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Home / Blog / Claims / Internal audit reveals extraordinarily high rate of denial of chronic mental stress claims

Internal audit reveals extraordinarily high rate of denial of chronic mental stress claims

December 6, 2018

“Workers’ compensation board denies over 90 per cent of chronic mental stress claims, audit shows” / Sara Mojtehedzadeh (Toronto Star, Dec. 4, 2018).  Since the Bill 127 amendment to the Workplace Safety and Insurance Act came into force, Ontario’s workers’ compensation board has allowed only 6% of chronic stress claims (those caused by longterm trauma or harassment on the job). According to an internal Workplace Safety and Insurance Board (WSIB) audit, just 10 of the 159 claims filed between January and May were approved.

Maryth Yachnin of IAVGO community legal clinic critiques the Board’s approach as creating unique and unreasonable barriers. Holding mental stress claims  subject to a higher legal test, the policy  requires workers to prove that their workplace was the “predominant cause” of their illness — whereas workers with physical injuries must simply show their workplace was a significant contributing factor.” Objections to the predominant cause test in the Board’s new Chronic  Mental Stress Policy (15-03-04) were raised last October in a letter to the Premier by a coalition of 12 clinics and private practice lawyers

The low number of claims may indicate workers are finding these barriers insurmountable. The IAVGO lawyer further suggests that if the Board’s ‘auto-denial’ deters claims being filed, the workers’ compensation system fails to function effectively. The true extent of health and safety risks remains unidentified, while employers will lose the financial incentive (of avoiding increased premiums due to high injury rates) to address those risks in their workplace.

Employers can harass with impunity?

In his commentary on the Star’s ‘bombshell revelation’, lawyer Antony Singleton provides further analysis of Board practice and policy as a step backward, especially for vulnerable workers.  (“Ontario: Open for Harassment”, Just Compensation, Dec. 5, 2018 ).  While Bill 127 finally restored, after a 20-year struggle, the right for workers suffering psychological injuries arising from employment to be protected by the workers’ compensation system, the WSIB’s new stress policy imposed significant threshold restrictions not in the legislation. With the WSIB’s 2017 claims denial rate for all injuries standing at 22% , the extraordinarily high 94% denial rate for chronic stress claims raises questions of systemic discrimination – and leaves employers virtually free from the costs of mental injury claims. The author calls on the Board to change how it adjudicates such claims, rather than leave itself open to Charter or human rights challenges.

Filed Under: Claims, Mental Health

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