Jun 082018
 

The following is from painmuse.org, a pain management discussion forum:

It Just Depression Scam

This a moot point because with the deterioration seen in the dorsolateral prefrontal cortex as a result of chronic pain, the mood problems could just a secondary phenomenon.

abstract here

Damage to that area can be induced through Interferon drug therapy; half the cases will develop depression. It has been suggested that those more “predisposed” to depression seem more susceptible to depression from this brain damage. This does not discount its role anymore than a thin boned person getting a hip fracture from a fall just because his/her bones are thin.

There has been much debate over the fact much so called depression in chronic pain is actually just what you would expect – distress over an illness pain sufferers are ill equipped to handle.

This is reflected by a review of the following article:

Fishbain DA, Cutler R, Rosomoff HL, Steele Rosomoff R. Chronic pain associated depression: antecedent or consequence of chronic pain? A Review.

Clin J Pain 1997;13(2):116±136.

Fishbain et al. (1997) recently reviewed the pain-depression literature in order to determine

whether depression precedes or follows the development of chronic pain. Forty-one studies were found which supported the concept of pain leading to depression and many of these studies indicated that depression improved following improvement in pain. Pain may, therefore have a very powerful `state’ effect in terms of leading to and modulating depression.”

It would make sense that chronic pain would wear someone down, but that does not necessarily stop insurers trying to conclude it is all in claimant’s head.

The usual tests scales for depression were never designed to be used in chronic pain cases. The concern is articulated here:

All the reviews describe difficulty in accurate and appropriate measurement of negative mood in pain patients. Whether research uses self-report questionnaires or clinician-administered inventories and diagnostic interviews; whether depression or anxiety is the sole subject of the questionnaire or constitutes a subscale within a generic questionnaire; and whether the scale was developed in psychiatric or medical populations, there is still no measure

  1. designed for (non-psychiatric) pain populations and

  2. which measures emotional well-being, in the form of positive affect, alongside negative mood.

In addition, many self-report instruments contain somatic items, which are known to inflate scores in pain populations (Bradley, 1994; Morley et al., 2002; Pincus and Williams, 1999; Pincus et al., 1996; Vahle et al., 2000).”….” As with depression questionnaires, anxiety questionnaires have been developed and validated on normal and psychiatric populations and their application in pain populations may be misleading.”

the widely used Beck Depression Inventory (BDI: Beck et al., 1961) suffers from all the problems outlined in our introduction (Morley et al., 2002): it contains items on sleep, fatigue, appetite, weight, and health concerns, and on work and sexual activity, which may be more related to pain problems than to mood (Wesley et al., 1991, 1999; Williams and Richardson, 1993); it was developed in psychiatric populations from which those with physical illness were explicitly excluded; and respondents can score no better than not depressed.”

Asking Psychological Questions that people will have just because they are in pain is called “criterion contamination”. This will lead to erroneous diagnoses or worse psychological labeling of someone who is just sick. Some questions in depression with questionable accuracy from:

Pain 109 (2004) 181–188

The development and testing of the depression, anxiety,

and positive outlook scale (DAPOS)

Tamar Pincusa, Amanda C. de C. Williams, Steven Vogel, Andy Field

abstract here

Beck Depression Score Inaccurate questions:

Weight loss

Lack of appetite

Difficulty sleeping

Feeling Irritable

Feeling Tired

Uncontrolled crying

Concerns about health

Loss interest in sex

Able to work

Loss of Interest in others

Answering high positive to all these “questionably accurate” questions would place someone in a severely depressed range where it may only mean they are in severe pain.

The Official Criteria for depression cannot be easily applied to someone in chronic pain:

For a proper diagnosis one is required to have:

  1. must have either answer 1 or 2 below and

  2. five items altogether

They include:

1) Depressed mood most of the day, nearly every day
(2) Markedly diminished interest or pleasure in all, or almost all, activities
(3) Significant weight loss NOT VALID
(4) Sleep disturbance NOT VALID
(5) Psychomotor agitation or retardation nearly every day
(6) Fatigue NOT VALID
(7)Feelings of worthlessness or excessive or inappropriate guilt
(8) Diminished ability to think or concentrate, or indecisiveness
(9) Recurrent suicidal ideation

With 3 of the 9 criteria invalid, one is left with 6 items of which 5 are needed for a diagnosis. A similar problem was encountered with cancer patients where items concerning weight loss and fatigue had to be automatically eliminated.

There are a few caveats required in interpreting the remaining depression criteria questions.

  1. People with chronic pain don’t enjoy life like the used to. Life can be very boring without money, and energy; and the pain can prevent many prior pleasurable activities. With poverty, they are often can no longer afford a car so getting out becomes a major undertaking. Depression scores finding lack of enjoyment need to take that into account.

  2. If you were to take normal subjects and deprive them of 15% of their sleep a day, within a short time, their optimism and sociability lessen and irritability increases. I am always amazed how much “depression” can disappear with proper sleep.

  3. Concentration does decline in chronic pain. Pain, lack of sleep, and medications can all majorly impact of this. One anticonvulsant used in chronic pain has been nicknamed by some “the stupid pill” because it can blunt mental functioning. Finding decreased concentration has to take that into account.

  4. The life of someone with pain is one of victimization. It is called the “invisible disability”; they look fine but suffer. This causes considerable scorn from friends, co-workers, employers, insurers, physicians and family. Life in effect can be hell. Workman’s Compensation Victims were followed for 1 year in this Ontario study called:
    “Victims twice over” – not only are they victims of an injury, they are victims of a punitive process.
    “Interviewees believed that the process victimizes them and renders them powerless and dependent on others.”
    Qual Health Res. 2005 Jan;15(1):30-48. Victims twice over: perceptions and experiences of injured workers. Beardwood BA, Kirsh B, Clark NJ.

abstract here

This in itself is going to be distressing and this can erroneously interpreted as depression. This cannot help but also engender feelings of guilt. I had one lady state, that with her religious background, she does not feel she can allow herself to enjoy life until she is well enough to go back to work. Attitudes to chronic pain and the inability to work create feelings of guilt so it can be difficult to know what the guilt question is actually measuring.

  1. It has been documented that the KEY cause of depression in chronic pain is the “subjective future” – that is – future dread
    European Journal of Pain (1999) 3: 221-233
    Subjective future as a mediating factor in the relation between pain, pain-related distress and depression
    Christina Hellstrijm, Bengt Jansson and Sven G. Carlsson
    “Helping patients to establish more positive thinking about the future would lead to therapeutic gains.”

    – a future in which a WCB victim deals with employers who only want him/her back if s/he is 100%, and case workers whose only real interest it seems is to contain costs by any means – which means getting him/her off WCB by any trick they can muster. This engendered future dread cannot help but thoroughly perpetuate any depressive distress symptoms

One finding demonstrating how inaccurate diagnosis of depression in chronic pain stems from the finding that a negative view of the future is considered very important, particularly in the Beck Depression Inventory. Surprisingly, may chronic pain patients however, do not necessarily share that idea. This has lead to new scales that strip out many of the useless questions that are used in grading depression.

abstract here

I think it is pretty obvious that 100% of chronic pain patients can be diagnosed depressed if you so wish, using criteria not designed for that population. Hence it is not valid to ever terminate coverage on a patient just because someone found them “depressed”.

The most elegant of scans uses the combination of lack of objective findings and depression to legitimize termination. The former is now an illegal maneuver, the latter immaterial. Neither can be used legitimately.

Anxiety Diagnostic Testing Unreliable

Anxiety questionnaires can rely heavily on “somatizations” – body pains and symptoms:

  • headaches

  • chest pains

  • stomach pains

  • constipation

  • tight tense muscles

  • dizzy, off balance (side effect of opioids)

  • tired, weak

  • palpitations (side effect of Amitriptyline used for chronic pain)

These can be invalid and can result from the medications the patient is on. Using above criteria, 100% of people with pain can be diagnosed as anxious. This problem arises from the fact these tests were not designed to be used on chronic pain patients – they were only normalized for use in psychiatric populations.

Anxiety is a common finding in the “normal population”. It does not render them chronic pain patients. Studies that have found anxiety in chronic pain populations have still had to face the fact the number one issue was still the level of pain.

Personality Typing Unreliable

Personality type-fitting is another tactic used to discredit claimants.

Yet. early analysis demonstrated chronic pain sufferers had relatively normal personality structure:

abstract here

The largest personality test is the MMPI. The biggest joke was findings on MMPI psychological test which showed elevations of depression, hysteria, and hypochondriasis – “triple V profile”.

Its presence in Rheumatoid Arthritis is just caused by extent of disease:

Arthritis Rheum. 1986 Dec;29(12):1456-66. Elevated MMPI scores for hypochondriasis, depression, and hysteria in patients with rheumatoid arthritis reflect disease rather than psychological status.

Pincus T, Callahan LF, Bradley LA, Vaughn WK, Wolfe F.

abstract here

This Triple profile can, however, label someone a personality case. Importantly, it has been demonstrated it is possible for this profile to disappear after successful treatment of the patient’s pain condition. This means that finding these personality factors cannot be reliably used to discount a patient’s pain.

Personality characteristics do not change over time – they are supposed to be stable. Yet, chronic pain sufferers personality profiles do change, again suggesting these evaluations are not valid. This study showed how abnormal personality characteristics and depression normalized after treatment was one involving pain relieving whiplash injuries with burning of neck nerves.

Wallis BJ, Lords SM, Bogduk N.

Resolution of psychological distress of whiplash patients following treatment by radiofrequency neurotomy: a randomized, double-blind, placebo-controlled trial. Pain 1997;73:15 – 22.

psychological gone with RX here

Another arduous 20 year study found that personality abnormalities in chronic back pain started after the injury:

Spine. 1995 Dec 15;20(24):2716-20.

Minnesota Multiphasic Personality Inventory profiles in persons with or without low back pain. A 20-year follow-up study.

Hansen FR, Biering-Sorensen F, Schroll M.

The results indicated that low back pain is preceded by elevated Minnesota Multiphasic Personality Inventory scales was not supported.”

abstract here

Another found psychological factors included STAI anxiety scores in head pain disappeared with pain treatment:

Head pain normalization MMPI here

Cephalalgia. 1994 Oct;14(5):368-73; discussion 319.

Personality characteristics before and after treatment of different head pain syndromes.

Mongini F, Ibertis F, Ferla E.

Clinical improvement leads to normalization of MMPI profiles and STAI scores in women. The psychometric data before treatment were not predictive for treatment outcome.”

Again here is a study showing successful treatment of pain removes the psychological problems:

With pain reduction here

Pain. 1975 Jun;1(2):177-81.

Personality changes associated with reduction of pain.

Sternbach RA, Timmermans G.

The results support the hypothesis that the neuroticism associated with chronic pain is the result of it, and may be reversible when the pain is reduced or abolished.”

Women seem to get the worst appraisals that their problems are psychological. The worse would have had to be pelvic pain.

Blaming the victim – The psychologizing of endometriosis

Ballweg ML

OBSTETRICS AND GYNECOLOGY CLINICS OF NORTH AMERICA 24 (2): 441- 444 JUN 1997

abstract here

Yet a recent study demonstrates that proper pelvic pain treatment can make “psychological problems” improve.

J Am Assoc Gynecol Laparosc. 1998 Nov;5(4):389-95.

Changes in personality profile associated with laparoscopic surgery for chronic pelvic pain.

Duleba AJ, Jubanyik KJ, Greenfeld DA, Olive DL

abstract here

The biggest joke have to be genital skin pain. This has been extensively discussed as psychological, yet now found potentially curable by Botox injects, or by treating a previously unrecognized external infection.

Lichen abstract here

Vestibulitis abstract here

The depression of Fibromyalgia, a primarily woman’s disease, improves with successful treatment as well, again suggesting it is pain that drives the symptoms.

Efficacy and adverse effects of intravenous lignocaine therapy in fibromyalgia syndrome
JH Raphael et al 2002

abstract here

CONCLUSION

A review of MMPI results in chronic pain makes the following very clear:

Clinical Psychology Review, Vol. 20, No. 5, pp. 533–559, 2000

THE MINNESOTA MULTIPHASIC PERSONALITY INVENTORY

CHRONIC PAIN: A CONCEPTUAL ANALYSIS OF A LONG-STANDING

BUT COMPLICATED RELATIONSHIP

Alexander A. Vendrig

it has simply been applied inappropriately (i.e., for determination of pain etiology or underlying personality structure “explaining” the chronic pain).”

Given that this is the most comprehensive psychological profiling tests, its comments are very chilling:

Psychological testing is inappropriate for determining if “personality” is the cause of pain. It must be clear from above that:

  1. Personality, depression and anxiety issues are much more likely to be caused by chronic pain.
  2. The diagnosis of anxiety, depression, or personality disorders cannot be used to discredit someone with chronic pain. Nor can they be used to terminate coverage.
  3. As reiterated earlier, the most elegant of scans uses the combination of lack of objective findings and depression (or “personality disorder”) to legitimize termination. The former is now an illegal maneuver, the latter immaterial. Neither can be used legitimately.
Jan 192017
 

By Gerald

An interesting e-mail crossed my desk from a worker that shows how convoluted the system is. According to the worker pain and suffering does not come under the WCA and stated that WCB Legal Services admitted during Judicial Revue that pain and suffering does not fall under the WCA. This is not true and WCB Legal Services should not be suggesting that pain and suffering are not covered under the WCA. When assessing impairment and using impairment ratings does factor in pain and suffering when assessing impairments. Providing compensation for an impairment is subject to the discretion of the WCB BoD under Section 69 of the WCA.

Prior to Jan 1, 1965 all workers received a lifetime pension for an impairment by multiplying an impairment rating by net earnings which factors in pain and suffering. After Jan 1, 1995, workers received a lump sum payment when assessed an impairment by multiplying an impairment rating by MIE. Curiously and thinking that all people are stupid, prior to the stroke of midnight an impairment rating was defined and used to determine an economic loss and after the stroke of midnight an impairment rating become a non economic loss. How can a word have two interpretations. Obviously, there is no correlation between an impairment and a disability and impairments are supposed to be used as a starting point or precursor in determining a disability so why then would WCB use impairment ratings as a direct method of rating a disability This sounds more like a fairy tale (Cinderella)  when mice turned into horses and at the stroke of midnight the horses turned into mice. Policy 03-01 Application 7 also includes chronic pain ( non discernible chronic pain) in assessing compensation but only provides medical aid but no loss of earnings, vocational rehab. or a PCI rating. Policy 03-01 Application 7 also provides compensation for non discernible chronic pain syndrome but does not assess any PCI rating for chronic pain syndrome. The SCC Martin/Laseur) also determined that chronic pain be recognized and compensation be paid although WCB has not and is not in compliance with the SCC decision and continue to not provide an impairment rating for chronic pain in itself without any objective findings which is illegal and contrary to the decision of the SCC. At one time pain was believed to be subjective and associated with malingering but over the last ten years with improved brain imaging a patient complaining of pain without objective findings could have brain imaging to determine if pain was evident. Of course even if brain imaging did indicate pain response many patients continue to have pain even after an injury heals. An example would be phantom pain in the case of an amputated limb. Of course the Government in Alberta turns a blind eye to everything WCB does or does not do as no one wants to disturb or annoy the sacred cow that was created by Government without any checks and balances.

Jun 272012
 

Rather than sit idly by and not providing a review of a claim that like thousands of other claims and benefits have been denied based on false medical information due to either malice or incompetence, I will present a claim that because the process that is supposed to provide a fair and unbiased decision resulted in the claimant, Mr. Milne having to proceed with civil litigation rather than to be subjected to abuse of due process, abuse of power and as well an abuse of an individual through the WCB decision making process.

 

The process itself is and should be relatively easy to follow but unfortunately the doctors and decision makers are either biased or incompetent. From the top down, the minister in charge of the WCB, the WCB BoD and the President of the WCB are incompetent and have no idea how the system is supposed to operate. Put all these clowns together and the result is a system that is in chaos.

 

In order to understand the events leading up to the filing of a civil suit by Mr. Milne the following court cases would have to be read in their entirety. All of the cases can be found on The Canlii web page that describes in detail what Mr. Milne was put through and is still going through with no place to turn to other than a continuation of civil suits that had due process been followed he would have never had to go to the courts. I will provide the links to the court cases for those who are interested or those who are contemplating civil action and the pitfalls that may be avoided by learning from Mr. Milne’s experience. I will present the links in chronological order;

 

http://www.canlii.org/eliisa/highlight.do?text=milne&language=en&searchTitle=Alberta+-+Court+of+Queen%27s+Bench&path=/en/ab/abqb/doc/2005/2005abqb594/2005abqb594.html

http://www.canlii.org/eliisa/highlight.do?text=milne&language=en&searchTitle=Alberta+-+Court+of+Queen%27s+Bench&path=/en/ab/abqb/doc/2007/2007abqb299/2007abqb299.html

http://www.canlii.org/eliisa/highlight.do?text=milne&language=en&searchTitle=Alberta+-+Court+of+Queen%27s+Bench&path=/en/ab/abqb/doc/2007/2007abqb407/2007abqb407.html

http://www.canlii.org/eliisa/highlight.do?text=milne&language=en&searchTitle=Alberta+-+Court+of+Queen%27s+Bench&path=/en/ab/abqb/doc/2008/2008abqb710/2008abqb710.html

http://www.canlii.org/eliisa/highlight.do?text=milne&language=en&searchTitle=Alberta+-+Court+of+Queen%27s+Bench&path=/en/ab/abqb/doc/2012/2012abqb302/2012abqb302.html

From review of Mr. Milne’s court records and my own personal knowledge of Mr. Milne’s claim, Mr Milne was injured in an accident on Nov. 4, 1995. WCB did accept his claim for an injury to his cervical spine which according to numerous doctors should have not resulted in any permanent injury or disability. Despite the fact that there was no medical diagnosis of why he continued to experience pain, he was sent to attend a pain clinic and work hardening program. Numerous medical tests indicated that there were no abnormalities involving the cervical spine, yet he continued to experience pain. He was discharged from the programs and was accused of malingering and treated with contempt for his continued efforts to find the reason for his pain. Rather than being wrongfully accused of malingering, Mr. Milne went out of Alberta for a medical diagnosis and treatment in Minneapolis where it was determined that he had injuries to the cervical spine facet joints which were treated by radial frequency ablation that resulted in Mr. Milne not having to take any pain medications. It was thus established that the cause of the pain was due to the cervical spine facet joint injuries and attributed to the accident on Nov. 4, 1995.

 

Based on this fact, Mr. Milne should have had the decision of the Appeals Commission to deny his claim, overturned and benefits paid, yet his claim continues to be denied by the Appeals Commission who clearly have a vendetta against Mr. Milne for proving them wrong along with their network of WCB doctors, which also included a MRP who also had been proven wrong. This action by the Appeals Commission by not granting a reconsideration based on new evidence and either directing WCB to pay benefits or by sending Mr. Milne’s claim back to Customer Services brings the administration of justice into disrepute. Noticeably also is the fact that Mr. Milne did request that the Appeals Commission subpoena numerous witnesses who were pertinent to his case and the Appeals Commission illegally refused his request despite the fact that the Alberta Court of Appeals has determined that refusing to subpoena witnesses results in procedural unfairness or a violation of the Rules of Natural Justice. By refusing Mr. Milne to subpoena witnesses, his only recourse was to file a civil claim against the doctors who provided false medical opinions and the WCB.

 

To add insult to injury, the Alberta Government is complicit in enacting legislation (Section 34 (4) of the WCA protecting unethical doctors from providing false medical information by not allowing any medical documentation to be entered into the courts which results in WCB’s network of doctors to provide biased and false medical opinions that results in denial of a claim or benefits without any responsibility or justification for their opinions. Questionably is why would the Alberta Government enact legislation that protects doctors from litigation by not allowing a plaintiff to use their medical reports in the courts to prove malice or incompetence. Both Plageman and Barnes had the audacity to claim in the courts that they do not have a duty of care to any claimant because they offer only an opinion and do not provide any medical care. According to the College of Physicians and Surgeons a doctor has the right to provide any opinion they want even if it is knowingly false or misleading and the College justifies this by stating that a doctor’s opinion is simply an opinion and it is the decision makers responsibility to ensure that the opinion is based on medical fact.

 

I have spoke to Mr. Milne on a number of occasions and have met him personally. I have discussed a class action lawsuit with him which would be based on what I consider to be a reasonable chance of success. From research, I have found that there are a number of areas where WCB policy is not in compliance with the WCA which would be the best way to proceed with a class action lawsuit rather to file a class action lawsuit involving individual claims or medical opinions that would most likely result in failure. At present I have three claims that I am assisting the claimants on and will be used as a test run to have WCB, the DRDRB and the Appeals Commission provide a decision on. All claims are long standing claims, one goes back to 1973, and two claims to 1993. All of the claims are backed by legal precedent which was heard and decided by the Alberta Court of Appeal and never appealed to the Supreme Court by either the plaintiff or the Appeals Commission. If any one wants the details, I would be more than willing to explain how WCB policy is not in compliance with the WCA and has not been since approximately 1960. If any workers know of a lawyer or law firm who would be willing to pursue a class action lawsuit based on my findings, I would be more than willing to provide then with the information I have gathered.

 

When I was involved with Justice Friedman in making recommendations to improve the system, one of my recommendation provided by myself was for total transparency in the system which is one of the major problems in the system and can be attributed to the Appeals Commission who believe that all claims are confidential, yet all of the court cases involving Mr. Milne provides his name, the names of all the doctors involved in his claim and as well the media can sit in and listen to the court proceedings. There is absolutely no reason why an in person hearing should disallow the media from attending or for that matter any member of the public. The public has a right to know who the Case Manager was, who the DRDRB member was, who the doctors were involved in the claim. Knowing all of this is the only way that people like myself can analyze a claim which would over a period of time indicate whether a doctor is always providing negative medical opinions, the competence of a Case Manager, the competence of a DRDRB member etc could all be analyzed by total transparency. As a person who has an extensive background as an analyzer (Most of my adult working life) total transparency is crucial in analyzing a claim. Total transparency would allow me to determine a trend in evaluating people involvement in the claim. For example: How many claims have Plageman and Barnes been involved in that were based on false medical opinions? I know a WCB doctor who has performed thousands of impairment ratings that were not performed correctly. How many other worker’s lives besides Mr. Milne’s have these doctors ruined by providing false medical opinions?

 

A recommendation by Justice Friedman was to get rid of George Pheasy who is another major problem with the Appeals Commission. The reason for this is numerous errors in law occur on a regular basis and Mr. Pheasy has no legal background in Administrative Law. He also does not possess any medical knowledge that is a major requirement of some one who is the Chief Appeals Commissioner. My experience with Mr. Pheasy is that he is an arrogant, pompous, narcissistic individual who rather than admitting to making mistakes, covers up these mistakes by refusing to reconsider new evidence that proves the Appeals Commission made a mistake. Covering up a mistake rather than admitting there was a mistake results in civil litigation as clearly in covering up a mistake you cannot then plead that it was an honest mistake. Two claims that I represented workers on resulted in irrefutable evidence that there was a causal relation. Despite the fact that the Threshold Reconsideration Committee did not agree with George, he denied the claim. The other claim went before a Human Rights Tribunal after the Appeals Commission had determined that there was no PCI rating and when the American Medical Association supported me by determining that there was an impairment rating and WCB agreed that there was, he refused to accept the evidence and forbid any one in the Appeals Commission to have anything to do with me.

 

There has been no improvements made in the appeals system and perhaps rather than going through more investigations of how to make the system more accountable and transparent, the Appeals Commission and the MRP should be abolished and any claim that is appealed following a decision of the DRDRB should go into the courts. The Office of the Appeals Advisor should be moved under the Minister in charge of the WCB and staffed by lawyers trained in Administrative Law who would represent workers in the courts at no charge. They also would use their judgement to appeal any lower court’s decision to the Alberta Court of Appeal and to the Supreme Court if necessary. No worker should be represented by any one other than a lawyer which would then make all claims decided on a level playing field instead of the bullying tactics used by WCB, the DRDRB and especially the WCB Appeals Commission used against workers with little education, limited finances and limited medical knowledge. An investigative article in the Edmonton Sun found that all workers who were represented by lawyers or union lawyers resulted in workers having their claims and benefits accepted as opposed to workers who could not afford a lawyer or were not represented by a union.

 

Noticeably is the fact that Mr. Milne was forced to represent himself and has done a remarkable job of doing so. I have great respect for Mr. Milne who despite all odds has not given up and his family has to be very proud of him for being the man that he is. It is unfortunate that the Office of the Appeals Advisor or WCB Advocates take a worker’s money and do not tell the worker that they do not have any legal right to represent the worker in the courts if a worker wishes to pursue a Judicial Review or Judicial Appeal of an Appeals Commission decision. For any one to act as their own lawyer without any legal experience does show how remarkable a person Mr. Milne is.

 

It is also a fact that WCB has spent over two hundred thousand dollars on this claim despite the fact that they maintain despite irrefutable evidence that the injury to the facet joints is not work related. How can it not be work related when, Mr. Milne had no prior history of a spinal injury. Of course, WCB doctors seem to always blame any spinal injury to degenerative disc disease. Noticeably also is that Mr. Milne also is suing WCB for several million dollars which again should not happen especially when the evidence and the final diagnosis by experts have determined that the injury was caused by the work. My advice would be to settle out of court and let Mr. Milne and his family alone.

 

According to Dr. Scanlon, the work hardening program and the chronic pain clinic did in fact cause further needless injury to Mr. Milne and I suppose that this is the reason why Columbia settled the civil claim against them out of court. How many times has this happened when a worker is sent for work hardening, FCE and chronic pain rehabilitation before a diagnosis is made as to the cause of the chronic pain? Common sense and logic would be that as long as a worker has chronic pain, you do not send him/her for a FCE, work hardening or chronic pain rehabilitation. To add insult to injury, any worker who has chronic pain despite normal test results is always sent to a Psychologist who will inevitably determine that the worker is faking the pain or malingering.

 

Based on Mr. Milne’s experience in representing himself, if a lawyer or law firm will not represent a class action lawsuit on a contingency basis, it would be perfectly legal for Mr. Milne to represent the class if he would join the class action and represent himself as being one of the plaintiffs. Of course class action lawsuits or lawsuits such as Mr. Milne filed would not be necessary if the Alberta Government would have a court provide a Judicial Inquiry or Public Inquiry into how the system operates or if not that, to appoint a review committee to hear long standing claims which are in the thousands. In fact I may even agree to sit on a committee to hear long standing claims.

 

The privatization of the Alberta WCB has been a dismal failure and the Government should consider taking back control of a system that instead of helping workers, treats workers with contempt. The assets of WCB belong to employers who fund the system and these assets would then revert to the Alberta Government. Recent studies have concluded that a public system is far superior to a private system who only are concerned with their own self interests rather than the needs of workers. Recent studies have also concluded that private WCB systems shift the costs of claims unto the public system who are forced to provide health care costs and social assistance to workers whose claims and benefits have been illegally denied. The costs for the public system to have these costs of caring for workers has been estimated in the billions of dollars in the U.S. and in Canada would also be in the hundreds of millions or billions of dollars. Going back to a public system is a no brainer and could have been a platform that the Wildrose party could have used to attain power. I must admit that at one time I favoured a private system but after a careful analysis, I no longer believe that a private system is a viable option. I have no qualms about admitting that I made a mistake unlike WCB, the DRDRB and the Appeals Commission who will continue to fight a worker even though they know they made a mistake.

 

Change is needed and turning a blind eye is not a solution. Because of the adversarial environment that exists with the WCB, excessive amounts of money is spent bullying workers to accept the denial of the claims and benefits. A publicly owned and operated system could eliminate this adversarial environment and reduce staff by 50-75%, thereby reducing costs. Reducing costs could also be attained by a mutual agreement by workers and employers sharing the costs of earning loss insurance which was a proposal made over one hundred years ago but was never considered.

 

Over the years we have witnessed workers like Gregory Jacks committing public suicide where he blew his head off with a shotgun, we have had hostage takings on numerous occasions in Calgary and in Edmonton, we have witnessed rallies and speeches, we have had a commission investigative process, we have had posturing in the legislation by various opposition parties, we have had lawsuits filed against WCB with mixed success, we have had legal precedents such as the Johnson decision by the Alberta Court of Appeals on several occasions supporting workers, we have had the Supreme Court determining in workers favour involving chronic pain, yet nothing has been done to change the culture of denial. It is only through the courts that workers have managed to hold WCB accountable but with no follow up. It is only through the courts that justice will be done or seen to be done and the only recourse for workers is a class action suit against the Alberta Government and the WCB for violating the principle of natural justice, violating the WCA and WCB policies. As some one who has never had a WCB claim, I cannot do any more for workers other than to explain to them why I consider a class action lawsuit and the reasons why I feel that a class action lawsuit would be reasonably successful.

 

Gerry Miller

 

“For evil to flourish, all that is needed is for good people to do nothing” – Edmund Burke