May 232019
 

By Gerald

Your response as to who has the burden of proof

(Read the response: Page One Page Two)

Dear Mr. Robinson;

While I appreciate the response from you as to who has the burden of proof in the workers compensation system, I question your response. As you know or should know, I believe in total transparency in any of my communications as there is nothing confidential nor should there be with any correspondence specific to WCB issues so I will send your response to all of my many e-mail contacts. From the FPO website your CV states, https://fpoalberta.ca/about-us/fair-practices-commissioner/ 

it would appear that you are somewhat qualified in administrative law but have no experience or background in administrative law that is specific to workers compensation administrative law that is vastly different than other administrative laws. As you know or should know, adjudication of claims is based on an inquiry system, not an adversarial system and therefore the burden of proof both for and against is on the “Board”.  Unfortunately for workers, adjudication is and has been based on an adversarial system rather than an inquiry system which is and always has been illegal. Your reply that the FPO does not provide legal advice is concerning as if the FPO is to assist workers and employers, then it is your responsibility to ensure that the correct method is used and understood by workers and employers who must be aware of who has the burden of proof both for and against in an inquiry based system unless you are concerned that if this was common knowledge that the FPO would be redundant and you all would lose your jobs. Is it thus better for you to keep workers and employers in the dark than to enlighten them with what should be common knowledge. 

Alberta’s workers compensation system is over 110 years old and from the time that the system first began, every one filing a claim should have known who has the burden of proof. In criminal law, every one knows that the burden of proof is on the Crown. In civil law the burden of proof is usually on the plaintiff although in some civil claims the burden of proof can be shifted from the plaintiff to the defendant according to the Supreme Court of Canada. It is grossly illogical to have a system that has been in existence for 110 years and you, WCB, DRDRB and the Appeals Commission do not know who has the burden of proof when the most important question in any legal system is who has the burden of proof.

Unquestionably, the determination of who has the burden of proof both for and against is the most crucial or one of the most important part of the adjudication process. Had this issue been determined decades ago, there would have never been any need for presumptive status for first responders. In every claim, as long as a claim remains in a neutral status, presumption takes effect and the benefit of doubt is historically always to have gone to the worker which is the way it was supposed to happen but because adjudication some how over the years took on an adversarial standard where the worker had to prove a work related injury or disease,  the benefit of doubt went to the “Board”. 

If a person reviews WCB policy 01-03 Part I Int. 3, the policy states that a worker does not have to provide any proof beyond a reasonable doubt. In an inquiry based system a worker is not required to provide any proof, that is the sole domain of WCB according to the WCA Section 17 (1). Policy 01-08 Part I specific to new evidence. What new evidence? If the burden of proof is solely on WCB and they have performed a thorough investigation, there should not be any new evidence and any new evidence should result in disciplinary action against an adjudicator who was not responsible for gathering the evidence. Taking this further, in the Appeals Commissions Practice Guidelines #5 Content J specific to new evidence that is presented to the Appeals Commission for reconsideration of an original Appeals Commission decision. What new evidence are they  referring to as if the system is supposed to be working according to plan and WCB has done their due diligence by investigating and gathering the facts, at no time should there be any new evidence. It is grossly illogical for the Appeals Commission to deny a reconsideration based on their belief that the worker has the burden of proof and with due diligence the evidence that a worker has provided now could have been presented at the earlier Appeals Commission hearing. Being that gathering of the facts is exclusive to WCB, it is illegal for a worker or an employer to gather the facts.

As you know or should know, the legislature has through legislation enacted the WCA that provides “exclusive jurisdiction” (Refer to Section 17(1) of the WCA) whereby only WCB is legally entitled to investigate and gather the facts and this is explained in WCB policy also by referring to WCB Policy (02-01 Part I) which I request that you read. For your information, the Ombudsman has already determined this issue and so did the Court of Queens Bench. The only problem is that WCB, DRDRB and the Appeals Commission are not complying with the WCA and WCB Policy which it is your responsibility to advise the Ombudsman or the Justice Minister to direct that WCB, DRDRB and the AC comply with the WCA and WCB Policy by placing the burden of proof both for and against solely on the Board. Of course no one makes these shysters and gangsters do anything as witnessed by the fact that despite the fact that the Supreme Court of Canada determined that chronic pain must be recognized and workers diagnosed with chronic pain must receive the same compensation benefits as workers who do not have chronic pain but receive compensation benefits which almost 20 years later they are still not in compliance.

As a public body that is set up to assist workers and employers, in order to assist and represent them, it is your duty to ensure that all workers and employers are aware that neither the worker or the employer has any burden of proof in an inquiry based system rather than passing the buck to the Ombudsman or the members of the legislature. If necessary, when the FPO is aware that WCB, DRDRB and the Appeals Commission are not in compliance with the law, that you contact the Justice Minister and have the Justice Minister direct that WCB, DRDRB and the Appeals Commission to comply with the law. Other than that, the FPO is another useless body created by Government. Have a nice day!

Mar 252019
 

By Gerald

The following reason is why the Alberta Human Rights Commission are dismissing complaints without investigating the legitimacy of the complaint. As well, any prima facie evidenced complaints specific to WCB are dismissed most likely on the direction of the Justice Minster and Minister in charge of the WCB;

The Alberta Human Rights Commission has put in place the Case Inventory Resolution Program in an effort to reduce a massive backlog of cases. For the past seven years the number of complaints received by the Commission has exceeded the Commission’s capacity to process them. Those unresolved complaints are carried forward into the next year resulting in a growing backlog of complaints. As a result, it can take up to 2 years for a complaint to reach the conciliation stage and approximately 4 years for a complaint to reach the investigation stage.

The Chief of the Commission, Michael Gottheil spoke on March 11, 2019 to the Canadian Bar Association Labour & Employment south section about the new program for addressing the backlog of cases at the Alberta Human Rights Commission.

The Case Inventory Resolution Program

As part of the change all complaints filed before January 1, 2019 will be placed in the Case Inventory Resolution Program, which will consist of an investigation team and a conciliation team.

  1. Investigation Team

There are currently 300 complaints in the investigation queue that have been through conciliation but were not successful in reaching a resolution and are now waiting for a Human Rights Officer to investigate.

The investigation team has been assigned to address the cases in the investigation queue. The team will consist of 4 Human Rights Officers, the Director and a Project Lead. The Human Rights Officers will be assigned 5 cases per week and the entire team will meet weekly to review the files.

The Human Rights Officers will review each case, gather additional information from the parties and may request specific information and submissions on whether the case should be dismissed or not. The parties will have 30 days to respond to the request.

Once all the material has been gathered, the Human Rights Officer will review the file and the parties submissions and discuss with the team. The Director will make a decision on whether the case should be dismissed or not.

The Chief of the Commission anticipates the 300 cases will be assessed within 4-6 months.

  1. Conciliation Team

There are currently 1200 to 1300 complaints waiting to be assigned to a conciliator to conduct conciliation.

The conciliation team has been assigned to address the cases in the conciliation queue. The team will consist of 6 Human Rights Officers, the Director and a Project Lead. The Human Rights Officers will be assigned 4 cases per week.

Initially, the Human Rights Officers will contact parties who have cases in this queue to inform them of the process, gather background information and schedule an in-person conciliation meeting 6-8 weeks down the road. Prior to the meeting the Human Rights Officer may contact the parties by phone and gather any additional evidence.

At the meeting, the conciliator will assist the parties in coming up with a resolution. If a resolution is reached, parties will sign a Memorandum of Agreement and Release. If no resolution is reached at the meeting, the conciliator will write a case summary with a recommendation to the Director. If the recommendation is to proceed to Tribunal, the conciliator will be encouraged to make a non-binding settlement recommendation.

The Director will then decide whether the case is dismissed or sent to Tribunal.

The Respondent will also be encouraged to make a settlement offer at this stage. The Respondent can request that the Director exercise their discretion under section 22 of the Alberta Human Rights Act to discontinue if the Complainant does not accept the offer.

The Chief of the Commission anticipates the 1200 – 1300 cases will be dealt with in 12-18 months and the conciliation team will likely start in May.

More information on the Alberta Human Rights Commission’s Case Inventory Resolution Program can be found here.

Mar 142019
 

By Gerald

Interesting that the Alberta Human Rights Commission would defer to any decision made by WCB or the Appeals Commission!

In Kebede v. SGS Canada Inc., 2019 AHRC 3the Alberta Human Rights Tribunal (the “Tribunal”) recently dismissed a portion of a human rights complaint on the grounds that the issue was already decided by the Alberta Workers’ Compensation Board (“WCB”).

The Complainant filed a human rights complaint asserting, among other things, that he suffered racially-based harassment and discrimination during the course of his employment with SGS Canada Inc. (“SGS”).

The Complainant sought compensation under the Workers’ Compensation Act for psychological injury that he alleged he suffered as a result of the same alleged racially motivated harassment and discrimination. The Complainant’s claim for compensation was denied by the WCB as it found no objective confirmation of work-related events or stressors that supported the Complainant suffering from “a chronic onset psychological injury arising out of and occurring during the course of employment.”

SGS sought the dismissal of the human rights complaint on the basis of the WCB’s denial of the Complainant’s WCB claim.

The Tribunal found that it could exercise its discretion to dismiss a portion of the complaint on the basis of issue estoppel as it found that:

  1. the same question was decided by the WCB;
  2. WCB’s decision was final; and
  3. the parties to the WCB’s decision were the same as in the human rights complaint.

The Tribunal exercised its discretion to dismiss the racially-based harassment and discrimination portion of the complaint as the Tribunal found that dismissing that portion of the complaint would not create unfairness. Specifically, the Tribunal noted that there was no new evidence or evidence of unfairness in the adjudication of the WCB claim.

This decision serves as a useful reminder of the Alberta Human Rights Commission’s powers under s.22 of the Alberta Human Rights Act to, at any time, refuse to accept a complaint on the basis that the complaint is one that: (i) could or should more appropriately be dealt with; (ii) has already been dealt with; or (iii) is scheduled to be heard; in another forum or under another Act.

This provision of the Alberta Human Rights Act may be particularly helpful to employers given the current delay in Alberta human rights matters proceeding to a hearing and the likelihood that another forum will issue a decision well in advance of an adjudication of the human rights matter. Further, dual proceedings may become more frequent given the increasing overlap between WCB and human rights matters, the increase in harassment related concerns in the workplace, and the added jurisdiction of Alberta Occupational Health and Safety over harassment in the workplace.

Mar 102019
 

By Gerald

This is an article written by Peter Rousmaniere who is a well known journalist and expert on workers compensation. I attended a webinar on Thursday March 7, 2019 at 10:00 AM hosted by experts in the area of workers compensation. The subject of using impairment ratings as a direct method of rating disability was discussed and the conclusion was that it has caused major financial problems for workers when determining disability which is why I went to court as this is a violation of a workers right to be compensated for a loss of earnings, not for the difficulty a worker would have performing basic activities of daily living which has got nothing to do with a loss of earnings.

Basically, the blame for all of this as determined by the Court of Queens Bench and supported by legal counsel on Feb. 20, 2019 was the fault of the WCB BOD who enacted the policy equating an impairment to a disability, thereby defrauding workers from receiving the loss of earnings they were entitled to. After the Penny decision, the Conservative Government should have directed that all claims prior to Jan 1, 1995 be re-adjudicated and workers life time pensions that were determined based on impairment ratings be re-calculated. It is obvious that the Conservative Government aided and abetted the Alberta WCB to defraud workers by failing to comply with the WCA as determined by the Alberta Court of Queens Bench and the Alberta Court of Appeal in the Penny case.  Rather than to re-adjudicate all claims prior to Jan 1, 1995, the Alberta WCB BOD simply changed their policy to enact a dual awards policy that separated an impairment rating from a disability rating by using impairment ratings to determine a NELP and an ELP to determine an earning loss.

It will be worthwhile for people to see how the Office of the Ombudsman will handle my complaint in regard to this matter. Will they sacrifice or kill the sacred cow or will they recommend that the Government re-adjudicate all claims prior to Jan 1, 1995 and pay workers what they are entitled to or will the Office of the Ombudsman simply attempt to coverall of this up just as the Conservative Government did after the Penny decision. None of this was an honest mistake as the Government and the WCB BOD knew what they done was wrong as witnessed by the fact that after the Penny decision, they separated impairment ratings from loss of earnings and went to a dual award system but failed to pay workers what they were entitled to prior to Jan 1, 1995.

Click on the following link:

https://www.workerscompensation.com/news_read.php?id=31849

Mar 072019
 

By Gerald

Interesting law suit going on across the border specific to presumption. In the U.S. all State workers compensation systems determine claims based on an adversarial system meaning the burden of proof is on the worker, yet most States enacted laws providing presumptive status for firefighters and extended presumptive status to other first responders, prison guards and nurses. Obviously this is discrimination when certain individuals are treat differently than other individuals and the Federal Government is now fighting the State Government. Presumptive status has opened up a can of worms all throughout North America. Question is, how can a State provide presumptive status to firefighters, first responders, prison guards and nurses and not provide presumptive status for workers employed at a nuclear weapons facility who would have far higher the risk of cancers than any firefighter. 

In Canada, we are supposed to adjudicate claims based on an inquiry system where the burden of proof is on the “Board”. The “Board” must not only determine if there were hazards in the work place, they must also prove that a worker was exposed to a hazard outside of the workplace and the time and place that the worker was exposed to the hazard. Because a worker always receives the benefit of doubt and if WCB cannot prove contrary, the claim must be accepted.  

Rather than providing special treatment for firefighters, first responders and continuing to add mote workers to the list of preferential treatment, why not simply enact legislation giving all workers presumptive status and force the “Board” to prove an injury or disease happened outside of the workplace which would make more sense than to having workers having the burden of proof without the medical and financial ability to provide evidence to support their claims. 

Gerry Miller  

DOL Files Suit Against Benefits For Ill Hanford Workers; State Considers Amending Law



Hanford, WA (WorkersCompensation.com) – The federal government is worried that a new law in Washington state would give workers at the Hanford nuclear reservation easier access to workers’ compensation than other employees in that state. Meanwhile, state legislators are contemplating an amendment to the law that could increase the number of workers eligible for benefits.

Last week, the Department of Justice laid out its case against the new state law, claiming that the 100,000 past and current workers at the nuclear weapons facility would have an easier time getting workers’ compensation, at a much greater cost to tax payers.

As previously reported in WorkersCompensation.com, the law, passed last year, makes the presumption that exposure to chemicals at Hanford caused illnesses in the employees there, up to and including cancer.

Hanford is considered one of the “most radioactive waste sites” in America covering 200 square miles of contaminated groundwater and including 53 million gallons of liquid waste, 25 million cubic feet of solid waste. The site was a facility for enriching plutonium during World War II and the Cold War, and is where more than 60,000 nuclear warheads were made. The facility closed in 1987.

The Department of Energy, which is responsible for the country’s nuclear facilities, is a self-insured entity and has contracts to cover six current contractors and seven subcontractors that employ workers at Hanford, as well as 61 former Hanford contractors and subcontractors, with workers’ compensation benefits.

The new law would increase the illnesses covered and could be so loosely defined that workers could be compensated for common illnesses, according to the federal government’s documents. The new law could be interpreted to cover illnesses like asthma, chronic bronchitis, Parkinson‘s disease, Alzheimer’s disease and strokes, the DOJ said.

For other workers in the state, a clear link between the illness and their work would have to be shown. Under the new law, work at the nuclear facility would be presumed to be the cause.

Also, the new law allows for claims that had been denied to be reviewed under the new and easier requirements.

The government did not object as the state legislature debated the law which went into effect in June 2018. But in December, the federal government asked a judge to overturn the law as a violation of the Supremacy Clause of the US Constitution – which prohibits states from regulating the federal government.

In its initial suit, the federal government also said the law puts the burden on the federal government to prove that the workers’ illnesses were NOT caused by their work at Hanford, and that the law discriminates against the federal government.

In filings on Friday, March 1, the federal government asked Judge Stanley Bastian to rule on the case prior to its going to trial. The state of Washington is expected to answer the suit and ask that the federal government’s claim be dismissed by March 22.

According to the lawsuit, prior to the law taking effect, the DOE received 5 or fewer claims per year for cancer, court documents said. Since the law took effect, the DOE has received 50 claims for cancer. The department said that 92 claims had been filed under the new law, and most of them would have been denied prior to the new law.

Penser North America, the administrator for the DOE’s workers’ compensation program, said it had referred 41 claims to the state’s Department of Labor and Industries. Of those, 31 were recommended for approval, while 10 were not. Of those 10, eight were approved by the DLI, Penser said in the court filings.

While the DOE can object to those cases, the level of proof to deny them was high, Penser said in court documents.

“DOE must obtain expert witnesses at a significant cost, and must search for, review and organize large volumes of medical documentation,” it said.

Advocates for nuclear workers said the government’s case may not apply

“The suggestion that the supremacy clause of the constitution should prevent the implementation of this program is certainly suspect as the federal government has chosen to employ private contractors at these facilities,” said R. Hugh Stephens, an attorney who specializes in workers’ compensation for former federal employees who worked at nuclear facilities. “These are not typically federal employees and federal employees are not qualified for this compensation, if I am not mistaken, but must apply for federal workers compensation through the US Department of Labor (DOL).”

Stephens also told WorkersCompensation.com he objected to the government’s burden of proof.

“While the government would suggest that its burden is too great, it is useful to remember that many of these workers were exposed to radiation and other hazardous substances without their knowledge or consent,” he said. “This is an ultra-hazardous activity to which different rules should apply. Most of these workers did not become injured after lifting a heavy box or lose their hearing because they were posted near a loud machine. These workers cannot breath because of exposure to beryllium (a dangerous metal), or have cancer caused by exposure to radiation, and those with hearing loss suffer from nerve damage due to exposure to toxic solvents. The shoe is certainly now on the other foot as workers used to struggle to prove their claims in the face of records lost by the DOE or its contractors.”

According to the DOE, if the judge ruled in its favor, sick workers and their survivors would be covered by the Energy Employees Occupational Illness Compensation Act (EEOICA) program administered by the US Department of Labor.

Stephens, whose clients fight sometimes years to get compensation through the program, said the government’s record should discourage a judge from ruling in the DOE’s favor.

“There is a long history of the DOE opposing rightful claims by hard working residents of Washington State. These issues are described at length in the EEOICA. While the Washington State legislature appears to have the upper hand in this dispute with Washington, DC, the federal government and its history of poor treatment of these workers severely undermine its position in this dispute.”

Amendment Considered

Legislation being considered in the state legislature would modify the law. “The presumption established for cancer is amended to also apply to any active or former USDOE Hanford site worker who has cancer that develops or manifests itself and who was not given a qualifying medical examination because a qualifying medical examination was not required,” stated an analysis of HB 1490. The bill was passed in the state House and is now before the Senate Labor & Commerce Committee.

Feb 282019
 

By Gerry

Here we go again. This time it is 911 Operators who will be receiving presumptive status. This idea in politicians heads that they have to keep adding more and more occupational groups to the list questions the mentality of people. Simply give all workers presumptive status and let WCB  prove contrary which is the way that workers compensation was first meant to be since 1908. It must be remembered that in the U.S. they adjudicate claims on an adversarial system as opposed in Canada which is supposed to be an inquiry system with the burden of proof on the “Board” both for and against but at some time over the course of a hundred years, the inquiry system become an adversarial system which placed the burden of proof on workers with WCB representing the interests of employers during the appeals process and on Judicial Review.

Few states include 911 operators in first responder presumption cover

Angela ChildersFebruary 27, 2019  REPRINTS

RegulationWorkers Comp CoverageWorkplace Safety

PTSD 911 first responders

A bill adopted by the Idaho Senate on Feb. 12 to allow post-traumatic stress disorder benefits for first responders under the state’s workers compensation system is drawing on a trend in presumption laws related to mental injuries, but is fairly unique because the proposed legislation includes 911 operators among those who can seek PTSD coverage.

Idaho’s move is in line with the more than 12 states with laws in the books for first responders who are diagnosed with PTSD, and is in line with the emerging trend of presumption laws that do not require that a mental injury be associated with one event. Minnesota, Florida and Washington passed such laws for first responders in 2018.

Most laws provide details on who is eligible — naming “peace officers,” “law enforcement officers” or “firefighters.” Less common is the inclusion of those who answer emergency calls, such as 911 dispatchers. Minnesota’s new law lists “public safety dispatcher” among those eligible while Florida’s law is less specific, requiring that the employees “witness” tragedy and later lists “hearing” an event —but never names dispatchers.

Brian Fontes, the CEO of Alexandria, Virginia-based National Emergency Number Association, said he applauds legislation that includes 911 dispatchers because it “reflects the reality of the job. These folks, like police and fire, are subject to the effects of PTSD and by having it in the law, it allows them, in essence, the same remedies,” he said.

A Northern Illinois University study published in the Journal of Traumatic Stress in 2012 found that the rate of PTSD among 800 surveyed emergency telecommunicators was between 18% and 24%.

Dr. Joel Fay, a retired police officer and psychologist and co-founder of the First Responders Support Network in Napa County, California, said he doesn’t see why 911 dispatchers would be excluded from this type of legislation.

“While their lives might not specifically be in danger … they have a great deal of exposure to trauma,” he said. “Most of it might be vicarious, but some is really direct when you hear what’s going on and can’t do anything to stop it.”

Feb 282019
 

Office of the Ombudsman

801- 6th Ave SW

Calgary, Alberta

T2P 3W2

Feb. 26, 2019

On behalf of Mr. Smith, I Gerald Miller wish to file a complaint against the WCB Board of Directors that has resulted in defrauding both workers and employers out of millions of dollars due to an inappropriate enactment of policy either by ignorance, misfeasance, abuse of power or an act of bad faith.

Compensation in workers compensation is supposed to be determined based on the difference between pre-injury earnings and post-injury earnings to determine a loss of earnings. Prior to Jan 1, 1995, loss of earnings was determined by using impairment ratings as a direct method of rating a loss of earnings which was found to be illegal by three different courts in three different provinces, Alberta (Penny case), Nova Scotia (Hayden case) and the Yukon, yet because of the WCB BOD enactment of policy specifying that loss of earnings was to be determined by the direct use of impairment ratings in assessing loss of earnings prior to Jan 1, 1995 this has resulted in defrauding employers and workers out of millions of dollars.

There is also the possibility that policy enacted by the WCB BOD did not direct that impairment ratings be used as a direct method of determining an earning loss. There is nothing in policy or the WCA that directs that impairment ratings be used directly as a method of rating a disability (earning loss) or that loss of earnings is derived by multiplying an impairment rating by net earnings to determine a loss of earnings so how or why did this happen. Conclusive proof that impairment ratings have nothing to do with a disability (loss of earnings) is supported by the fact that prior to one second before midnight of Jan 1, 1995 impairment ratings were used to determine an economic loss by multiplying net earnings by an impairment rating and one second after midnight of Jan 1, 1995, impairment ratings were used to determine a non economic loss questioning the mentality of the people interpreting how an economic loss (loss of earnings) should be calculated.

On review of WCB Policy 04-04 Part I it states in part; WCB provides permanent disability benefits to the worker for any measurable permanent clinical impairment “AND” for any impairment of earning capacity meaning that there are two awards referred to as dual awards. Proceeding onward, the policy then states; a worker is considered to have a permanent disability when a work injury results in a permanent clinical impairment, an impairment of earning capacity due to permanent compensable work restrictions or “BOTH” Reading to this point, there is no mention of multiplying net earnings times an impairment rating. Reading further. When an accident occurred before Jan 1, 1995 WCB provides the following permanent disability benefits: a permanent disability award in the form of a pension, to compensate the worker for the permanent clinical impairment “AND” assumed loss of earnings which results in two awards, one award is a pension for the permanent clinical impairment and another award for an assumed loss of earnings. On further analysis, there is nothing to indicate that net earnings have to be multiplied by an impairment rating to determine a loss of earnings, although upon further analysis of Policy 04-04 Part II Application 5, Question 1 and 2 which upon analysis does attempt to explain how an earning loss is calculated by using impairment ratings but confuse the issue by equating a disability(loss of earnings to an impairment. You cannot call a disability an impairment or an impairment a disability any more than you can call a cat a dog or a dog a cat as both words are totally different. Regardless of how the BOD or WCB attempt o explain how to assess a loss of earnings, you cannot determine a loss of earnings by multiplying 90% of net earnings by an impairment rating unless the impairment rating was converted to a disability rating and then multiplying the disability rating by 90% of net earnings. For example if a worker was assessed a 20% PCI rating, this would have to be converted to a disability rating by factoring in each individuals unique characteristics such as their skills, education, job history,adaptability, age, environmental requirements and modifications. In other words you cannot equate an impairment rating to a disability rating without taking all the factors of an individual that are unique to the individual into consideration.

Impairment ratings have no correlation to earnings at all as an impairment rating excludes work as a component in the assessment of an impairment. Impairment ratings measure a workers ability to perform simple basic activities of daily living which are presented in Table 1-2 of the AMA Guides. Impairment ratings are assessed based on such medical conditions that involve minor difficulties in urinating, defecating, brushing teeth, eating getting an erection, ejaculating, orgasm, sleeping etc., which has got nothing to do with work or calculating an earning loss. Clearly using impairment ratings as a direct method of determining an earning loss questions the mentality of the WCB BOD and the people who adjudicate claims who obviously never did question how or why impairment ratings could be used when an impairment rating had nothing to do with work, a disability or loss of earnings. Note: there is nothing in the WCA that directs that WCB pay lifetime pensions for an impairment. The WCA does direct that WCB pay lifetime pensions based on a disability (loss of earnings) In fact, prior to 2018, there was no legislative requirement for WCB to pay any award for an impairment as that remained discretionary prior to 2018. Obviously if you multiply a PCI percentage rating times any numerical figure, the result would be equal to an impairment award not a disability (loss of earnings) award. You do not multiply apples times oranges and expect to get a banana.

On Feb.20, 2019, I attended and represented Mr. Smith on Judicial Review which was specific to the illegal use of impairment ratings being used as a direct method of rating a loss of earnings. It was acknowledged by the Court, WCB Legal Counsel and the Appeals Commission Legal Counsel that doing so was not in compliance with the WCA and contrary to the directives of the AMA Guides that specified that the AMA Guides cannot be used as a direct method of determining a loss of earnings. The AMA Guides are very specific and states per verbatim; 

Impairment percentages derived from the “Guides” criteria should not be used as direct estimates of disability. Impairment percentages estimate the extent of the impairment on whole person functioning and account for basic activities of daily living, not including work. The complexity of work activities requires individual analysis. Impairment assessment is the necessary first step for determining disability.

It was agreed that the blame for the fraud was the WCB BOD and according to the WCA Section 6(a)(i) the WCB BOD has jurisdiction to enact policy determining compensation, thus adjudicators were forced by statute to support defrauding workers and employers. This then leaves only the Government who can direct that the WCB BOD rescind their pre Jan. 1, 1995 policy where impairment ratings were used illegally to determine an earning loss, re-adjudicate all claims prior to this date basing a loss of earnings on calculating pre-injury to post-injury earnings. Not doing anything would bring the administration of justice into disrepute.

Despite the directive of the AMA Guides, the WCB BOD enacted policy that resulted in using impairment ratings as a direct method of rating a disability that has resulted in criminal fraud as determined by the Calgary Commercial Crimes Unit after investigation into the illegal use of the impairment ratings being used as a direct method of rating a loss of earnings.

Being that this is a systemic problem, I have advised other workers to also file complaints. According to Section 27 of the WCA, the Ombudsman after an investigation can recommend to the Government that an injustice or hardship to a worker or workers has resulted and it most certainly has, the Government may direct the “Board” to pay the worker or workers from the accident fund or refer the matter to the Court of Queens Bench for an assessment of damages and to pay the worker or workers the amount of damages assessed.

An example of how the inappropriate or illegal use of using impairment ratings as a direct method of rating a loss of earnings resulted in defrauding workers was presented in the Judicial Review based on defrauding Mr. Smith entitlement to compensation using impairment ratings as a direct method of rating a loss of earnings. 

In 1988, Mr. Smiths pre-injury gross earnings were $18,469.02 . Referring to Appendix E of WCB policies, 90% of his net earnings according to Appendix E would be approximately $14,376.20. Because he was unable to work (total disability) he would have had zero earnings which should have resulted in a life time pension of $14,376.20 annually. By using impairment ratings (20% impairment rating) as a direct method of rating a loss of earnings rather than basing his pension on pre-injury earnings to post injury earnings, Mr. Smith inappropriately received $2875.24 net a year based on multiplying $14,376.20 by 20% resulting in defrauding Mr. Smith of $11,500.96 net annually from 1988 onward.

By using impairment ratings as a direct method of rating an earning loss, if a worker did not receive an impairment rating and had a total loss of earnings or a partial loss of earnings, a worker would not receive a lifetime pension as legislated in WCA Section 56 (11). (WCB defines a disability in terms of a loss of earnings) Using common sense and logic and the ability to read would result in any one knowing that one size does not fit all. An impairment rating of any percentage would result in a PPD (loss of earnings) anywhere from a 0% PPD to a 100% disability (PTD) depending on the unique characteristics of each individual as is explained in Chapter 1 of the AMA Guides.

As well as workers being defrauded, employers also were defrauded by using impairment ratings as a direct method of rating a loss of earnings. Using the same gross earnings as an example, a worker who did not have a loss of earnings but received a 20% impairment rating would receive $2875.24 annually for the rest of their lives, thereby defrauding employers by having to pay lifetime pensions even though the worker had no loss of earnings but would receive a lifetime pension because the worker had minor difficulties urinating, defecating, brushing their teeth, combing their hair, getting an erection, ejaculating, reaching an orgasm etc which are simple basic activities of daily living. Why would WCB force employers to pay workers with no loss of earnings lifetime pensions because they had minor difficulties urinating, defecating, getting an erection, ejaculating etc. Of course, employers when the accident fund is in a surplus situation, they receive dividends in the billions of dollars as opposed to workers who receive nothing and has resulted in Alberta employers having the lowest premiums in North America on the backs of workers and therefore probably should not be paid restitution.

Question is, why would the Alberta Government, knowing that impairment ratings cannot be used as a direct method of rating a loss of earnings, not have directed the WCB BOD to rescind the policy, re-adjudicate all the claims prior to Jan 1, 1995 based on the correct method of determining an earning loss which was by using a workers pre-injury earnings and compared to a worker’s post-injury earnings to determine an earning loss, especially after the Penny decision by the Alberta Court of Queens Bench and upheld by the Alberta Court of Appeal as well as the courts in Nova Scotia and the Yukon. This questions whether the Government were complicit in criminal fraud which would be reasonable to suggest.

I would suggest that all workers whose injuries occur prior to Jan 1, 1995 and had their PPD lifetime pensions calculated directly on impairment ratings file a complaint with the Office of the Ombudsman using this e-mail as a template which can be edited for each individual’s own use.

Gerald K Miller for Mr. J. Smith

Feb 282019
 

By Gerald

On Wednesday Feb.20, 2019 we attended a Judicial Review which resulted in the Court, WCB Legal Counsel, Appeals Legal Counsel  and I agreeing that the blame for using impairment ratings as a direct method of rating a disability was the WCB BOD who are responsible for enacting policies specific to how compensation is paid. The Judicial Review was specific to how workers and employers were cheated or defrauded by WCB prior to Jan, 1 1995 based on the WCB BOD enacting policy that has resulted in worker suicide, family poverty, family breakups and homicidal thoughts of killing WCB employees when in fact WCB, DRDRB and the Appeals Commission were simply complying with policy enacted by the WCB BOD. This case points out the fact that workers anger is misdirected by blaming WCB, DRDRB and the Appeals Commission for making decisions based on what was believed to be total ignorance or incompetence or deliberate attempt to defraud workers and employers. While some people may wonder why I am concerned with employers, my involvement with workers compensation is and never was as a worker advocate. My concern has always been fairness and well reasoned decisions by adjudicators. The Judicial Review did conclude with the agreement by all parties including the court that by using impairment ratings as a direct method of rating a disability besides defrauding workers resulted in defrauding employers who were paying workers life time pensions despite the fact that they had no loss of earnings, thereby increasing employers premiums determined by lay people (WCB BOD) who did not bother to read the first chapter, especially pages 4 to 18 of the AMA Guides which had they done this they would have most likely not enacted the policy equating an impairment to a disability.    

The adjudication of all claims are based on the WCA, WCB policy and WCB Regulations. The WCA and WCB Regulations are enacted by Government. WCB policies are enacted by the WCB BOD who are selected by the Alberta Government on the basis of having an equal number of the BOD representing workers, employers and the general public. The selection process is supposed to ensure that policies enacted by the WCB BOD are reviewed by the equal number of worker representative, employer representative and public representatives. How or why the WCB BOD enacted policy that used impairment ratings as a direct method of rating a disability whether this was done blatantly or maliciously or whether through ignorance or incompetence as the AMA Guides specifically states on page 13 per verbatim;  

Impairment percentages derived from the Guidescriteria should not be used as direct estimates ofdisability. Impairment percentages estimate the extent of the impairment on whole person functioningand account for basic activities of dailyliving, not including work. The complexity ofwork activities requires individual analyses.Impairment assessment is a necessary first stepfor determining disability.

It was determined by the Court that the WCB, DRDRB and the Appeals Commission were forced by statute to comply with the BOD who through the enactment of policy by the WCB BOD that impairment ratings must be used as a direct method of rating a disability even though the AMA Guides directed that impairment ratings not be used as a direct method of rating a disabilityIn affect the WCB BOD were totally blamed by the Court, WCB Legal Counsel and the Appeals Legal Counsel for defrauding workers and employers out of millions of dollars of compensation and no one could do anything about it because Section 6 (a)(i) of the WCA states that;

The board of directors

                             (a)    shall

                                     (i)    determine the Board’s compensation policy, and according to the Court, WCB Legal Counsel and the Appeals Commissions Legal Counsel left them with no option but to use impairment ratings as a direct method of rating a disability even though it was illegal and determined by three different provincial courts in Alberta, Nova Scotia and the Yukon to be illegal and that they must follow the policy enactment of the WCB BOD even if using impairment ratings used as a direct method of rating a disability is inappropriate and contrary to the WCA.  

An example of criminal fraud and supported by the Calgary Commercial Crimes Unit was presented to the Court through the enactment of the WCB BOD  policy where a worker who was totally disabled would receive a partial disability pension by using impairment ratings as a direct method of rating a disability rather than using pre-injury earnings as a reference to post injury earnings as they began doing on Jan 1, 1995 after the Court of Queens Bench and the Alberta Court of Appeal determined that using impairment ratings in determining disability was not in compliance with the WCA. For example: If a worker had a 20% PCI rating, this rating would be used to determine a disability rather than using pre-injury to post injury earnings to determine a loss of earnings. An actual case (my client) was presented to the court involving a 1988 accident where the worker’s 90% of net resulted in pre-injury earnings of $14,000 a year and his post injury earnings was zero dollars resulting in a $14,000 net loss of earnings annually. Rather than pay a worker a $14,000 loss of earnings, WCB, DRDRB and the Appeals Commission would through the BOD policy by using impairment ratings as a direct method of rating a disability would multiply $14,000 net earnings times 20% which equals $2800.00 which is $11,200  less than what a worker is entitled to resulting in defrauding a worker, forcing the worker into poverty, family breakups, suicides and intentions of killing WCB employees when they were simply following WCB BOD policy. On the other hand the same worker earning pre-injury earnings of 90% of net of $14,000 a year with no loss of earnings when multiplied by 20% would receive $2800 a year for the rest of his/her life despite having no earning loss thereby defrauding employers. Worse yet, workers who did not receive an impairment rating (0%) and had a loss of earnings would receive nothing as multiplying any amount of money by 0% results in zero loss of earnings.  Questionably also is why would WCB pay life time pensions to workers who have difficulty in defecating, urinating, brushing their teeth, combing their hair, getting an erection, reaching a orgasm and still are capable of working. That does not make sense but apparently it makes sense to the WCB BOD and embraced by WCB, DRDRB and the Appeals Commission and that is precisely what impairment ratings are used to assess. Impairment ratings have got nothing to do with the ability to work and determining an earning loss. This is the shit system that the Government has forced onto workers and employers and administered by a bunch of highly paid goof balls. A good example of this shit show can be found by reading the first Appeals Commission decision that comes up when you input “permanent clinical impairment” is Decision 2003-873. The worker was provided with a 8.13% PCI rating which these pathetic morons used as a direct method of rating a PPD of 8.13% and were paying him a lifetime pension despite the fact that he had no earning loss as stated in para 13. Why would any one pay this worker a lifetime pension when he had no loss of earnings. This basically results in defrauding the employer by having to pay a lifetime pension to a worker who had no loss of earnings and in reality received a windfall gift from WCB at the expense of the employer. On the other hand this same worker who may have been an older uneducated heavy manual laborer who could not adapt to performing other work would receive the same 8.13% PPD derived form a PCI and determined to be totally disabled but would receive only 8.13% of 90% of net earnings. These are the highly paid morons, supported by the Government who decide what workers are entitled to and employers are paying out when there is no loss of earnings.

In legal terms, the WCB BOD are or were acting in bad faith as well as misfeasance in public office by using impairment ratings as a direct method of rating a disability despite clearly written language in the AMA Guides specifying that impairment ratings cannot be used as a direct method of rating a disability. 

It is noted that the WCB BOD are not protected by legislation and are not entitled to making what may have been an honest mistake unlike WCB, the Appeals Commission and Medical Panels who are not culpable and cannot be sued. The WCB BOD can be sued as they have no protection under the WCA. Being that the WCB BOD are selected by the Government, it is apparent that the Government has to direct the WCB BOD to rescind their policy of using impairment ratings as a direct method of rating a disability prior to Jan 1, 1995, grandfather all claims and pay workers what they were and are entitled to. As well, workers who did not have any earning losses but received life time pensions, WCB must be directed to reimburse employers for any increases in their premiums or change their experience ratings to reduce their premiums. 

Questionably is if the Government does nothing it would question their sincerity to make changes and correct the wrongs to workers and employers. By correcting what was and is an abuse of power, bad faith and misfeasance in public office by the WCB BOD prior to an election, it may result in more people voting NDP rather than Conservative as all of this fraud occurred under the regime of the Conservative Government who must have known of the massive fraud but did nothing. Having had more experience than any one else over the last 30 years with the adjudication of claims, I remain convinced that the best thing for workers and employers is to have the Government simply abolish the entire system rather than have workers gullible to  believe that the system was established to assist them and then find out that this was nothing but a lie. That is a fallacy as the system has a history of destroying lives and the only reason it exists is to protect the employer from litigation as witnessed by a recent decision of a court in the U.S. awarding 14 million dollars to a worker’s estate after being diagnosed with mesothelioma and dying and whose employer did not have workers compensation coverage who had opted out. Had the employer been covered under workers compensation, the employer would not have been sued and the estate of the worker would have wound up with peanuts.

The Government by forcing workers and employers into one of the most corrupt organization in the world created the darkest day in human history. I say this because it is true. Prior to June 1, 1996, Case Managers would advise workers to apply for CPP disability benefits to increase their ELS. Workers would apply for CPP disability benefits believing that the additional pension would help them pay for the necessaries of life. When their application for CPP benefits was accepted, worker’s entire CPP disability pensions were immediately seized and their ELS was reduced or eliminated. Other provinces because workers pay 50% of the premiums, could legally claw back only 50% of workers CPP disability unlike Alberta who clawed back 100% of the CPP disability pension depositing this money in the accident fund, thus resulting in workers subsidizing employers in this province by reducing the amount of premiums employers pay. Although, WCB stopped clawing back CPP disability pensions on June 1, 1996, workers whose injuries occurred prior to June 1, 1996 still continued to have 100% of their CPP disability pensions clawed back. Besides this, Case Managers would advise workers that in order to get work, they would have to lie about their health and ability to work. I have verified this with workers and employers who had the belief that if a worker signed a contract and swore that they had no health conditions this would be a valid legal contract. In reality it was nothing more than a piece of paper that meant nothing.

Interesting in the Judicial Review, the Judge commented on the Penny case questioning her ability to read and comprehend the decision. According to her version of the Penny case, the Alberta Court of Appeal did not uphold the decision of the Court of Queens Bench that using impairment ratings as a direct method of rating a disability was not in compliance with the WCA. According to her, the Alberta Court of Appeal disagreed with the Alberta Court of Queens Bench and drew my attention to para. 14 of the Penny case and I advised her that when reviewing any document, you do not read one part of the document, you read all parts of a document. I asked her if in fact the Alberta Court of Appeals had not agreed with the Alberta Court of Queens Bench, then why did the Alberta Court of Appeals dismiss the appeal of the Alberta Appeals Commission. She refused to answer and sat their dumbfounded that I was questioning her ability to read and comprehend what she was reading. Overall, she was a very nice lady and did allow the case to proceed with very little of the usual court procedures.  

As usual even after the Judicial Review, I had and will proceed with a back up plan as I did expect to lose because of the WCA supporting an administrative system where policy is enacted by goof balls that cannot be questioned by adjudicators and the courts but can be remedied by Government intervention. Fortunately, I was retained by the worker at no cost and unlike other workers who retain lawyers or worker advocates who charge thousands of dollars for retainer fees as well as costs and disbursement the worker I represented is not being left with massive debt despite losing the Judicial Review. 

My back up plan is to file a complaint with the Office of the Ombudsman to investigate whether the fraud was the fault of the WCB BOD or was the WCB BOD’s policy of using impairment ratings as a direct method of determining a loss of earnings a misunderstanding by adjudicators. On review of the WCA and WCB policy there is nothing in either one that directs that an earning loss is to be determined by multiplying 90% of net earnings by an impairment rating, thus possibly exonerating the WCB BOD. I am presently writing up the complaint to the Ombudsman and when completed I will send a copy of the complaint to every one and especially to those workers whose accidents occurred prior to Jan 1, 1995 who were defrauded by determining an earning loss by multiplying 90% of net earnings by an impairment rating. I believe that all workers should send in the copy of my complaint that I will send to every one as an attachment, edit it where necessary based on their own circumstances and simply sign their name to the document and send it in and wait for the Ombudsman to respond. This will also determine whether the Ombudsman is simply a yes person for the Government and refuse to upset the sacred cow or will actually recommend to the Government to reimburse employers and pay workers what they were entitled to.

Jan 302019
 

By Gerald

I have been diligently working on two long standing claims, one ten years old and the other 46 years old that resulted in denied claims and benefits that now have been reviewed and benefits that should have been paid 46 years ago are now being paid on the most minimal method WCB can think of. Most if not all long standing claims if reviewed by competent persons like myself would be overturned because of major, most likely blatant denials and not simple mistakes by all three levels of appeals and the only thing standing in the way was the Klein government and now the Notley government  who for whatever illogical reason are or were convinced that the same decision made previously by any of the three levels of incompetence would not change. I beg to differ as the devil is in the details and the proof is that any one with any expertise in workers compensation would have very little trouble in having most if not all the past denied claims and benefit decisions over turned, just as I have began to do.  

First and foremost is that workers by law do not have to appeal a claim thus eliminating any statute of limitations as there is no statute of limitations based on new evidence. Those workers who have filed appeals have placed themselves into a quagmire of uncertainties by appealing a decision of a Case Manager to the DRDRB who more than likely will uphold the decision of the Case Manager even when the evidence does not support a denial. Appealing a decision of the DRDRB to the Appeals Commission is one of the most foolish things I have ever done and in hindsight, I would advise no one to appeal anything because as long as the claim remains at the Customer Service level and new evidence becomes available, there is a better chance of having the new evidence used to have the initial denial over turned. 

I have put a great deal of thought into this and I must apologize for the lengthy e-mail but once I get going, everything that is wrong with the system comes to the fore and in my opinion there is nothing good about the system. I was recently requested to assist a worker whose claim goes back 28 years and I have never seen a claim so convoluted, so disgusting in my entire life. The worker in question came to Canada as an immigrant chasing the Canadian dream. A well educated man, former member of the Polish Navy and emigrated via Germany. He worked very hard when he arrived and very shortly become an apprentice electrician and several months into the job, he injured his back in a work related incident. He was accepted on workers compensation and endured two subsequent back surgeries that resulted in failed back surgery leaving him a broken man with his hopes and ambitions of fulfilling the Canadian dream totally out of the question. Still convinced that even after failed back surgery, he requested WCB pay for upgrading his education which they refused.He paid his own university expenses (University of New Brunswick) on borrowed money and received his degree. All the jobs he had were interrupted by problems with his failed back surgery. WCB treated this young ambitious man with contempt, disrespect, lying to him as to what he was entitled to, cheating him of what he was entitled to and made his life a living hell which he is still enduring.

Not being able to express himself fluently in the English language he was insulted by WCB personnel and also by the Appeals Commission. Not knowing the WCB system he was forced to pay for WCB Advocates like Thomas Lukaszuk who took his retainer fee and left him high and dry. This was followed by our illustrious Justice Minister, Ganley who took his money posing as an expert in workers compensation law. He went to the Courts on Judicial Review and to the Alberta Court of Appeal but unfortunately there are very few Judges who are experts in administrative law that is specific to workers compensation and the advice he was given by the Court was to give up. Like many other workers he heard of me and requested my assistance. I was utterly flabbergasted by him referring to an Appeals Commission Decision 2018-0311 https://www.canlii.org/en/ab/abwcac/doc/2018/2018canlii67014/2018canlii67014.html?autocompleteStr=2018-0311&autocompletePos=1

Reading though this should be a convincing argument that the worst thing that a worker can do is to file appeals. The claim is so convoluted that the Appeals Commission have no idea who has jurisdiction, them, the DRDRB or Customer Services. Despite my expertise, I also have no idea who has jurisdiction to hear new evidence, appeal to who and the worker himself is confused by appealing or requesting a reconsideration for claims he made that were accepted. As well he was diagnosed with drop foot, bilateral metatarsalgia, left ankle equinus, bilateral functional hallux limitus  which are all compensable conditions, high blood pressure, major depressive disorder as a result of his disability and unable to work and support his family and did not receive any compensation for any of these conditions. Being that WCB uses PCI ratings as a direct method of rating a disability which was found to be illegal by the Alberta Court of Queens Bench and upheld by the Alberta Court of Appeals, he received a PCI rating of 20% which they did not convert to a disability rating to determine a loss of  earnings. He received no PCI or PPD (loss of earnings) for any of his lower extremity diagnosed conditions and as well for his psychiatric assessment diagnosed as major depressive disorder which a psychiatrist attributed to his treatment by WCB. Again, no PCI ratng for the major depressive disorder caused by WCB. Unfortunately for him, all of this was denied and not knowing the system and how WCB and the Appeals Commission use manipulative methods for much of the illegal methods used by WCB, many of his appeals and requests for reconsideration were subject to the statute of limitations and the worker cannot proceed despite the fact that he was entitled to receive an  increased earning loss based on total disability. 

Because he kept appealing and requesting reconsiderations he was subject to the statute of limitations whereas if he simply gathered more evidence and not appealed, his claim would have never have gone through the appeals process. 

The worst case scenario is appealing a claim to the Appeals Commission and having the claim turned down based on falsified documentary evidence provided by WCB Medical Consultants who despite a worker requests to subpoena the doctors,the Appeals Commission refuse, thus allowing doctors of having no responsibility in defending their opinions. The Appeals Commission have rules of procedure that makes it impossible to present new evidence and is why it is far better to not appeal and when new evidence becomes available a worker presents the new evidence to WCB who have very little reasons to deny any new evidence. 

It is clear to me that the Government in 1988 believed another level of appeal would be beneficial to workers which clearly is a mistake as prior to 1988, an appeal could be made to the WCB BoD and they were far better at reviewing claims than the Appeals Commission. The WCB BoD were comprised of equal representation of workers, employers and the general public as opposed to the Appeals Commission who are made up with most likely political appointments with no worker representation at all which leads to a reasonable apprehension of bias when adjudicating claims. Further to this when there is a Judicial Review, both the Appeals Commission and WCB join forces using money out of the accident fund to fight a worker who is forced to represent themselves leading to procedural unfairness or in the words of Justice Maclean, not a level playing field. Fortunately for some workers, the NDP Government did rescind legislation that would allow the Appeals Commission to not being able to review or adjudicate claims prior to Nov. 1988 but neglect to enact legislation as to who has jurisdiction to reconsider claims prior to this date.

The present Government brought in the Fair Practices Office which based on one workers experience is as useless as the Appeals Commission as some workers are now finding out. According to a letter sent to a particular worker who e-mailed me the letter, the Fair Practice Office is simply another name for the Office of the Appeals Advisor but now under the Minister who is as dense as they are. The worker in question believed that the Fair Practice Office would assist him and in a letter he received which he sent me a copy, they refused to assist him and recommended that he contact some one else to assist him. This is the copy of the letter that he sent to me from the worker that he received from the FPO.

I am writing in response to the Worker’s Authorization form you recently submitted to the Worker Appeals
Branch of the Fair Practices Office (FPO).

The Worker Appeals Advisor Branch was formally the Office of the Appeals Advisor (OAA) department at the
WCB. The department transitioned to the FPO on December 1,2018.

I reviewed the numerous correspondence sent to you over the years from the Office of the Appeals Advisor
which confirmed that the office was unable to provide any assistance to you regarding ongoing appeal issues.
The most recent letter was sent by Janet Welch, Manager of the OAA, on June 1-, 2018. In that letter, it was
confirmed that we were once again unable to provide any assistance to you.

I have reviewed your claim file and your most recent correspondence to the WCB and to the Appeals
Commission and I am in agreement that we are unable to assist you with any current appeal matters.
However, you are able to obtain alternate representation or to continue representing yourself.

Perhaps Ms. Notley and Ms. Gray could explain why the FPO have refused to assist him and then recommending that he represent himself or pay thousands of dollars to people like Ganley and Lukaszuk for a  retainer to have some one else represent him. According to Section 3(1)(e) of the Fair Practices Office Regulation it says per verbatim; The Commissioner shall establish procedures respecting the following: “the assistance of workers, workers dependants,or employers in navigating the workers compensation system, including procedures respecting the direction of workers, workers dependants or employers to an appropriate resource, person or organization for assistance”.  

What does navigating the workers compensation system mean and what assistance do they give as evidently they did in fact refuse to offer any assistance to the worker. The worker compensation system also includes Judicial Reviews which can be very costly. Rather than have workers left with having to represent themselves through the system, why not simply get rid of the FPO and bring in legislation allowing workers to utilize the accident fund to hire some one to represent them throughout the process including legal representation in Judicial Reviews, thus creating a level playing field if in fact a worker is able to find a lawyer who is an expert on workers compensation systems which at this time, there are no lawyers in Alberta who are experts in workers compensation. 

Workers through being forced into a system that does not work not only cannot sue the employer, they cannot sue WCB, DRDRB, FPO, Appeals Commission, Medical Panels, they cannot subpoena witnesses and have lost all their rights under the Charter simply because they were forced by Governments to give up their rights to in exchange for the insecurity of having claims and benefits accepted, burden of proof placed on them illegally and forced onto Social Assistance. On top of all of this workers were forced into an administrative system rather than have their day in court, go through a fair trial and adjudicated by a real judge rather than the morons who have never been trained in administrative law that is specific to WCB systems, deciding medical issues without any training in medicine. This is the historic agreement that workers were forced into by Governments who through legislation provided absolute power to adjudicators without any checks or balances provided by Government. A letter from Gray to a worker explained that the Government has no control over WCB or the Appeals Commission. That being the case, who does have control. If I may, the people who do have control over WCB, DRDRB, BoD and the Appeals Commission is the Government who have the power to enact legislation that would force WCB, DRDRB,BoD and the Appeals Commission to comply with the legislation but choose not to protect workers from the corruptible and blatant abuse of power that the Government has given them. For example: no one knows who has the burden of proof, for and against. Under the Charter, can the Appeals Commission deny the attendance of witnesses despite all the evidence in all workers claims being based on documentary hearsay and without the right to have witnesses subpoenaed and cross examined, the Appeals Commission make their decisions on documentary hearsay. Should workers not be entitled to be represented by legal counsel and have this paid out of the accident fund. In the workers compensation system specific to causation, if the cause is unknown, why is the benefit of doubt not given to the worker. Legislation could remedy all the inhumane decisions made by all three levels of adjudication but even when the SCC determines that chronic non discernible pain must be compensated for, the Alberta Government does not enforce the decisions of the SCC. WCB and the Appeals Commission deny paying for medical marijuana as the archaic legislation in the WCA allows WCB discretion to pay for medical marijuana which legislation could force WCB to pay for any medical assistance that is prescribed by the workers doctor. Numerous states in the U.S. are enacting legislation to force WCB insurance companies to pay for medical marijuana which has been scientifically proven to assist chronic pain rather than opiates which are addictive, have serious side effects and is a major contributing factor in suicides.

Administrative law is not the same from one body to the other and how a decision is made has no real consequences in any other administrative functions unlike workers compensation decisions that can and does result in suicides and homicides because of grossly illogical decisions made by incompetent or blatant denial of claims or benefits. It is crucial that no mistakes be made to prevent unnecessary deaths. There should never be any mistakes especially when a claim is in doubt which in many cases it is, the benefit of doubt must go to the worker. There are numerous administrative bodies that work quite well. There are administrative bodies that are appointed to determine how many chickens that a poultry producer can send to market, how much milk to send to market, labor board etc. A farmer does not commit suicide or kill his family because the egg marketing board cut back on the amount of eggs the farmer can send to market. Another good example is human rights which is an administrative system based on an adversarial principle but a complainant need not pay to have some one represent them as once a complaint has been accepted, Legal Counsel for the Director takes over the complaint and the complainant receives legal representation at no cost.  

Appeals could be drastically reduced or eliminated entirely if at the Customer Service level, witnesses such as doctors were subpoenaed and cross examined under oath. Cross examination of witnesses in all legal systems is a corner stone of the justice system but for some grossly illogical reason most if not all claims go on for years because of in most cases doctors knowingly or ignorantly providing false medical evidence that becomes a part of the documentary file that cannot be cross examined as you cannot cross examine a piece of paper. An example that I experienced first hand is when I filed a claim on behalf of a worker for post polio syndrome caused by trauma. A WCB Medical Advisor (Dr. Grieve) falsely claimed that post polio syndrome was not caused by trauma. I contacted two of the world’s leading experts in post polio syndrome (Dr. Richard Bruno and Dr. Lauro Halstead) and both verified that post polio syndrome can be caused by trauma, either through a physical or mental cause. The Appeals Commission questioned the qualifications of the two worlds leading experts and found the opinion of an unknown and incompetent General Practitioner more compelling and accepted the opinion of the WCB Medical Advisor by the name of Dr. Grieve who incidentally also provided false evidence on behalf of WCB and the Appeals Commission who denied a claim based on her evidence. This claim went to Judicial Review cited as Boyd v. Alberta (Workers Compensation Board) where the Court of Queens Bench overturned the decision of the Appeals Commission, the DRDRB and the Case Manager determining that Dr. Grieve did not provide a valid or compelling medical opinion which made the schmucks that denied the claim look like fools. In the 46 year old claim that I was involved with, WCB in the meantime, had arranged for a Physiatrist  who had experience in PPS and he supported trauma as being he cause of the worker’s PPS thus forcing WCB to provide benefits ($92,000.00) that obviously will be appealed as the amount of money is far less than what he is entitled to as he received more money from Social Assistance in 46 years than what he is getting from WCB that in reality is only $2000.00 a year. As usual there was no interest added or COLA increases.   

Unfortunately for all workers, even though an injury may have occurred 40 years or more ago, WCB according to policy do not have to provide a loss of earnings going back to when the injury occurred. Policy 04-04 Part II Application 5 Question 7  allows WCB to select a half way point between when the injury first occurred and the date of the examination that confirmed the injury. For example in the case of a worker I represented it was noted by the surgeon performing back surgery that the worker did not have a claw foot at that time but when examined several months later, he noted the worker had developed a claw foot as a result of his back injury that severed his sciatic nerve which never did grow back. It took over 40 years for WCB to acknowledge the claim for a claw foot and then they took the half way point which was 1974 and the date of the examination by a doctor in 20015 that confirmed that the claw foot developed in 1974 but the worker received half of what he was entitled to. To suggest that this is not corruption would suggest that Clifford Olson was a good honorable man even though he raped and killed numerous children. Obviously Gray and Notley are aware that the system is broken and has been for decades and still persist in ignoring the obvious. 

Another example of outright lying was when a Case Manager lied about an employer offering modified work when both the employer and the worker denied that modified work was offered. Despite the evidence from both the worker and the employer, both the DRDRB and the Appeals Commission accepted the documentary report of the Case Manager who blatantly lied to receive her bonus after terminating his claim when she wrote in her report that the employer offered modified work and the worker refused the offer resulting in the DRDRB and the Appeals Commission denying his claim. Despite my request to subpoena the Case Manager and the employer, my request was denied by the Appeals Commission and documentary evidence provided by the Case Manager which cannot be cross examined was used to deny the claim. I have reason to believe that the decision to deny subpoenaing the Case Manager and the employer was done deliberately by the Appeals Commission to ensure that the DRDRB and the Appeals Commission were not made to look like fools. These are but two of the many instances where I have requested subpoenaing of witnesses and been denied because under cross examination any witness will eventually fold especially when their evidence provided by documentation becomes subject to cross examination. I have had the Appeals Commission question the qualifications of world recognized medical experts supporting me in other situations and then denying the claim based on local doctors who provided falsified documentary evidence that cannot be cross examined. Although we have what is referred to as an Inquiry based system in Canada, the appeals process does not use this model as the appeals process is conducted on an adversarial model but adjudicated on a documentary basis leading to a culture of denial. In the U.S. adjudication is based on a adversarial model but adjudication is based on having the litigants (worker and employer) along with witnesses, generally doctors, appear in court, heard by an ALJ, (Administrative Law Judge) not some ignorant Case Manager, DRDRB or an Appeals Commissioner. An ALJ who has extensive training in workers compensation law listens to the evidence and makes a decision based on the evidence that is provided and cross examined by lawyers on both sides. Because of the expertise of worker’s lawyers versus the expertise of employers lawyers, it is rare that a worker’s lawyer ever loses. Worker’s lawyers because of their expertise and track record of winning represent workers on a contingency basis with many of them earning very lucrative earnings. 

Despite the WCA in Alberta giving Case Managers and the DRDRB the same powers as the Court of Queens Bench, they can in all claims, conduct an in person hearing, subpoena witnesses, hear the evidence under cross examination which they argue they do not have the power to do that. My argument is that if they have the same powers as a Judge, they do have the power to conduct an in person hearing, subpoena witnesses and cross examine the witnesses under oath which if done, would save millions of dollars in added costs by reducing or eliminating the hundreds or thousands of claims going to the DRDRB and the Appeals Commission on documentary evidence that cannot be cross examined. 

Researching the people involved in the WCB system, they all have a a common link based on their curriculum vitae. In the case cited as Boyd v. Alberta Workers Compensation Board, the Appeals Commission Legal Counsel was Dale Wispinski who was arguing against Mr. Boyd who is now the Chief Appeals Commissioner. In my opinion this would be a reasonable apprehension of bias when the Chief Appeals Commissioner is a former opponent of a worker.  The recently appointed Chair of the WCB BoD who was supposed to represent workers when she served as a member of the WCB BoD assisted in enacting Policy 04-04 Part II Application 5 Question 7  that allows WCB to pay only half of what a worker is entitled to. When looking at the Appeals Commissioner’s CV they all share a common thread, that being former members of WCB (New President of WCB is a a former WCB executive) and as you go down the list of Appeals Commissioner’s all or most are former Government employees, lawyers, managers, and employers with no blue collar workers selected by the Government to serve as Appeals Commissioners. The only person who would be considered to be a genuine blue collar worker is Stephan Dussault who was selected by the Government on May 8, 2018 and when looking on Canlii he has been involved in only 4 decisions and supported the worker in 3 of the four decisions. Questionably when reviewing the fourth decision he was involved in which is obviously in error as you cannot use the Alberta Guides in conjunction with the AMA Guides. The reason being is that impairment ratings taken from the AMA Guides are based on difficulty performing simple basic activities of daily living as opposed to the Alberta Guides that assess impairment ratings based on how an impairment rating may impact the workers life outside of the workplace which includes personal and social activities resulting in different reference points. On top of that, WCB by law cannot use the AMA Guides because the doctors who provided the impairment ratings are American doctors who are not licensed to practice the healing arts in Alberta, thus negating any impairment ratings provided by American doctors. Please read the WCA that makes it illegal to use foreign doctors assessment of impairment rating. Along with this, the AMA Guides do not use ROM in determining impairment and began using DRE (Diagnosed Related Estimates) in the 5th Edition and carried over to the 6th Edition. ROM assessment were found to be inaccurate as range of motion assessment and found to be subjective (under the control of the patient) which led to false assessments when a patient was malingering.  A person does not have to be a rocket scientist to be an Appeals Commissioner as blue collar workers with a junior high school education could adjudicate claims and make the same mistakes as the people selected. 

Questionably is why there is only one blue collar worker on the Appeals Commission when there are more blue collar workers injured or killed on a yearly basis. The overall makeup of the Appeals Commission are white collar workers who have more than likely have never done a heavy manual job in their life. Generally in law when being judged, you have the right to be judged by your peers, not people who have no understanding of what it is like to be forced to live in poverty , work hard to make a living in many cases in inclement weather as opposed to desk jockeys that have no idea what it is to perform blue collar work. Obviously the Government has this idea that blue collar workers are not intelligent enough to adjudicate claims and based on my experience any dummy could adjudicate claims as there is nothing difficult about studying the WCA, WCB policy or WCB regulations. When people are given jobs and allowed to make numerous mistakes and not beheld accountable, you could appoint Mickey Mouse and Donald Duck, feed them bird seed and not have to pay the excessive wages to the Appeals Commission.  

The worker in question along with hundreds or thousands of other workers would benefit from having his long standing claim reheard by competent, knowledgeable people like myself rather than the scum bags that are adjudicating claims at present. While I have continuously stated that the whole system is corrupt which it is and can be proven beyond a reasonable doubt. When a worker files a claim, a Case Manager will usually deny the claim, knowing that a large percentage of workers will not appeal. If they do appeal to the DRDRB, the DRDRB will deliberately deny a claim knowing that a large number of workers will not appeal to the Appeals Commission. The Appeals Commission will deliberately deny a claim knowing that most workers do not have the financial capability to hire a lawyer to go to Judicial Review and despite the fact that I am considered an expert, I cannot represent a worker in the court because the Government has enacted the Legal Professions Act to stop me from representing workers in court even though I was legally entitled to represent workers before Adjudicators who had the same powers as the Court of Queens Bench which is grossly illogical. If I had the expertise to represent workers in the system, then on Judicial Review, I should have the right to represent workers in a private Chambers setting before a Judge who has less power than the Appeals Commission as a Judge cannot overturn the decision of the Appeals Commission, by law all he can do is to send the claim back to the same body who denied the claim and they have the legal right to deny the claim again sending it back to the same body who denied the claim which is a violation of the Rules of Natural Justice. The same body cannot judge their own case but in the sick system, the Rules of Natural Justice are kicked to the curb. Any  worker who files for a Judicial Review without an expert to represent them is a damn fool and are made to look like a fool by WCB and Appeals Commission Legal Counsel who can lie to a Judge and have lied to a Judge simply because most Judges do not have a clue how the system works, are unfamiliar with the WCA, WCB policies and WCB regulations. 

Workers are not advised by Case Mangers what thy are entitled to despite workers being described by WCB as being clients, instead they are treated with contempt, rude and unacceptable behavior when they question their claim. Many workers are totally ignorant as to what they are entitled to such as personal care allowances, house keeping allowances, home maintenance allowances, interim relief allowances, PCI ratings due to every imaginable medical condition that range from sleep disorders, erectile difficulties, dry mouth, constipation, high blood pressure, liver disorders, stomach disorders, difficulty urinating, difficulty defecating, obesity, gait, chronic pain, sensory deficits, loss of muscle strength, any side effects of prescription medications, etc. which would include anything that makes it difficult to perform simple basic activities of daily living or the impact an impairment would have on activities outside the workplace such as riding a bike, dancing, playing ball, soccer, golf which are all social or personal activities that a worker may have difficulty with.  

I have no idea why the Government provided regulations giving WCB the right to not having to pay interest on claims that were illegally or blatantly denied and then after years of fighting for acceptance of the claim and benefits,there is no interest on the monies that WCB pays out. According to the B.C Supreme Court in a class action Judicial Review cited as Johnson v. Workers Compensation Board, Madam Gray determined that WCB has to pay interest from the  effective policy date and also retroactively. She provided a common sense explanation. The class action became totally convoluted when WCB and WCAT appealed the decision to the B.C. Court of Appeal. The B.C Court of Appeal determined that she had made an error in law and determined that she did not have jurisdiction on the retroactive issue and directed she rule on the WCB BoD new policy providing interest only if it could be proven that the decision to deny was blatant. On a rehearing, it was determined that the WCB BoD have by legislation the right to do anything they wanted as long as it was not patently unreasonable. The interesting part of the Johnson case was that the argument that was presented as being the reason for not paying interest was to protect the accident fund which is what I and many others have claimed was the primary reason for the way WCB adjudicates claims and not to ensure that  workers do not become a charge on family, friends and society which was supposed to be the primary purpose of the system. The whole system had evolved from what was intended by Meredith to nothing more than protecting an employer from litigation and protecting the accident fund which questions why the NDP bothered to put in the preamble of the WCA what is pure and simple bullshit by stating; “whereas the purpose of the workers compensation system is to provide appropriate compensation to workers who suffer workplace-related injuries and illnesses, whereas the central focus of the workers compensation system is the health and well-being of workers. This sounds good in theory but in practice the whole purpose of the system is to protect employers form litigation and to protect the accident fund to keep premiums lower than other provinces to entice employers to stay in a location or have other employers in other provinces re-locate. Why would Government pass legislation empowering WCB to avoid paying interest on a debt owed to workers unless they are complicit in defrauding workers. That being the case, no one should have to pay interest on any outstanding debts to protect their savings accounts. There is very little doubt that claims are blatantly denied, knowing that if at some time in the future if they are forced to accept a claim or benefits, they do not have to pay interest on the accrued benefits which in essence encourages the denial of claims and benefits. Workers cannot sue WCB for making a mistake, they cannot collect interest on monies owed leaving workers who have lost their homes, broken marriages, children growing up in poverty and the Government sits back and does nothing. Little wonder workers turn to violence when the Government fails to protect them from a body like WCB who in many peoples minds are nothing more than organized crime or racketeering.

Prior to Jan 1, 1995, WCB used PCI ratings as a direct method of rating a disability which was found by the Court of Queens Bench and the Alberta Court of Appeal to be illegal which it always was illegal but the morons with high paying jobs never realized that there was no correlation between an impairment and a disability which WCB defines as a loss of earnings which resulted in workers receiving life time pensions when they received an impairment rating when they did not have a loss of earnings. Using impairment ratings a s a direct method of rating a disability also provides inadequate pensions for those workers who may be totally disabled from working at any gainful employment and receive an inadequate pension based on an impairment rating that has nothing to do with the ability to work or to determine a loss of earnings from pre-injury to post-injury. Workers or more likely their representatives who clued into this fact began filing claims for every imaginable impairment rating to increase their life time pensions despite the fact they may never had a loss of earnings. The high paid morons at WCB finally decided that after the Alberta courts determined that impairment ratings used as a direct method of rating impairment was illegal and separated the impairment rating from an earning loss by now using impairment ratings for a NELP and an earning loss as an ELP. 

Jan 232019
 

By Gerald

Unfortunately for workers in Alberta the WCA (Section 80(1) allows WCB to deny any payment for necessary medical treatment that has been determined to be a necessity by medical experts. The blame for this repressive attitude lies entirely with the Government who refuse to peruse the WCA to delete oppressive powers that have been provided by the Government leaving workers at the mercy of unqualified WCB Medical Consultants who do not have a clue what they are doing which is followed by case managers who do not have a clue what they are doing, DRDRB who don’t have a clue and the Appeals commission who also don’t have a clue what they re doing. Prompt and necessary medical care is required to eliminate or reduce the medical complications of a work injury to prevent workers from becoming totally disabled or god forbid dying because certain medical procedures were denied. The whole system is a total disaster and has been for decades with no improvement seen even after reviews by Doerkson, Friedman and the latest by Norrie, Carpenter et al who probably meant well but dd not have a clue how to improve the system. 

Our courts in Alberta would most likely refer to Section 80(1) of the WCA and comply with the WCA rather than uphold the principles of the right to appropriate medical care under the Charter based on security of the person.