Progress report

The panel released a progress update, Working Together: WCB Review Progress Report (0.3 MB), to government in November. The report describes the major activities the panel has undertaken since it was established in March and is only intended to reflect key themes of what the panel has heard from stakeholders up to early November.

Engagement Phase – June/July 2016

 

Over the summer, the Panel invited people to share their perspectives several ways:

  • Through a serious of online questionnaires with tailored questions for different audiences
  • Using a workbook and Guide to the Review of the Workers’ Compensation System, which outlined many topics and asked questions about various aspects of the system
  • By inviting stakeholders and interested individuals to send in written submissions.

The Panel received over 1,700 questionnaires, over 200 written submissions and 67 workbook responses.

Organization submissions

The following organizations have agreed to share their submissions.

 

Injured Worker Sessions – September 2016

 

In September, the Panel met in person with Albertans who have suffered injuries and illnesses and interacted with the WCB. They shared their personal experiences about their injuries and illnesses, about their journeys through the claims process, and about the impact it had on their lives and their families. While each person’s story was unique, the Panel was struck by how consistently certain issues arose.

 

One of those issues is the need for respect, dignity and compassion in the workers’ compensation system. Regardless of how the details or circumstances of workers’ claims might differ, they all involve people at the centre of them. It’s important that people feel they are treated with respect.

 

The Panel also heard about the need for transparency. There’s a confusion about how decisions are made in the workers’ compensation system. This has understandably led to a degree of distrust. People want to know how the system works, what’s being decided, and the reasons for those decisions, as claims move through the process.

 

Injured workers also expressed a belief that the system deliberately puts up barriers and roadblocks in an effort to block, stall and deny claims, or in the hope that workers will simply abandon their claims out of frustration.

 

A message the Panel took away from these meetings is that there is a desire for Alberta’s workers’ compensation system to be more balanced – with a focus on people, and not just dollars. People recognize that the system needs to be financially stable, but there’s a sense that the right balance is currently lacking.

 

The thoughts above represent some of the input the Panel received from injured workers.

 

It’s important to note that it’s not all the Panel has heard throughout this review.  They also received many other thoughts and opinions from many other sources, including employers, unions, industry associations, health professionals and other interested Albertans. There is a remarkable amount of consistency in the themes and ideas that are emerging from those submissions as well.

Working Together Sessions - November 2016

On November 16 and 17, the Panel engaged nearly 100 stakeholders to discuss Alberta’s workers’ compensation system in greater detail. An array of employers, unions, employer and worker representatives, safety associations and industry associations participated at this engagement opportunity.

Below is a flavour of what we gathered during the two days, organized by topic area.

 

Establishing and Adjusting Benefits

 

Participants had a number of things to say about the way WCB benefits are established and adjusted over time. Here are some highlights.

  • Lots of people question why the WCB has a cap on insurable earnings, in terms of the maximum allowable dollar amount and the fact that the benefit is calculated only on 90% of earnings. We heard that the “90%” amount helps encourage return to work, but we also heard opinions that it runs contrary to the idea of replacing a worker’s earnings.
  • The challenge with adjusting worker benefits to account for future salary and career progression is that it can often be speculative. Some suggested using an objective and evidence-based approach (such as average weekly earnings in an industry) could standardize the way benefits are adjusted over time.
  • It was suggested that if a disability is permanent (versus temporary) then it may make sense to make the worker’s benefits more fulsome over time, in terms of accounting for health and pension benefits that they have lost as a result of being off work.

 

Deeming Process

 

There is dissatisfaction with the WCB’s current deeming process. The Panel heard many suggestions and comments, including:

  • The deeming process is not transparent, not well understood by workers and employers, and to the extent it is understood it is not considered fair.
  • Jobs used for deeming earnings should reflect reality and be connected to Alberta’s labour market.
  • One idea is to inject greater independence into the deeming process, to mitigate concerns that the purpose of the deeming process right now is to keep claim costs down.
  • Rather than being a paper exercise, deeming should be more hands on. Approaches like training-on-the-job should be utilized.
  • People said the related area of vocational rehabilitation should also be improved so that it genuinely focuses on realistic and appropriate retraining for the worker.
  • It was said that date-of-accident employers should have every opportunity to bring employees back to work, and that vocational rehabilitation services should support that rather than get in the way.
  • Vocational rehabilitation work is highly specialized, and should be led and done by appropriate specialists and professionals.

 

Medical Conflicts

 

Participants said that there are too many conflicts right now related to medical issues, and these cause delays and inefficiencies in the system. They provided ideas to improve the situation, including the following:

  • It would help to raise awareness among physicians about how the workers’ compensation system works.
  • The relationships between the medical community and the WCB could be vastly improved. Right now there is frustration in the medical community and feelings that the WCB does not pay sufficient respect to the opinions of medical professionals.
  • To avoid legendary battles of opinions between specialists, it would help to reduce the amount of “doctor shopping” that occurs in the system.
  • It was said that medical consultants employed by the WCB should play an advisory role, not a role of forming medical opinions. The opinions should be left to practising physicians and specialists.
  • Medical professionals who perform independent medical examinations (IME) need to be provided with all relevant information about a worker, so that there can be greater confidence in the IME.
  • Infusing more independence into the medical side of the system could help improve worker choice and reduce medical conflicts. One idea put forward was the creation of a “roster” of specialists from which workers could choose.

 

Presumptive Causation

This is an area that stands to grow in importance as the labour market faces issues such as an aging workforce, more repetitive stress injuries, and a trend where workers change employers more often than in the past. Key points made by participants include:

  • Expanding areas of presumptive coverage might make sense, but that it should be evidence-based. Some people suggested using independent panels of medical experts to make these determinations.
  • The legislated “schedule” of occupational diseases has not been updated in decades, even though medical knowledge has advanced in that time. It would be helpful to update the schedule.
  • The costs associated with occupational diseases should perhaps be borne by an industry group rather than an individual employer, recognizing that within some industries people change employers more frequently now.
  • One view was that employers need the ability to seek ‘cost relief’ from the WCB. The ability of employers to seek cost relief from the WCB has changed over time. Employers would like to enhance their ability to seek cost relief, as this is seen as an effective process.

 

This is an area where more study needs to be done. As part of that, the Panel will be hosting a “Trend Talk” in December that will involve discussion of presumptive causation and presumptive coverage. Stakeholders will be invited to attend that engagement opportunity, where the Panel hopes to learn and hear more.

 

Return to Work

 

There appears to be a widely shared view among stakeholders that there is room to improve return to work processes. Among the views expressed were the following highlights:

  • There should be early return to work planning that is collaborative in nature. It would help for the employer, worker and WCB to all have dialogue together so that there is a shared understanding of what is possible and what the plan is.
  • To facilitate and inform return to work planning, it would help for employers to receive all relevant information about a worker’s capabilities. This should happen as early as practical.
  • Smaller employers do not always have a good understanding of what a return to work can look like, or what’s considered acceptable. It would be helpful if the WCB could provide information and support to employers in this regard,
  • Even though they are physically ready to return to work, some workers have emotional or psychological challenges (e.g., dealing with the fact that their job has changed or that their capabilities are different, etc.) It would be valuable for the WCB to support workers to deal with these challenges.
  • The WCB could be more “hands on” in return to work. Rather than passive letters and phone calls, it should use approaches such as worksite visits. It was said that the WCB used return to work coordinators in the past, and perhaps this could be done once again.
  • When people are pushed back to work too quickly there is a real risk that they will re-injure themselves or pose a risk of injury to others. These are not the conditions for a successful return to work.
  • Workers who return to work should be held to the same expectations as every other worker in respect of following workplace rules. Employers have concerns that these workers are effectively “immunized” from consequences right now due to the way WCB policies are currently written.

 

Duty to Accommodate

It is clear that this is a controversial area. Some of the points the Panel heard are as follows:

  • It is largely recognized that employers already have a legal duty to accommodate workers who are returning from illness or injury. The question is how to best ensure workers can exercise their rights to be accommodated.
  • Some people don’t believe the WCB should be involved in enforcing the duty to accommodate. To them it is a question of employment law that is best dealt with by other forums, such as the Human Rights Commission.
  • Other people say that forums such as the Human Rights Commission are too reactive and have long wait times these days. As a result, workers are not able to assert their rights to be accommodated in a timely fashion.
  • Still others have questions about giving the WCB a whole new area of work to do, particularly since they have concerns about the WCB’s ability to perform its current mandate effectively.

 

Reviews and Appeals

 

Participants had several comments about the review and appeals processes in the workers’ compensation system. Thoughts provided by participants included the following:

  • The WCB’s current internal review process – the Dispute Resolution and Decision Review Board (DRDRB) – is rather useless in its function. It is perceived as routinely “rubber stamping” decisions and does not resolve issues in a meaningful way. It was said that the only reason people use the DRDRB is because doing so is a mandatory step before one can go before the Appeals Commission.
  • In particular, there should be more independence injected into the DRDRB (or an alternative internal review process of some kind.)
  • The internal review process should focus on genuine problem solving, and taking a serious ‘second look’ at a decision that has been made.
  • There should to be more transparency in the review process. The people who have interests in the decision (i.e., the worker and/or employer) ought to know who is involved in the review, and understand the review process.
  • Timelines and accountability for decisions should be introduced.
  • The Appeals Commission process seems to work well, and is an improvement over what used to exist. That being said, people are concerned about the timeliness of Appeals Commission decisions.
  • Decisions of the Appeals Commission should be followed by the WCB.
  • The WCB appears at Appeals Commission hearings and participates as a party. This is seen by many people as intimidating and adversarial. Some people say the WCB should remain neutral, rather than “fighting for” its decision on a matter.
  • It was suggested that the Office of the Appeals Advisor (OAA) should have greater independence from the WCB, so that workers have greater confidence that the OAA has the worker’s interests at heart when it is advising.
  • People indicated they would appreciate an expansion of the support provided to employers in reviews and appeals, especially for smaller employers.
  • Both workers and employers would find it beneficial if there was some kind of role or resource that helped them in navigating the workers’ compensation system and its various processes.

 

Alternative Dispute Resolution (ADR)

 

There were mixed views about incorporating alternative dispute resolution processes in the workers’ compensation system. Key points included the following:

  • Some people suggested that ADR processes would be helpful, as they could provide additional opportunities to resolve issues in a non-adversarial way.
  • Others had the view that incorporating ADR processes would simply add more process steps to the system and, in turn, risk contributing to more delays when there are disputes.
  • Some participants suggested that if existing processes in the system allowed for more collaboration and dialogue, then it might not be necessary to insert formal ADR processes into the system.
  • Others suggested that ADR might be helpful when addressing issues around vocational rehabilitation, deeming and return to work.

 

Policy Development

 

One of the functions of the WCB Board is the development and establishment of policies. These policies cover a number of areas that impact workers and employers, and so there is stakeholder interest in how they are developed. Thoughts provided by participants included the following:

  • The policy development process used by the WCB should be more transparent and more understandable.
  • There should be formal opportunities for stakeholders to raise issues that they feel need to be addressed with new policies or policy changes.
  • The process used for developing policies should include opportunities for public comment and stakeholder engagement.
  • The procedures used by the WCB should always be consistent with policies that have been established by the WCB Board.
  • WCB policies should be periodically evaluated to ensure they are achieving their intended objectives and to assess unintended consequences. These evaluations should happen on a regularly scheduled basis.
  • The WCB Board should establish performance measures for the organization. However, people are concerned about the connection of performance measures with bonus pay for WCB staff.
  • It might be useful for performance measures to cover areas related to claims processing or claims costs. However, there was a strong consensus among stakeholders that these should NOT be connected to bonus pay of WCB staff or senior management.
  • Participants indicated that regular statutory reviews of the system would be welcome. In terms of how often reviews should occur, most people’s preferences fell in the range of between 5 and 10 years.

 

WCB Board Representation

Participants expressed views about the representation on the WCB Board and the role that it plays. These views included the following:

  • Certain board members are supposed to be representative of worker interests and employer interests but it appears that they forget this.
  • The board seems to be focused primarily on financial matters rather than bringing worker and employer perspectives to the table.
  • The board members ought to be trying to achieve balance between worker and employer perspectives when they make decisions about premiums, benefits and other matters. Some people feel that this is not currently the case.

 

Engagement with the WCB Board

 

Participants expressed a desire for greater opportunities to engage with members of the WCB Board. Key suggestions included the following:

  • Since the decisions made by the WCB Board have an impact on workers and employers, stakeholders would like to have input as to who is selected for membership on the Board. One idea, for instance, is that there could be stakeholder participation on an interview committee of some kind.
  • The selection of board members should be competency-based.
  • WCB Board members should regularly engage with the stakeholders they are intended to represent, and even perhaps with members of the public.
  • There should be regular and timely communications directly from the WCB Board, through mechanisms such as newsletters or town halls, especially for small employers and non-unionized workers who may not have organizations representing them.
  • The WCB Board should be accountable to the public, and should regularly report on established performance measures.

 

Safety Associations

 

Participants provided comments about safety associations and the roles they thought the WCB should play with respect to safety associations. These included the following:

  • The WCB should strictly remain a collector and remitter of funds for some safety associations, and should otherwise not have any involvement with them.
  • Safety associations should be more accountable to their members, since their members are funding them.
  • Workers should have greater representation on safety associations.
  • It would be more appropriate for Occupational Health and Safety (OH&S) to monitor the performance of safety associations, since workplace safety is their mandate.

 

Claims Reporting

 

Many people had views about whether and how there is room to improve the reporting of claims. There were suggestions that claims suppression can occur in some workplaces, and people offered perspectives about how these issues could be addressed. Some of the key comments include the following:

  • There are many aspects of the workers’ compensation system that inadvertently can discourage claims reporting. For example: the experience rating component of premiums, the poor performance surcharge, and lost time claims.
  • It was suggested that claim costs be shared more broadly across industries, rather than having so much responsibility land with individual employers.
  • Bringing back cost relief was suggested as a way to encourage better reporting.
  • Some people suggested that the WCB use scaled or tiered systems to account for the diversity in size among employers. These kinds of changes might lessen the cost implications of claims.
  • It was said that the key problem is not the collection of information about claims, but how that information is being used. Lost time claims were particularly cited as a concern, since they impact an employer’s ability to bid on work.
  • One idea was that the WCB could change the threshold at which a claim becomes a lost time claim. This would give the WCB more flexibility to provide support to workers, and it would mitigate the challenges that employers are facing around the way lost time claim information is being used.

 

The Panel is alive to the fact that lost time claims are being used by general contractors and others in the economy as a proxy for a company’s safety rating, and arguably, this may not be driving the right behaviour among employers. This and other data-related issues will be examined at a data symposium that the Panel will be hosting in January.

 

Premium Setting

 

Not surprisingly, there were many views from stakeholders about the how the WCB establishes premiums. Major themes that we heard on this topic include:

  • The premium setting system seems to include too many sectors now. It might make sense to simplify things and have broader sharing of risk across industries, especially since employees increasingly move between different employers.
  • Smaller employers are not as capable as larger employers of taking advantage of certain incentive programs. The result is that those incentive programs are unfair and create premium inequities across an industry.
  • It would help if the WCB could account for the diversity of size among employers when it calculates premiums.
  • Industry Custom Pricing (ICP) is unfair to smaller employers, who can often be pulled into such a scheme against their will by larger employers in the same industry.
  • Many employers felt that ICP is not effective as it currently exists.
  • The WCB should consider requiring that discounts on employer premiums be spent by an employer on injury and illness prevention and safety programs.

 

Accident Fund Management

 

The Panel heard a lot of opinions about how the WCB manages the WCB Accident Fund, particularly as it relates to surpluses in the Fund. Key points included:

  • Surpluses in the Fund belong to employers and should be returned. They are the result of too much money being collected by the WCB in the first place.
  • If surpluses in the Fund are going to be distributed to employers, those distributions should be used for health and safety programs.
  • Many said any surpluses in the Accident Fund should not be used by the Government of Alberta or the WCB.
  • There were suggestions that surpluses should be used to enhance benefits or improve safety in workplaces, rather than be distributed back to employers without condition.
  • If a surplus is generated in the Fund due to better-than-expected investment returns, then it should be left in the Fund. Having a healthy surplus in the Fund would be good, to guard against possible downturns or “bad” years.
  • People agreed that the Accident Fund targets should be set using actuarially sound principles.

 

There are clearly divergent opinions about the WCB Accident Fund. Participants had various views about the target range that should be used to manage the Fund, with some saying it is currently too conservative. There are also clear philosophical differences among stakeholders about the ownership of monies in the Accident Fund. Many employers take a view that the money in the fund belongs to employers, while many unions take a view that the money in the fund is for benefits. The Panel has noticed that there are also misunderstandings about the Accident Fund out there, and these contribute to the polarized views that we are encountering.

 

Vision and Values

 

The Panel invited participants to describe their vision for the workers’ compensation system in the future, and to identify the core values they felt should be present in the system. There was a remarkable amount of consistency in the input the Panel received.

 

In terms of vision, participants described a future system that:

 

  • Is focused on helping injured workers get healthy and return to work when they are fit to do so.
  • Is committed to providing good customer service, both to employers and to workers who depend on the system.
  • Is clear and upfront with employers and workers about what to expect and what is expected, while using active listening and respectful communication.
  • Provides timely decisions, so that workers can receive timely treatment and employers can plan in a timely fashion.
  • Incorporates education – for workers, employers, for the medical community and WCB staff – so that people understand how the system works and the roles that everyone plays.
  • Works in a collaborative way with workers, employers and the medical community, and engages in dialogue to come up with plans and solutions.
  • Empowers case managers and other decision makers to “do the right thing” to help injured workers.
  • Includes real quality assurance measures that take into account human dignity and avoid conflicts of interest.
  • Uses processes and procedures that are efficient, but also fair and respectful.
  • Incorporates some form of oversight, so that systemic problems and complaints are identified and addressed, and continuous improvement is encouraged.

 

The following values were among those frequently articulated by participants:

 

  • Ethical – The system should be ethical in its structure and its treatment of workers and employers, with no conflicts of interest.
  • Evidence-based – Decisions made in the system should be rooted in data and evidence to the greatest extent possible.
  • Fair – Procedures should be fair and the decisions made should be unbiased, consistent, and in line with policy and the Meredith principles.
  • Transparent – People should know and understand how the system works and why and how decisions were made.
  • Compassion – The system should be compassionate, and treat injured workers with respect and dignity.
  • Accountable – The system should be accountable to employers and to workers, and also to the public.
  • Sustainable – The system should be financially sustainable, while providing appropriate benefits and remaining cost-effective.

It was acknowledged that several aspects of the above vision and values might already be expressed by the WCB, but participants felt they are not necessarily lived in day-to-day practice right now.

Trend Talks – December 2016

“Trend Talks” took place in Calgary on December 16. Approximately 70 stakeholders representing employer and worker interests gathered with our Panel to hear from the following experts:

  • Dr. Charl Els, a psychiatrist, addiction specialist and Associate Clinic Professor with the University of Alberta, who discussed current trends and evidence around presumptive coverage for post-traumatic stress disorder (PTSD);
  • Dr. Phil Karpluk, Director of Medical Services with Alberta OHS, who provided his perspectives on occupational disease;

And a suite of four panelists who provided their unique perspectives on the impacts of bullying and harassment in workplace injury and illness, including:

  • Vicki Giles, a lawyer with McLennan Ross LLP;
  • Leanne Chahley, a lawyer with Blair Chahley;
  • Peter Lambooy, Vice President Operations with the WCB; and
  • Rob Feagan, Executive Director of OHS Delivery with Alberta Labour.

A few points from the event include:

  • PTSD is not as straightforward as, “You have a traumatic event and develop PTSD.” The reality is that the majority of people who are exposed to trauma will not develop PTSD. There are a number of factors that contribute to higher risk of developing PTSD, particularly genetics, as well as family history, proximity to the trauma, how supportive a recovery environment a person has, and other factors.
  • Occupational disease is an area where there is some inconsistency among workers’ compensation systems in Canadian provinces. Alberta’s system has in fact been a leader in this area. One of the challenges is the amount of data that is currently collected about occupational disease. While a number of organizations (including Alberta Health Services, the Cancer Board and the Medical Examiner’s Office) collect medical data, this doesn’t always include occupational information. Greater alignment on the data collection front would put Alberta in a better position to enhance its efforts on occupational disease.
  • When it comes to bullying and harassment in the workplace, there are two real goals. One, obviously, is to make sure workers who suffer injuries and illnesses from this conduct are provided with the assistance they need. The other goal is to encourage workplaces to stamp out this conduct so that further incidents are prevented. The challenge is finding a solution that furthers both goals. This isn’t as easy as it might sound. We heard that if it’s not done carefully, a change to policy or legislation could cause unintended consequences such as curtailing legal avenues to workers or driving workplace bullying and harassment further into the shadows, which would end up hurting more than helping.

Data Symposium – January 2017

As part of its operations, the WCB collects data from employers about workplace injuries and illnesses, resulting in the largest repository of data of this kind in Alberta. Various stakeholders have recognized the importance and potential usefulness of this data. Stakeholders have also expressed concerns about this data, its limitations, and how it’s being used. To investigate these issues, the Panel worked with representatives of Alberta’s Occupational Health and Safety (OHS) branch to host a data symposium at the end of January. Approximately 100 people attended the symposium, representing unions, industry associations, safety associations and other stakeholders. The data symposium featured guest speakers who presented on issues such as information and privacy rights and data-driven decision-making. The symposium also enabled stakeholders to discuss what’s working well, and not working well, when it comes to data in the workers’ compensation system.

Here some of the big “takeaways” from the data symposium.

  • There are some things that people think are working well when it comes to data in the system. For example:
    • The data that’s requested from employers is generally easy to collect.
    • The data is protected and stored securely, which gives people confidence about maintaining privacy.
    • Approved organizations can easily access the data online.
    • People find the data relatively easy to navigate, which makes it easier for them to mine the data for trends and information.
  • There are also ways in which the collection and use of data is not working well for stakeholders. For example:
    • Data collected by the WCB has been collected for “insurance”-type purposes (such as helping establish premiums), but it is being used for purposes for which it was not intended. This is having consequences on the ground.
    • A significant concern is the use of “lost time claim” data, which the WCB makes available. Companies in various sectors are using this data as an indicator of employers’ safety records when they hire subcontractors, even though the data is neither intended for this purpose nor a particularly great indicator of safety. There are concerns that this dynamic is contributing to suppression of WCB claims, because employers (and their workers) do not want to be disqualified from securing work.
    • The data collected by the WCB does not identify details or root causes about injuries and illnesses. For example, one cannot discern the severity of a particular injury or the circumstances surrounding the injury, even though these are important things to know if one wants to make workplaces safer.
    • Data results are not always timely, and this can undermine their usefulness. To be useful for informing injury and illness prevention in workplaces, data has to be relatively recent in nature.
    • Different provinces and territories use different definitions, classifications and coding methodologies for data in their systems. This makes it difficult for organizations to assess the performance of industries and employers in Alberta relative to those in other provinces and territories. Being able to clearly see how Alberta workplaces “stack up” would be informative.
    • Even within Alberta, different definitions and classifications are used by organizations that collect various types of data around worker injuries and illnesses. This makes it more challenging for our province to undertake prevention efforts.
  • When we asked people to describe their vision for data in an improved system, we heard a lot of consistent things. For example:
    • Definitions, methodologies and coding structures should be harmonized across provinces and territories. But even before that, these things should be harmonized within Alberta. Right now data sets are not aligned and harmonized among WCB, OHS and other organizations that might have data which is informative for workplace safety. An improved system should feature harmonized data collection among these players in Alberta.
    • Data should be used for the purposes for which it was intended. If a different use for the data is contemplated, this should be discussed with stakeholders that have interests in the system.
    • An improved system should strive to identify and adapt the best practices that are used by jurisdictions across Canada and around the world.
    • There needs to be trust amongst those who are providing information (employers and workers), the WCB and OHS. People need to have trust that data will be used appropriately and fairly, consistent with what has been committed. The roles and expectations on all sides should be clear.
  • Overall, stakeholders told us they would like to see enhanced data collection, use and management to assist in improving the worker’s compensation system. By the end of the data symposium, one of the strongest messages we received was: this needs more work. Our Panel heard a great deal of consensus that some kind of forum should be established –featuring representation from employers, workers, the WCB and OHS – to delve deeper into the issues and make improvements to data collection and use.