Video by Doug Brinkman:
Click on the following link: http://www.cbc.ca/news/canada/
Just as I predicted, sometime in the near future, providing presumptive status for any occupation rather than all occupations is discrimination and would come back and bite the goofs that voted for and passed legislation for firefighters, then extended this presumption to first responders. There is and never has been any evidence that firefighters or first responders have any higher risk than any other occupation when compared to the general public which is how epidemiological evidence is gathered and is why the National Academy of Science does not or will not use the general public as a reference in determining causation.
Seems like Ontario always has to lead the way as the people we elect to represent us in Alberta must have fallen off a turnip truck. While I am a born and raised in Alberta resident, my question to the Government is why is it that Alberta is not leading the way in workers compensation issues rather than being the follower even going so far as to adopt the Meredith Principles which initiated in Ontario. Perhaps, the Alberta Government would simply rescind all legislation providing differential treatment to one group of workers and bring in legislation providing presumptive status in all claims for all workers and force WCB to prove contrary which is the way that it was intended to be right from the beginning according to Dr. Terrance Ison who before his death was Canada’s leading expert in workers compensation issues.
One of CIWAA’S goals is to have the provincial government re-open all WCB claims that were rejected due to an opinion by an independent medical consultant. We are in the process of gathering information and would like to hear from anyone whose claim was rejected because of an opinion by an independent medical consultant.
Carol will respond to all emails on behalf of CIWAA. Your information will be very useful to us as we work together to change WCB laws for the better. Please state if it can be shared with others.
If you feel you were unfairly assessed by a doctor, you can complain to their College. For a medical doctor, the complaint must be sent to the College of Physicians and Surgeons of Alberta (ACPSA). For a psychologist, the complaint must be sent to the College of Alberta Psychologists. Below is their contact information and link to the complaint page of their website. If you would like assistance completing these forms, please contact us.
1) College of Physicians and Surgeons of Alberta (ACPSA.)
2700 – 10020 100 Street NW
Edmonton, AB T5J 0N3 Canada
2) College of Alberta Psychologists
- College of Alberta Psychologists
2100 Sun Life Place
10123 – 99 Street NW
Edmonton, Alberta T5J 3H1
Toll free in Alberta at 1-800-659-0857
- Fax: 780-420-1241
Click on the following links; https://www.thestar.com/news/g
Little doubt that this is going to cost the Ontario WSIB billions of dollars to rehear long standing claims and then provide compensation to the thousands of workers whose claims and benefits were illegally denied. The ripple effect of this also will affect workers in Alberta and as well as other provincial governments whose claims and benefits were denied based on pre-existing conditions. Of note is that the issue is specific to the NEL (non economic loss) in Ontario and a NELP (non economic loss payment) in Alberta which is a separate discretionary award based on impairment ratings.
While the problem and subsequent blame involving apportionment is being blamed on Dr. Chris Brigham who is a friend of mine (Dr. Brigham was the Senior Editing Chair of the AMA Guides 6th Edition) who was basically doing what the “Guides” direct. Apportionment is used when there is a pre-existing condition and a compensable condition when the pre-existing condition is subtracted from the compensable condition to reach a whole person impairment. Being that workers compensation is based on a medicolegal scenario, by law using the thin skull rule, workers should not have their impairments apportioned as opposed to in the field of medicine, there must be apportionment.
The former Conservative Government after the review by Doerkson and Friedman reports enacted Section 157 .1 of the WCA to hear long standing claims which due to lobbying by the Alberta Chamber of Commerce suggesting that the decisions made by the long standing Review Panels would not change appreciably which I beg to differ. If all long standing claims were reheard by competent Review Panel members such as I, over 90% of the claims and benefits that were denied would be overturned. According to the Alberta Chamber of Commerce, the cost to review long outstanding claims would be approximately 4 million dollars which I also disagree with. The cost would most likely result in hundreds of millions dollars or billions of dollars going to workers who have been cheated from receiving benefits by WCB and the Appeals Commission and the latest news from Ontario would certain support my estimate of the cost. Unfortunately in Alberta we have no lawyers, worker advocates who are experts in worker compensation law and medicine so we have to wait for lawyers in other provinces to establish precedence.Lawyers and worker advocates in Alberta take advantage of desperate workers who use much needed money for food, lodging and care of workers children and make these workers believe that they are experts in law and medicine, take their money and then leave the worker and their families destitute. The blame for all of this is the provincial governments who aid and abet criminal fraud against the most vulnerable people, workers who put their lives on the line every day of the year trying to earn an honest dollar. These are the real heroes in our society, not just first responders who get all of the limelight.
Many people wonder as to why workers are forced back to work on the opinion of a “Board” doctor as opposed to a workers primary care doctor which happens all the time. Here is the answer. WCB Medical services provided all doctors with what were called medical duration guides which quite simply was the average length of time it should take for a full recovery from a work related accident. WCB Medical Advisors who never examine a worker would use these guides to determine when the worker should make a full recovery. As any one who is familiar with medicine knows, some people recover much earlier than others and some may recover much later or not at all. A WCB Medical Advisor would be asked by the Case Manager if the worker has recovered from an accident or illness and the WCB Medical Advisor would go to the duration guides and determine that the worker should have fully recovered despite the primary care doctor who has a duty of care to the worker and will not sign the WCB form indicating the worker can return to work. The worker is told that the WCB Medical Advisor has determined that the worker has recovered and they must return to work or have their benefits terminated. This evidently happened to Patrick Clayton who injured his knee and was sent back to work based on medical duration guides.
The Alberta WCB redesigned their web site and in doing so like everything else that could incriminate them decided to eliminate any trace of the medical duration guidelines. I have searched for these guides and unless I have missed them, they are gone which is a good thing for workers now but evidently was not a good thing for workers who were forced to return to work and re-injured themselves more severely than the original injury.
WCB Medical Advisors are protected by provincial governments through legislation who when confronted with providing false and misleading medical opinions will simply say they made an honest mistake. Case managers do not cherry pick as the article suggests, Case Managers are directed by upper WCB management that they must accept the medical opinions of a WCB Medical Advisor and not to request a second medical opinion or to accept the medical opinion of the workers primary care physician. I know this for a fact as I was told this by Francine Taylor-Gobeil, a WCB Case Manager. When will people finally realize that most, not all workers compensation systems are the most corrupt organizations in the entire world and make organizations like the Hells Angels look like pussies.
Determining causation to have a claim accepted is and has to be the stupidest condition of disability insurance. One hundred years ago causation involved only a half dozen causes and primarily physical causes and a hundred years later we have thousands of causes, both physical, mental and diseases caused by thousands of toxins int the work environment and outside of the work environment. Other than guess as to how or what level these toxins are within safe limits, no one knows what levels are safe or when there are a mixture of toxins, what the risks are. In reality, the system has become a money making scheme for doctors to guess what the cause may be because medical science lags far behind what is considered to be medical certainty. Workers face a quagmire of unsupported medical opinions that rarely result in established fact resulting in extreme costs to the system for unsupported medical opinions and is why WCB systems have reserves for unfunded liabilities to pay benefits to workers whose claims were illegally denied because the medical opinions were not valid. If in fact medicine was an exact science, there also would be no need to have reserves for unfunded liabilities.
When doctors provide medical opinions that are found to be invalid, there should be consequences with suspensions of their licenses, incarceration, or fines. The same should apply to Adjudicators who use unsupported medical opinions to illegally deny claims. The whole reason why workers are supposed to receive the benefit of doubt is to avoid any mistakes and when there is a difference in medical opinions, the benefit of doubt should be used rather than to beat a dead horse by having more doctors involved who provide more unsupported medical opinions. A system that was supposed to be for workers is under total control of doctors who determine the duration of injuries or diseases and send workers back to work before they have fully recovered, doctors determine work restrictions. Doctors determine whether a worker can perform sedentary work, light work, heavy work. Doctors determine whether a worker has chronic pain or whether workers are malingering. Doctors determine whether a worker has a psychological diagnosis or if they are faking. Doctors perform functional capacity evaluations that result in severe permanent injuries by forcing workers to perform activities they are not capable of performing. ( A doctor performing a FCE forcefully rotated the neck of a worker I am representing during an FCE and x-rays performed after the forceful manipulation of the neck determined the reason why the worker could not rotate his neck is that the worker had severe cervical spine problems) In actuality the medical costs of all workers compensation systems cost more than the benefits workers receive. Obviously the system has changed over the last hundred years and rather than change the system a hundred years later, the government continues to provide band aids to an ugly and gaping wound.
Lay people especially Adjudicators have this idea that doctors are experts in causation which they are not. Most doctors or all doctors receive their information from medical journals and text books rather than performing any studies of their own. What they read in these medical text books or journal is in many cases not true for the simple reason that there have been many incidences of ghost writers who write medical information in these text books and journals which are not based on any scientific studies or the medical information is written by writers employed by pharmaceutical companies and companies providing toxic materials to retailers who sell this toxic material to consumers. If a person can read and has access to medical libraries, the same information that these so called experts is available in all medical libraries and if a person does go to a medical library which I have done on numerous occasions, you will find doctors researching the same material as a lay person. I have read thousands of pages of medical literature that I was able to read with no difficulty at all in the Foothills Hospital Medical Library where in numerous cases the text books were outdated and had never been revised.
How many people are aware that pharmaceutical companies pay doctors millions of dollars to have their patients act as guinea pigs for new pharmaceutical products that have never been thoroughly tested. Doctors receive new cars, swimming pools, houses etc. to prescribe new prescription medications to unsuspecting patients who take these medications and become deathly ill or die. Take for example Bayers who introduced Baycol as a cheaper cholesterol lowering medication that when taken with gemfibrozil resulting in numerous deaths before it was pulled by the FDA but not before 31 deaths were reported. As with all statins, there is a risk of rhabdomyolysis which can lead to kidney failure and muscle wasting. This is only the tip of the ice burg as no one knows the cause of the interaction between any drug or toxin. Although many toxins when used by themselves pose relatively little danger, when mixed with something else becomes deadly. Mix bleach and ammonia and then get ready to call an ambulance. Take any statin with grapefruit and chances are you also would be faced with a risk of dying.
There are solutions to this hundred year old problem and that is to provide workers in the private sector the same dual disability insurance as workers in the public sector have such as fire fighters, police, paramedics as well as all other public servants by making all employers carry dual disability insurance so that if a claim is not work related, then a worker is not left to fend for themselves. This could be on a cost shared basis just as it is in the public sector. The other option is to abolish the antiquated workers compensation system and make it mandatory that all workers be provide disability insurance without any conditions such as proving causation which in most cases is impossible as no one knows what causes any medical condition as genetics always play the biggest role in all medical conditions whether psychological or physical. WCB could continue to provide disability benefits for all workers. This could also be on a cost sharing agreement between employers and workers thereby eliminating paying millions of dollars to doctors for unsupported opinions and also significantly reducing the number of employees in the workers compensation system and as well reducing costs to employers.
I must admit that I always had difficulty as to how presumption is supposed to work in all workers compensation systems and in review of workers compensation systems across Canada, I finally have figured that out by reading various decisions from WCAT and especially those that use Dr. Terence Ison’s book “Workers Compensation in Canada 2nd Edition”. It seems that New Brunswick is one of the only provinces in Canada that relies on Dr. Ison’s explanation of how presumption works. All claims begin in a neutral state and some one has the burden of proof but no one knows whether it is the “Board” as suggested by Dr. Ison or the worker. Whoever has the burden of proof in determining causation must trigger the presumption by determining on a de-minimus standard meaning that to support causation, there only has to be a very trivial relation to the work environment. This then triggers the presumption that then has to be contradicted by some one, either the “Board” or the employer which again is unknown who then has to prove that the injury or disease arose outside of the work environment by specifying the risk outside of the workplace along with the time and place. According to WCAT decision derived from Dr. Ison’s book as a legal guide, it is illegal to provide a negative opinion without supporting evidence that would provide the risk factor and the time and place the accident occurred outside of the workplace. All of this makes sense when explained by well trained WCAT members in workers compensation law using Dr. Ison’s explanation of how presumption is triggered. Unfortunately in Alberta there are no well trained Adjudicators as witnessed by the number of claims that are denied as opposed to the number in New Brunswick that have been over turned by the New Brunswick WCAT because the the de-minimus standard was successful and there was no evidence to the contrary. Obviously something is rotten in Alberta when claims are denied without knowing who has the burden of proof, what is considered to be de-minimus and if successful triggers the presumption, who then must prove contrary and what evidence is required to prove contrary. While there are numerous decisions supporting my interpretation, rather than citing a two or three hundred WCAT decisions, if you go to Canlii and click on the following links http://www.canlii.org/en/nb/nb
After review of 103 decisions made by the New Brunswick WCAT by inputting Dr. Terence Ison in the document text area on Canlii, I received 103 decisions specific to my search specific to Dr. Terence Ison as my search criteria. Out of the 103 decisions there were 88 appeals accepted and 15 denied which I have reviewed and agreed with the decisions. The number of appeals accepted results in an acceptance rate of approximately 85% as compared to the Alberta Appeals Commission acceptance rate of appeals that is considerably lower than 50% which I suspect is due to the fact that the Alberta Appeals Commission do not understand how presumption is defined by the courts. Both the New Brunswick WCA Section 7 and the Alberta WCA Act Section 24 (4) are identical so how then can two different Appeals Tribunals interpret the “Acts” differently I will be reviewing other WCAT decisions in other provinces as to how they interpret their presumptive legislation and will send my review to all my e-mail contacts.
I have stated on many occasions that the primary reason why the system does not work is because of the imbeciles that are in total control of the system. For example: PCI ratings are considered to be an important part of providing compensation to workers, yet the Alberta WCB are the only WCB in Canada that uses two different impairment guides that cannot be used interchangeably when assessing PCI ratings. In other words if a WCB Medical Consultant defers to the AMA Guides because the Alberta Guides are silent or deficient which they usually are, the PCI ratings from the AMA Guides have to be converted to a higher PCI rating than what is found in the AMA Guides.
The reason for this is because the Alberta Guides reference their PCI ratings to the impact an impairment rating would have on a worker performing activities outside of the work environment as opposed to the AMA Guides which is referenced to the difficulties a worker would have performing simple basic activities of daily living and excludes personal and social activities. Having said that, common sense and logic would determine that if the AMA Guides provided for example a 10% PCI rating which is referenced to simple basic activities of daily living, then the PCI rating obtained form the AMA Guides has to be converted to a higher rating when referenced to activities outside of the work place. Obviously it is far less difficult to perform simple basic activities of daily living (defecating, urinating etc.) than it is to perform activities outside of the workplace such as playing baseball, hockey, football, mountain climbing, etc. For example: a 3% PCI rating is assessed for chronic pain which is referenced to simple basic activities of daily living in the AMA Guides which when referenced to the Alberta Guides would have to be significantly higher than 3% PCI because of the fact that playing hockey, baseball, football and mountain climbing would be far more difficult to perform because of pain and would have a greater impact than the performance of simple basic activities of daily living. Question is, why would any one continue to use the antiquated Alberta Guides when the AMA Guides are the gold standard used by every one else in the world when determining impairment?