Thursday, April 9, 2009

This is written for the province of Alberta and Canada as a whole. SOMETHING MUST BE DONE !

Workers Compensation Boards in Canada, which are under Provincial legislation, are all part of the Association of Workers Compensation Boards of Canada.
http://www.awcbc.org
Workers Compensation Boards in Canada are members of The American Association of State Compensation Insurance Funds, or AASCIF, is an association of workers' compensation insurance companies from 27 different states, plus 10 workers' compensation boards in Canada. In the US, these companies--loosely referred to as state funds--each specialize in writing workers' compensation insurance in a single state. Some of these companies operate as private insurance companies, whereas others act as agencies of their respective state governments. In Canada, all workers' compensation insurance is provided through workers' compensation boards, which have complete jurisdictional and administrative powers related to workers' compensation in their respective provinces.
Home link http://02cd9d2.netsolhost.com/public/1.0_overview.htm
Link of interest, that directly pertains to audits and anti-fraud prevention, which raises questions. http://02cd9d2.netsolhost.com/public/jul_aug_sep06/audit.htm
Addition of this link Titled Model Audit: Internal control over financial Reporting: http://02cd9d2.netsolhost.com/public/Third_Quarter_2008/modelaudit.htm
This link pertains directly to the Province of Nova Scotia: Everything is all in-house, no input from outside resources that was noticed. http://02cd9d2.netsolhost.com/public/Fourth_Quarter_2008/leadership.htm
And functions with all kinds of fun and entertainment at whose expense? http://02cd9d2.netsolhost.com/public/archive/july-august-september03/3.2.3_july-august-september03.htm


Workers Compensation Boards of Canada are also part of The International Association of Workers Compensation Boards:
http://www.iaiabc.org/
Which have input of information pertaining to; managing claims, Provincial or State Law, even financial matters. What I find most interesting is that on a web page of the I.A.I.A.B.C they refer to themselves as “an association of government agencies that administer and regulate their jurisdiction’s workers' compensation acts”
The IAIABC specializes in:
• Connecting individuals for the exchange of information and the development of lasting relationships,
• Identifying current issues and future trends to help improve the administration of workers' compensation, and
• Answering inquiries, saving members time and money
Types of IAIABC Membership
There are different types of IAIABC membership that recognize the unique needs and situations of your company or agency. Dues are paid annually, running a calendar year, and can be pro-rated on a monthly basis. Following are the membership categories. Benefits and annual dues that are associated with each category vary in amount.
Jurisdictional Membership
Jurisdictional members are governmental agencies, commissions, boards, councils and courts.
Associate Corporate Membership
Associate Corporate members are associations, insurers, employers, medical providers, and more. Associate Corporate membership includes employees in branch or remote offices of the same company and parent or majority-owned subsidiary companies.
Associate Individual Membership
Associate Individual members are individuals/employees with professional or personal interest in workers' compensation.
EDI Membership
EDI members are Associate member companies with a desire to be on the front lines of setting national EDI standards. EDI are also considered Associate Corporate Members.
City/County Membership
City/County members are local city or county government agencies.

Now if Workers Compensation Boards of Canada are Internationally Associated by not one but three separate Associations, why is it allowed to have Quasi-judicial rights in Canada?
Why is the Federal Government of Canada allowing Canadian Charter of Rights to be VIOLATED continuously by these associations ?
Why is it allowed to be part of Provincial Government Unions? Especially when it’s an arm’s length of Government!
It is obvious that the WCB’s in Canada are not independent organizations as they claim, they just use independent names.
WCB’s in Canada should either be a Government agency or Independent, regardless no organization has the right to full jurisdiction and authority over Canadian Citizens, WCB of Alberta Polices alone, is a contradiction to the Canadian Charter of Rights.


PRINCIPLES OF WORKERS' COMPENSATION (Alberta)

The principles contained in Sir William Meredith's 1913 Final Report (see Appendix C) are the foundation of workers’ compensation in Alberta. Since 1913, these principles have evolved to reflect changing conditions. The principles are intended to be a “living document” and will continue to evolve as circumstances necessitate. Where does it say in the Meredith report that it is intended to be a living document? How can a document evolve as circumstances necessitate, when laws change but have no effect on the organization that hides behind a quasi-judicial system, more manipulations?

Today, the Workers' Compensation Board - Alberta operates according to the following principles¨, which apply to all workers and employers protected by the Alberta Workers’ Compensation Act. These principles provide direction to management in the development of policy and establish a frame of reference for the Board of Directors for policy decision-making. The principles also provide staff, management, our clients and the general public with guidance on the interpretation and application of policy. The principles are intended to provide the “why” or philosophical basis behind the policies. The articulation of principles provides transparency and points of reference for all stakeholders so that policy decisions of the Board of Directors can be better understood. Policy is written by the WCB for the WCB.

SYSTEM
1. Exclusive Jurisdiction
The WCB should strike the right balance between affording choice to workers and employers in areas where choice is in their best interests, but in matters where the WCB has expertise or where choice may not be in the best interests, the WCB should exercise exclusive jurisdiction.
2. No Fault
The WCB assumes liability for the injury in work-related circumstances despite the presence of fault on the part of a worker or employer. The WCB’s determination of what is “work- related” must appear reasonable to an ordinary, clear-thinking person. The worker’s compensation system should also encourage individual and employer accountability in other ways.
3. Protection from Lawsuit
Protection from lawsuit should apply in situations where the activities causing the injury are part of the employer’s normal insured activities, based on a reasonable person test, and operate to displace any tort remedy for that injury.
4. Employer Pays
Employers are expected to pay the full cost of the system.
5. Neutral Administrator
The WCB is a neutral and autonomous administrator of the workers’ compensation system and strives to balance the interests of workers and employers by providing fair compensation at a fair price.
6. Appeals Process
The appeals process should be fair, impartial, independent and accessible. Appeals issues should be resolved as early as possible in the process.
7. Incident Prevention
Both the benefit and premium structure should promote incident prevention and reduce risk of loss.
FINANCIAL/PREMIUM
8. Balance between Collective Liability and Individual Accountability
The premium structure should reflect a balance between collective liability and individual employer accountability. Collective liability maintains insurance protection by spreading the costs of workers’ compensation across all employers. Employer premiums should contribute to collective liability and also be reflective of their accident experience to promote accident prevention and disability management.
9. Full Funding
There should be sufficient funds on hand to meet present and future liabilities incurred along with a provision for reasonable reserves. Rates should not fluctuate wildly from year to year. (New buildings and in-house bonuses handed out along with rebates to Safety Associations are liabilities?)
BENEFIT
10. Work-Relatedness
The WCB determines which part of the injury or illness is caused by work and compensates for that part.
11. Employability not Employment
The system should strive to restore an injured worker, through rehabilitation, to a state of pre-accident employability, not employment.
12. Retrospective Earnings
The worker’s historical earnings (up to a prescribed maximum) form the basis of the compensation rate, which is a percentage of the earnings, recognizing the normal deductions that worker would pay and encouraging return-to-work. Compensation is based on provable information, not speculation. It recognizes “What was”, not “What could be”.
13. Health Care
The WCB decides the nature, sufficiency and cost of health care, bearing in mind individual needs and system well-being.

14. Quality of Life
The WCB should take reasonable measures to maintain a reasonable quality of life for a severely injured worker where the worker has not otherwise been compensated.
15. Survivor Benefits
Survivor benefits should make reasonable provision for the spouse** and any dependent children of the deceased worker.
** As a result of the Adult Interdependent Relations Act, benefits available to spouses may also be available to adult interdependent partners as defined by the AIR Act.
¨ These principles were approved by the Board of Directors on December 11, 2001 (BoD Resolution 2001/11/57)
As I am not a lawyer, these principles appear to be loop holes for the workers compensation system to give room for their determination as to how theses are applied. Particularly the areas of Jurisdiction, protection from lawsuit, no fault, neutral administration, appeals process, work relatedness, employability, health care, retrospective earnings, quality of life, survivor benefits.
There have been many problems over these, due to WCB’s handling of these principles, as they seem to pick and chose as to how to handle each and every principle to individual claims, not all are handled the same.
Examples of each:
Jurisdiction: having this allows the WCB to make decisions, right or wrong, there is no recourse of action for any party involved.
Protection from lawsuit: WCB’s use this to protect themselves as the employer’s representative, regardless of any situation that may have legal consequences.
No fault: WCB’s assume accountability for the injury and determination of “cause of injury” even when it is “clear to an ordinary, clear thinking person” workers have to fight for their fair treatment
Neutral Administration: now this had to be the biggest loophole of them all,
Neutral and autonomous; when they control all aspects of the compensation system
Strives to balance interests between workers and employers; WCB is the employers representative, of whom injured workers detest, from their abuse of power; employers disprove of the injured worker due to their increases in premiums and WCB’s continuous comments of malingering and fraudulent abuse of the system.
Appeals Process: There is evidence of appeals purposely mishandled, paper work kept by claims managers for months, Supervisors stating the out come of decisions BEFORE appeal is heard, Appeals panels making decisions on legal/ medical / charter of rights and human rights issues that are not qualified for this position
Employability not employment: is this where deeming comes into play? Where an injured worker is deemed to be employed in a position that they have no experience, qualifications or interest in? Even when an injured worker chooses a new occupation, the WCB will and has denied the worker to proceed. It is do it their way or no way.
Retrospective Earnings: There is a ceiling limit to the amount that will be paid out to the injured worker, regardless of income. WCB Alberta claims 95% of the injured workers wage paid out and depending on which year of injury determines the maximum amount. Permanently injured workers are the hardest hit by this, as WCB’s continually reduce benefits as time goes by.
Health Care: WCB’s should not be allowed to determine health care as already has been proven by injured workers that have fallen for this trap, also proven by Physicians that make recommendations for their patients, care and treatment, is ignored or over ruled by claims managers/ WCB doctors who do not even see the patient and improper rehabilitation practices.
Quality of Life: This only applies to severely injured workers, which is determined by the WCB’s; permanently injured workers have to put-up with humiliation, poverty, abuse and frustration. All due to the WCB’s choices of “what is best for worker and employer”, while preventing the permanently injured worker’s from having a quality of life above the poverty line, let alone the social aspects that affect the permanently injured worker in their communities and socially as a whole. Which have been and is the main reason of permanently injured worker suicides, of which the WCB’s denies any wrong doing that caused the emotional breakdowns.
Survivor Benefits: How many spouse’s or dependents have been fighting for their rights after death of a worker?
What about the spouses and dependents of permanently injured workers that have committed suicide due to the actions of the WCB’s?

Workers Compensation Boards have become the sole authority over the injured workers and their physicians, claim managers over ruling medical professionals. WCB hired physicians that do not even see the injured worker physically, making diagnoses of the injury.
Appeals Commission chairs ruling on legal, medical, Canadian Charter of Rights and human rights issues that are unqualified for the position of such decisions. As many court judges have stated in their closing rulings.
Many injured workers have to wait until the WCB has closed their claim before getting proper medical attention, due to loss of medical and judicial rights when in the WCB system.
Recommendations:
Massive changes need to be changed and met:
1. Removal of the Principals of Jurisdiction and Neutral Administration.
2. All medical needs covered by Canadian Health care system, Insurance Corporation’s removal of hiring private medical or rehabilitation staff for injured workers diagnoses or treatment; but may be employed to ensure safe and appropriate rehabilitation.
3. Emergency /closest physicians or workers personal physician: shall be deciders of degree or cause’s of injury and all treatment.
4. Government having direct responsibility for insuring, that the WCB’s do not abuse their position pertaining to the care of the injured worker; federally as a whole; provincially as individual.
5. Board shall provide all necessary needs and insuring all needs to assist/allow the worker to progress to a new life with any and all assistance needed due to injury.
6. Proceeds and payments by the employers to the employers fund for injured workers to be handled by the provincial auditor, along with employment insurance to assist in benefits, as injured pay into that as well, but are not able to collect if injured on the job.
7. WCB to only concentrate on retraining necessities, appropriate rehabilitation and any needs/ aids for the injured worker including personal mobility or daily aids, safe transportation for injured workers, meal and expenses for any injury related appointment or meeting.
8. Deeming of employment to no longer be regarded as basis for benefit entitlement.
9. Employer’s refusal / restriction or interferences of medical care to be open for lawsuit.
10. WCB’s shall recognize the need and importance of injured workers in dependency and privacy.
11. WCB’s shall encourage in an injured workers plight for independence of income, in assisting by supplying the resources available and insuring that all injured workers, who choose this route, are competent in success.
12. Injured worker training to be taught in schools across Canada.
13. Appeals to be heard only by qualified person’s , not those chosen for personal or corporate reasons, there should be at least one qualified person from each of the legal and medical professions on a hearing committee.
14. Violations of Canadian Charter of Rights or human rights shall have charges laid directly to the person or persons that made the infringement.

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