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 disability. In 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.
