Worksafe BC neither working nor safe for injured workers with chronic pain — study

Tom Sandborn weighs in on the plight of chronic pain patients who deal with WorkSafe BC.

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Dr. Hershler has a prescription for addressing the damage he sees being done to chronic pain patients who deal with WorkSafe BC. (He is careful to say that his criticisms of WorkSafe are focused on its treatment of chronic pain patients; he sees the body as doing a fairly good job with patients who have experienced acute injuries at work.) The reforms Hershler wants to see around the treatment of chronic pain patients by WorkSafe BC include a move to separate chronic pain from other work-related injuries dealt with by WCB and return the medical care of such injuries to each patient’s own family doctor and specialists. He also advocates steps to ensure economic security for injured workers who often are cut off from WorkSafe payments during the review and ap­peal process of a decision by the body to disallow their claims. Also important, he said, was access to a second opinion without cost to the injured worker and choice of therapy providers for workers. He argues that WorkSafe should stop inflicting “punitive job-search programs” and ensure workers are given adjusted or modified work during a gradual return-to-work process. He wants the province to ensure workers are rehired and given work appropriate to the their physical abilities, or provided with adequate and appropriate retraining for workers when they suffer permanent impairments. He underlined the importance of returning the care of injured workers with chronic pain to their family (attending) physicians and their respective pain specialists. Having treatment for these patients being delivered by doctors on the WorkSafe payroll or contract, he contends, creates at the very least a perceived conflict of interest.

When I spoke with Jennifer Leyen, director of Special Care Services at WorkSafe BC (the department responsible for patients diagnosed with chronic pain) on June 9, she emphasized her respect for Dr. Hershler, with whom she has worked for several decades. She told me that although she disagreed with much of Hershler’s analysis (particularly the references to “punitive job search” requirements and the suggestion that injured workers should continue to receive payments from WorkSafe while their review and appeals process took its course) she welcomed his paper as an opportunity for more dialogue about how to best serve patients with complex needs.

“I don’t see this as negative,” she said. “While there are limitations to the study, limitations Dr. Hershler mentions himself, these nine cases are real people, and we can always learn more.”

She told me she thought meeting with Dr. Hershler to discuss his paper would be a good idea. She noted that WorkSafe BC awarded chronic pain pensions to over 2,500 injured workers last year, and suggested that the nine cases reported in Hershler and Salomon’s paper represented a very small and not a random sample from that population (which, to be fair, is a point Hershler makes as well.)

Nevertheless, the policy reforms at WorkSafe BC Hershler calls for make sense to me, and, if implemented, could go a long way toward improving the unhappy lot of injured workers with chronic pain. But they may not address all the dysfunction at WorkSafe. When the current provincial government came to power it instituted changes in procedures and pensions that many critics saw as draconian and anti-worker. The most persuasive statement of the case against the new arrangements at WorkSafe can be found in Adding Insult to Injury Changes to the BC Workers Compensation System, 2002-2008: The Impact on Injured Workers (Guenther, Patterson, O’Leary) and while it makes for a desolate read, the thorough study is absolutely crucial to understanding where we are currently in this province in terms of dealing fairly with injured workers. And front line workers at WorkSafe have been telling me for years now (although unwilling to speak for attribution) that their own working conditions have deteriorated over the last decade as they have been tasked with administering policy changes that evoke rage and despair from their clients while struggling to make an expensive, cumbersome and complex new computer system work. The impression grows that WorkSafe BC is in trouble as an organization, and that injured workers who depend on it are too often ill-served. It may be time for a healing intervention.

Is there a doctor in the house?

Tom Sandborn lives and works in Vancouver. He has covered labour and health policy issues for more than a decade and also reviews books and covers arts issues. He has appeared in the Vancouver Sun, the Tyee, the Columbia Journal, the Globe and Mail, Trade Talk, Compass, The Raven and the Quarterly Review. He welcomes feedback and story suggestions at [email protected].

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