Jun 212018

By Gerald

WCB policy 03-01 Part II Application 7 specific to chronic pain and chronic pain syndrome is broken down into two parts, one part of the policy is specific to chronic pain and the other part of the policy is specific to chronic pain syndrome. According to the policies and how they are interpreted by WCB, DRDRB and the Appeals Commission, workers diagnosed with chronic pain will not receive full compensation benefits as would other workers who are diagnosed with discernible organic diagnosis. Workers diagnosed with chronic pain may receive treatment only as per WCB policy, with no monetary benefits or any rehabilitation benefits. Clearly, this is discrimination. WCB policy 03-01 Part II Question 2 states in part: “WCB may consider treatment for chronic pain” but only if chronic pain has the prescribed characteristics found in question 2. WCB Policy 03-01 Part II Question 3 states in part; “chronic pain syndrome may be compensable” meaning that chronic pain syndrome is compensable ( Compensation is based on loss of earnings,  if a worker meets all the prescribed conditions as well as marked life disruption

If a worker is diagnosed with chronic pain syndrome, according to WCB policy, they will receive full compensation which would include monetary benefits and vocational rehabilitation which also results in discrimination against workers diagnosed with chronic pain who only receive treatment for chronic pain and is contrary to to Alberta Human Rights Legislation and Section 15.1 of the Charter. This is not rocket science and questions what convinced Smallwood and Mason to  dismiss my complaint despite being upheld by the Southern Regional Director (Pardeep Gundara), the Southern Regional Investigator, Shirleen McGovern( Lawyer) and the Director’s Legal Counsel, Jim Foster. Questionably is if WCB paid Mason and Smallwood to dismiss the complaint because the overwhelming cost of having to rehear all claims involving chronic pain and having to pay workers hundreds of millions of dollars in restitution along with interest for the benefits workers are supposed to be entitled to. The complaint was so simple that any moron should have been able to understand, yet Smallwood and Mason dismissed the complaint based on what they considered to be lack of prima facie evidence to support the complaint. Clearly if workers diagnosed with chronic pain  would only receive treatment, no monetary benefits, no vocational rehabilitation, they are not being treated equally but clearly being treated differently than other workers who received full monetary benefit.

As every one knows or should know, Section 56 of the WCA provides a lifelong pension for an impairment rating that WCB were using illegally as a direct method of rating a disability. That has been factually proven by the Alberta C of QB and the Alberta Court of Appeals, the courts in Nova Scotia and the Courts in the Yukon. This means that in order to be assessed a PPD in compliance with Section 56,  a worker must receive a PCI rating. If a worker does not receive a PCI rating, a worker would not be entitled to a PPD and life time pension meaning that all workers diagnosed with chronic pain would not receive a PCI rating, no PPD rating and no lifetime pension. PCI ratings are derived from the Alberta Guides and if the Alberta Guides are silent or deficient, then a physician in order to provide a PCI rating may use the AMA Guides latest edition. The Alberta Guides do not and and to this day never have provided a PCI rating for chronic pain which leaves only the AMA Guides that did not provide a PCI rating for chronic pain until 2007 when the AMA Guides 6th Edition were published. Questionably then if all workers must be assessed a PCI rating, what “Guides” did WCB use to assess a PCI rating prior to 2007.  Impairment ratings cannot fluctuate by any more than 10% which would mean that physicians had to have some sort of guidelines to ensure consistency. No one in WCB can answer this question as no one knows how they could have assessed a PCI rating without any “Guides” Further questioning is, “can foreign doctors who have no standings in Alberta or Canada determine on behalf of WCB what compensation workers in Alberta will receive. In my legal opinion, this would be illegal. No one at this time knows who provided the impairment ratings for the Alberta Guides and we know that American physicians provided impairment ratings for the AMA Guides meaning that foreign physician are in fact determining what benefits workers in Alberta would receive.

Worse yet because impairment ratings do not measure a workers ability to work, workers who were diagnosed with erectile dysfunctions, had difficulty reaching an orgasm, brushing their teeth, defecating, urinating prior to Jan 1, 1995 would receive up to a 15% PPD rating for the rest of their lives when WCB were illegally using impairment ratings as a direct method to determine a PPD rating and after Jan 1, 1995 would receive a 15% lump sum payment for a NELP as opposed to workers diagnosed with chronic pain who received nothing  but treatment  How then could Mason and Smallwood determine that workers diagnosed with chronic pain were being treated equally. Receiving no benefits other than treatment for chronic pain while other workers receive full benefits such as a loss of earnings, vocational rehabilitation and as well medical treatment would not be considered to be equal treatment.

Any one who claims that the administrative law system is far better than having claims heard in the courts has to have rocks in their head. Administrative law systems and adjudication by morons who have no training in medicine, no training in law, have no idea how to interpret legislation, regulations or WCB policy should not be adjudicating claims when no one has a clue what they are doing has no advantage over having claims heard in the courts under civil law. Administrative systems could work if we had a Justice Minister who was an expert in administrative law as it pertains to workers compensation, a minister in charge of WCB who knew the system inside out and a premier who also was an expert in administrative law as it pertains to workers compensation. Unfortunately this is not the case with all of the a fore named people having as much of a clue as the people adjudicating claims. If administrative law  was better why is it that claims that go back nearly 50 years are still being disputed and there are thousands of disputed claims with many workers simply giving up or committing suicide. The same crap that existed when the Conservative Government were in power is the same crap that will continue during the time the NDP Government is in power with very minor changes being made to a corrupt and badly managed system to the detriment of workers. Anything worth doing is worth doing right and if you cannot do it right, scrap the entire system, entitle workers to social services benefits and allow workers to sue the employer under the rules of civil procedure and not give workers the false sense of security that this is an inquiry based system and all they have to do is file a claim if they are injured and WCB will look after them. This is nothing more than a crock of shit and not realized by workers until they are injured, only to find they are on the outside looking in.

The whole system is convoluted and ambiguous with no one including the Office of the Ombudsman. I requested that the Office of the Ombudsman make this determination as to whether the system is an Inquiry system or an Adversarial system. The answer to this was that when a claim is filed, it is an Inquiry system and the burden of proof is on the “Board” It becomes an Adversarial system when a worker appeals the decision of the Case Manager  according to the Office of the Ombudsman. According to Justice Millar who presided over a Judicial Review which we won, the system is based on an Inquiry system and remains an Inquiry system throughout a claim. Question is, does any one really know how the system works. You would think that after over 100 years that the system would be a smooth running system rather than a system that no one can explain the purpose and philosophy of workers compensation and if it is even required being that the majority of workers wind up on Social Services or CPP Disability.

  11 Responses to “Workers diagnosed with chronic pain discriminated against and the reasons why they are discriminated against”

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  10. I was diagnosed with CRPS. Bullied and harrassed at work belittled in front of customers. I went to my union rep who told me that because I was casual, I had no rights. The General manager for the company lives in Edmonton, he refused to do anything about the bullying and harrassment. WCB couldn’t do anything. I got let go from my job. WCB is saying that because lidocaine infusions are experimental that they would no longer be covered. I have been getting them since last June along with ketamine cream. I have been told in writing that WCB will no longer cover anything. WCB put me in for job search. There was a lot of mistakes communication and some emails I did not receive from my case worker. There was a letter written up on Friday the 15th. I received it late Monday after noon and WCB was closed. So I emailed my caseworker to respond. I went to my apt for job search at which time I was told that my caseworker discharged me from it. I sent an email to her and told her that she did not give me any time to respond if that letter was done on Friday and it left Edmonton and it got here late Monday afternoon that is completely unfair the lady who I met the next day refused to take my paperwork in regards to the job search so I mean emailed everything to my case worker it’s been 2 days and I still have heard nothing and apparently my caseworker is not in the office and I’ve asked her to reinstate. I am being told that any medications that they were paying for they are no longer going to cover and that I’m too basically just suck it up with the pain I have seen several doctors and specialists and their recommendations have repeatedly been denied. When I first got injured it was recommended that I go to an intense Therapy Program to help deal with the CRPS WCB denied. At least four to five times.

  11. Gerald I like your site and I know you truly have compassion to injured workers but I have trouble reading and understanding what this is all about. The WCB system is too complicated for me and I believe many others feel the same. The system if it is to run a fair and just program for the workers should be private and competitive which likely would be cheaper and more efficient. Private insurers can offer 24/7 insurance and their agents work together with the policy holder ensuring the claims are correctly taken. The Workers Compensation Board and their personnel are unfit for such employment requiring companion and empathy.
    Sort of like the NDP and socialism. Their system only works for them and their friends which obviously does not include injured workers.

    I still do like your site and what you are trying to do but still nothing is changing to better conditions of the injured workers.

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