July 13, 2021
OUR FORMER president of the BC Building Trades Council, Lee Loftus, was a prized member of the workers’ representatives on the Policy, Practice and Consultative Committee (PPCC) for many years.
The PPCC consists of two Workers’ Compensation Board (WCB) vice-presidents, five representatives from the employer community, and five representatives from the worker community. As the WCB’s premier consultative body, their role is to provide input and advice regarding the stakeholder consultation processes and perspectives on priority issues; identify stakeholder issues; receive updates on key initiatives; and share relevant information and concerns.
After the election of the provincial New Democrats, the Minister of Labour appointed Loftus to the WCB Board of Directors, the ultimate stewards of the WCB system. Subsequent to Loftus’s new appointment, I was nominated to take his place on the PPCC as a workers’ representative. Although it has been on the agenda for many years, the chronic pain file has recently heated up at the PPCC. That’s because the board’s adjudication of chronic pain claims is abysmal and recent medical science has unequivocally revealed this fact.
If an injured worker suffers from chronic pain, the WCB determines whether the pain is disproportionate to the actual accepted injury. To be disproportionate, the pain must be generalized rather than limited to the area of the impairment, or the extent of the pain must be greater than that expected from the impairment.
If the injured worker makes it through this “chronic pain hoop,” they will be granted an additional 2.5 per cent of total disability (i.e., 2.5 per cent of the long-term wage rate established on the claim). Given that chronic pain can be a totally debilitating condition, sometimes preventing workers from being able to function effectively in any work context, a meagre 2.5 per cent
disability award is nothing short of criminal.
But what is happening in the real world?
Lots! A new scientifically based classification of chronic pain has been developed by a task force of the International Association for the Study of Pain (IASP), and this classification was adopted by the World Health Organization in the new edition of the International Classification of Disease-11 (ICD-11),which is the global standard of disease classification.
Given this development and the myriad scientific reports addressing new methods of diagnosis, treatment, and compensation, the WCB contracted high-ranking medical specialist Dr. Williamson to review their chronic pain policies and recommend changes.
The good doctor submitted his report about a year-and-half ago for WCB’s consideration. In essence, the report found that the WCB’s current management, diagnosis, assessment, and treatment of chronic pain does not adhere to the new medical evidence. Who’d a thunk it!
Using Dr. Williamson’s findings as well as the recommendations from Janet Patterson’s New Directions: Report of the WCB Review 2019 and Paul Petrie’s Restoring the Balance: A Worker-Centred Approach to Workers’ Compensation Policy 2018, the PPCC workers’ representatives are aggressively advocating for significant changes to chronic pain policy. These changes, if successfully implemented, would create a paradigm shift (or should I call it a tectonic shift!) in chronic pain assessment and diagnosis, treatment, and compensation.
For example, in addition to advocating for pain specialists to be intimately involved in the process, we are advocating for a compensation range of zero to 100 per cent of total disability. This compensation range for chronic pain is the only logical way to fairly compensate workers. Why? Because in keeping with the Workers’ Compensation Act, the Board is legally required to compensate injured workers for their loss of earning capacity. Secondly, because all other impairments are compensated on a sliding scale as specified in the Permanent Disability Evaluation Schedule. And, finally, because the medical evidence acknowledges that a worker can be totally disabled due to chronic pain and unable to earn a wage.
By Merrill O’Donnell