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WSIB responds to Alec Caldwell’s post alleging a claims denial binge: “No change in the WSIB’s allowance rate”

John Slinger, the WSIB's chief operating officer, said that Canadian Contractor's article by Alec Caldwell contained "inaccuracies."


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November 11, 2015 by Steve Payne

Editor’s note: Yesterday (Nov. 10), the WSIB’s chief operating officer, John Slinger, sent us his official response to Alec Caldwell’s post arguing that the WSIB has been improving its financial position on the backs of denied claimants. Here it is…

Note: We have made a note in Alec’s article of the WSIB’s unfunded liability being $7.5-billion, according to Mr. Slinger, not the $9-billion Alec stated.

 

I am writing to you today to correct the record in terms of the inaccuracies contained in the article which appeared in the online version of your publication on November 10 by Alec Caldwell regarding the WSIB. The following are the key points I am writing to address:

Claims Eligibility

There has been no change in the WSIB’s allowance rate. Today, workers are getting their claims approved faster than ever before. In fact, 92% of all eligibility decisions are made within 2 weeks, compared to 65% in 2008.

Health Care Costs

Regardless of the type of injury or its severity, the WSIB’s role is to give the support needed, to make sure that, wherever possible, workers are able to recover and return to work and that there are no financial costs for the worker as a result of the injury.

When an injury occurs or an illness is diagnosed, the WSIB acts quickly to ensure workers receive timely, specialized medical care. The WSIB has established a network of Specialty Clinics and Programs of Care throughout Ontario that integrate recovery treatment and return to work planning to ensure optimal outcomes.

Today over 40 per cent of claims are now treated through at least one of these programs, up from just 18 per cent in 2008. Workers are returning to work more safely and sooner. For example, compared with 2010, the number of workers today with back injuries that develop permanent impairments has decreased by over 80 per cent.

Financial Sustainability

Returning the WSIB to financial sustainability is central to the well-being of injured workers, by ensuring the system is there for them in the years to come. It was only in 2009 that the Auditor General warned that the state of the WSIB’s finances was so unbalanced that it threatened to collapse the entire system. This would have been a catastrophic loss for Ontario workers. That threat is now a receding memory with the system’s Unfunded Liability now down to $7.5 billion (not, as your article states, “somewhere around $9 billion”) from an unsustainable high in 2012 of $14.2 billion.

All of this is framed by the strongest recovery and return-to-work outcomes of any province in Canada: Throughout 2014, 92 per cent of injured workers with lost-time injuries returned to work with no wage loss within 12 months of their injury. I hope the foregoing serves to correct the record as portrayed by Canadian Contractor.

Sincerely,
John Slinger
Chief Operating Officer
The Workplace Safety and Insurance Board


Steve Payne

Steve Payne

Steve Payne is the editor of Canadian Contractor magazine
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14 Comments » for WSIB responds to Alec Caldwell’s post alleging a claims denial binge: “No change in the WSIB’s allowance rate”
  1. Tim Milberry says:

    2010 was struck in the head by a backhoe 5yrs latter here I am on odsp and ccp disability diagnosed ptsd anxiety and depression? as of 2yrs ago was good to go back to work wsib say’s only prob need clearance from doctor to go back to my job not going to get that are my? not been paid by wsib for last two years guess under the bus I go I had to spend three weeks in hospital do to being suicidal and homicidal? Not proud of that but still here thanks to the good doctors at Kingston general hospital could have been another death do to wsib bullying we won’t stand for that in schools but OK for wsib totally brutal to try to deal with these hartless people (all I did was wen’t to work and look at me now) lost girlfriend apartment cars and now in collections and living with my mother? not nice at 53yrs old not much to look forward too is there

    • Shane marks says:

      Girl friend hurt herself at work washing cars and tore her shoulder . Was forced back to work with a injury and is now suing WSIB . Funny how legitamate claim was denied after she had to stop working because her shoulder was still not healed . She will win and they will have to back pay her for the last two years … Oh and guess what still having shoulder problems . WSIB is a f#cking scam

  2. Laura Feeney says:

    John Slinger is an overpaid liar, and given the opportunity I would say it to his face; however, this will do for now.

    http://writehere.com/post/150206-2/attention-david-marshall-at-the-wsib

    Laura Feeney

  3. Harold Kinley says:

    John your full of crap! The only reason you have the strongest recovery and return to work is because your denying claims and people have to go back because of the financial burden wsib creates. Your specialty clinics are more of a lion hunt looking for the weak to pray on.

  4. Sean Keane says:

    Peculiar,
    Mr. Slinger’s response shows that the WSIB is certainly following you magazine and it’s many articles dealing with their alleged incompetence. With a wide range of Media Outlets now covering the plight of Injured workers, seemingly endless coverage of those who have been denied benefits or have taken years to fight for what they deserve. Mr. Slinger has made no comment.
    However what he has done is provide a picture that seems to back up what the media is portraying. The reason behind the decrease in the Unfunded Liability. How did it drastically decrease in the last two years. What changes occurred within the WSIB. They have boasted for the last couple of years a zero increase in employer premiums so that didn’t generate a surplus. They have hired more back to work specialist’s, Doctor’s and Nurses, a larger number of Auditor’s etc… again would be a reverse effect. Is this gentleman implying that injuries have drastically decreased, people are no longer requiring their services.
    Does he think we are all fools, funny he has never mentioned the lawsuits filed against them, the amount of which continue to grow, he has never responded to the fact that a lot of these situations and decisions when getting to WSIAT are overturned. He has no comment about the multitude of WSIAT decisions similar in nature that are time and time again resolved and at every turn the WSIB is told by WSIAT their decision process is flawed. The following day WSIB continues business as usual and perpetrate the same offence on their next victim.
    So I as Mr. Slinger how he would like to respond to these issues, simply put we know your following these articles and response’s.

    Sean Keane

  5. Erin Hawkins says:

    I recognise as an employer paying your premiums as you’re required to so, you unlikely do not know who to believe. I will summarize what WSIB has been doing for at least a decade but has accelerated their attacks on injured workers in the last 5 years. WSIB collects premiums from employers to protect themselves from lawsuits & to provide for workers who are injured on the job. Like a person buying a life insurance policy, $100,000.00 for your dependents to provide for their financial futures. Imagine that when that day came and your family tries to collect with your death certificate in hand. The response of the insurance company was to tell your dependents & beneficiaries that they will only pay them $20.000.00 or simply refuse payment altogether take it or leave it…file an appeal. If you appeal though we may refuse past benefits paid to you. How would you feel? This is how injured workers are feeling. How is this possible? WSIB is an arm’s length agency of the Ministry of Labour. WSIB; Don Marshall, Elizabeth Witmer & John Slinger tells the Labour Minister what he wants to hear but the reality is completely different for injured workers. The truth is in the details. WSIB has implemented discriminatory policies that completely overrides WSIA legislation. Such as “deeming”; deeming an injured worker well enough to return to work based on WSIB’s new policy & not based on medical evidence of the worker. Creating clinics to rubber stamp this false medical information that contradicts a worker’s specialist reports. Outright denial of all benefits to older & psychologically injured workers based on new policy not WSIA. Deemed 80% to 100% reductions to injured workers benefits based on “phantom” wages when a injured remains medically unable to work. Why should employers care if it keeps their premium rates down? Employers are paying twice for these worker injuries, through premiums and through their taxes as these now poverty stricken injured workers & their families fall onto various government programs since WSIB is not paying legitimate claims, arbitrarily reducing benefits & health care supported by lots of medical evidence. My own situation is supported by numerous medical reports from 5 doctors & specialists stating I remain unable to work for medical reasons but WSIB has cut my benefits by 80% through deeming. Taxpayers are paying for these workers & their families since WSIB has refused to pay but this hasn’t stopped WSIB from collecting premiums so where are these premiums going? Check out the Sunshine list, there’re hundreds listed from WSIB. WSIB is suggesting this is necessary to cover an unfunded liability or put another way to put enough in their savings account to pay for bills that do not come do for payment for another 10-30 years. These injured workers & their families are your neighbours but they may also be your consumers. Therefore forcing them into bankruptcy doesn’t help local businesses.

  6. Bob2 says:

    $9 billion, $7.5 billion, tomatoe, tomato

    It still looks like huge incompetence, not to mention that this incompetence is being paid large sums of money, eventually Karma will get these people, it does come for all, believe me.

  7. John Çowles says:

    Ìñjùŕeď worker should get all benefits from the W.S.I B. The workers in 1915 give up there ŕight to sue the W.B.C. àñd to treat fair , àñd get benefits às long as the injured last.

  8. Erin Hawkins says:

    Ontario Workers; do you think you’re covered if you are permanently disabled in your workplace? WSIB does not track what happens to these injured workers whose benefits are arbitrarily cut. They track how much has been paid out in benefits and how long these benefits have been paid. Therefore when WSIB talks of benefit reductions they are talking about benefits cuts but not a reduction in the need for these benefits. But WSIB likes to suggest that they are helping injured workers better so benefits paid out have declined. These statements are misleading since injured workers are simply having benefits cuts before they are medically able to return to work. Real recovery times for specific injuries can’t be reduced through benefit denial since the body continues to need the same amount of time to heal regardless of whether injured worker is receiving WSIB benefits or not. Most of WSIB statistics are from 20 years ago before WSIB introduce drastic policy changes that completely undermine Worker Compensation Legislation, WSIA & intentionally forces injured workers into poverty. I recognize most readers will not know who to believe on the WSIB debate, injured workers, physicians or WSIB executives. I will summarize what WSIB has been doing for at least a decade but has accelerated their attacks on injured workers in the last 5 years. WSIB collects employers’ premium that protects employers from lawsuits & to provide for workers who are injured on the job. Like a person buying a life insurance policy, $100,000.00 for your dependents to provide for their financial futures. Imagine that when that day came and your family tries to collect with your death certificate in hand. The response of the insurance company was to tell your dependents & beneficiaries that they will only pay them $20.000.00 or simply refuse payment to them altogether take it or leave it…file an appeal. If you appeal though we, the insurance company may reverse decisions for past benefits paid to you. How would you feel? This is how injured workers are feeling. How is this possible? WSIB is an arm’s length agency of the Ministry of Labour. WSIB; Don Marshall, Elizabeth Witmer & John Slinger tells the Labour Minister what he wants to hear but the reality is completely different for injured workers. The truth is in the details. WSIB has implemented discriminatory policies that completely override WSIA legislation. Such as “deeming”; deeming an injured worker well enough to return to work based on WSIB’s new policy & not based on medical evidence of the worker. Created clinics to rubber stamp this false medical information that contradicts a worker’s specialist reports; and outright denial of all benefits to older & psychologically injured workers based on this new policy not WSIA. Claims accepted that are “deemed 80% to 100% reductions” to injured workers benefits based on “phantom” wages when injured workers remain medically unable to work. Why should employers or Ontarians care if it keeps WSIB premium rates down? Employers are paying twice for these worker injuries, through premiums and through their taxes as these now poverty stricken injured workers & their families fall onto various government programs since WSIB is not paying legitimate claims, arbitrarily reducing benefits & health care supported by lots of medical evidence. My own situation is supported by numerous medical reports from 5 doctors & specialists stating I remain unable to work for medical reasons but WSIB has cut my benefits by 80% through deeming. Taxpayers are paying for these workers & their families since WSIB has refused to pay but this hasn’t stopped WSIB from collecting premiums so where are these premiums going? Check out the Sunshine list, there’re hundreds listed from WSIB. WSIB is suggesting this is necessary to cover an unfunded liability or put another way to put enough in their savings account to pay for bills that do not come do for payment for another 10-30 years. These injured workers & their families are your neighbours but they may also be your consumers. Therefore forcing them into bankruptcy doesn’t help local businesses or the economy.

  9. Erin Hawkins says:

    WSIB 2015 Economic Statement-
    November 20, 2015
    In the 1970s, the Union of Injured Workers rallied injured workers with its four demands and its description of workers’ compensation as “cheap insurance for boss”. After 40 years, the Board in 2015 is proud to announce “even cheaper insurance for boss”. They call it a “2015 Economic Statement” and you can find it attached to a recent News Release. It is a continuation of a 20 year pattern that began with the election of Mike Harris in 1995; it is only fitting that his Minister of Labour, Elizabeth Witmer would be at the helm of the Board for this announcement.
    A BRIEF HISTORY
    Injured worker efforts beginning in the early 1970s led to real improvements for injured workers over the next 10-15 years, and increasing assessments for employers. When Mike Harris’ government took office in the 1990s, he promised to reduce benefits and assessments and he did so. Drastically. His government reduced assessments by 30% and benefits by 15% in a variety of ways. This disparity between the assessment and benefit cuts eventually led to a significant deterioration of the WSIB’s financial position; it was masked for almost a decade by spectacular investment returns, but this windfall ended in 2007. The WSIB then had to choose between raising assessments, cutting benefits or allowing the Board’s financial position to remain poor. The Board decided to raise assessments by a total of 9% between 2008 and 2014 and to cut benefits in a number of less visible ways:
    • more claims denied (almost double the previous rate)
    • a removal of any concern about sustainability in the return to work process
    • much greater use of surveillance to deter claims
    • much more stringent decision-making with respect to psychological conditions
    • extreme reluctance to accept that middle-aged and even older permanently impaired workers are unemployable
    • revision of policies and practices with respect to the aggravation of pre-existing conditions
    • reduction of NEL awards by administrative practice
    Most of the benefit cuts were achieved without any specific change in policy by administrative fiat from senior management.

    THE 2015 ECONOMIC STATEMENT

    The modest assessment rate increase and the significant benefit cuts have resulted in a better financial position for the Board. Here’s what the Statement says:
    Over the past five years, transformational changes in operations and improvements in workplace safety have resulted in a remarkable turnaround in the WSIB’s financial position. Despite some concerns about a slowing economy, there is a possibility for the WSIB to reach the legislated target of 100 per cent funding five to six years ahead of schedule. This gives rise to the opportunity to reduce employer premiums and provide much needed assistance to Ontario’s employers beginning as early as 2017. Once 100 per cent funding is reached and a prudent margin of safety is maintained, employer premiums can be reduced to a level that is well below the Canadian average and more than $2 billion can be returned annually to Ontario’s economy.
    And the Statement details what the WSIB plans to do with its foreseen bounty- a reduction in premiums of 13% by 2022 and further reductions until premiums will be just over half what they are today in 2032, levels that Mike Harris could only have dreamed of.

    THE UNDERLYING IDEOLOGY
    What does it all add up to? Lower benefits for injured workers, lower premiums for employers and “$2 billion injected into the Ontario economy”. Wait. Isn’t that trickle-down theory? If you give a whole truckload of money to employers in the form of lower assessments, they’re going to invest all of it in the Ontario economy, right? Maybe they will and maybe instead they’ll return more money to their shareholders. Book those all-inclusive luxury cruises now.
    Income inequality has many causes. Sometimes it is dressed up. This is one of those cases.
    Big business are getting cheaper insurance but most businesses are paying twice for injured workers; premiums & through their taxes as injured workers are forced unto taxpayer funded government program to survive in poverty.
    Gary Newhouse, Barrister and Solicitor & Michael S. Green, Barrister and Solicitor
    Workers’ Compensation Lawyers

  10. Erin Hawkins says:

    November 5, 2015
    Whistleblower Report Exposes WSIB Interference in Medical Care:
    Doctors Allege Injured Workers are Re-Victimized by the Compensation System
    (TORONTO, ON) ─ The Ontario Federation of Labour (OFL) and the Ontario Network of Injured Workers’ Groups (ONIWG) today released a damning report exposing interference on the part of the Workplace Safety and Insurance Board (WSIB) in the medical care of injured workers.
    “This report confirms what injured worker advocates have been hearing for years – that the WSIB system is more interested in clearing its case load than supporting workers who have been seriously injured on the job,” said OFL Secretary-Treasurer Nancy Hutchison. “These doctors are blowing the whistle on the WSIB’s punitive practice of ‘deeming’ injured workers eligible to resume work when their treating physicians and medical professionals have clearly stated the opposite. The report we are releasing today tells the story of these doctors and their patients. We hope it will force a formal investigation into the WSIB’s treatment of medical advice and lead to systemic change.”
    The report, called “Prescription Over-Ruled: Report on How Ontario’s Workplace Safety and Insurance Board Systematically Ignores the Advice of Medical Professionals,” was produced with the assistance of six registered psychologists who originally raised the alarm about the WSIB’s management of medical care and medical evidence as it relates to WSIB benefits recipients. However, since then, many other medical professionals and injured workers have come forward to share similar stories about the WSIB’s failure to heed medical advice regarding readiness to return to work, insufficient treatment, blaming ‘pre-existing’ conditions for ongoing illness, and using independent medical reviews which proclaim patients to be healed, despite the evidence of treating practitioners.
    “Over the past 5 years, we have seen an alarming decline in WSIB services from difficult to impossible,” said Sudbury-based Rehabilitation Psychologist, Dr. Keith Klassen. “When I talk to other psychologists and health professionals they describe the same pattern. From what we see it seems that the WSIB has become a service whose prime objective is simply not to serve.”
    “The red tape is tangling up legitimate claims and preventing injured workers from getting the coverage they need,” said Sudbury-based Rehabilitation Psychologist Dr. Giorgio Ilacqua. “Behind every claim is a real person, with a family that has been turned upside down by a workplace injury, they deserve immediate and consistent care, not bureaucracy and red tape.”
    “The net effect is a WSIB system that re-victimizes the very injured workers it is mandated to compensate and protect,” said Hutchison.
    To download the full report, visit: http://ofl.ca/wp-content/uploads/2015.11.05-Report-WSIB.pdf
    The Ontario Federation of Labour (OFL) represents 54 unions and one million workers in Ontario. For information, visit http://www.OFL.ca and follow the OFL on Facebook and Twitter: @OFLabour

  11. Erin Hawkins says:

    WSIB BY THE NUMBERS
    2014 WSIB Highlights Schedule 1 and 2

    The truth is in the details: WSIB no longer tracks actual RTW outcomes. WSIB tracks the amount of benefits paid out for accepted workers’ claim. Many accepted claimants have their benefits reduced through WSIB’s new discriminatory policy that determines a worker well enough to RTW whether these injured workers are medically well enough or not. Whether an injured worker has returned to work or not phantom wages are deducted from their WSIB benefits throwing injured workers into poverty. The injured workers included in WSIB’s 87% as noted in the small print; “87% of injured workers were OFF FULL LOE BENEFITS within a month of an RTW staff member’s involvement”. WSIB makes it appear that 87% of injured workers have successfully RTW but many of these injured workers have had their benefits cut by 60%-100% while they remain medically unfit to RTW.
    The human body requires the same amount of time for injuries to heal regardless of whether or not an injured worker is receiving Full LOE. Today’s workforce is older on average so in fact these injured workers would require more time for their injuries to heal. Therefore when WSIB talks about a reduction in benefits being paid out to injured workers, they are talking about cutting injured workers benefits whether or not an injured worker is working or not through deeming recovery times based on WSIB policy and the deduction “deemed phantom wages” from the injured workers’ WSIB benefits. Registered Claims are also down by more than 100,000 from their highs and worker fatalities have increased or have been almost constant. The truth is in the details; WSIB isn’t honoring WSIA and not paying all of the benefits injured worker’s entitlement that they need. Serious permanent workplace injury => poverty & dependence taxpayer funded programs.

    Employers covered by the Workplace Safety and Insurance Act are categorized as either Schedule 1 or Schedule 2 employers. This report presents statistics for Schedules 1 and 2 separately.
    Schedule 1
    Schedule 1 employers are those for which the WSIB is liable to pay benefit compensation for workers’ claims. Schedule 1 employers are required by legislation to pay premiums to the WSIB and are protected by a system of collective liability.
    Schedule 2
    Schedule 2 employers are employers that self-insure the provisions of benefits under the WSIA. Schedule 2 employers are liable to pay all benefit compensation and administration costs for the workers’ claims.
    By The Numbers
    Data in By the Numbers: 2014 WSIB Statistical Report may not match previously published results. This is due to factors such as data maturity, updated definitions and methodologies, and rounding. Data in By the Numbers is matured three months, with the exception of benefit payments, which represents cash paid during the year to or on behalf of injured workers and are not matured three months following year end. Percentages may not add up due to rounding.
    © 2015 WSIB, CSPAAT
    Privacy / Protection des renseignements personnels
    Terms of Use / Modalités d’utilisation

  12. Erin Hawkins says:

    Quicker decisions = quicker denials so an injured worker can spend the next decade in WSIB’s appeals process.
    Even seriously injured workers whose claims are accepted; claims are arbitrarily reduced to below poverty levels through deeming so injured workers and their families are not receiving the full 85% of pre injury earnings. Are these workers ready to return to work? NO Reduction of benefits paid out = benefits cut while worker is still unable to RTW. WSIB only tracks how much is paid out in benefits; WSIB does not track successful RTW outcomes. Benefits are cut & WSIB closes the injured worker’s file whether the injured worker has RTW or on OW.

  13. Sabina says:

    WSIB sent me to their Altum Clinic. I had a torn meniscus resulting in an unstable knee. I should have had surgery to trim the meniscus but WSIB’s doctor did not recommend it. Within 11 months, my cartiriledge was stripped down to the bone by this damaged meniscus in my knee. I now have advance stage arthritis in the knee largely due to this doctor’s negligence. I found out after the fact, unstable knees should have arthroscopy.

    This doctor tried to convince me I had pre-existing arthritis. Another orthapod assure me when I initially had the injury, I had no existing arthritis in the knee. WSIB’s doctor then tried to mis-diagnose me with a much minor patella tendonitis to cover/delay the diagnosis of chondrosis/arthritis.

    He refused to order anything which would cost WSIB except grueling physio.

    Things which would have helped me: orthotics, knee brace, massage therapy, chiro were denied me because as he put it, “WSIB” would not approve.

    ANYONE having a work related injury, do not go to WSIB’s clinic.

    You will have a poorer quality of care than if you go to OHIP clinic.

    WSIB Clinic doctors have crossed the line from fiscal budget restraint to malpractice, and outright fraud: ready to misdiagnose workers to prevent/delay claims