Releasing all safety records fraught with problems

Richard Truscott is right in his assessment however, his reasons for not releasing the numbers are exactly why they should be released. For far too long the data that has been collected and compiled by both WCB and WH&S has been the wrong metrics to gauge safety performance and worse the basic accounting is abysmal. Releasing the numbers will force much needed change on the record-keepers. Without the harsh glare of public and business scrutiny the status quo will never change and to be blunt, people will continue to die.

Releasing all safety records fraught with problems

WCB staff paid bonuses for getting injured workers off benefit payments

Attention needs to be brought to bear on this broken system. I've been watching this type of thing going on for far too long and feel ineffectual in any of our efforts to make meaningful change. Sad, as it is an easy fix. Unfortunately, we have the wrong people in positions of trust. There is no leadership, vision or will to execute. This is no slight to the WCB employees in the trenches who are tying to do a good job. Often times they are stymied from doing what is right. It is no wonder that turn-over rates and stress leave is high.

WCB staff paid bonuses for getting injured workers off benefit payments

WCB: We Need to Negotiate a Better Deal

It has been 22 years of looking at WCB claims and how the overall system works from an organisational behavior perspective. I have watched with dismay as employers have consistently "shot themselves in the foot" out of pure ignorance and in some cases laziness for not becoming better educated. In particular, there is a real dearth in the understanding of how premiums are calculated which has led to support and in some cases lobbying for inappropriate change. Also, WCB has done an excellent job of misdirecting employers away from the issues that could immediately impact the way WCB conducts business. The following are four proposed items that if implemented would have an immediate and direct impact with respect to WCB management:

1. No time loss less than $1,000:

Given that medical costs have continued to increase almost exponentially the fact that the $1,000 dollar figure has not changed since originally implemented means that it is much easier to broach the thousand dollars and have the total apply to your experience account. WCB needs to increase this figure to at least $1500. This would have a substantial impact on a number of minor claims.

2. Medical Form – needs to contain capabilities & restrictions. Remove fitness for work aspect:

Removing the section where the doctor states whether or not modified or alternative work can be performed and adding in a section where the Doctor can indicate physical capabilities would effectively eliminate all questionable temporary total disability (TTD) where a treating physician has stated totally disabled from all forms of employment with a relatively minor injury e.g. cut baby finger.

This change would eliminate the Doctor from becoming a gate keeper which was never their intended role. It would force WCB to do the critical thinking and seek out modified work opportunities. In essence, this one simple change would eliminate a majority of claim processing by WCB and hold them accountable to their mission which is a “focus on return-to-work”.

3. Medical Service providers that do assessments can’t do the treatment

Often times WCB will refer an injured worker for an independent medical exam, a fit for work exam or a functional capacity examination. Typically these are done at one of three facilities, Lifemark, Millard and Canadian Back Institute. While all this may be legitimate what is troublesome is the ability of these facilities to recommend further treatment e.g. occupational rehab, work hardening etc. In essence, they are obtaining a captive referral which they then medically recommend further treatment. The perception is that this may not be in the best interest of the worker but in the best interest of the treating facility as they benefit financially from doing the treatment. To eliminate this situation the provider that does the assessment should not be allowed to do the treatment. This would make the assessment truly independent and more reliable.

4. Real Time Decision Making

Customer service at WCB needs to be provided in real time in order to meet the requirements of both progressive employers and in ensuring that delays do not hinder the injured workers recovery. The WCB demand for the Employers report to be submitted within 72 hours of being notified of the accident is too long a time period. Given that this is too long then the WCB goal of adjudication within 14 days of injury and return to work planning within 10 days of acceptance of a claim is completely inappropriate. The goal is for WCB to provide decision making the same day they received the information. It is up to progressive employers to ensure that the WCB receives all the information necessary to make a decision. In this regard, WCB has the capability to make real time decision.

None of the above items requires legislation change and can be made so with the simple stroke of a pen. WCB however is reluctant to make these changes as it fundamentally transforms the way they currently conduct business and puts more accountability on them to fulfill their mandate of providing "strong disability management and modified work programs."

In future blogs, I will explain each of the above points in more detail.

Effecting “Real” Change in the WCB System

The opportunity  exists for WCB-Alberta to become the standard bearer in how all compensation systems are administered to achieve:

1.    Accountability for all stakeholders;

2.    Real time decision making capability; (that is, the same day claim information is submitted, a decision is provided); and

3.    Collaborative approach for returning injured employees back to the workplace.

The goal is “no time loss” as this is essential in ensuring that injured employees are not victimized by the bureaucracy through erosion of the occupational bond, and in keeping WCB premiums to a minimum. This goal is even more critical in key industries where good safety statistics determine whether a contract is awarded or not. Indeed, multi-million dollar contracts are being won or lost due to the number of time lost incidents and the number of time lost days. Progressive employers have concluded that they can no longer afford to wait for WCB to manage their injured employee’s rehabilitation and return-to-work.

WCB is being challenged to keep pace with the level of early intervention and involvement from this group of employers. Unfortunately, they are not able to provide the expedited adjudication that is required. Indeed, it can be easily demonstrated that WCB is the cause of unnecessary time lost claims and unnecessary time loss days. Currently time loss is resulting from three sources:

1. Safety failures (result of poor safety by the Employer);
2. Inability by WCB to provide early intervention in return-to-work planning; and
3. Employers not being actively involved.

WCB is failing in fulfilling its mission on focusing on return-to-work. As a result, is responsible for unnecessary time loss. Currently, the goal from date of accident to acceptance of claim and first payment is 14 days, to be obtained 55% of the time. WCB business procedures state that a return-to-work plan must be developed 10 days from claim acceptance. The best case of 24 days is unacceptable in today’s highly competitive market which requires "same day as injury" return-to-work planning and implementation.

Call to Action:

1. WCB must meet a new standard of service delivery by obtaining “real time” same day adjudication.

2. WCB needs to encourage employers through the Experience Rating Program to engage in case management activities and penalize those that do not.

3. WCB needs to re-examine their role and move towards adjudication and away from Case Management wherever possible.

In Alberta, we have the opportunity to effect real service delivery improvement due to the following:

• Current structure of WCB adjudication
• Progressive Employers with a vested interest; and
• Fact that a minority of employers are responsible for the majority of WCB claims.

To achieve real time decision making employers must take on the case management role. WCB needs enhanced collaboration with respect to information gathering and development of return-to-work proposals. If the employer is "doing the heavy lifting" then a reasonable expectation from WCB is real time service delivery.