How Insurance Works

CRWDP Webinar: Dana Howse (March 19, 2019)

[Pam Lahey] Thank you all for joining us today for our eighth webinar in the CRWDP New Researcher Webinar series. Before I
introduce our panelist for today, I wanted to remind you that we will have a
Q&A session after the webinar, and after the panelist will speak will have questions.
We are delighted to have Dana Howse, Dr. Dana Howse with us today
to talk about her research on injured workers and their moral engagement in
the compensation system. This was her doctoral research that she
did in Ontario, however Dana Howse is joining us from Newfoundland, where she is a Postdoctoral Fellow with the Center for Research on Work disability Policy
and housed with the Newfoundland Cluster at Memorial University. Without
further adieu, I’m going to hand this over to Dana. [Dana Howse] Hi there! You can hear me, Pam? [Pam] I can. [Dana] Great, thank you, everyone for tuning in for this
presentation. Today, as Pam mentioned, I’m going to be presenting my doctoral
work which I did while I was in Ontario, and I did that as a trainee of the
Center for Research on Work Disability Policy, where I’m now a Postdoctoral
Fellow. So, it’s nice evolution there of my research. I’m going to talk to you
today about my doctoral work which examined injured workers’ experiences
with problematic workers’ compensation claims in Ontario. But before I dive into
that, I thought I would tell you about the surprise in my Master’s
work that really ignited my curiosity in workers’ compensation, because I’m often
asked “what led you into this field of research?” So, my Master’s work I did at Memorial
University here in Newfoundland and Labrador, and that was part of a large
multi-component study examining occupational allergy and asthma to snow
crab; what we called crab asthma. So, basically, there were high numbers of
plant workers who handled and processed crab or who worked near the crab
processing areas, and they were developing symptoms of
allergy and asthma. And this larger study was undertaken to measure the prevalence
of the illness and to explore elements of plant design and that sort
of thing. And my piece of that study examined the quality of life and
socio-economic impacts of crab asthma, and that involved interviews with
symptomatic workers about the effects of their condition on their work and home
life. So, I went into these interviews in small coastal processing communities
in Newfoundland and Labrador expecting to hear stories of extended sick leave,
high unemployment and high rates of compensation claiming. But I didn’t I
didn’t hear those stories. No one was taking time away from work at the plant,
and of the 27 symptomatic workers I interviewed not one had filed a workers’
compensation claim. What I did hear about were workers’ strategies for staying at
work despite being quite sick. They told me about the medications they took, the
layers of clothes they wore, EpiPens they kept in their lunch bags, and so on. I
walked away from my Master’s work with these lingering questions about
why these sick people were still at work and getting sicker, in fact, and why
hadn’t they reported their illness or filed a compensation claim.
And, so, these lingering questions ultimately shaped my doctoral research.
When I was set out to do my dissertation research, I decided to
examine underreporting, so, basically to examine why those crab processing workers didn’t report their symptoms. And I discovered through my
review of the literature that underreporting is a big problem with as
much as 90 percent of work-related injury and disease going unreported. So,
my objective in the beginning then of my doctoral program was to understand how
and why injured workers filed compensation claims, and I wanted to do
this by speaking with both injured workers who had filed and those who had
not filed. So, I could really access a range of filing experiences and beliefs
and concerns around compensation. So, I found out my recruitment flier through
social media and classified ads and unions and work injury health clinics, as
well as through injured worker groups to try and connect with injured workers, as
I say, both those who had filed and those who had not filed. But non-reporters
didn’t turn up, and I suspect this is for the same reasons that they did not file
a claim in the first place. The literature suggests that people who
don’t report work injury don’t do so because they don’t recognize their
injury as work-related or reportable, or as an injury that’s somehow eligible for
compensation, and they also don’t report because they may have fears that
reporting will somehow compromise their job or their income. So, injured workers
who had filed claims did respond to my recruitment efforts and so those are the
ones that turned up for interviews and for the most part they were upset with
the compensation process and reported troubled unresolved claims and
unsatisfactory claims outcomes so I ended up with a naturally occurring
extreme case sample that was really fertile for reviewing the social
dynamics of those more problematic claims so
many of the injured workers in my sample belong to injured worker groups and
several others knew of these groups and regularly engaged in worker initiatives
so overall the participants in my sample were more engaged with the system and
they were differently positioned within the system then injured workers who
would not file the claim or who had filed claims but had a smoother
uncomplicated cleaning experience so I shifted my focus little and I began
reviewing the literature to see what it had to say about problematic cleaning in
particular and what that literature really showed
was that 20% of the claims that are filed are prolonged complex and
adversarial so they’re problematic and these problematic claims are associated
with chronic disability unemployment financial and emotional suffering for
the injured workers and they’re also associated with significant financial
and administrative burden for the compensation board so while it’s a
relatively small proportion of claims that are filed that become problematic
as I say about 20% these problematic claims are actually estimated to account
for 80% of claims related costs in the system so I then sort of shifted my
focus a little bit and I refined my research interest so going forward
my objective really was to understand problematic claiming in particular from
the injured workers perspective and before I kind of go on with the actual
study I just wanted to say a few things about workers compensation in the event
that some of you tuning in aren’t entirely familiar with the compensation
system so workers compensation in Canada is a provincial responsibility and it’s
administered by provincial workers compensation boards and as Pam noted off
the top my research was carried out in Ontario so this particular study
examines workers experience with and the particular policies and practices of
Ontario’s workplace safety and insurance board which is commonly known in the
province as the WSIB the system in Canada was established in
1914 and it was based on the recommendations of Sir William Meredith
who was appointed to a Royal Commission to study workers compensation and the
system eras proposed is widely referred to as a historic compromise in which
workers surrendered their right to sue their employers for injuries or
illnesses sustained at work in exchange for compensation in the form of wage
replacement and healthcare benefits and the foundational elements of Canada’s
compensation system really captured in the Meredith
principles that are drawn from Meredith’s 1913 report and so they’re
generally captured in five principles the system firstly the system is a
no-fault compensation system that was designed to attenuate the adversarial
relations between employers and workers by eliminating the litigious civil suit
process and administering compensation for work-related injury or illness
regardless of fault so there’s no argument over the
responsibility or liability for an injury the second principle is that
there are guaranteed benefits so there is a fund established to guaranteed
funds exist to pay benefits of workers claims thirdly employers share
collective liability for workplace injury so the system is funded by
employer premiums determined by and paid to the administering agency the workers
compensation board the board administers the system it’s an independent trustee
j’n C that operates independently of the government and so it’s charged with
balancing the interests of both employers and injured workers by on the
one hand collecting appropriate premiums from employers and on the other paying
out timely and fair compensation to workers with injury or illness and
finally the Workers Compensation Board has exclusive jurisdiction over
compensation and is the final decision-maker for all claims so who can
submit a workers compensation claim employers are required by law to submit
a claim for any injury or disease that results in health care or absence from
work or less than regular pay as a result of the injury or illness workers
can file if they suspect their employer has not and health care providers are
not required to file a report but they can do so if there were patient requests
it but health care providers are required to submit the requested health
information materials upon request by the board once the claim has been
initiated and throughout my I’ll talk about being on a compensation
claim or the compensation process by this I refer to the experiences events
scenarios and trajectories that really start with the opening of a compensation
claim and ends when the injured or ill worker ceases to interact with the
compensation system so for me the end of a claim is not went defined by when it
is closed by the board for example I’m interested in that process that may
extend beyond the end of the file as far as the board is concerned when an
injured worker may still be engaging with the system through the appeals
process or through their active engagement in injured worker groups and
so on so back to my study my methodology my overarching theoretical approach was
what I call discursive interactionism so I employed a blend of several macro
level theories of symbolic and structural interactionism and discourse
theory to guide my conceptual framing my methods and my interpretation of the
social dimensions of injured workers lived experience of problematic claiming
so essentially I’m interested in how injured workers make sense of their life
situations and how they create meaning and construct their identity through
social interactions but I’m also interested in look me beyond those sort
of local event level interactions and I’m interested in how the meanings
injured workers attribute to their experience may be shaped by the broader
social environment and I’m also really attentive to language and it’s related
role in meaning making so my analysis here assumes that the language available
to people shapes and limits how they generate and express ideas as well as
shapes and limits the actions that they take so the study
methods of focused ethnography focused ethnographies are conducted two studies
smaller sub cultural units such as institutions or loosely pinnacle groups
of people who share for example a similar occupation or health condition
so using ethnographic ethnographic methods of thick description I carried
out in-depth interviews with workers to understand their experiences of claiming
within a particular cultural and social context within the the workers
compensation system my sample for in-depth interviews included 10 men and
16 women there was a range of employment statuses including H employed 13 on
employees and then 8 others who are either in modified work undertaking
retraining working part-time or studying as a student the types of work covered
office work trades healthcare and community work and other forms of work
and there was a wide range of injuries are presented in my sample as well with
8 was a gradual onset injury 15 was a more acute sort of injury there were
musculoskeletal conditions broken bones exposures and so on I also conducted
analysis of documents and texts produced by and for one the WSIB
and – the injured worker movement and I did that in order to really access that
broader social and institutional context in which workers claiming experiences
play out for my data analysis I really moved back and forth between data
collection and analysis so that I could pursue discoveries from early interviews
and document analysis in subsequent data collection and interpretation also so
that I could really apply new concepts and frameworks as they occur to me or
became relevant so I employed multiple analytic devices to see my data more
deeply and anew in different ways so my analytic approaches approaches
included post interview me mowing multiple layered readings inductive and
deductive coding constant comparison I investigated deviant cases in
conditions of possibility I generated situational maps and I also perform
discourse analysis so the central finding of my of my work was given away
in the title in fact it’s that injured workers in this study understand the
compensation process and the attitudes and behaviors of the WSIB
and employers morally they understand it according to socially produced notions
of good in bed right and wrong and in terms of worthiness and the injured
workers goal framings of compensation can be seen throughout the studies
interview data in the language workers used and in the challenges and
strategies they noted in their accounts so I could see their moral experience of
claiming expressed in four ways basically in their concerns with
mistrust dehumanization judgment and confrontation and I could also see
workers moral engagement in the system and how they seemed to respond to their
claim experience by performing identity work so workers in this study spoke
about wariness toward their employers and the WSIB
and examples of injured workers distrusting parties in the compensation
process and questioning their interests regularly emerged in the data so you can
see in this first quote that I’ve pulled out here to demonstrate this concern
with trust where this worker says there needs to be a watchdog over the WSIB
that says ok when an employer and the WSIB start working together to limit
employee claims the employer or the injured worker can report this a report
to this agency who then oversees it injured workers seem to feel dehumanized
and also by features of the compensation system that they believed neglected or
denied their individual and personal or human attributes and needs they
complained that the WSI B’s one size fits all approach reflected the board’s
conception of injured workers as just part of business
than as unique individuals meeting and deserving help and care and the second
quote shown here sort of demonstrates that concern it reads like it’s just I
don’t fit into your mold you’re trying to fit I’m square and you’re trying to
fit mean around mold and guess what it’s not going to work so they’re going by
their program that they set out for everybody and everybody better line up
and just file right in right a third expression of workers moral engagement
in cleaning was their feeling of being negatively evaluated by the WSIB in
their employer among others and of being judged as having lower moral worth
injured workers perceived judgment associate with their claiming process
was visible in three key ways they felt scrutinized they felt blamed and they
felt perceived as dishonest and I’ve selected three quotes here to sort of
demonstrate those concerns so workers perceived the WSI bees
information-gathering efforts as and follow-ups as excessive scrutiny as
though they were conducted to frustrate or discourage claimants and to render
their claim ineligible so this person says in the first quote the next letter
I got from the board they knock him down they’re referring to their doctor there
they knock him down and they said we needed more information I gave him the
same information over and over and over enough to wallpaper Toronto of 50 times
and my doctor got so disgusted with it he just gave up and he said no more in
regards to blame although a fundamental feature of the system is that it’s no
fault it doesn’t really eliminate the notion
of blame or questions of guilt and innocence that injured workers
experience blame is an inherently moral judgment which injured workers perceived
on the part of the WSIB and their employers oftentimes from the
moment they engage with the system as this worker notes it seems that with
WSIB you’re guilty to mute until you can prove you’re innocent and there’s a
perception of people trying to milk the system even though they put them almost
into bankruptcy and trying to do so and finally workers the sort of third
dimension of this feeling of judgment is that workers felt they were perceived as
dishonest they perceived that the legitimacy of their health problem was
questioned and they felt their health records and social relations at work
were closely examined for evidence of wrongdoing or inappropriate claiming so
as this worker notes I’m very fine at documentation I can trace back five
years and I can tell you by going through my diary that I was doing five
years ago on this day I keep very meticulous notes because the way I
figure it is that somebody’s going to come back on me and they’re gonna ask me
a question and I’m going to be ready this person has developed this sort of
habit of keeping very meticulous notes an anticipation of being you know seen
as dishonest or said to be lying finally worker’s moral engagement in the
system was evident in their concerns with confrontation
workers perception of adversary relations with WSIB personnel and the
employers and their regular use of fight language and metaphors and they’re
claiming accounts so they often used language like fight or whose side are
you on or workers compensation is a battle and that sort of thing as you can
see here in this quote you know so it’s a big chain of events that leads down to
the fact that okay who’s fighting for me and if you don’t fight for yourself
nothing is going to get done but you know they throw up roadblocks they throw
up roadblocks that you know they can’t see you today or you know I don’t have
the information right now so finding ways to put you off
I also saw in my interview data that injured workers are performing what I’ve
called identity work and I see this as further evidence of their moral
engagement in the system but also their response to their perceived degradation
of their moral standing so workers endeavor to manage the assault on their
character through the performance of this so-called identity work to resist
these feelings of judgment and stigma and attributions of blame and fraud
associate with their status as compensation claimants so they
constructed positive moral identities in accordance with cultural expectations
and shared understandings of what’s considered to be morally upright and I
borrowed from Irvine call and Smith who did a study looking at homeless people
and borrowed sort of their framework for examining identity work and they
suggested that there might be four activities or tools that someone might
employ to sort of rebuild their moral standing and those are the strategic use
of props the arrangement of personal appearance the selective association
with others and identity talk so in regards to props I could really see that
in the interview data when injured workers talked about the documentation
as you saw in the earlier quote there a lot of the injured workers who came into
these interviews had stacks and stacks of files and folders and letters from
the Compensation Board letters from their doctors and so on they kept
meticulous notes very carefully documented every stage as a process so
that if a question was raised they were prepared so I saw this as an example of
the strategic use of props I could also see the arrangement of personal
appearance in injured workers stories as well it’s not it though it’s not as
though I observed sort of faking or exaggerating of an injury or illness in
the interviews but I could definitely see workers alluding to the expectations
that they act a certain way that they would either be contrite or look sick or
perform their disability in a certain way and they sort of talked about the
need to manage their appearance so they didn’t look too well to be off work on
compensation so the workers noted that their demeanor and their emotions needed
to be managed in order to sort of give the right impression and elicit positive
responses from the system so one worker for example felt his claim was hampered
because he exhibited hanke anger in a doctor’s appointment and he felt that
the WSIB really focused on that behavior so he said they
try to make me look like a psychotic nutcase because I yelled at the doctor
so they use that but they didn’t mention anything about the medical aspects of
the injury so there is this sort of recognition that how you appear and how
you act is important and you have to manage to that another injured worker
spoke about feeling rushed back into retraining before she was ready and
because she was still experiencing a great deal of pain due to her back
injury so in order to comply with the return to work process she she attended
this retraining but lay on the floor during the session to sort of
demonstrate that she was there too soon and that she was in a great deal of pain
sort of making visible another wise in visible condition I could also see from
my interviews with injured workers and attempt to associate selectively with
others so I could see the injured workers associating with injured worker
groups or sympathetic doctors or professionals to really sort of help
rebuild their positive identity and to align with people who could help advance
their claim finally I could see the injured workers using identity talk to
sort of preserve their social identity and present themselves as worthy of
esteem positive assessments and other relevant rewards such as workers
compensation benefits so worker strategically shared certain information
in their accounts of their claiming experience to verbally reconstruct their
moral personhood their constructive moral identity embodied a number of
attributes that they believe are considers morally acceptable and I
highlighted three so injured workers framed themselves and talked in a way
that presented them as good workers so they wanted to work they were physically
fit and able to work they’re knowledgeable about their work and as
this quote here shows one worker said I keep myself fit I worked out all the
time and that sort of helped me with my injuries and he talked about how he was
able to recover and will return to work far more quickly because he was so fit
the workers also presented themselves as legitimate claimants those who were
doing hazardous work and incurring real injuries we often talked in great detail
about the specifics of their injuries the real medical kinds of aspects of it
talking about you know which part of the spinal cord had been injured and so on
and they also sort of demonstrate their legitimacy by talking about just how
dangerous their work was as this person here does in the second quote and they
say people are quitting the field because it’s dangerous and they didn’t
expect it would be we’re in a dangerous situation
and finally the injured workers talked about the real suffering they were
experiencing and basically indicating that being on workers compensation is
not a picnic it’s not something someone would do if they didn’t have to and
there’s a great deal of suffering experienced by those on a workers
compensation claim and this worker talks about a conversation he had with another
one who was going through a really bad time and he says he told me he was
living out of his truck with his children and wife and the next day on
the news here he went back to that office with a sawed-off shotgun and blew
his head off so there were some really extreme stories of very painful
suffering that injured workers told I think as part of this identity work so
once I established that injured workers engaged with compensation more lean and
understand in moral terms I began to consider what might produce that wrong
claiming experience what accounts for it why do they experience it moral terms
rather than legal or economic terms for example so I began to consider the other
sorts of forces and contexts that might be shaping the workers moral engagement
in claiming which you can see here the sort of the bottom of this diagram in
the orange so I began to sort of look at discursive influences that might be
operating within the workers compensation system and context and I
considered three in particular I considered the justice discourse of the
injured worker movement which was operating more locally around the
injured workers and then be outside of that more broadly I considered the in
of a sick role discourse and as well the influence of neoliberal ideas of work in
health so many of the injured workers in this study were connected to the injured
worker community or movement and exposed through its activities and texts to a
justice discourse the movements framing of compensation as an issue of justice
and integrity which I observed in my analysis of the movements documents and
texts so a significant concern of the injured worker movement relates to
integrity and I could see this in the emphasis on the need to convince the
various players involved and especially those who have relevant power in the
compensation system that injured workers are telling the truth about their
injuries how they sustained them and what they’re able to do post injury and
one way I could really see this in the injured worker movement was in its
creation of an injured workers speaker school in 2007 in Toronto and other
areas in Ontario and the purpose of that school was to really help injured
workers to not only speak publicly about their experience but to do so
proficiently and convincingly the second key concern of the movement that I saw
through its documents and texts was its seeking justice for injured workers so a
key strategy of the movement has been to evoke the Meredith report that I
mentioned earlier and to call attention to the historic compromise and to
emphasize the particularly moral language of Meredith’s report that
refers to a fair and just system the text of the injured worker movement also
reveal its perception of the WSIB as being preoccupied with financial
efficiency and accountability and really disregarding the fundamental principles
of the system that merit is founded argue that the injured worker movements
justice discourse offers in particular morally oriented language and justice
related concepts for understanding and talking about their situation so
interview data reflected these dimensions of the justice discourse
interview participants experiences of claiming
included their desire and efforts to be believed and seen is trustworthy and
their references to marry this principles and calls for a fair and just
compensation system reflect those notions of justice and you can see that
in this quote that I bring up now this worker says I mean the compensation
thing was based on 1912 Sir Meredith you’ve heard and the Meredith’s report
back then was if a man was injured he should be compensated and that’s what
it’s supposed to be and it’s not what he said back in 1912 I mean pretty well 100
years ago it still applies today but they’re not following that and he’s
referring here to the WSIB I also considered the influence of sick
role discourse on how injured workers engage with compensation claiming so
sick role is a theory that was introduced by Talcott Parsons in 1951
and importantly this theory frames illness as a social role with rights and
responsibilities so the theory basically says that incumbents of the sick role
have the right to take time away from regular responsibilities to get well and
they have the right to be free of blame for their condition and in turn they are
expected to have their condition legitimized by medical authority they’re
expected to get well and to want to get well and to seek medical advice to do so
so I argue that the sick role dis courts contributes to society’s understanding
of illness as a moral issue rather than say or in addition to seeing it as a
medical or biological one so the sick role creates expectations of good
citizens those who cooperate with authorities quickly recover from illness
and resume obligations and these may be expectations that injured workers are
unable to meet so in breach of the sick role injured workers often struggle to
have their condition recognized by both their doctor and the WSIB
they fail to recover as quickly as the Workers Compensation Board deems
appropriate if at all and the experienced scrutiny and blame so they
don’t even enjoy the rights afforded to people
who are sick for reasons unrelated to work so injured workers trying to meet
expectations of the sick role and of the WSIB process may feel attention to on
the one hand eagerly participate in their early and safe return to work and
on the other hand appears sufficiently unwell to demonstrate the legitimacy and
extent of their suffering essentially they must strike a careful balance
between doing too little and doing too much and this tug of war places injured
workers in an in-between social space where they’re seen as neither sick nor
well and where they experience the moral weight of being unable to assume the
rights and obligations of neither the sick role nor the health role so I argue
this experience shapes worker’s moral understandings and practices related to
cleaning like sick roll discourse near liberal discourse frames health and
illness and moral terms as well it shapes societal understandings of what
individual attributes and practices are to be commended or discouraged and I
argue that either directly or indirectly through the compensation boards policies
and practices neoliberalism exposes sorry imposes expectations of good
citizenship which injured workers may be unable to meet I’ll highlight two
dimensions of neoliberalism that contribute to moral framings of illness
the first is market fundamentalism neoliberalism champions a competitive
market that is free from government intervention and restraint and relies
upon productive competitive citizens to contribute to a healthy economy in the
neoliberal context systems of social support are frowned upon and framed as
promoting dependence and laziness so this discourse casts those who are
reliant on social supports as dreams and I argue has failed near liberal citizens
this discourse has also led to tightened eligibility criteria for and
surveillance of those who rely on these supports this consequently can increase
the scrutiny and suspicion of injured workers secondly
neoliberalism promotes the individual responsible ization of health so good
neoliberal citizens are self-reliant they avoid risks the responsible for
health their health and economic well-being and they contribute to the
society and wider economy so neoliberalism then frames health as a
duty rather than a right of citizenship so in a mere liberal context at
champions Health’s and productivity through work injured workers who are
unemployed and trying to recover if they can recover may be seen and see
themselves as failed citizens and any bleep may be blamed for the injury or
ill health which they were responsible for avoiding so consequently there’s an
increasing effort on the part of sick people to engage in strategies to
reassert their moral credentials in order to resist the judgments associate
with illness and unemployment as I have shown in the identity work performed by
injured workers finally I considered the mediating role of a workers compensation
board in all of this in my analysis of the WSI Bea’s texts suggest that the
WSIB has taken up the neoliberal discourse becoming increasingly more
business-focused over time and increasingly preoccupied with financial
efficiency I argue that the WSIB is an intermediary of neoliberalism and may
play a role in shaping injured workers moral experience of cleaning through its
own participation in neoliberal discourse which defines compensation as
a matter of business and cease financial efficiency as a key institutional
objective so in its various texts including strategic plans and the
operational policy manual and various website materials the WSIB
consistently represents itself as a bureaucratic institution and you can see
this reflected in language throughout those texts so it describes claimants as
customers it describes itself as easy to do business with it talks about the
effort to transform the WSIB into a modern sustainable and customer centric
organization as it’s texts the WSIB emphasizes its
decision-making practices that are fair consistent equitable and
non-discretionary and based on up-to-date and clear policies for me all
of this is evidence of the board seeing its engagement in claiming as
bureaucratic or business exercise the WIP is understanding of claiming as a
business enterprise is also evident and its adherence to eligibility criteria
for judicata claims the WSI B’s eligibility policies and practices
define who is eligible for compensation and who is not and factors related to
the worthiness or deserving of the deserving of the claimant are not
considered and this just this sort of standardized decision making reflects
the WSI B’s bureaucratic stance and elements of the neoliberal discourse
that promote operational efficiency of social supports through tightened
eligibility criteria secondly my review of the WSIB texts for the past 20 years
demonstrates the WSI B’s growing focus on financial efficiency texts from the
early to mid-2000s suggests that its priorities were balanced across
workplace safety and injury prevention and financial sustainability but more
recent years for text reflect a different agenda that focuses almost
entirely on efficiency and financial responsibility for example in the 2012
to 2016 strategic plan which I’ve shown just a little sort of visual image of
here four of the five key pillars pertained to finding efficiencies and
addressing the unfunded liability only one pillar relates to the compensation
of injured workers so as an agent of neoliberalism I argue that dww si B’s
conception of claiming as a bureaucratic enterprise as opposed to a moral
enterprise as the injured workers conceived it and it’s preoccupation with
efficiency function to further cast injured workers as bad citizens and
dreams on the system so what does all this mean for claiming
I argued as injured workers in the WSI Bay’s conceptions of claiming are not
only different they are problematically related the different conceptions of
compensation between injured workers and the WSIB for example have implications
for how each party interprets the attitudes and behaviors of the other
injured workers who see the WSIB is being preoccupied with finances and
efficiency may interpret the various steps in the claim process as being set
up to deny claims they may see aspects of the process as unnecessarily complex
and see the system as anti claimant and full of deliberate roadblocks and
deterrence as you can see here in this quote where this worker says the WSI D
they probably have a meeting once a week and say okay don’t let any claims don’t
approve any claims this month you know put the roadblocks up they were very
effective in doing that because they did every step of the way there was like a
brick wall I swear the compensation board on the other hand with its focus
on administrative efficiency and cost reduction may view claims as an
impediment to cost-cutting and perceive injured workers efforts to access
benefits as illegitimate even suspicious injured workers for example rather than
being viewed neutrally as people availing themselves of their rights to
compensation appropriately may be viewed negatively by the WSIB adjudicators for
knowing too much at the outset of their claims or for enlisting professional
assistance such as from a lawyer so the supervisor of my doctoral work Joanie
can conducted a study of frontline service providers at the compensation
board and she observed there that claims adjudicators perceived employers as
justified in trying to reduce their premium payments and maximize fund
rebates while the efforts of injured workers to avail themselves of their
entitlements and benefits were viewed of viewed as evidence of workers taking
unjustified advantage of the compensation system or even abusing it with its focus on bureaucratic aspects
of compensation I argue that the WSI Bea’s attempts to eradicate blame in the
system by tightening adherence to policy and eligibility criteria and by D
personalizing the process actually to greater scrutiny of injured workers
more deny cleans and the potential to magnify even if it’s unspoken the issue
of bling which heightens explicit and implicit accusations of blame and
hostility between the WSIB and its claimants
moreover injured workers who are focused on justice and their own own moral
standing encounter the WSIB discourse that appears to them to deny their
existence and diminish their worth and as such I suggest their moral
indignation may grow and become further entrenched similarly I propose that the
WSI B’s efficiency discourse becomes self reinforcing in the face of injured
workers moral positioning to adjudicate claims on a moral basis would be
unwieldly and discretionary so the WSIB becomes more and more bound to notions
of eligibility and more exclusively committed to its efficiency discourse so
the chasm between the two sides grows even more wide so I put forward a few
sort of some food for thought I suppose in in light of the findings of this
research and suggest ways forward for injured workers as WSIB
and I suggest that the WSIB can consider how its discourse and practices are
perceived by injured workers so the board ought to consider what its public
texts convey and whether injured workers feel present in those texts and
strategic plans the board might examine the main sites of tension and ways to
improve relations so what perhaps goes on in terms of relations between
frontline adjudicators and claimants to to generate tensions and how can that be
attenuated I also suggest that the board explore ways to align its policies with
these prevailing discourses about work and health and finally I recommend
enhanced communication between the two parties to foster understanding of the
other’s position and then in regards to ways forward for
research I think it would be fruitful to further explore ways other compensation
policies and programs may collide with dominant discourses to examine whether
injured workers might conceive claiming or argue their cause in other terms
besides moral terms and as well to consider the claiming discourse and role
of employers so while my analysis really focused on the compensation board
certainly employers are very much present in the data as well and I think
a lot could be done there to further examine the role of employers so there
you have it thank you very much thank you so much Dena your methodology is so
thorough and the presentation was very thought-provoking we have now 13 15
minutes my apologies before we end the webinar so I’m gonna
get straight to the questions we have three that I will start with Steve
mantas thanks you for your excellent presentation in your slide on the sick
role you mentioned that the worker is expressing the challenge of not doing
too much but also not doing too little this sounds similar to Sherri Torrance
recent paper where which describes other income support programs we’re doing
worse means doing better and doing better can mean doing worse do you think
what do you think of this yeah I mean I sort of framed this in my dissertation
as this dilemma right of trying to meet all of these sort of competing demands
on injured workers so you know we have this program now early and safe return
to work in Ontario where the sort of discourse is that the earlier you get
workers back to work the better that is for their recovery outcomes ultimately
but so injured workers are sort of compelled to comply with this sort of
return to work program even though they don’t feel ready but at the same time
they’re also met with you know a lot of suspicion and scrutiny around
the legitimacy and extent of their injury to begin with so there’s this
competing sort of demand to appear sufficiently unwell
well at the same time appearing sufficiently interested in and ready to
return to work as quickly as possible mm-hmm okay and Steve continues actually
I’m wondering if this tension is part of the neoliberal approach to policymaking
I think it is I think it’s certainly certainly shaped by that right
you know the effort to get injured workers I think off of claims more
quickly is certainly a neoliberal effort or evidence of that neoliberal sort of notion around you know pulling back of
state intervention and so on and making sure people are self-sustaining and
responsible for their own health and contributors to society and so on and
and making sure people are less reliant on these social supports so I think in
many ways a system that you know is trying to get workers back to work as
quickly as possible you could suggest is partly shaped by those neoliberal
discourses mm-hmm over the past 40 years continues there’s been an increasing
practice at WSIB and WCB of not dealing or meeting with the injured workers in
person is this part of the move to efficiency do you think I think so you
know the the board is always talking about becoming this sort of modernized
you know customer centric organization business entity of sorts so I think yeah
that’s I’m sorry can you repeat the end of Steve’s question there actually do
you think that not meeting or dealing with injured workers in persons part of
the move to efficiency yes yeah I mean I think the board
oftentimes reframes it as you know trying to sort of move through clean
adjudication more quickly and triaging more quickly so if you just have a phone
call we can basically sort out the claims and make sure we’re moving
through that backlog more quickly but you can see as well of course how how it
might operate to you know cut costs for the board as well mm-hmm okay Tom
McKenna’s asks in terms of the underreporting you find a reporting or
under reporting difference between workers in regular employment versus
workers in preparers employment for example casual or temporary and what
about workers who have ESL issues yeah for sure the literature definitely
suggests that more vulnerable workers are even less likely to report than
those who are in more traditional you know working arrangements so you will
definitely see greater underreporting amongst those who are precariously
employees you know new Canadian workers you know certainly undocumented workers
you know it’s definitely a more likely or there’s a greater rates of
underreporting under those sort of more vulnerable working groups you know I
remember interviewing or speaking with a physician in Toronto who worked with a
lot of sort of immigrants and undocumented workers and there was
mention of one who actually had an amputation rather than report it so
people have have very you know have great fears and concerns around
compromising their income and their jobs or future employability if you take into
account you know temporary foreign workers you know they’re very concerned
about not being brought back to work again if they if they report or file a
claim mm-hmm that’s wow that’s shocking actually and
really tragic so here Mun has question he’s from OWA
in Toronto and he thanks you for your insightful presentation and ask
what do you believe would motivate the WSIB
to engage in meaningful discourse around the moral hazard entrance in their
processes and policies as they’re clearly stated goal is to spend the
little absolute resources as possible so it’s to reduce cost to their customers
and the employers mm-hmm so what was my work sorry what would motivate the board
to to engage in the meaningful discourse around moral hazard go ahead yeah I
think you know creating that space to hear from and sit across the table from
injured workers and have you know that meaningful conversation and to to truly
understand their experience of compensation you know to to hear about
the suffering and that you know because there’s this assumption that if we make
this sort of compensation available more and more people will see fit to take
advantage of us and so I feel that in my findings and injured workers so often
describe the suffering they’ve experienced experienced as a result of
filing for compensation you can’t help but wonder how you could even assume
going forward that someone would you know try to take advantage of the system
that has been has created so much trouble for them mm-hmm we have seven
minutes left so if anybody has any other questions please post them now and one
has come in so actually tom has a media a statement as opposed to a question
within within an aging workforce and more workers working past 65 this is a
question is there a trend to underreporting in this fruit goodness
I’m not familiar with that particular literature around aging workers so I’m
sorry I can’t answer that question I mean I could speculate I’m sorry Lee
unsure about aging workers around whether they would feel vulnerable I
mean perhaps it was they have fears around perpetuating this discourse that
aging workers might be more susceptible to injury in the first place so they
certainly wouldn’t want to be an example of that I can imagine the concerns they
might have around filing but I’m really not familiar with the evidence around
that okay well it may be a for further research so Sally Kempton asks first of
all excellent presentation Dina I’m wondering if you could say anything
about the effect of WSIB discourses on the health of injured workers which must
which must certainly be costing both the worker and the system more money mm-hmm
yeah I mean there’s there’s certainly a wealth of information or literature
sorry look examining the consequences of being a workers compensation claim in
tun Ontario and it health impacts are pretty significant you know certainly
physical and mental health impacts strained relationships and and you know
breakdown of marriages and that sort of thing
so the health impacts are well documented in the literature the health
impacts of the discourse in particular I would say would be fairly similar
certainly you know the mental health impacts I think of of being you know
perceiving this discourse that you’re a cheat or you’re lying about your work
injury and you’re you know failed me or liberal citizen and and that sort of
thing you can imagine the the mental health impacts of reckoning with that
sort of discourse that you’re very much aware of mm-hmm okay there is actually another question
coming in it’s just been delayed for a moment so while we’re waiting
to that question to come in I’m wondering if we can go back to Paris
amongst concern about the discourse and I want you to piggyback on that and ask
if do you think that engaging in a moral discourse about the injury claims has
has that created a situation where the board is now more reluctant to deal with
injured workers i I wonder if that’s they’re resistant to dealing with claims
because of the the moral stance that’s being mm-hmm yeah I mean I sort of make
that argument in my dissertation that you know that is a potential consequence
of injured workers pursuing this moral argument around claiming is that for the
board to entertain a moral of juda keishon process means essentially you
know what would that look like it would be incredibly messy they’d have to
abandon these sort of very standardized non-discretionary practices that they
currently hold on to so tightly you know it’s very important that the
board be seen as adjudicating claims and a fair equitable transparent
non-discretionary manner so how do you reconcile this call to to consider
claims from a moral a more moral positioning so it does it’s so I argue
that the response to that then is is holding on more tightly to these
eligibility criteria and standardized practices to sort of in to sort of
resist the suggestion that they ought to be adjudicating claims from from a moral
position or considering notions of deserving this or worthiness right well
thank you for expanding on on that you did touch on that in your presentation
we do have one more question um it has come in
I want to quickly sort of extend that line of questioning by asking are there
I know that in social assistance system workers have discretion and I wonder if
the same type of practice is happening WSIB it are there worker are there
moments within education or managing of claims where workers discretion will you
know be used to make decisions as opposed to going by book can you give me
an example of what that workers discretion might look like well the 20%
of claims that are problematic that are being turned down well do you see this
consistently across the board with every worker or do different workers treated
differently handle the cases differently do you mean the adjudicators or the
injured worker claimant sorry both injured worker the workers that are that
first see the claims before it even goes to adjudication right hmm I’m not sure
how to answer that question I guess you know I refer back to actually my
supervisor Joe niek and who conducted a study you know within a workers
compensation board and observed sort of Judah caters work and and notice that
you know there were instances of using discretion despite the public sort of
you know representation that it was all very non-discretionary standardized
practices but when push comes to shove and things get very busy and claims are
very messy there are moments where it adjudicator will use discretion to kind
of make decisions around a claim and so on
I entered your question or not and and I would love to get into it further but
we’re running out of time and I do need to get to Karen’s question she says
where the findings presented or shared with workers compensation staff and a
leader and what was the interpretation of the
workers spoken moral claiming experience yeah so I haven’t given a specific
presentation to board representatives yet that’s sort of on my you know a must
do for me to make sure that this sort of gets into the hands of people who might
consider it so I haven’t gotten any response in fact to you know
my interpretation of the injured workers stories that I heard through my research
yeah at this point well what I’m wondering so the second part of that
question was what solutions were found together but if you haven’t had that
conversation I guess that is yet to be determined
mm-hmm okay if anybody has any other questions and I don’t Dana and would you
mind if I sentence you they forwarded them of course yes and my email address
is here as well I’m very happy to receive any emailed questions and to
continue the conversation further it’s a little bit of an interesting dynamic
here where I’m just you know reading a question and not able to have a
conversation right I very much invite a conversation with anyone who wants to
continue okay well thank you so much Danny for your time and thank you to all
our members who attended to today’s webinar we look forward to seeing again
in April have a have a good day thanks so much thank you bye

Leave a Reply

Your email address will not be published. Required fields are marked *