endorse the WCB inclusion of specific rehab services that are recognized by the courts, benefit plans and insurance carriers for injuries and disabilities which are other than industrial and which are presently excluded. Third, we do not endorse the lack of training provided to today's WCB rehab case workers.
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We have listed 19 recommendations:
We recommend that CARP be represented on the Ontario WCB --
The Vice-Chair: Excuse me. We are running over. Due to time constraints, if the members of the committee wish to read those over, they can pose some of their questions out of those.
Mr Ramsay: Thank you for your very concise presentation. I was curious about your mentioning a couple of times how the Americans seem to be so much more advanced than we are in rehabilitation diagnostics and processes. There may be some very good reasons, maybe given their military history, why they are ahead and that sort of thing. But why are we not adapting the research that has been done and that is available out there? Why are we not purchasing or certainly borrowing this expertise?
Ms Scott: Private industry and the insurance industry, here in the province or nationally, do so. A private rehabilitationist practising in Ontario -- and we do have people who have private practices that assist the legal clientele of this province -- does purchase those services and does obtain the resources and research available through our US counterparts. It is the same as some of our hospitals within the Ministry of Health and facilities within the Ministry of Community and Social Services. They are always searching for better resources and programs.
In vocational rehab or industrial rehab, which are basically controlled by the Workers' Compensation Board today, they do not do so, for reasons we do not know. It is available to them. We have offered our assistance, and even the people who are employed at the board are aware of the services that are provided. I think it just comes down to it having to be a policy decision, and that again becomes a legislative process.
Mr Ramsay: So would you say, really, that rehabilitation is still not a serious priority of the WCB?
Ms Scott: I do not think it ever has been taken seriously.
Mr Arnott: Ms Baptiste and Ms Scott, thank you very much for your presentation. We appreciate your input.
You mentioned that your association has 500 members in the province of Ontario, is that correct? How many people are there presently engaged in the practice of vocational rehabilitation of some sort, whether it be with Comsoc or the Workers' Compensation Board or so on?
Ms Baptiste: The membership is not divided into occupational groups that way, but the majority of them are in vocational rehabilitation. Because of privacy issues and that kind of thing, we have not divided it that way. We are now putting out to the membership that we would like to do that and are getting their authorization relative to obtaining more information other than what they go through for the accreditation process, where they do have to give details.
Mr Arnott: Perhaps my question was not clear. I was wondering how many jobs there are, how many people there are who are not members of your association.
Ms Baptiste: That is hard to number, but I would say that in terms of people who practise rehab or are in the field of rehab and are employed in that, you are probably looking at a couple of thousand.
Mr Arnott: Presumably some of those people do not meet your accreditation or certification criteria.
Ms Baptiste: Yes and no. A lot of them would, but some of them are certified already. For example, certified occupational therapists have their own association, though some of them may double over and join ours. Certified social workers have their own. Certified psychologists, who are also licensed, have their own but will also be members. Physicians have their own groups but will also be members. So there is a lot of overlap and some of them prefer to belong to their very specialized group, rather than the overall rehabilitation group, which is a process as defined in here.
Mr Arnott: As to your recommendation that your organization be recognized as the formal authority for workers' compensation voc rehab counsellors, how would that affect some of the other organizations that are presently --
Ms Baptiste: I think it would set a precedent as well for Comsoc, you are right, for its voc rehab department. It could start moving forward from there. Our concern is that Comsoc has stricter hiring requirements. Our concern lies with the hiring requirements of the board and complaints that we have received directly. That is the problem. So the WCB system has begun not to be taken seriously by consumers and citizens of Ontario. I think you need to be aware of that.
Mr Arnott: Should the board adopt recommendation 4, "That CARP's accreditation process be recognized as as qualification for employment at the Workers' Compensation Board, and that certification be required for vocational rehabilitational counsellors," are there enough people out there to meet your accreditation standards?
Ms Baptiste: Oh, yes.
Ms Scott: For the case workers, no. The case workers do not meet the criteria.
Ms Baptiste: The WCB case workers.
Ms Scott: Yes, the WCB case workers do not meet the present criteria for accreditation with our organization. It used to be that before they could be employed at the board they had to meet accreditation. They changed that.
Mr Arnott: Presumably some do not, but some must.
Ms Scott: Some probably would. We just have to encourage them to apply. It is not encouraged any longer.
Mr O'Connor: I want to thank you for coming and speaking to us today. Clearly, as somebody speaking for workers who are seeking rehabilitation and making sure there is fairness in the system, you should not have been excluded out of the system for so many years; 20 years is ridiculous.
I think everyone in this room would agree that the right to employment is something we all share in common, and when a worker is injured, that same worker has the right for rehabilitation so the person can get back to work whenever possible.
Right now it seems there is an awful lot of delay at the board. Of course, as members we have a lot of these people coming to our constituency offices, sharing their concerns and their frustrations and trying to get through a little bit quicker. Do you feel there have been changes within the board where, in trying to strike a balance maybe in the books as to what the money should be spent on, it is trying to balance the system at the cost of the injured worker by having a person who is not accredited through your criteria, in which case then the case worker handling that person's case is not necessarily performing the task that is most necessary for that injured worker?
Ms Scott: I agree. I think one of the principles the board is going to have to adopt in order to make rehabilitative services succeed in this province is to remove rehab services from the adjudicative process, where it is time-limited and they have to meet criteria, etc. One person's broken back and return-to-work plan is much different from another person's broken back and return-to-work plan. They could be totally different economically, financially, socially, etc. Unfortunately, the board has a limit for certain back diagnoses to return to work, so it becomes purely an adjudication process. Six months and the dinger goes off. You might be able to negotiate some extension. That is no way to develop a rehab program, through negotiation and adjudication. That is not a rehab plan at all.
Working with employer groups on return-to-work processes in my employment, the employers have always shown a willingness to return workers to work. They just want to know how. They are concerned with the cost factor, which is understandable for an employer. They always are for any type of component, not just for an injured worker but for productivity costs, etc. If they are shown properly and they are assisted in a more positive process, then I am sure the employers are co-operative in returning people to work. If they can be shown a business plan, that in order to get this person back to work this is what we have to do -- because that employer is responsible for that injured worker till death anyway, he would be amenable to spend the money, because he sees the person as an investment. They have invested a lot of money previously, and they are going to anyway, even if he is no longer employed by them. So employers just need some assistance. That, generally, is what they would say to me at a work site: "How do we do this? Please help us. How can we get them back as soon as possible without risk of another injury or risk to another worker?" That was always the question; it was never the question of cost.
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Mr Arnott: Referring again to recommendation 4 -- and I will read it again for the benefit of those listening, "That CARP's accreditation process be recognized as as qualification for employment at the Workers' Compensation Board, and that certification be required for vocational rehabilitational counsellors" -- are there any other workers' compensation boards in Canada, in any other jurisdiction, that presently do this?
Ms Scott: All WCB boards in other provinces recognize CARP as an accredited body of rehabilitationists to the point where we have corporate memberships. Confederation Life Insurance Co can become a corporate member of CARP, stating very clearly that it does recognize CARP as an accreditation process for the rehabilitationists it employs. It provides credibility to that organization. Alberta is a corporate sponsor. Alberta's Workers' Compensation Board is a corporate sponsor. Newfoundland is a corporate sponsor through the national body.
Mr Arnott: Applicants for jobs as vocational rehabilitation counsellors within those boards are denied jobs if they are not accredited with you. Is that correct?
Ms Baptiste: As long as they meet the requirements for accreditation.
Ms Scott: It is interesting that the majority of persons on our national board -- I sit on the national board -- are basically from workers' compensation boards nationally.
Mr Wood: Just briefly, I see on page 11 of your presentation that you have three points. They are that rehabilitation should start within 30 days of an accident, mandatory rehiring and the establishment of a separate vocational rehabilitation division. I am just curious. Is this going to help considerably with recommendations of this kind being put into effect?
Ms Scott: Would it be effective rehab if it was separated?
Mr Wood: Yes.
Ms Scott: I believe it would be, because it would be removed from an adjudicative process then, the claims being recognized by the board as basically bona fide under the act. Let's take them from the board's adjudicative process and let's send them to a rehab division of some sort, preferably independent of the board, and let's allow rehabilitative processes to be conducted.
Mr Wood: And a timetable as well?
Ms Scott: On a timetable? Yes, it can be timetabled.
Mr O'Connor: Given the need to get rehabilitation started as quickly as possible, do you think it is possible to set a timetable or guidelines on that or do you think we should still allow that to go through the adjudication process?
Ms Scott: Rehab starts from the day of injury. When you walk into that doctor's office, that is when rehab starts. A lot of our private practitioners work within the medical component, where they will work on a team with physicians, occupational therapists, physiotherapists and speech therapists. They will model the case with goals and objectives for the individual. Rehab starts on day one. Once the medical is maximized, then we can look at other objectives in order to successfully place somebody back into the community. We have to do realistic goal-setting. Some of our injured persons cannot work again, but we should be able to rehabilitate them to a point where they are happy with their present existence.
Mr O'Connor: Do you feel that in going through the rehabilitation process there is a risk, perhaps, of an injured worker being returned to work too quickly?
Ms Scott: Yes.
Mr O'Connor: Do you feel that is happening today?
Ms Baptiste: Yes, and there is a lot of documentation on that, especially with repetitive strain injuries. The decisions are laden with a lot of medical and legal and ethical implications, and these are not being taken into account. That is why you have so many injured workers complaining. They have reason to.
The Vice-Chair: We are way over our time. I am sorry. I thank you both for your insight into your dealings with the board. You will be one of the first groups of people to get a copy of our final report when it is up and about.
Ms Scott: That would be appreciated. We want to make all of you aware that if there is any assistance that you require in developing any recommendations around the rehabilitative process, the organization is more than willing to assist. Just let us know.
The Vice-Chair: Good. Thank you again.
I have a request for the members of the committee, that we flip the next two individuals. Is there any problem?
Interjections.
The Vice-Chair: I do not know. They are both a bit large to flip physically, so I think we will just flip the order in which they appear.
ODOARDO DI SANTO
The Vice-Chair: Odoardo Di Santo, thank you for coming before us today. You are becoming quite a familiar face in the room as it is, so I think I will just turn the floor over to you and let you begin with your presentation.
Mr Di Santo: Thank you very much. It is not the first time that I have been flipped anyway.
I am very pleased to be here today to discuss with you the issue of service delivery at the Workers' Compensation Board. I have been the chair of the board for 41 days and it goes without saying that I do not yet have all the answers to the important questions and the issues that have been raised before you. However, I appreciate the opportunity to discuss some of these concerns in a general way and to take some questions from you after my presentation.
Workers, employers and various associations that have appeared here in recent weeks have raised a number of key issues regarding the range and general quality of board services. Most of these points have to do with what impedes service and how the board can improve it. They focus on three areas where there has been a great deal of change: in the area of equipment -- that is, the new technology introduced to help the staff to do their jobs; in the area of new legislation and policies, and in the area of staffing.
In the area of technology, you have heard many concerns expressed about telephone answering machines and the new imaging system at the board. I agree with these concerns. The purpose of new technology should always be to help you to do your job more effectively. That was certainly the intention of those who introduced this new technology, but it is clear that technology cannot be used as a quick fix for more fundamental problems. Technology should serve people, rather than the other way around. My impression is that the benefits of the new technology at the board can be preserved if we use it appropriately and if we use it as a tool and not as a solution.
I must say that at this stage, probably because the new technology introduced is very complicated and very advanced, there has been a long period where the people who have been using the technology have been trained. Now they are starting to use the technology with more confidence and hopefully it will bear some fruit.
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On the legislation front, there are concerns about too many legal and policy changes that distance the board from its clients and create communication barriers. While I caution that all progress involves change, but all change is not necessarily progress, I think we can say it must be appreciated that workers' compensation issues go right to the heart of many of our most important social, political and economic concerns. It is a very dynamic world we live in. We must respond to increasingly complex and difficult realities. Some issues simply cannot be simplified. I can promise, however, that each new policy change will go through a rigorous internal justification process before it is proposed. I can also promise that our new public consultation process will be given every support my office can give and that we will take all necessary steps to ensure that our communications are clear and understandable.
In the area of staffing, we have heard that board staff are often difficult to contact, slow to make decisions and unaware of the board's own policies and procedures and carrying case loads that are too heavy. Once again, I agree with these concerns, but in my opinion the board's front-line staff are doing a fantastic job in coping with an overwhelming situation. I have been privately touring the board regularly as well as consulting with front-line staff in small groups. They understand the problems as well as any of the presenters and have given us concrete advice on how to address them. I am very impressed with their dedication and their feelings of frustration at not being able to deliver the very highest quality of service and their willingness to co-operate in any plan to improve service. They will be our most important resource in the weeks and months to come.
I have a personal theory about the true nature of the service delivery problems, which I will share with you. If you look at the board's own statistics, less than 1% of all claims submitted are denied on the grounds that they are not related to the claimant's work, yet they seem to have built a very complex, expensive, cumbersome and frustrating adjudication process to filter out that tiny portion of claimants. I believe virtually everyone in Ontario shares these values: the dignity of work, pride in our personal honesty and an aversion to taking something for nothing. Yet, sometimes one has the impression that what we do at the board carries with it an implicit assumption that claimants themselves do not have these values. I think this is an accident of history. No one is really to blame, but I believe deeply that many of our service problems would disappear if board processes truly reflected the personal values of the people of Ontario.
To start with, I want to build a board that has a human face and is respected for the important services it provides and its sensitivity to client needs. To achieve this, we plan to place service delivery above all other goals. We know we cannot possibly please everyone, but we can address the legitimate concerns of workers and employers with compassion and efficient management. Employers have justifiable complaints, especially regarding assessment premiums. The development of a revenue approach with extensive employer input is a clear signal that the board is becoming more sensitive to its client needs. But you will not be surprised if I say that this goal of better service will not be achieved overnight. We obviously need time to transform the Workers' Compensation Board into the responsive public agency we all want it to be. As client service improves, the board hopes to enhance the growing partnership between employers and workers and between labour and management. To me, this partnership between labour and management is very important and economically sound. In the years ahead the survival of Ontario's economy will depend in large part on the degree of partnership between the major players.
Rehabilitation of injured workers is an important element of this partnership. In Europe and elsewhere in the world, co-operative methods are used to rehabilitate the injured workers, and we will be carefully looking into how we can improve our rehabilitation services over the coming months. Working together to rehabilitate and reintegrate injured workers into the economy makes sound financial sense. This has been proven already in many countries.
But more important, it is simply a matter of justice. Compensation for workplace injuries involves more than paying benefits. It is also a matter of restoring dignity, a sense of self-worth and an opportunity once again to contribute to and share equitably in our collective wealth as a society.
The Workers' Compensation Board is a key element in the economic, medical and community life of this province. Workers turn to us in their time of need. Employers rely on us to make the best use of their contributions. Government looks to us as a major component of public policy. This is a great responsibility for us at the board. We are looking forward to the challenge of improving the board's service, making the board more responsive to its clients and giving the system a more human approach.
The next three years will be challenging, exciting and filled with opportunity. We must consolidate the changes of the past so that we can face the future with renewed confidence and meet all our challenges in ways that are personally satisfying and fulfilling.
I want to thank you for giving me the opportunity to learn your views and share with you my own personal visions of the workers' compensation system. I look forward to the report of your committee. In turn, I would like to invite all committee members to visit the board and see our operation at first hand. Now I will be happy to answer your questions.
Mr Ramsay: First of all, congratulations on your appointment, Mr Chair. You obviously have a challenging task ahead of you, as you know; you have been a worker adviser. We all wish you well in your task.
What has really struck me in the presentations we have heard in the last few weeks is the consistency in the complaints that come in, whether from employer groups or people representing injured workers. In many of the things you have listed, there seems to be an overriding consistency resulting from much of the change that has happened to the board in the last five years. Seeing it all together, I have great sympathy for the people at the board who have tried to wrestle with all this change. You spoke in your presentation of the time you had started to talk to and consult with front-line workers. Are they saying the same things we have heard in these presentations in these last few weeks?
Mr Di Santo: As I said in my presentation, the front-line work has been part of the internal reorganization that has taken place in the last five years. As such, they feel they were delivering a certain type of service before. Many of them find a new structure does not allow them to do what they used to do and think that it is not totally satisfactory. Of course, they are the people who hear from the clients, both the employers and the workers, because they are at the telephones and have to route the complaints of the workers. They are really the front-line people. They are mostly affected by the pressure that comes from the workers and in that respect they are very much aware of the problems. They are the first ones who want to see the situation get better so they can do their job better and they can satisfy our clients, both the employers and the workers.
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Mr Ramsay: As you used to be a member of the provincial Parliament, you know that depending on the area of Ontario you represent, we have very big case loads of injured workers we represent to the WCB. Mostly it is my staff I must give credit to in Kirkland Lake and Haileybury offices in my riding. They work very hard with people who have back injuries trying to get them a decent pension. I know it is a little easier to assess, but I noticed that one day somebody would just come in and say, "Gee, I'm starting to lose my hearing." My staff would start to question them and they would say, "Five years ago I retired as an equipment operator." They would take down some information and four weeks later the person would get a cheque for $15,000.
I would sort of marvel at that and wonder about it. Maybe it is deserved; maybe it is not. Where that is sort of an easy thing to assess very quickly an award can be made in a hearing-loss case, and yet we struggle year after year trying to get people with -- I know back injuries are difficult, but you can really see they are in pain and they really cannot work. I just hope you can streamline some of this to alleviate some of the suffering that is there and the cost of doing all of this.
Mr Di Santo: As you know, we are governed now by Bill 162, so the new cases will be treated in a different way from the accidents that happened before January 1990. Certainly, as I mentioned in my presentation, there are two aspects to the case that you are talking about. For the cases that happened before 1990, I think we have a major problem. One problem is the pension and the level of the pension, and we can discuss whether it is adequate or not. The second problem is that a number of those people with back injuries become unemployable for all intents and purposes. Because of that, when they are assessed for pension, if they qualify they will receive the old age supplement and basically their income shrinks to a level where it is not comparable to the pre-accident income.
Those are the people who are negatively affected by the results of the accident. Now, I think -- this is my personal conviction -- nobody should be punished or penalized because of an accident. Those people are penalized because our society does not give them any right to gain employment after an accident. They have access to employment only if a willing employer hires them back, but the employer has no obligation at all.
I mentioned in my presentation all the jurisdictions in western Europe. In western Germany in 1919, 72 years ago, mechanisms were introduced so that society took charge of the responsibility of giving rights to injured workers and the disabled in general. There are different systems. In one country you have a quota system. In Sweden you have a different system, where the government takes the responsibility of paying the wage differential between the productivity of the injured or disabled worker and the remuneration.
We have to move towards that system in Ontario and I think we can do it. I have been speaking to some boards and I think we all agree that the government itself perhaps is not the best example of employment equity. When I was an MPP, the largest number of people with back injuries who were not re-employed were employees of the city of Toronto and Metro Toronto. I remember the union, Local 79, trying year after year to convince city council that those workers could be used in other capacities. That does not happen unless we have a legislative mechanism that makes it compulsory. I think the government has already shown the way we have to move with employment equity for disabled people and we have to extend that to the injured workers. Unless we do that, we are going to have thousands of people unemployed, not because of their fault, but because society does not give them a chance to be re-employed.
If we do that, we do a great good to our society as a whole and to the WCB system because I think everybody understands that if a worker is on pension, on supplement, there is no income and there is no bread for his family, so he or she tries to go back to the board to get more benefits and then comes to you, to the MPPs. They want to appeal the pension, and reopen the case because they want a little bit more money basically.
Mr Arnott: Mr Di Santo, I want to thank you very much for your willingness to come and listen to our concerns and answer our questions today and to congratulate you on your appointment personally.
As a member of the Legislature who occasionally -- I do not get inquiries about WCB as perhaps do some of the other members, I do not have as much industry in my riding -- but the thing I find the most frustrating, when I am trying to advocate on behalf of injured workers in my riding, is the unresponsive nature of the board. When you make a telephone call there is often a commitment that you will hear back in a certain number of hours and it just does not happen.
If an injured worker could better understand what the basis of the decision of the board was, they could better understand the decision, obviously. My feeling is, there is not enough accountability of the front-line people as to meeting their commitments.
I would like to hear your thoughts on that and if there are any steps you are considering to increase that accountability.
Mr Di Santo: Brian King, who is the vice-chairman of administration and president of the board, will tell you about the programs we are undertaking concretely in order to try to solve the problems raised before you which are very real problems. We are not here to apologize or to try to minimize, because we have to look positively at what we are going to do as opposed to trying to put the blame on whoever.
I think it is true that some of the decisions are probably not understandable. They are not very simple, but if you go before the hearings officer, the quality of the decisions that come from that branch now are infinitely superior because of clarity, because of reasoning with the decision that came out 10 or 15 years ago. We have to make an effort in that sense and we have to train our staff better and make the system more workable, because perhaps the present structure does not lend itself to giving the results the injured workers expect and that we should give.
I do not think it is acceptable that an institution like the board, with the excellent resources, should not function and deliver the service people expect.
Mr Arnott: You said you have personal theory about the true nature of the service delivery problems, and you said about 1% of all claims are denied on the grounds that they are not related to the claimant's work.
I wonder if you can tell me, if you know roughly, of the total claims made at the board, what percentage are denied for whatever reason in the first instance.
Mr Di Santo: That is an answer I cannot give you, but in 1991, from 1 January to 30 April, out of 116,017 claims, only 1,022 were denied, which means 0.9%.
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Mr Arnott: For the 1% that were denied on the grounds that they are not related to claimants' work, what steps would you be willing to consider to minimize those?
Mr Di Santo: That occurrence is unavoidable because anyone can claim and ask for entitlement but it is up to the board to adjudicate the claim and make the decision.
The Vice-Chair: So far, we have five more people wanting to ask questions, so I would ask those who want to ask to keep them as concise as possible. Keep them nice and short and if possible I would ask the same of Mr Di Santo. Anyway, we will start at the top of the list. I know it is not always easy to answer a question in five words or less so -- Mr Wood?
Mr Wood: My question is along the same lines as Ted just had answered. From the top of page 4 I get the impression that too many people are being taken for granted, that the accident might not have happened on the job and we have to spend all kinds of dollars in resources to make sure there is no fraud in that. I am quite surprised when you mentioned the fact of 1% because I read in the paper the other day, and on a number of occasions, that welfare is considered around 3%, income tax is considered around 3% -- a certain amount of fraud or whatever involved in it. First of all, I wanted to say that with 1%, maybe we should not be spending all those --
Mr Di Santo: I want to clarify this. These are not cases that are not allowed because of fraudulence, these are cases that are not allowed because they are not considered to be work related. What example can I give you? If somebody has back problems and -- no, that is not a good -- I do not have an example at this point, but the fraudulent cases are minimal, much less than 1%, just totally insignificant.
Mr Wood: I personally have been involved in some investigations where somebody gets hurt and there is an investigation as a result of it --
Mr Di Santo: These are cases that are not accepted on their merit, not because they are fraudulent.
Mr Wood: Okay. I wish you many happy days and months in your job. Hopefully it will make my job as an NDP member a little easier in future years.
Mr Dadamo: I had mentioned a couple of weeks ago -- congratulations by the way -- that the office I have in Windsor takes approximately 60% of workers' compensation. Depending on how you do and how your staff and the Workers' Compensation Board here in Toronto does, it will make our life a little bit easier. From page 4 you say, these are your words, "To start with, I want to build a board that has a human face, a board that is respected for the important services it provides and its sensitivity to client needs." On the last page you used "human approach," which I like. You have a big job ahead of you. How much control do you as chair have to inject healthy and positive changes at the Workers' Compensation Board?
Mr Di Santo: I have been there only five weeks so I am very new and by far I do not control all the mechanisms -- probably very little. But what I can tell you is that I have been touring the board and talking to the people. There is a genuine interest in the staff of the board to be helpful in a way that is personal, that is related to the injured in a way that injured workers feel they are understood, that they are dealing with people. And I can tell you that all the staff at the board have been very helpful until now. Perhaps sometimes we have also problems that are the result of the frustration of adjudicators who are dealing with the workload and are under constant pressure because the telephones ring continuously. Sometimes they probably react in a way they should not, but in general I think the staff at the board want direction and want to feel that at the top the people want them to appear in a certain way. I am confident they will do that. There is nothing mathematical, nothing scientific, but it is a question of human relationship, and we are developing it.
Mr Dadamo: We have your address; we know where you are.
Mr Klopp: I also congratulate you on your new position. It came across a lot over the last few weeks from a number of people, so that I understand you are going to be looking at maybe the policy side -- Bill 162. With many of the people on both sides, it is a question of whether the staff even know or understand the bill. What ideas do you have to get the staff trained to know these changes and get them up to speed? Can you give us any ideas on how you are going to get the staff trained and up to speed on such things as Bill 162, because that is the one that has come across?
Mr Di Santo: We are developing, and actually we are going to make a major effort in training the staff. I would appreciate it if you asked the question of Mr King because he is the chairman of administration and is developing the programs. The commitment I can make is that we have come to the conclusion that training is part of the program, and this is one of the problems we will address immediately.
Mr O'Connor: Everyone has congratulated you enough. Thank you for coming here today and being with us. Being someone who has spent a major part of my life in an industrial setting, and seeing injured workers time and time again going through the frustrations, not necessarily receiving adequate rehabilitation -- the two people here presenting before you were from CARP. They put a little presentation on. They talked about having a role in helping the board. Is it a possibility that the board can use that organization to perhaps get the rehabilitation aspect played in a more important area? As you say, you want to get a human face put on the board so the injured worker then has somebody he or she can respond to. The rehab worker responding to the person in need, the injured worker, may be a quick way of getting that injured worker back into the workplace. Is that a possibility?
Mr Di Santo: I cannot speak specifically about that organization, but in general terms I can say rehabilitation is one of the priorities we have chosen. It is so essential for the system to work properly. We should be able to give workers medical rehabilitation and vocational rehabilitation so that they can return to a job as soon as possible. So rehabilitation will be a high priority for that reason alone.
As you know, we have rehabilitation strategy in place. The board has changed its approach to rehabilitation in the last two years, and we are now using extensively the rehabilitation community clinics throughout the province. The system is open to input from other organizations and, I suppose, also from the group that appeared before you people.
Mr O'Connor: You spoke of legislation. Is there any way that we, as legislators, can help to improve the rehab at the board? Is there some mechanism there by which you see our helping you to fulfil that role in getting that injured worker rehabilitated and back to work?
Mr Di Santo: As I said before, rehabilitation is intimately connected with employment equity, because unless there is an outlet, rehabilitation becomes meaningless. We need to do two things; one is to rehabilitate injured workers as soon as possible; and two, to give them a worthwhile job after rehabilitation. I think that if the board accepts my ideas we will go to the Minister of Labour and make a formal proposal. At that point it is up to you legislators to see if what we are proposing is acceptable and enact the legislation.
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Mr O'Connor: I thank you for that and I look forward to seeing those recommendations come forward.
The Vice-Chair: Ms Murdock, one quick one.
Ms S. Murdock: Thank you, Mr Chair. Actually, thank you again for coming. I know we have spoken an awful lot and I have heard you say this before in regard to society taking responsibility for injured workers and the disabled. I know what my own views on this area are, but just for the record, if the government were to come through with legislation for employment equity for injured workers, included within the employment equity plans that we have, the argument we are going to get against doing that, and I can hear it now, is the whole concept that you have an injured worker who is receiving a pension from the Workers' Compensation Board and gets hired for Ontario Hydro in some capacity and at a full salary and is now receiving full salary plus pension. As I said, I know what my views are on that, but I would like to hear what you have to say in regard to those people who will make that argument.
Mr Di Santo: I think the workers who would be re-employed are workers who obviously have a lower productivity in comparison with other workers who are 100% able. In the employment equity system we know, the government is contributing a certain amount of money to make room for those workers, basically.
As far as the pension is concerned, that is an argument that has been going on for decades. The problem is that, even with Bill 162, there is a recognition of non-economic loss. With the old pension, what was the non-economic loss and what was the economic loss were undetermined, because the workers just received a small pension because of the disability resulting from the accident.
I do not think that is an argument that should be used to convince the legislators not to enact equity legislation, because I think what we are talking about is the right of the person to have access to a job, and that is the primary goal. In terms of compensation, I think that can be discussed, but I do not think it is an argument that can be used to defeat the purpose of the equity we are seeing.
Ms S. Murdock: See, I told you I was going to be quick.
The Chair: Thank you, Mr Di Santo.
Mr Di Santo: Thank you.
The Vice-Chair: Naturally, you will be one of the very first to receive the recommendations of this committee. Thank you once again for coming before us.
BRIAN KING
The Vice-Chair: Mr King?
Mr King: Thank you, Mr Waters, committee members. As you are aware, I have provided a handout of some brief remarks. I do not intend to repeat them here. Perhaps I could just give you a very short outline for the people who are here present.
During the past few weeks you have gotten from the presenters, and I have heard a good number of those people making presentations, the view of the service problems at the Workers' Compensation Board, so I do not intend to repeat those.
Second, being relatively new to the board, you will probably, or may, ask me some questions which I am simply not up on at the present time. I have brought the senior vice-presidents, who will be available if there are technical questions. I will not bother introducing them at the present time. Their names are on my handout.
Third, I do not think you have to impress upon either Mr Di Santo or myself the importance of service. I think you know quite a bit about Mr Di Santo's background. My own is in the field of workers' compensation as well. It is a given, and it is in the board's mission statement, that quality service is one of the four top priorities of the board.
Various people have different explanations for why the service problems exist, including the introduction of technological change, the reorganization, the introduction of new legislation and the need to respond to those challenges. One of the things I did notice in a number of presentations, however, is that the dedication of the staff of the workers' compensation board was not being called into question in outlining the service problems. I wish to doubly concur with that.
To give you just a brief idea of where we are headed in the shorter term, we are looking at the service problems in view of those that we think we can fix immediately or in the very short term, such as the telephone system. However, to bring the Ontario Workers' Compensation Board to a position of quality service, there are those that are going to take greater time.
I have identified two of them. That is, the importance of the staff of the Workers' Compensation Board to the organization. I have included in the presentation a copy of a recent mission statement on human resources that was presented to staff. It is now up to the executive level to show that it is more than just a paper document, but that we will be putting it into practice. Second, I have indicated that staff training will receive a top priority, and I expect in the relatively near future to be able to outline some more concrete details of training initiatives.
I would finally ask that if you have any questions during your deliberations on the recommendations following the public hearings, please feel free to be in touch with myself or through my office. We can provide technical answers to questions you may need in your deliberations.
I am going to touch on a couple of things that arose during the questioning of Mr Di Santo. One of them was the question of accountability of front-line staff.
The entire basis of my own theory of how you develop a well-run and efficient compensation system is that the first approach one has to the board is the most important approach and that if we alienate people at the first step, then we may have alienated them throughout the course of their claim. I myself put the very highest emphasis on the training, the qualifications and the skill levels of the initial adjudication level.
We have expanded our staffing to such an extent over the past few years to meet the increasing demands that we simply do not have staff who are trained to the extent we would like. That is one of the areas, if not the key area, where the training will go. The importance of those first-line adjudicators comes into play all throughout the claim, as it progresses towards maximum medical recovery and rehabilitation, as it affects the numbers going through our appeal processes, as it affects the numbers of telephone calls we get from parties.
So yes, the importance of front-line accountability is vital. It is difficult to hold people accountable if they have not got the proper training and tools and skills yet, and when we are in a position to have given them those skills, there will be a very strong move. They are accountable now, but not in the way we would like, I think, and part of that is the management's problem of getting them better trained and to develop a better training method so that we do not run into problems of a shortage of trained people.
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Without in any way being defensive about the service levels at the board, I thought it might be helpful to you to get a very brief idea of how change can affect the service levels. You have in your handout something called the Monthly Monitor, and if you turn to page 3 of that Monthly Monitor, you will see a bar graph. The board introduced a good deal of its technological change in the fall of 1990, and I do not think it takes very much examination of this chart to notice what happened to one of the functions at the front end of the compensation system. This is the end where the documents that come in to establish a claim get registered and sent out for adjudication. When things go awry at the compensation board through introduction of change, such as the technological change of imaging that occurred, it is there in black and white to see what happened to the system. There was a breakdown and a need to recover from a very difficult period of time.
In addition, if you would go to the next page, page 4, the board of directors issued a policy directive stating that claims would have to be determined 12 weeks after being registered. Entitlement would have to be decided after 12 weeks. As you can see, again, that is moving down to a period of a better number from where it started out, without being where we would like it to be at the present time. It just does indicate that the board graphically was in a good deal of difficulty with its service problems and some recovery is now taking place. Again, I stress that I am not trying to be overly defensive, but if you recall getting complaints during certain time periods, I think I might be able to look at some of these charts and predict when those complaints may have been at their height.
Page 8 will give you an idea of the vocational rehabilitation services. The black bar on the left outlines the case levels in 1989-90. You can see that it was relatively constant at around 15,000 claims. Beginning in the 1990-91 period, the white bar shows how much of an increase there has been in the rehabilitation function at the board, the number of new claims that are coming in. In April 1990 we had 15,600 claimants on vocational rehabilitation and in April 1991 we had 30,000. The board predicted a lot of this, because the new act, Bill 162, is far more rehabilitation centred or focused than the previous bill.
In 1990 there were 199 vocational rehabilitation case workers. At present there are over 400 vocational rehabilitation case workers. So the board has doubled the number of case workers, but the case load has doubled as well. In addition, those new case workers now have an aggregate of one years' experience under their belt in training. So we have a problem both with the numbers of people coming on to rehabilitation and the training skills of the people who are doing the rehabilitation.
Finally, in terms of this graphic portrayal of the service, if you turn to page 11 you will notice the telephone inquiries. During the period I indicated, we were having an introduction of new technology, in October of last year. You will note that there were over 21,000 phone calls into the Workers' Compensation Board in a day. That is a massive amount of calls. We have a lot of staff, and if you could divide the calls up among all the staff, that would not be too bad, but they do not want to talk to just a staff member; they want to talk to the person who can help them with their problem and, quite frankly, we have just got too many calls coming in and too few staff to handle them. As the service problems started to settle down from the introduction of the technology, we are now down to around 16,000 telephone calls a day coming in.
One other point I will make on that is that those calls do not come in from 8 o'clock in the morning through until 5 o'clock in the afternoon. Those calls come from 10 o'clock in the morning till 3 o'clock in the afternoon. That is when the load factor for telephone calls comes in.
But again, just graphically, you can see that the board was in a good deal of difficulty. The service levels of telephones during a crucial period of time really accelerated.
Finally, in terms of my preliminary remarks -- and with some trepidation, because several people have advised me not to raise this point -- service is really a symptom of a problem; service is not necessarily the problem. It is like the temperature or it is like the fever, so I have been searching for the root of the problem in my investigations into the service complaints. I think one of the primary ones is to do a good deal of the first level of adjudication, which was the point you raised. It is vital that we do that, to bring back the morale of the staff, to settle the technological changes, to make sure people have a handle on it.
But quite frankly, workers' compensation boards all across Canada -- and I have been to 11 of the 12 boards in Canada -- are to a greater or lesser extent facing because very difficult new problems. Some of those new problems are the new types of claims that we simply have no experience in adjudicating. People are filing claims for chronic stress, and they are filing claims for repetitive motion injuries, which we are working on and we are adjudicating, but they are new experiences for us in the compensation world. Ten or 20 years ago, the average claim was a trauma. It was relatively straightforward as to whether it happened at work. It was relatively easy to adjudicate. Now we are getting new types of claims that we lack the experience base to handle and that are the subject of a good deal of public debate as to whether they properly fall under the workers' compensation system or under a broader system of social benefit. A good deal of debate and argument is taking place there.
Some argue that the solution to that problem does not lie in workers' compensation but in some other system of more universal coverage. I make no comment one way or another, except to put it forth as one of the explanations as to why compensation boards are having difficulties in the 1980s and 1990s with service levels.
The other one I will bring forward for the committee's consideration -- and this is in no way ideological; it is based upon my experience in viewing what goes on in the 11 other boards in Canada I have visited -- is that Ontario has the most adversarial compensation system I think I have ever seen. By that, I mean that the original intent of workers' compensation was to replace tort as a method of compensating injury. The courts are an adversarial system where two parties come together and argue, and a learned judge makes a decision on the basis of those arguments as to who wins and who loses. The compensation system started off as a system where an administrative body, the Workers' Compensation Board, inquired and investigated a claim for benefit and made a decision.
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In Ontario right now the system, for various reasons, is very adversarial. In my opinion, part of the reason the board is having difficulty with its service -- and this may be a chicken-and-egg argument -- is because of the adversarial nature of the compensation system.
When it is designed so that workers and employers have disputes over work injuries, we do not make it easier for employers and workers in Ontario to worry about the important issues of productivity, maintaining Ontario as a manufacturing base. I, as an outsider, a relative newcomer to Ontario, find it of some concern to see the degree of adversarial compensation that exists in this province. Thank you.
Ms S. Murdock: You have sort of answered the question I was going to ask, based on your 24 years' experience in Saskatchewan and Manitoba. But ending on that, if you ended the adversarial nature -- and by that you mean the appeal rights for both sides, I presume -- would you be suggesting that the appeal rights for both sides would be removed or limited? Is that what you are suggesting?
Mr King: I am loath to make any suggestions in the area of reduction of the adversarial relationship.
Ms S. Murdock: I know that the comment has been made -- not necessarily here at hearings -- but certainly it has been made that it causes a lot of delays when you can just call in as a worker's rep and say, "I object to a claim."
Mr King: Here is my concern: Bill 162 is predicated upon a successful rehabilitation of injured workers back into the workplace. The plan is designed so that injured workers are rehabilitated back into the pre-injury employer's workplace, wherever possible. If, because of the adversarial nature of workers' compensation in Ontario, a dispute takes place between the employer and the worker about the compensation claim validity and on the various steps and appeal all along, it is going to be very difficult to maintain a relationship between the two parties that will lead to an effective rehabilitation back into the workplace. In other words, if alienation takes place because of the --
Ms S. Murdock: Particularly by the time you get through the appeal system, it could be two years.
Mr King: I am not claiming that employers are fighting claims because they want to fight against their employees. It is that, because of various things that exist in Ontario such as the second injury fund and such as merit rating and such as the high assessment rate, employers are very concerned about workers' compensation costs.
There are really only three things they can do about it. One is to try to work on safety, another is to work on rehabilitating the worker back into the workplace as quickly as they can, and the third is to fight the claim, to prevent it from being established or reduce the costs on that claim. So my concern is not with the rightness or wrongness of anyone's position; it is whether we can make this system work if too much alienation takes place because of the adversarial system.
Ms S. Murdock: I am not asking you whether it is right or wrong.
Mr King: I agree with that.
Ms S. Murdock: I just wondered whether reasons would have to be given. Is that the kind of thing you are thinking, that when you appeal a decision you do not just appeal it? For instance, it was suggested by the CUPE -- I think it was CUPE, one of the presenters -- that a lot of the advocacy groups for employers have been hired and are simply lodging objections and appeals from old claims that have been sitting in the files for years. They are just objecting; I mean, "I object to the decision of," and do not give any valid reasons. Is that one area that -- -
Mr King: It is very easy for me to be misunderstood in my answer and I want to stress once again: this is not ideological. Appeals are coming at us from all sides.
Ms S. Murdock: Yes. I am not talking just employer side; I am talking worker side as well.
Mr King: We have, internal to the compensation system, two levels of appeal. We have the initial decision being made, we then have the review branch where a review takes place, a paper review, and then we have a hearings branch, and a good deal of litigation does take place at all three layers: at initial adjudication, at review branch and at the hearings branch. All I am trying to point out is that when you involve litigation, you involve rules of natural justice for both sides, and that leads to delays because you simply must allow people time to prepare.
I am merely pointing out that this, in my view, is leading to some question as to whether we can provide the service that people want us to provide. We simply have delays built in through process and through rules of natural justice that we cannot solve easily. And I have this larger concern, which is whether the new bill, which so heavily stresses rehabilitation, will ultimately succeed in getting workers back to work.
Mr Dadamo: You were alluding to an operative word a little while ago called telephones and you used it quite extensively during your presentation. I still find that the first impression is the longest-lasting impression in someone's mind. Now the initial contact is the telephone, right? What is the mandate of yourself or Mr Di Santo or the WCB to help alleviate some of that? In the riding in Windsor where I am, people are still getting answering machines.
Mr King: There are two parts to the answer. Someone had asked Mr Di Santo what authority he has to effect change, and his authority is to keep on me because I guess I am the administrative person responsible. We are working to leave the machine in the compensation system only where it is requested or specifically called by whoever is getting in touch with us. We have a system whereby people can make a simple inquiry about their compensation claim by use of a machine. We will leave messages as to when their cheque was mailed or other messages, and about 1,000 of those 16,000 phone calls a day that I mentioned are being handled by that machine, which means that people are beginning to utilize technology.
But the problem is that they would get that machine whether they wanted to or not. It would say to them, "If you want to talk to me, you press zero," or "If you want to go to..., you press 1." So what we are doing is, very shortly we will be setting the machine -- sorry about my simple language, but that is about my level -- we will be putting the machine over here with a special telephone number. We will be advertising that heavily, so that people who are utilizing that and who wish to get that direct message that they are after can continue to use it, and they can use it after hours as well because it does not sleep.
But our plan is that the first call that comes in will meet a human voice, and further, that they will not be then transferred to an answering machine. It is called a warm hand-over. We will attempt to put them through to the party they wish to speak to. If that party is unavailable, we will ask them if they wish to leave a message on the answering machine. If they do not want to do that, we will ask them if they want to leave a message with the person who answered the phone, and we will get the call returned as soon as possible. So the difference we are working towards is that a human voice is the first voice you get. I looked at some progress reports on that. There are some logistical problems but we are talking in terms of less than months. We are talking in terms of a short term in which we will be moving to this solution.
1730
The Vice-Chair: Mr O'Connor, you have maybe one and a half minutes.
Mr O'Connor: One thing I asked Odoardo when he was here was about legislators trying to help the process. I have heard there are a lot of delaying tactics written into the act that have been used, not necessarily in trying to help the injured worker receive the compensation he needs, and which in turn puts an added strain on social assistance and other programs.
Is there any way then that we can speed up or enhance the process so that we get that person through the adjudication process and into rehab more quickly? Does it require legislation or just policy changes?
Mr King: The management committee at the Workers' Compensation Board and the board itself are acutely aware of the service requirements we must meet. You will be getting formal requests for legislative amendments from the board, which will serve either to correct what we consider to be drafting errors or, if not drafting errors, parts of the act which perhaps retard us or deter us from providing the proper levels of service.
One thing about workers' compensation, though: It is an issue which affects industry and employees and it is really a social contract between the two of them to some extent. What we have to keep working on is to get that recommended solution from the parties, or if both of them do not agree that it is the proper solution, through a consensus model, then it may not work as well as we would like. We will be coming forward with recommended improvements to the compensation system. Right now I could not volunteer anything for you.
The Vice-Chair: I thank you, Mr King, for coming before us. I would also like to take this opportunity to thank you, Mr Di Santo, and the people from the board. They have been very attentive throughout these hearings and I know they are awaiting our report with bated breath. They just cannot wait to see what we come down with. Of course you will receive your copy as soon as Mr Di Santo does.
ORGANIZATION
The Vice-Chair: There are a couple of other things we have to deal with, first a budget that was passed out. Are there any questions on it? No questions?
Mr Ramsay: Are we still on the record? Is this discussion on Hansard?
The Vice-Chair: We can be -- unless you wish --
Mr Ramsay: It does not matter. I was wondering first of all whether we have set a date to begin the summer sessions for committee. Has that been decided by the House leaders yet?
Ms S. Murdock: We cannot hear.
The Vice-Chair: Okay, we will hold everything up for a sec.
In answer to that, item 2 on our list is the sitting times for the summer.
Mr Ramsay: All right. I guess that is to do with the budget. You are presuming we are going to travel. Has that been decided yet?
The Vice-Chair: It appears at this point -- and on Monday we will probably be discussing it -- we are hoping to have a subcommittee meeting which I am also to inform you of. It looks like we will probably have wage protection, and there was some assumption that we would travel around on that. I believe that is where it is. With the Chair not being here, I am not exactly sure.
Mr Ramsay: My question is, is it not a little difficult to decide on the budget when we really do not know what we are going to be doing?
The Vice-Chair: Okay, assuming we do get the wage protection -- and all indications from the House leaders are that it will be at that point -- that is what we will be doing. They are looking at five weeks of hearings. That is what we are going to request. I think the House leaders have agreed there will not be any committees meeting until at least 29 July. We are looking, hopefully, at August and 1 September, something like that. This was just a budget we had brought forward based on those assumptions.
Mr Klopp: This is only my second time on one of these budgets. I am assuming that just because we pass this budget, it is a fairly standard procedure they go through, and it does not mean that just because we put down travel time, we are going to go and say, "Well, let's go travel." It is just a standard procedure for us to pass, and then I hope we will all frugally make sure we do not waste any more money on this project.
I was concerned last time about some of the numbers we had. But it was pointed out by the clerk that just because there are $10,000 for printing, we do not go and spend $10,000 for printing, but that you might as well have that in your budget so that you know what is going on. I do not have a really big problem with this budget, knowing that I am also part of the group. If we do not have to travel, we should not travel, but the money should be there. So if you are looking for a motion to pass it, I am ready to pass it now and get on with it.
Ms S. Murdock: I move that the supplementary budget in the amount of $226,770 be approved, and that the Chair be duly authorized to present the budget to the Board of Internal Economy.
The Vice-Chair: Any further discussion of Ms Murdock's motion? There being no further discussion, all those in favour of the motion? Opposed, if any?
Mr Dadamo: Not opposed; for the sake of being able to make some summertime plans like regular people do, is it the subcommittee that will put together the time frame as to when we are meeting during the summer months?
The Vice-Chair: At this point, that is very much in the House leaders' hands. The three parties will sit down and prioritize who sits when and which committee sits when and then it comes back to us. That is my understanding.
Ms S. Murdock: Mr Chair, that is true. From 10 August to 15 August, I am in BC on the Canadian Regional Conference of the Commonwealth Parliamentary Association, and given that I am also the parliamentary assistant to the Minister of Labour and will be carrying the Wage Protection Act, if that is the legislation we will be carrying, I will not be able to sit during that time.
The Vice-Chair: I believe they are taking all those things into consideration. I seem to recall seeing something where they are going to try to make sure all members of the committee have only one major committee function through the summer months, therefore we may assume our fearless leaders and the whips in the House leader's office are going to determine what committee we are going to be on and where we will be.
Ms S. Murdock: I do not care what happens; I am going to be in BC on 10 to 15 August. They can schedule it if they wish, but I just want you to know.
The Vice-Chair: Wait a minute. We are not finished yet. We have a couple of other things.
Mr Ramsay: I insist that the member be here with us.
The Vice-Chair: There has been a suggestion that the subcommittee only meet on Monday at 3:30 and that we meet as a whole committee on Wednesday, our regular committee day, and that we would be prepared to give instructions to the researcher on Wednesday.
I think it was in Mr Di Santo's presentation today that there was some talk about an informal visit to the board, if we so wished, outside of our normal committee time, which would not cut into this. So maybe if everyone wanted to talk to their subcommittee person between now and Monday, we might be able to get that put together if so wished.
Mr Ramsay: Mr Chairman, the purpose of the subcommittee meeting on Monday is to organize our schedule?
The Vice-Chair: Yes.
Ms S. Murdock: One other question to the researcher: In the summary of witness recommendations we have been getting -- which are so well done, I might add -- I was just wondering how much work would be involved in summarizing in chart form or whether it could be done. For instance, so many of the groups had such similar views, or repeated the same kind of problems that occurred, that it would really just make it a lot easier to integrate them.
The Vice-Chair: This is the number one concern? The number two concerned --
Ms S. Murdock: No. A chart that says "telephones" along the side, for instance, would have "telephones" along a side, the groups down a side and you would just put a dot or check or something on those groups who stated that --
The Vice-Chair: Oh, we are into a camping book now.
Ms S. Murdock: No, you would have one page with all the information on it, really. That is what I am suggesting.
Ms Luski: In addition to that type of summary.
Ms S. Murdock: It is just a question, Mr Chair.
Ms Luski: I will do my best. I will see if I can pull something together for Wednesday.
Ms S. Murdock: Thank you.
The Vice-Chair: Any further questions? Any other discussion? Hearing none, I adjourn the meeting.
The committee adjourned at 1742.