What is a workers compensation claim

what is a workers compensation claim

- worker states, "I am currently a victim of this system. I have lost my home and everything except a few personal effects. I have had the opinion of five(5) othopedic specialists who have examined and treated me over-ruled by WCB's non-specialist Paid medical consultant who has never even met me let alone examined my injuries."

- worker with multiple injury claims threatened by WCB with being cut off benefits despite continuing medical issues. He claims WCB tampered with and falsified his medical evidence. They also phoned his physician to attempt to discredit the worker. The physician responded by warning the WCB that further calls of that nature would be considered harassment. WCB forced the worker into inappropriate training while disabled which caused further injury and ridiculed him by telling him that he was not smart enough to be retrained. They refused him physiotherapy. They told him to omit revealing the existence of compensable injuries to prospective employers. The worker characterizes his treatment by WCB as harsh, callous, oppressive and discriminatory.

- worker with 3 crushed discs and severe pain denied compensation despite WCB agreeing that there is an injury.

- workers repeatedly contact the CIWS with cases against the WCB that they feel should go to court, however, they cannot obtain a legal remedy due to either an inability to afford a lawyer or because of the refusal of law firms to take on WCB cases.

- worker was knocked off a truck and received back injury. The employer did not file an injury report because he was operatring illegally. The WCB believed the employer, not the worker and denied the claim as fictitious. Worker took time off work anyway and later went back to work at a job that did not require lifting, Yet, walking around at home one day, his vertebral disc broke in half.

- worker had surgery with subsequent physical limitations and pain, yet the WCB cut off compensation saying worker is discharged "with no limitations".

- worker was off work with a heel injury but was cut off by WCB when they found out he also needed back surgery. Worker is depressed, on medication and still unable to work.

- An appeal was made through a lawyer and the Appeals Board ruled unanimously in the injured worker's favour. When the claim went back to WCB though, the Appeals Board decision was ignored, the claim was denied and the file was closed.

- man was sent into a confined space without protection and suffered lung damage. Despite proof and witnesses, WCB does not accept the facts of the case and denies the claim.

- man's WCB claim was initially denied but later the Appeals Board reversed that ruling. Now WCB is appealing their own Appeals Board decision! Meanwhile, the family is looking for a place to live and the mother is working in a remote location desparately trying to save her home. Thus two children are without their mother and the family may soon lose their home.

- despite having had repeated physician requests for an MRI, WCB refused to pay for it and worker had to pay for his own MRI. Results showed that the injury was work-related yet WCB refused to believe the MRI. Worker was cut off compensation.

- worker was told by WCB that he had a chronic terminal illness. This was false. Yet this false information was revealed to the worker's employer and coworkers. No compensation was received by the worker for his legitimate injuries.

- worker won after a 5+ year wait at appeal yet received only one tenth of entitlement.

- surgeries cancelled when WCB disallows claim

- disabled workers report "financial devastation due to WSIB's criminal decisions and treatments".

- disabled workers forced into homelessness and have to live on the street even with children involved.

- disabled workers report having to give up their children due to financial devastation and homelessness.

- disabled workers report mental exhaustion because of WCBs treatment of them

- disabled workers report that they have thoughts of suicide on a regular basis.

- A physiotherapist, chiropracter and doctor all assess worker as having chronic back pain but the WCB disagrees without ever having seen the worker and blames the impairment on an ankle injury the worker never had. WCB refuses to contact the other care workers for clarification. Without investigating, WCB closes the file, refuses to represent the worker and states that there is no evidence to support the claim.

- WCB-hired specialist made comments about worker's abilities, job performance and weight and implied that worker's "very soft hands" suggested 'deconditioning'. These comments disturbed the worker who felt insulted.

- The WCB nurse (who never met the worker) contacted the worker's doctor to force the worker back to work. WCB told the worker that the doctor had recommended light duty and the worker's claim was denied. Later, when worker obtained their file, it was found that the doctor had never recommended light duty but had said the worker was unable to return to work. When worker filed a complaint about the WCB nurse, nothing was done.

- workers have to pay their own medical bills for specialists to prove to WCB the extent of their injuries.

- heavy equipment operator with repetitive stress injury was denied compensation because WCB said it was arthritis. Yet blood work from doctor says worker has no arthritis.

- when worker received their file from WCB, half of the documents were missing including most hospital medical files, x-ray reports and letters from the worker's lawyer.

- WCB adjudicator overrode doctor's restrictions and worker was sent into light duty work. Worker asked for an ergonomic assessment of the light duty workplace but document was incorrectly recorded and then the adjudicator withheld it from worker's file for almost two years. During appeal, the workplace was finally inspected by a panel but when they arrived the area was empty of all personnel and production. It was obvious that the employer would not cooperate but the panel made their decision anyway - in favour of the employer.

- chlorine gas accident that caused irreversible lung damage was labelled as asthma. Worker claims that the safety violation was hidden in a cover-up due to political expediency because the accident happened in a government department (about 30 years ago). Worker is still fighting for recognition of the accident by WCB and by government.

- worker's WCB file is "well over 15" inches high". The injustices make worker ". sick to my stomach, I've started to have nightmares. wake up with my heart pounding, and can't function on 2 hours of sleep. If I try to sit to read through my file I end up in severe pain within 15 minutes. "

- worker found out about injustices in the case file that were hidden until worker decided to represent himself. He found out that the specialist informed WCB that he was willing to see the worker and set an appointment date but WCB cut off benefits and didn't tell the worker about the appointment.

- worker in severe pain all the time and can't sit for more than 15 minutes yet has to go 300 miles to get to the WCB appeal.

- worker despairs saying, "Everybody just passes the buck and doesn't care. I'm exhausted and know that nothing will change, there is no quality of life left in this body anymore. I've had to shut-up and not talk about my injury or the treatment I've received as my family has already been stressed out enough over the lack of treatment that I've received."

- when worker had some money left, worker went to a lawyer who stated that it was the worst case of bungling he had ever seen. He stated that I needed to get more proof of my injuries as he was willing to file a lawsuit but needed to wait until all appeal avenues were exhausted due to WCB regulations.

- worker sold all possessions to pay for medical treatment. Credit cards are maxed out and what little money was left was needed to feed the children and provide housing.

- worker "tried to be strong and return to work but this has put everyone at danger as I'm in extreme pain and the naracotic meds that I'm on did weird things to my brain, which made my job extremely dangerous to the public."

- when worker found out that worker's advocate was a former employee at WCB, worker "felt abused even more. ". When worker tried to represent himself, it caused much mental anguish.

- claim took almost one year to get approval. After surgeries, physio, etc. and continuing pain and difficulty with limb, WCB decides injury is resolved. Worker started appeal process. Seven months later, still no appeal, no income, constant daily creditor calls and missed mortgage payments.

- claim was denied as pre-existing, but the injury was a complication of a previous work injury accepted by WCB!

- 21 year old injured and was never treated for all injuries. Has had three surgeries and wears a brace. Has received no re-education, was forced to move and all WCB said was that he can work as an order desk clerk. Family member says, "Comp doesn't care that this injury is for life. When will the government realize these young people are our future. "

- workers advisors are reported to be doing " absolutely nothing " to help injured workers. Worker says, "I can't get anywhere with these people and I just really need some help. I have a worker with (deleted) and honestly he has done absolutely nothing in regards to helping me with anything. In fact in 6 months I havn't so much as recieved a phone call from him."

- workers report being penalized at work for making a WCB claim.

- after being told by physio and neurologist that worker could not be helped due to the severity of the injury, worker was told by WCB that it was OK to go back to pre-accident work contrary to the family physician who said worker could not go back to work. This is despite the fact that WCB doctors have never seen the worker nor have they consulted with the worker's doctor. Due to extreme financial troubles, worker tried three times at three different jobs and only worsened. Later, worker independently saw four different specialists who confirmed that the worker cannot go back to work. Specialists said there was not much they could do about the injuries now but if they had seen the worker when the injuries first occurred, the worker's life could have been made a bit more comfortable. Worker has extreme physical and financial challenges and three children who " go without ".

- worker waited 2 years for an appeal tribunal at which the worker won. The case was referred back to WCB who refused to implement the tribunal decision.

- workers forced into remortgages and loss of homes where the rents are more expensive than the mortgages they had before.

- workers forced into excessive overtime work to make ends meet

- workers report writing to their provincial governments about WCB abuses and getting nowhere. Provinces use the "arm's length" excuse to avoid getting involved and thus allow WCBs to remain totally unaccountable.

- doctor accidentally placed misinformation in injured worker's file that resulted in denial by WCB. When the doctor tried to contact WCB to rectify the error, the doctor was told that if he continued trying, he would be denied access to assess any other WCB client and that the WCB would report him to the medical board and have him fired.

- totally disabled workers report being caught in the middle between the CPPD (Canada Pension Plan Disability) and WCBs (workers compensation boards) where neither are taking into account the worker's physical, mental or financial wellbeing. Disabled workers report 'falling through the cracks' as both agencies fail to provide adequate support.

- Worker was dropped unconscious from a high dose of chemical gas. WCB denied that the chemical had any long term or neurological effect yet family says worker went from sharp, witty and intelligent to dumb and slow with a constant severe headache. WCB 'brushed off' the worker and his family doctor and gave him anti-depressants, tranquilizers and painkillers - then cut off his financial support. Worker now has to choose between paying for house or food and says he feels retarded, has no hunger, and cant remember things. Family is afraid he will lose his mind and jump off a bridge.

- WCB sent worker to a rehab center before he had any real medical tests other than an xray. After a month in rehab, worker was worse and in pain all the time. As soon as the rehab program ended WCB cut worker off compensation. Worker appealed and lost. Eventually a doctor sent worker for an MRI - result - a fractured vertebrae, bulging disc and torn spinal muscle. Worker couldn't find lawyer so has been on CPP Disability and AISH (assured income for severe handicaps) for ten years. Worker is still on morphine and other meds and doctor believes he has developed fibromyalgia/chronic myofascial pain syndrome.

- Surgeon advised worker not to do any work until he re-examines worker but WCB disagreed and said worker could return

to work so they would not pay. Worker had no income so was forced back to work prematurely - then developed further tendon and ligament damage - now has to wear brace and requires further physiotherapy. WCB says that their statistics/records show that for that type of injury, nothing more is required from them and they ignore repeated calls from the doctor.

- toxic chemical injury claim denied twice due to insufficient evidence, yet when the injured worker investigated, the evidence was available in the WCB's own library. Claim was subsequently accepted, yet retraining in a toxic environment caused further toxic chemical injury. Claim was discontinued when 'retraining' ended. Claimant, now sicker, went bankrupt.

- suicidal depression because of direct abuse by WSIB

- injured workers feel they are being profiled as criminals for wanting WCB benefits.

- WCB case manager telling the doctor what he should do about the injured worker as if the case manager was a doctor

- permanently injured worker denied benefits because he refused to take a test that doctors said would further injure him.

- WCB psychiatric report says patient "malingering" despite two family physicians, a psychiatrist, two psychologists, a neurosurgeon and pain clinic employees all stating that worker has legitimate pain. Appeals Commission sides with WCB-employed psychiatrist whose report clearly erred on dates, history and names. (WCB doctors have "template reports" and sometimes not all the blanks are entered correctly.)

- case manager's computer notes say that worker will never be able to physically handle the job they are providing "Training on the Job" funding for - but still lets worker try anyway

- WCBs routinely working with same employer for 'Training on the Job' programs even though the employer has "laid-off" previous employees as soon as funding was finished. At least two of these employees are known to have never been able to work again.

- WCB doctor wrote note that injured worker was not to lift more than 20lbs at rehabiliatative evaluation session. Evaluation report says worker was uncooperative with self-imposed limit of 20 lbs (worker had supplied doctor's note prior to assessment).

- worker with neck dislocation injury tries to work more than a year after injury. Reaches for hammer on job site and pulls a neck/shoulder muscle. In bed on meds for a week. Worker's doctor submits report to WCB saying all due to original injury. WCB opens up new claim for this incident despite all doctors clearly stating that it is all related to the initial dislocation

- injured worker being threatened by WCB case manager with being "cut off" compensation despite being diagnosed with permanent work restrictions by specialist

- WCB cut off wage loss benefits for a multiple injury case claiming the injured worker had achieved "maximal medical recovery" yet they ignored several body areas that had not yet recovered, including a spinal injury, a head injury an ankle injury and chronic pain.

- denials or delays of months or years causing bankruptcies and other financial devastation

- WCB setting up 'bogus' companies that 'hire' injured workers so that WCB can cut the worker off benefits

- injured worker in WCB rehab facility aquasizer pool was abandoned during evacuation for gas line leak and left alone in building

- refused MRI by WCB, then worker paid for MRI with charity from family and immediately therafter was booked into back surgery

- single parent injured worker cut off benefits wrongly

- injured worker lost everything - home and truck

- rehab/pain clinic teams introduced sleeping aids - when injured worker slept in, they were cut off

- case workers making notes to their assistants predicting when the pain would plateau

- wage loss calculations based on erroneous amounts

- doctor said injured worker had to keep as active as possible, then WCB videotaped them doing tasks in their yard but failed to acknowledge the days required to recover in between activities (WCB then failed to supply videotape that was used by the review board)

- empIoyers not paying into WCB and therefore not reporting accidents

- injured workers getting phone calls during Christmas holidays threatening to cut their coverage

- WCB demanding new information the day before the due date then cutting coverage when injured worker unable to provide the information

- injured worker receiving $260 per month while raising 3 children

- injured workers and their children going through eviction from their rental accommodation when unable to pay

- injured workers having to pay for their own transit between cities for specialist appointments

- injured workers report being treated "like dogs"

- WCB refusing to pay for home care recommended by threee professionals

- northern worker forced to pay for own visits to southern specialists

- injured worker's family forced out of home with young children

- WCB selectively ignoring sections of the claims manual that would advance the worker's claim

- video surveillance used inappropriately

- WCB rules injured worker capable to return to any occupation while taking large amounts of morphine

- injured workers suffering chronic pain labelled as "uncooperative" by WCB vocational rehab operations

- payment for required medical assistance devices denied

- payment for pain medication denied

- WCB estimates seasonal worker's long term wage rate using the lowest level of employment in the year

- the raises each year for people on WCB pensions are well below the cost of living increases

- injured workers unable to get a lawyer if WCB is mentioned

- provincial human rights commissions ignoring injured workers

- restrictions by surgeon post-surgery totally ignored by WCB

- 20 year employee demoted after injury with pay decrease

- injured worker asked for time off rehab for funeral but told that WCB doesn't get paid to be compassionate

- in spite of family funeral, injured worker told to go to rehab or the WCB would cut them off comp

- injured workers being refused treatment

- being cut off required medications

- injured workers going to welfare to pay for rent and medications

- workers in chronic pain being told to go off pain medications and go back to work

- doctors refusing to deal with patients who are on narcotics for pain

- workers suddenly out of work with no income while injured and WCB still refuses any assistance

- workers being forced to return to work while in severe pain and heavily medicated without regard to safety

- seven years to get to first tribunal

- WCBs and WCB doctors manipulating and/or suppressing medical (and other) evidence

- cover-up of toxic chemical hazards causing death

- cover-up of toxic chemical accidents causing permanent disability

- specialists' diagnoses being ignored by WCB if it favours the worker's claim

- specialist's request for surgery refused by WCB doctor until the injured worker threatened lawsuit, then the WCB doctor changed his diagnosis and allowed the surgery

- injured workers being cut off compensation without notice or explanation

- injured workers having to apply for government assistance when they should be receiving workers compensation

- children suffering physically and mentally from poverty

- specialists' reports being overrruled by WCB doctors, nurses, and even non-medical staff

- workers' claim files being 'lost' or simply 'disappearing'

- compensation being denied based on fraudulent employers' reports

- employees too scared to file an accident report because of intimidation

- being forced back to inappropriate work that further injures the worker

- WCB using generic 'time tables' for recovery time, then cutting the worker off benefits regardless of the real medical situation of the worker

- inadequate, sub-poverty-level compensation

- increasing debt and bankruptcies due to inadequate compensation

- loss of homes

- divorces

- suicides

- inaccurate medical assessments by doctors who are paid by WCBs

- assessments being made on workers by WCB-paid doctors without even seeing the worker or consulting with the worker's GP.

- WCB using doctors who have been reported to the College of Physicians and Surgeons for investigation

- inappropriate use of AMA guides for assessing injury

- inappropriate (and illegal) use of impairment ratings when WCBs should only be assessing 'disability', not 'impairment'

- doctors who have lost their licenses due to disciplinary reasons doing employee medical investigations.

- physical harm caused by WCB medical examinations

- stress related conditions caused by the workers compensation process itself (examples reported - insomnia, depression, anxiety, palpitations, etc.)

- WCB refusing to compensate for these conditions because they are supposedly not 'work related'

- WCB withholding medical evidence (a criminal violation)

- WCB suppressing "core" facts and information relevant to the case

- WCB doctors falsely accusing the injured worker of 'malingering', 'being a complainer' and/or 'trying to abuse the system'

- WCB involved in 'covering up' workplace hazards for some employers

- inappropriate treatments ordered by WCB nurses without a doctor's order

- inappropriate treatments leading to further injury

- compensation cut off because of 'non-compliance' with these inappropriate and harmful treatments

- medical evaluations that have nothing to do with the injury

- inappropriate psychiatric evaluations of physically injured workers

- verbal abuse and harrassment by WCB employees against injured workers

- intimidating phone calls from WCB

- WCB failing to comply with Appeals Tribunal decisions

- inappropriate use of surveillance of the injured worker

- injured workers being told by WCB employees to 'find a job' or 'retire'

- injured workers being told by WCB to 'just work through the pain'

- discrimination against certain types of injuries (example: chronic stress diseases)

- cruel and abusive psychological treatment of injured workers by WCBs

- false billing statements (for undelivered services or interventions)

- false diagnoses

- manipulation of facts, evidence, dates, medical words and expressions

- concealment of facts and evidence

- recurrent use of avoidance or distraction techniques (such as unnecessary tests)

- multiple medical reports for the same visit/intervention

- coverup of wrongdoing that caused physical harm

- putting intentional and inappropriate emphasis on the injured worker's psychological status rather than addressing physical origins or causes of injuries

- inappropriate psychological profiling

- denegrating the injured worker's character

- WCB falsely accusing the injured worker of having a family history of alcoholism, even when this is refuted by an independent psychologist's report

- violations of trust leaving the injured worker feeling "emotionally raped"

- WCB adjudicators who disregard doctors and specialists who say the injured worker is unable to work - compensation is cut off anyway

- injured workers unable to eat properly

- feel they are "fighting for their life"

- doctors refusing diagnostic tests because they report that the worker is 'malingering' when subsequent tests show that there was, indeed, an injury

- physiotherapists refusing to do assessment because the worker is in severe pain and WCB using that to deny benefits because of 'incomplete assessment'

- employer falsely denying injury occurred and WCB believes the employer over the worker

- requests by doctors for diagnostic tests refused by WCB

- specialists recommendations not implemented by WCB

- specialists stating that premature return to work caused further re-injury and/or failure to heal properly

- WCB using generic 'time tables' for recovery time, then cutting the worker off benefits regardless of the real medical situation of the worker

- workers repeatedly forced into inappropriate psychiatric examinations for physical injuries

- being forced by WCB to do physiotherapy exercises against specific doctors orders to abstain from all activities because of a high risk of injury

- important evidence not being presented in court

- company doctors lying about the physical damages

- people being fired for trying to stand up to the company

- threatened with loss of employment, workers go back into dangerous jobs with unhealed injuries

- taking advantage of employees who only speak English as a second language to make them stay in a damaging situation

- injured employees being told they have no right to disability or insurance

- injured employees being told that their 'time has run out' even if they are still inured

- employees being told that, even if they return to their job, they will lose seniority and pension

- employers taking advantage of functionally illiterate people

- threatening the life of an injured worker's children

- injured workers having to live off the charity of friends

- injured workers having to live off the charity of religious institutions

- injured workers having "nothing left to lose"

- no recognition for over 20 years of service during which the worker was given increasing responsibilities

- inability to sue either WCB or the employer due to lack of funds or legislative restrictions

- employment situations being referred to as "sweat shops" right here in Canada

- unions refusing to help the injured worker because it is too much trouble (or other reasons)

- employers using company lawyers to manipulate and intimidate workers

Source: www.ciws.ca

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