Putting People First

FINAL PHASE BCNU representatives participated in a Sept. 3 focus group held at the union's head office as part of the Patterson Review's assessment of BC's workers' compensation system. From left: BCNU WorkSafeBC advocates Guinevere Loi, Zuleika Gedeon and Kerry Birch, BCNU director of occupational health and safety Moninder Singh, reviewers Janet Patterson and Jim Parker, BCNU executive councillor Adriane Gear, WorkSafeBC advocate Gregory Rabin, BCNU manager of occupational health and safety Lani deHek and BCNU communications officer Katharine Kitts.

Getting injured while on the job is an unfortunate and often unexpected experience for many workers in BC. And there is no shortage of stories about the WorkSafeBC compensation claim approval process being more painful than the injury itself.

But now, for the first time in 17 years, a formal and independent review of the entire workers' compensation system could bring much-needed changes to better support injured workers across the province.

The review comes on the heels of the provincial government's announcement in April that now sees nurses included in the list of occupations that have the presumption of a workplace mental injury when adjudicating mental disorder claims. Nurses celebrated the decision, but the WorkSafeBC claims process continues to make it difficult for those in need of assistance.

The ambitious job of reviewing WorkSafeBC has been led by board reviewers Janet Patterson and Jim Parker, who both bring years of experience to the table. Patterson is a retired labour lawyer who practised in the province's workers' compensation system and Parker has helped workers from various sectors navigate the claims process. Over several months the Patterson Review collected mountains of feedback from people who work in a number of industries, including health care, about their personal experience with the WorkSafeBC compensation process and asked them how they think it could be improved.

"It's time to make the necessary changes to the entire process so that it better reflects the needs and interests of all injured workers."

 

- BCNU executive councillor  
  Adriane Gear

Feedback was provided by a number of BCNU members who took the time to submit their recommendations to the review on what they think needs to happen to make the compensation process more employee-centric. Members shared their thoughts by participating in an online questionnaire or attending several public hearings held across the province in June.

BCNU encouraged members to provide feedback after the provincial government officially announced the WorkSafeBC review in May. The union's occupational health and safety department and its WorkSafeBC advocates, who specialize in assisting members and their claims, also developed an in-depth report on the state of WorkSafeBC as a whole. The extensive 50-page submission examined the industry hazards for nurses and other health-care workers and highlighted numerous recommendations and policy changes BCNU would like to see implemented when it comes to processing claims. Many of these recommendations focused on code of conduct practices, the length of time it can take to investigate and process a claim, the surveillance process and the overall culture at WorkSafeBC.

PRESENTATION IN VICTORIA

The Patterson Review also invited BCNU to participate in a June 6 in-person hearing in Victoria. 

BCNU executive councillor for health and safety Adriane Gear and a team of union occupational health and safety officers gave a presentation on the work BCNU has been doing to help improve nurses' working conditions by highlighting the numerous violent incidents that take place in acute, community, residential and other types of health-care settings. 

During the presentation, Gear took time to highlight BCNU's commitment to keep nurses safe through increased awareness, violence prevention measures, and ensuring the principles, tools and guidelines that make up the National Standard for Psychological Health and Safety are implemented in workplaces across the province.

She also acknowledged BCNU's hard-fought win to have nurses included in the list of eligible occupations that have the presumption of a workplace mental injury, but says more needs to be done to ensure that workers who make mental health claims are treated fairly.

"While the changes outlined by the provincial government in April have been positive, workers suffering from work-related mental disorders still face a higher bar to compensation that those suffering from work-related physical injuries," states Gear. "We believe the current 'predominant cause' test for significant work-related stressors creates a disparity between those seeking compensation for psychological injuries and those suffering from physical injuries under the same compensation system."

She adds that it's more common for physical injuries to be compensable than mental disorder claims.

 "For a physical injury to be compensable, the worker must establish the workplace incident was more than a trivial or insignificant aspect of the injury, but need not be the sole cause of the injury," she explains. "However, for mental disorder claims, the predominant cause test requires a higher bar for a worker to have their claim allowed. We believe this is discriminatory against workers suffering from psychological injuries."

Gear's presentation included an anonymous first-hand account from a nurse who worked in Surrey Memorial Hospital's psychiatry unit and who supported patients with acute psychiatric disorders and severe emotional problems. The Patterson Review was told how this nurse was almost brought to tears after a patient swore at her, hurled insults and started to become aggressive. After enduring numerous similar incidents with the same patient, she began experiencing panic attack symptoms and felt nauseous and dizzy. Despite this, WorkSafeBC denied this nurses' claim after deciding there was no evidence the patient had tried to intimidate or threaten her.

Gear explains that it is stories like these, which may not seem as dramatic or horrific as others, that are all too common for nurses.

"Unfortunately, it's typically only the horrific workplace incidents that are currently accepted under the mental disorders policy," she says. "We recommend that WorkSafeBC treat mental disorder claims the same way that physical injuries are treated. It is our position the current mental disorder policies create systemic barriers for injured workers, resulting in injured workers not being able to access the workers' compensation benefits legislated to support and assist them."

EMPLOYERS PULL OUT

The optimism over finally having the opportunity to focus on the hurdles that employees experience when navigating WorkSafeBC was dampened after a group of 46 employer organizations representing the bulk of BC's business community announced in August that it would be pulling out of the review, complaining it was biased. The business forum which represents a range of employers across all economic sectors, including health care, is fearful that changes to workers' compensation could increase their costs. The group has also claimed the review lacks objectivity, despite the assurance of Labour Minister Harry Bains who, in a letter to the Council of Construction Associations in June said the reviewers "were committed to improving worker navigation of injury claims" and "not to make wholesale changes to the workers' compensation system that employers fund."

Gear says these employers' decision to pull out of the process is a clear indication that many are used to having complete control and aren't willing to engage in a review process if there is an appearance of concern for workers' welfare.

"It's a 'my way or the highway' type of thinking," she says. "I don't understand why so many employers still don't believe that prioritizing the health and well-being of their employees should be their primary interest."

"We recommend that WorkSafeBC treat mental disorder claims in the same way that physical injuries are treated."

 

- BCNU executive councillor  
  Adriane Gear

In 1996, the NDP government of the day established a Royal Commission to study Workers' Compensation. But the commission's 1999 recommendations were shelved after the BC Liberals were elected in 2001. In fact, the Liberals enacted a new Workers' Compensation Act in 2002 that incorporated recommendations from many of the same employers involved in the recent pull out.

In early September, as the review entered its final stages, Patterson and Parker conducted a focus group with Gear and BCNU director of occupational health and safety Moninder Singh and BCNU WorkSafeBC advocates. The meeting provided an opportunity for the review to present the issues it identified as important or urgent in the course of its work over the previous three months. The focus group discussion also acknowledged the "deep fix" that's needed in the system, and agreed that for too long workers have had dreadful experiences when filing claims and getting compensation.

The issues the Patterson Review has identified (see sidebar) clearly reveal an obvious need to listen to the worker and be proactive when providing treatment and support, especially in the early stages. All too often, the worker is left to manage alone, until the situation gets to a point where a claim is required.

The final assessment of the Patterson Review is due to be provided to the government as this issue of Update Magazine goes to print. Once it is publicly available it will be essential reading for anyone who's had difficulties navigating the WorkSafeBC compensation process, including the many nurses who have received injuries while caring for patients, and doing the job they love to do.

"It is well known that nurses and health-care workers have among the highest injury rates in the province and face specific industry hazards attributed to patient handling," says Gear. "Many of these people have had to jump through unnecessary hoops after they've been injured, just to be heard. It's time to make the necessary changes to the entire process so that it better reflects the needs and interests of all injured workers." •

UPDATE (October 2019)

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