Workers Compensation MANITOBA

[beatenwoman2005]

OKay all I heard this story on the radio today. A fellow wanted some attention in regards to worker's not being treated properly by Workman's compensation board.

I have to agree that injured workers are not being compensated when they have a life time disability. They are not given awards fairly, and to top it all off Workers compensation board average's 60 MILLION dollar surpluses every year. At what cost are these surpluses accumulated... well I can tell you that they only pay 3000.00 for a 60% loss of usage of a person's arm........they then tell the person that their CHILDREN should look after them, now WTF kind of system is that?

Instead of boasting about their "RELAXED HAPPY employee's" at WCB, why do they not take into consideration the 3% of permanetly impaired worker's that are injured every year . Think about it.... out of 100 thousand 3000 workers are impaired for life, that is NOT alot of people to give a proper award to.

This "RULER" or rather "NO FAULT INSURANCE" has gone wayyyyyyyyyyyyyyyyyyyyyyyyyyyyyyy too far when dealing with injured people.

They need to re-examine the WCB rules and regulations... not to mention all of the DOCTOR's in Manitoba that are given monies every year for dealing with WCB CLAIMS......

Open up people, this poor fellow did the wrong thing by driving into the building, BUT he has drawn attention to the fact that this needs to be looked at.

[guyser]

What the hell are you talking about? What does "no fault" have to do with WCB ?

But let me tell you this. WCB is a broken system in large part due to the workers themselves. They do not disclose or they hide the true amount of their pay, employers fudge figures all the time, back dating so that claims are not denied....the list is endless.

I have no sympathy for the family that gets caught out due to cheating. The kids, yes, they are innocent but other wise the rest of them.pffffffffffffft.

As for being an honest person caught up in the WCB nightmare, I feel for you, all 30 of you.

So, dont Docs deserve something for filing claims on behalf of patients? Why are you ragging on them?

[beatenwoman2005]

What the hell are you talking about? What does "no fault" have to do with WCB ?

But let me tell you this. WCB is a broken system in large part due to the workers themselves. They do not disclose or they hide the true amount of their pay, employers fudge figures all the time, back dating so that claims are not denied....the list is endless.

I have no sympathy for the family that gets caught out due to cheating. The kids, yes, they are innocent but other wise the rest of them.pffffffffffffft.

As for being an honest person caught up in the WCB nightmare, I feel for you, all 30 of you.

So, dont Docs deserve something for filing claims on behalf of patients? Why are you ragging on them?

[beatenwoman2005]

Look years ago the PC government "DEEMED" that there would be a no fault insurance... through MPIC... to my understanding the WCB took this formula and applied it with the help of the government for the benefit of employers'.

Now all looked wonderful on paper... the human cost.... 100 thousand dollars is provided in an accident resulting in death... one eye, or both eyes is 100 thousand dollars... SO the human body is only based on 100 thousand dollars...... now take a person who earns minimum wage and multiply that over 30 working years... what is the amount at 5.00/ hour... over a lifetime, NOT including interest etc... that amounts to 288 thousand dollars... Based on 5 bucks an hour.... so a human life is worth MORE than 100 grand.. I am DISGUSTED with people who think that a life is worth nothing.

WCB PIE formula for a limb is 25% of the over all body (25 thousand dollars)..... if you loose 60% usage of it, they take the 25% and divide it by the percentage that is LOST.

DO you think a person's arm is worth 25 thousand dollars? They will never hold their child again, wipe their backside, play ball, etc........

For the percentage of people that "SCAM" the system they are BUSTED with stake outs by WCB, as well as people who are in their lives......

As for employer's BSing about a persons wage.... they generally only do it if they can BENEFIT from it in the long haul with reduced WCB amounts that they have to pay.

Insurance is there for people who need it, when the insurance is not there there is a greater Financial cost to the public for not covering basics such as disability tax credits, assisted living, etc... the list goes on and on....that is not even including a cost to the immediate family for their time, energy, and LOST wages of providing care to their disabled loved one.

I say to you guy, what are you worth...... oh right you must be at the top of the food chain so you do not care about the person that serves you, baths you in hospital, pumps your gas, builds your buildings, builds your furniture, or grows your food......

Injured workers deserve Better than what they are getting in Manitoba.

How funny you never even commented on the fact that WCB has a 60 million dollar surplus every year.......

[guyser]

Ok, lets look at this and break it down.

[ Now all looked wonderful on paper... the human cost.... 100 thousand dollars is provided in an accident resulting in death... one eye, or both eyes is 100 thousand dollars... SO the human body is only based on 100 thousand dollars...... now take a person who earns minimum wage and multiply that over 30 working years... what is the amount at 5.00/ hour... over a lifetime, NOT including interest etc... that amounts to 288 thousand dollars... Based on 5 bucks an hour.... so a human life is worth MORE than 100 grand.. I am DISGUSTED with people who think that a life is worth nothing ]

They are not dead , they are being paid for the loss of limb, or both eyes. One cannot compare earnings over a lifetime and expect to get that back. The one time payment is $100,000. Invested somewhere it may double in 30 years. So whos out of cash? No one said a life is worth nothing. Why try and muddy the discussion. Stay on topic.

[WCB PIE formula for a limb is 25% of the over all body (25 thousand dollars)..... if you loose 60% usage of it, they take the 25% and divide it by the percentage that is LOST.

DO you think a person's arm is worth 25 thousand dollars? They will never hold their child again, wipe their backside, play ball, etc........

For the percentage of people that "SCAM" the system they are BUSTED with stake outs by WCB, as well as people who are in their lives...... ]

A persons arm is worth 25 G I suppose. Why wont they hold their child, wipe the butt or play ball? Use the other arm for that. You have two you know.Besides, any injury will come with a lawsuit and they will get mmore money out of the insurance company then. You never heard of Jim Abbott ? Played pro baseball with only one arm. Imagine that .

Stake outs RARELY do anything but frustrate the insurance industry. We can get people doing things they should never even think about doing and once in court the judge will (this is actual case) dismiss our cliam as it "was only one day he did that and may have felt fine that day" Judgement to the defendant.

Now you dont have to yell at me, and whether I am on the top of the food chain or the bottom is inconsequential.I pump my own gas, but only for the car, I let someone else do that for my boat. But of course I care about the others, what makes you think I dont? It is just that I dont have a bleeding heart for every perceived slight out in this cruel world. As for the guy that builds my houses.,...oh my, he could buy me ten times over.

As for your ending bon mot, I think WCB is a scam every way until sunday.They WCB are scamming because the workers are scamming the WCB and there are far too many fraudulent claims.

Kind of like auto insurance, but the profit is there so why rock the boat?

[geoffrey]

Buy additional insurance, you get what you pay for with the WCB... you know the coverage going in, you know what you'll get when you get hurt.

It's rather silly to complain about it afterwards.

You can purchase additional insurance if you feel the amounts are not enough to cover your losses.

[sideshow]

People miss the point of the WCB and the act that governs its actions.

WCB came about as a compromise. In, I believe it was 1915 or so, when it was enacted, the purpose was two fold-to provide workers with an income during times of injury, and to relieve employers of the threat of being sued by injured employees. Now this was obviously more of a win for the employees, as they would usually lose their lawsuits anyways, but it did supply the employer with a measure of stability.

As to the conservatives messing with the act, they did make some changes in 90 and 92, but it was mostly due to some eligibility and financial tweaks-in employers favour of course.

And the NDP have made a few tweaks in the other direction (im speaking of the manitoba perspective here).

The problem with the WCB act is it deals with issues after workers are injured. Nobody wants to see anyone get hurt working. But safety is very much a matter of cost. Perhaps some of the money put into the reactive WCB should be put into proactive (Health and Safety) rules/regulations?

And the WCB does have several levels of appeal, and an independant panel that makes decisions. To be honest, I think that if anyone is abusing the system, it is employers as they threaten, hide claims, or frustrate the process to keep their experience ratings (dollars per hour premium costs) down.

But we all know there will and are people stealing from what is a good program.

[Hydraboss]

Beaten, who don't you quit yammering until you know something? 3000 out of 100,000 is a huge amount of permanent disability cases. If a company had that kind of record, they would have already been shut down. Why don't you educate yourself about WCB's in Canada before you get on your high horse?

As has been said, the WCB's are broken and should be abolished. As an employer, I would gladly see each and every worker that wanted to sue, in court in front of a judge. The premiums alone that most mid to large businesses pay would cover quite a few lawsuits PER YEAR.

You commenting on WCB policy is like me commenting on piloting the space shuttle. I could make the words come out, but I doubt they would make any sense to anyone who actually knew how to fly it.

[sideshow]

Beaten, who don't you quit yammering until you know something? 3000 out of 100,000 is a huge amount of permanent disability cases. If a company had that kind of record, they would have already been shut down. Why don't you educate yourself about WCB's in Canada before you get on your high horse?

As has been said, the WCB's are broken and should be abolished. As an employer, I would gladly see each and every worker that wanted to sue, in court in front of a judge. The premiums alone that most mid to large businesses pay would cover quite a few lawsuits PER YEAR.

You commenting on WCB policy is like me commenting on piloting the space shuttle. I could make the words come out, but I doubt they would make any sense to anyone who actually knew how to fly it.

Case in point. Employers hate WCB. It's a cost (of doing business) that they dont want. Because today, like in the past, there are some employers (Hydraboss it seems would be in this category) would just as soon see the workers as "Canaries in the tunnels" as pay to cover their injury costs.

[Hydraboss]

In addition to my having no use for any WCB, you forgot to mention that my wife is still on modified duties after being on lost time for nine months. We would have been farther ahead without WCB, much farther. I not only deal with the Boards as an employer, I deal with them on a personal level.

As a Director of HSE, I also see every single injured worker from the three provinces we do business in. Let me tell you, other than the scammers (and there's lots of them) the vast majority of truly injured workers would rather deal with me than the WCB.

[sideshow]

LOL! Yes, sounds very "compcall" in nature......

The vast majority of employees know nothing of the process, and as such, while injured, are just happy for any scraps that can be tossed to them to pay bills while they recover.

As for your wife, I knew nothing of her condition, so I could not comment on her status. I can hope for a speedy recovery for her though. Do you think perhaps that some of her coworkers may see her as a "scammer" for being off for 9 months? It seems those that use the system (rightfully so?) are always suspect.

Oh, and how do you deduce who the scammers are? Are you a physician? Provide a polygraph? I think it is unfair to judge whether or not someone else is in pain or not without a full (which in my experience is almost never done) evaluation. Touching your toes and coughing at a company recommended GP doesnt address health issues.

[guyser]

Oh, and how do you deduce who the scammers are? Are you a physician? Provide a polygraph? I think it is unfair to judge whether or not someone else is in pain or not without a full (which in my experience is almost never done) evaluation. Touching your toes and coughing at a company recommended GP doesnt address health issues.

None of us know...but given enough first hand knowledge of who what and when,coupled with the draconian rules that WBC forces employers to implement, we can make a reasonable call and say that WBC is a mixed up screwy rip off for a lot of people.

The whole system is wrong. Right intentions, wrong implimentation.

WBC mandates, injury-file a report no matter how small an injury. Rates are based on injury profile and claims.

So the circular route is thus....make claim cost goes up, make claim but no payout, cost goes up, ergo next time you dont want a claim used against you so your rates decline, all the while roughly the same number of claims have to be paid, yet there are fewer dollars coming in thus the rates must go up to cover the existing claims, and then employers tighten up about no claims being reported unless very serious..and so on and so on.

My case (as a young man) worked in an abbotoir. Pushing sows on the rail and one jumps the track and the 4LB stainles steel bar comes down, with the sow (220lbs) still on and hits me in the neck knocking me out cold the whole while I am face down in an inch of cold pig blood.

I am awakended by a co worker and taken to the nurse. She calls the boss who hired me (plant manager) and we talk. He asks do I think I am alright. Yes I think I will be. Do I want to make a WBC claim , or could we discuss you taking as much time off as needed WITH full pay in lieu of claim at WBC.

I took the days off , even tho that night I was rushed into emergency due to something I contracted in the pig blood. One night stay and released with a letter for my boss. WBC never knew about it.

And you know why? The main reason was this was not a negligent accident by the company. It was purely blind luck and lack of epxerience on my part. I felt they were being fair with me, likewise in return.

[Hydraboss]

The vast majority of employees know nothing of the process, and as such, while injured, are just happy for any scraps that can be tossed to them to pay bills while they recover.

And this is the reason that these same workers talk to me AND to their WCB Case Manager (who is supposed to be neutral).

As for your wife, I knew nothing of her condition, so I could not comment on her status. I can hope for a speedy recovery for her though. Do you think perhaps that some of her coworkers may see her as a "scammer" for being off for 9 months? It seems those that use the system (rightfully so?) are always suspect.

Lots of them probably suspect her. Like anything else, the smaller percentage of scammers get all the press.

Oh, and how do you deduce who the scammers are? Are you a physician? Provide a polygraph? I think it is unfair to judge whether or not someone else is in pain or not without a full (which in my experience is almost never done) evaluation. Touching your toes and coughing at a company recommended GP doesnt address health issues.

While not all cases are clear, there are many that are extremely transparent. One thing that most scammers have in common is that they can't keep their mouth shut about how smart they are. What they forget is that the guys they work with that they brag to ALSO don't know how to keep their mouths shut. Word gets around really quick, even to me. And, no, I am not a physician. I have, however, dealt with a great number of cases of workplace injury over the years. Rarely do I see a case that I haven't already gone through in the past, and I am quite able to spot ones that don't seem to be consistent. What has to be kept in mind is that the Alberta WCB no longer has a straight-forward method for employers to dispute the validity of a claim.

As for a full evaluation, the worker's doctor is the primary contact for short-term injuries. The opinion of a company-paid physician carries no weight with a compensation board and that is why this type of treatment/evaluation is almost non-existent in Canada. If there is a question regarding validity or severity of a lost-time injury, the Adjudicator/Case Manager from WCB can arrange a Medical Status Exam (MSE) or an Independant Medical Exam (IME). The joke is that while the doctor conducting the IME cannot have any other involvement in the worker's treatment, the majority of these physicians work almost exclusively for the WCB. What exactly is "independant" about that? The WCB's mandate is to get injured workers back to their "pre-accident level" employment as fast as possible, and if you COULD check, I'm sure you would find that a lot of the return-to-work cases have probably caused more damage to injured workers than the original injury. It's all about the money.

In the case of my wife, the "independant" physician actually has his office in the Millard Center (this is the rehab center in Edmonton, which also has WCB Case Managers and physicians working in it). Both we and her employer would have been better off financially had we sued them. The WCB increases the employer's rate by percentage (which will probably cost them in the six digit area) and my wife received the maximum payout per week (which because of the maximum insurable earnings set by the board, amounts to less than 60% of what she makes while working). Lose - lose situation. Unless you're the WCB, in which case you win in a huge way.

[geoffrey]

As a Director of HSE, I also see every single injured worker from the three provinces we do business in.

What's HSE?

EDIT: Nevermind, I misread the comment...

Edited March 3, 2007 by geoffrey

[sideshow]

Oh, and how do you deduce who the scammers are? Are you a physician? Provide a polygraph? I think it is unfair to judge whether or not someone else is in pain or not without a full (which in my experience is almost never done) evaluation. Touching your toes and coughing at a company recommended GP doesnt address health issues.

None of us know...but given enough first hand knowledge of who what and when,coupled with the draconian rules that WBC forces employers to implement, we can make a reasonable call and say that WBC is a mixed up screwy rip off for a lot of people.

The whole system is wrong. Right intentions, wrong implimentation.

WBC mandates, injury-file a report no matter how small an injury. Rates are based on injury profile and claims.

So the circular route is thus....make claim cost goes up, make claim but no payout, cost goes up, ergo next time you dont want a claim used against you so your rates decline, all the while roughly the same number of claims have to be paid, yet there are fewer dollars coming in thus the rates must go up to cover the existing claims, and then employers tighten up about no claims being reported unless very serious..and so on and so on.

My case (as a young man) worked in an abbotoir. Pushing sows on the rail and one jumps the track and the 4LB stainles steel bar comes down, with the sow (220lbs) still on and hits me in the neck knocking me out cold the whole while I am face down in an inch of cold pig blood.

I am awakended by a co worker and taken to the nurse. She calls the boss who hired me (plant manager) and we talk. He asks do I think I am alright. Yes I think I will be. Do I want to make a WBC claim , or could we discuss you taking as much time off as needed WITH full pay in lieu of claim at WBC.

I took the days off , even tho that night I was rushed into emergency due to something I contracted in the pig blood. One night stay and released with a letter for my boss. WBC never knew about it.

And you know why? The main reason was this was not a negligent accident by the company. It was purely blind luck and lack of epxerience on my part. I felt they were being fair with me, likewise in return.

Well first off, your company broke the law-they have to report that injury. Now if your company wants to be self insured, they could still send you home on full pay (call it sick time, whatever.). You can file a no timeloss claims which doesnt raise the employers experience rating premiums, and gives you time to heal.

I think a lot of the problem is that employers and employees know nothing of the act, or the way its administered. I know that at my last employer I had to deal with the most inept HR people that had no clue how to deal with this sort of thing. Educating them takes time, as the act is not just a little nothing paper.

[sideshow]

The vast majority of employees know nothing of the process, and as such, while injured, are just happy for any scraps that can be tossed to them to pay bills while they recover.

And this is the reason that these same workers talk to me AND to their WCB Case Manager (who is supposed to be neutral).

As for your wife, I knew nothing of her condition, so I could not comment on her status. I can hope for a speedy recovery for her though. Do you think perhaps that some of her coworkers may see her as a "scammer" for being off for 9 months? It seems those that use the system (rightfully so?) are always suspect.

Lots of them probably suspect her. Like anything else, the smaller percentage of scammers get all the press.

Oh, and how do you deduce who the scammers are? Are you a physician? Provide a polygraph? I think it is unfair to judge whether or not someone else is in pain or not without a full (which in my experience is almost never done) evaluation. Touching your toes and coughing at a company recommended GP doesnt address health issues.

While not all cases are clear, there are many that are extremely transparent. One thing that most scammers have in common is that they can't keep their mouth shut about how smart they are. What they forget is that the guys they work with that they brag to ALSO don't know how to keep their mouths shut. Word gets around really quick, even to me. And, no, I am not a physician. I have, however, dealt with a great number of cases of workplace injury over the years. Rarely do I see a case that I haven't already gone through in the past, and I am quite able to spot ones that don't seem to be consistent. What has to be kept in mind is that the Alberta WCB no longer has a straight-forward method for employers to dispute the validity of a claim.

As for a full evaluation, the worker's doctor is the primary contact for short-term injuries. The opinion of a company-paid physician carries no weight with a compensation board and that is why this type of treatment/evaluation is almost non-existent in Canada. If there is a question regarding validity or severity of a lost-time injury, the Adjudicator/Case Manager from WCB can arrange a Medical Status Exam (MSE) or an Independant Medical Exam (IME). The joke is that while the doctor conducting the IME cannot have any other involvement in the worker's treatment, the majority of these physicians work almost exclusively for the WCB. What exactly is "independant" about that? The WCB's mandate is to get injured workers back to their "pre-accident level" employment as fast as possible, and if you COULD check, I'm sure you would find that a lot of the return-to-work cases have probably caused more damage to injured workers than the original injury. It's all about the money.

In the case of my wife, the "independant" physician actually has his office in the Millard Center (this is the rehab center in Edmonton, which also has WCB Case Managers and physicians working in it). Both we and her employer would have been better off financially had we sued them. The WCB increases the employer's rate by percentage (which will probably cost them in the six digit area) and my wife received the maximum payout per week (which because of the maximum insurable earnings set by the board, amounts to less than 60% of what she makes while working). Lose - lose situation. Unless you're the WCB, in which case you win in a huge way.

Well I would say that the problem is not WCB as a concept or legislation, but rather the way its administered? Perhaps an arms length group of unbiased physicians making the decision as to which injuries were compensable or not would help alleviate some of the problems?

I mean we all know that there are scammers out there. But there are also legitimate people unable to get their WCB claims handled properly either.

And as for the scammers-well thats stealing. From WCB, which is obviously funded by employers, so they are stealing from their work. And the burden of proof should be on the employers, and if that burden is proven, then that employee should be let go. Nobody likes a thief. A few firings here and there might make a few more a bit more honest.

[Hydraboss]

Geoffrey, sorry I should have spoken more clearly. HSE = Health, Safety and Environment.

Well I would say that the problem is not WCB as a concept or legislation, but rather the way its administered? Perhaps an arms length group of unbiased physicians making the decision as to which injuries were compensable or not would help alleviate some of the problems?

Sideshow, I agree that as a concept, WCB makes sense. However, it is not at all simple to change the administration of the Board. WCB is legislation and all changes must be made at the government level. Case in point: If you have had a back injury (current or past) and you pay for an MRI on your back for an unrelated problem, the WCB has the legal right to obtain the results EVEN IF THEY REFUSE TO PAY FOR THE TEST. The Board has it's own legislation (the Worker's Compensation Act in Alberta), and all provincial legislation allows for WCB legislation to take precedence under the "Other Act" loophole.

As for an "arm's length" unit of doctors, why would they? Doctors are paid on a percentage of standard billing to the board. As an example, for a dentist that is allowed to charge a health plan based on the Provincial Dental Schedule, say, $60 for an exam. If the same dentist examines the same patient on a work-related injury, he would be able to bill $87. (These numbers may be off a little, I'm not at my office computer) The same applies to any medical or medical-related process. I have workers that go to their family physicians to be seen about a minor injury (pinched finger, etc) and when I receive the C-151 doctor's report, the worker is supposed to be seen for follow-up exams EVERY WEEK for 4-6 weeks. WTF? This is how the WCB makes sure that workers do not have to wait on any waiting lists that normal people do. How long does it take for your doctor to get you in for an MRI? The WCB can usually get you in within 48 hours.

The only part of the WCB that works is THE IDEA of no-fault employer/worker insurance. The entire system is set up to screw both employers and workers. As an employer, I would rather be able to pay an employee for three or four days off to let a sore arm heal. So would most workers. BUT IT IS ILLEGAL. If I pay a worker, I have to report it and the WCB sends me a cheque.

I mean we all know that there are scammers out there. But there are also legitimate people unable to get their WCB claims handled properly either.

More than you may know. Search the net for e-groups of injured workers, and read their stories of how the WCB screwed them. I know that there are lots of employers that do this as well, but they are playing the system as it is set up. Not illegal, just morally wrong.

And as for the scammers-well thats stealing. From WCB, which is obviously funded by employers, so they are stealing from their work. And the burden of proof should be on the employers, and if that burden is proven, then that employee should be let go. Nobody likes a thief. A few firings here and there might make a few more a bit more honest.

I have had cases where the company has cell-phone video of "injured" workers doing things the they are supposedly incapable of doing. The WCB will not even view this material, and we have received letters telling us to back off as they feel we are creating a "hostile working environment". There is no way a worker can be called on the mat for faking unless they piss off a Case Manager and he or she decides to investigate the worker's claim.

Want a good one? Six years ago there was a field worker that we sent to do a crew job out of town. KEEP IN MIND THE WORKER PUT ALL OF THIS IN WRITING TO THE BOARD. When his shift at the rig ended, he and his crew drove back to the town they were staying in. They did what every damn oilfield worker does after shift. They went to the local bar and got drunk. While playing pool (remember - he's drunk) he tripped on another guys cue and broke his leg. Compound fracture. The Board accepted his claim and he was off work collecting full benefits for almost six months. Why? He was deemed a "captive employee" which means that even though he was off duty, the company was paying for his hotel room and he couldn't go home that night. In essence, the Board said he was still working. Now the big problem with this was that the worker made six digits a year, but his benefits only allowed for him to receive $711 per week. My total on this claim? $86,000 billed against one of my accounts. So who got screwed in the end? Employer AND worker.

[sideshow]

You make some great points. And those kind of examples that you have provided do indeed highlight the problems with the WCB as it currently is. I just don't personally think the baby should be thrown out with the bathwater.

It seems no matter what insurance, benefit, or whatever, people will abuse where they can. And unreasonable rules and decisions will be made.

The example you state about a drunken worker playing pool-completely unreasonable, and I can understand why you would be frustrated with the system after having to deal with that kind of thing.

As well, I am personally in favor of not only firing an employee that is proven to have faked an injury, but think that they should be fined and/or criminally prosecuted. Basically its stealing from the employer (as they pay the premiums) and if it was a private insurance company (like say making a fake automobile or home insurance claim), they could/would be charged with fraud. And maybe if it was easier to charge these people, perhaps there would be less scamming, which would ease the financial burden on the employer.

[guyser]

Want a good one? Six years ago there was a field worker that we sent to do a crew job out of town. KEEP IN MIND THE WORKER PUT ALL OF THIS IN WRITING TO THE BOARD. When his shift at the rig ended, he and his crew drove back to the town they were staying in. They did what every damn oilfield worker does after shift. They went to the local bar and got drunk. While playing pool (remember - he's drunk) he tripped on another guys cue and broke his leg. Compound fracture. The Board accepted his claim and he was off work collecting full benefits for almost six months. Why? He was deemed a "captive employee" which means that even though he was off duty, the company was paying for his hotel room and he couldn't go home that night. In essence, the Board said he was still working. Now the big problem with this was that the worker made six digits a year, but his benefits only allowed for him to receive $711 per week. My total on this claim? $86,000 billed against one of my accounts. So who got screwed in the end? Employer AND worker.

I know I am going to get flamed on this one......but I happen to agree with the WCB ruling in your posted case. And this is from someone who has no respect for WCB.

The worker is in fact on the company dime when he is out of town. This is actually documented in many lawsuits whereby the worker causes a liability issue. If he was driving his vehicle for the job, whether supplied by the Co or not, he causes an accident, the company gets named in the lawsuit. (it is covered by a companies Non-Owned Auto Liability endorsement.) The same goes for damage out of the vehicle or on a site.

This can be seen in the breadth of the companies demands of its employers while representing the company. They can restrict all alcohol consumption while away among other things.Hell , as it is now, employers in the US have said lose weight or be fired, stop smoking or be fired, any alcohol in your system while working (even if left over from last night) and you will be fired.

Not so sure I agree with many of these , but it is what is happening.

Now for the video of your worker doing things he shouldnt and the WCB refusing to even look at it.....I know exactly what you mean. Pretty damn crazy.

[guyser]

As well, I am personally in favor of not only firing an employee that is proven to have faked an injury, but think that they should be fined and/or criminally prosecuted. Basically its stealing from the employer (as they pay the premiums) and if it was a private insurance company (like say making a fake automobile or home insurance claim), they could/would be charged with fraud. And maybe if it was easier to charge these people, perhaps there would be less scamming, which would ease the financial burden on the employer.

Insurance companies are very leery of charging anyone with fraud. Pretty much never do it, and I have had clients who were caught scamming , and I was convinced they would go down for it.

Nope, never charged. It was a guy here in TO, on auto benefits from an accident and unable to work. He was collecting a weekly paycheque from us. But he was also on welfare......and not being too bright, he asked the welfare case worker if they would pay his auto premiums, "sure we will--let me call your broker and arrange it for you".....they called, and I asked them what the hell are they talking about, we are paying him weekly for disability from an car crash. "Oh...well then we have a problem"

Turns out he was making a killing. We were paying (maybe $500 per week)the welfare office was paying and also paid for his premiums, and he was driving a cab for cash. The welfare lady and I figured out he was making about $80,000 ......tax free income.

Yes, he was caught, but no one pressed any charges.

Insurance companies rarely rarely ever charge anyone.

[sideshow]

One case, one example. I have seen many, many cases where charges have been pressed. And it is not technically the insurance company that presses the charges, rather it is the law enforcement officer that does.

[Hydraboss]

The worker is in fact on the company dime when he is out of town. This is actually documented in many lawsuits whereby the worker causes a liability issue. If he was driving his vehicle for the job, whether supplied by the Co or not, he causes an accident, the company gets named in the lawsuit. (it is covered by a companies Non-Owned Auto Liability endorsement.) The same goes for damage out of the vehicle or on a site.

This can be seen in the breadth of the companies demands of its employers while representing the company. They can restrict all alcohol consumption while away among other things.Hell , as it is now, employers in the US have said lose weight or be fired, stop smoking or be fired, any alcohol in your system while working (even if left over from last night) and you will be fired.

No flaming guyser, just a question. If that worker is considered to be on company time, then shouldn't he have to comply with company rules whenever he is considered so? If the company I work for has the responsibility for him, then perhaps our Drug and Alcohol Policy should apply. If this same thing happened while he was on a job site (during working hours) he would have been fired immediately. So if WCB coverage is going to cover him on my account, I should have control over the situation. If you loan your buddy your car, knowing that if he gets in an accident your insurance will have to pay the collision, how would you feel about him letting you know that he will be going to the bar, drinking, and driving it home? Do you want control over his actions? Would you even let him have the car? What if you weren't home and the buddy was your roommate? Would it be okay with you to be held responsible for him grabbing your keys without your permission and doing the same thing? What if he were deemed a "capitve roommate"?

I would have no problem with the ruling if it were consistent in it's application. The Board, however, makes decisions based on the individual interpretation of the Case Manager. Anyone who believes otherwise should spend a day looking through "restricted access" WCB employee case files. Your head would spin on your shoulders.

[guyser]

One case, one example. I have seen many, many cases where charges have been pressed. And it is not technically the insurance company that presses the charges, rather it is the law enforcement officer that does.

Tell me about them please. I would like to hear as I am in insurance and rarely have I heard anyone getting charged.

[guyser]

No flaming guyser, just a question. If that worker is considered to be on company time, then shouldn't he have to comply with company rules whenever he is considered so? If the company I work for has the responsibility for him, then perhaps our Drug and Alcohol Policy should apply. If this same thing happened while he was on a job site (during working hours) he would have been fired immediately. So if WCB coverage is going to cover him on my account, I should have control over the situation. If you loan your buddy your car, knowing that if he gets in an accident your insurance will have to pay the collision, how would you feel about him letting you know that he will be going to the bar, drinking, and driving it home? Do you want control over his actions? Would you even let him have the car? What if you weren't home and the buddy was your roommate? Would it be okay with you to be held responsible for him grabbing your keys without your permission and doing the same thing? What if he were deemed a "capitve roommate"?

I would have no problem with the ruling if it were consistent in it's application. The Board, however, makes decisions based on the individual interpretation of the Case Manager. Anyone who believes otherwise should spend a day looking through "restricted access" WCB employee case files. Your head would spin on your shoulders.

That is exactly what is happening. The company can dictate that if out of town you are subject to all our rules until you are back in your own bed.Including booze and drugs.

What I think has occured is Canadian business' do not want to seem so controlling as some in the US but we go with the same ruling after the fact.

Now if my roommate borrowed my car , he would be subject to the no drinking rule.

Should he grab the keys as I am not home and crash the car, I would have him charged with theft as it relieves me of any "fault" with the insurance company. Sucks , but thats they way to clear your name.

As for WCB restricted files, I know you are shocked, and rightfully so.There seems to be no rhyme nor reason for some of their decisions.

[sideshow]

One case, one example. I have seen many, many cases where charges have been pressed. And it is not technically the insurance company that presses the charges, rather it is the law enforcement officer that does.

Tell me about them please. I would like to hear as I am in insurance and rarely have I heard anyone getting charged.

MPIC (Manitoba Public Insurance Corporation) involves the Police and has fraud charges filed all the time. If someone files a fraudulent claim, then they are stealing. No different from any other type of fraud/theft.