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Home / Blog / Benefits / Pre-existing conditions : WSIB trimming the bottom line?

Pre-existing conditions : WSIB trimming the bottom line?

October 27, 2016

“Looking for fairness, not cash for life” – 54-year-old Dan O’Connor’s 19-year career as a paramedic ended 3 years ago after a workplace lower-back injury. Deemed as having reached “maximum medical recovery” by the WSIB, this recipient of a service award from the Governor-General has tried 4 times to return to work, following rehabilitation and surgery and despite unremitting pain which made even retraining for a computer job unbearable. In what his doctor Terence Woods calls an evolution of the original injury, the pain has migrated to his neck and legs. Labelled “unco-operative and continually complaining” in an August 2015 letter from the Board, Mr O’Connor was denied compensation for symptoms other than those associated with his lower back vertebrae, with the claim by the Board that they were caused by pre-existing conditions.

In following-up with the Board, Dr Woods says bluntly his medical concerns were ignored and his questions “dodged and deflected”. He asks the key question: if his condition is pre-existing, how was he able to do his job effectively for almost 20 years?   “I can’t help feeling that Mr. O’Connor is being almost persecuted, with devastating consequences.”

Mr O’Connor’s plight led off Tuesday’s CBC Radio Ontario Today programme on the WSIB and its policy on pre-existing conditions [podcast no longer available online]. His story and those of others who called in to the show were all too common to Maryth Yachnin, lawyer with the IAVGO community legal clinic. She traces the increasing use of degenerative disease and other pre-existing conditions in denying benefit entitlement back to WSIB President and CEO I. David Marshall’s 2010 appointment with a mandate to reduce the unfunded liability. However in pursuing its cost reduction strategy, the Board and government have violated both their promise not to achieve full funding on the backs of injured workers, and a key principle of workers’ compensation – the “thin-skull principle” that one takes a worker as one finds him or her (that is, the Board cannot consider any pre-existing conditions unless they were already debilitating the worker before the workplace injury). As noted by physician Michel Lacerte, critical of the Board’s application of the policy, everyone over the age of 40 has some degeneration of the back and neck.

In profiling the case of another paramedic, Mark Winegarden, the Toronto Star found that since 2012 approximately 80% of appeals by injured workers to the Workplace Safety and Insurance Appeals Tribunal (WSIAT) over claims denied for an alleged pre-existing condition have been successful. In waiting to achieve some justice, however, many will have suffered irremediable financial losses and stress.

Note: WSIB President Tom Teahan will be featured on CBC’s Ontario Today next Wednesday at noon.

Learn more:

  • Fagan, Laurie. 2016 Oct. 26. “WSIB slashes injured Pakenham paramedic’s compensation: Dan O’Connor ordered to resume training after insurance board pins blame on ‘pre-existing conditions’ ” (CBC News Ottawa)
  • Bresnahan, Robyn. 2016 Oct. 26. “WSIB worker: How thousands of Ontario workers are seeing their benefits cut because of pre-existing conditions” (CBC Ottawa Morning) – podcast

Filed Under: Benefits, In the News

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