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An important role the Ombudsman can fulfill is to clarify for
an authority the urgency of dealing promptly with a complaint.
These are situations that need to be dealt with quickly otherwise
there may be significant consequences for those caught in the
middle.
In this case Mr. O contacted us to complain that a claim he had
made to the Workers’ Compensation Board (WCB) had taken so long to
process that he had received disconnection notices for utilities
and he feared bank foreclosure on his home if funding did not
become available immediately. Although Mr. O had been receiving
wage loss income from the WCB for the previous two months, there
had been a significant delay in issuing him retroactive pay due to
the need for an opinion from a WCB medical advisor. This is the
money Mr. O needed in order to make payments on his home.
After we notified the WCB of Mr. O’s concerns, the WCB redirected
its request for a medical opinion to a medical advisor who could
deal with this matter quickly.
Within a week the WCB had received the medical opinion it
required, and proceeded to issue Mr. O retroactive payments
totaling $28,000.
WCB error leads to reduced benefits for injured man
Workers’ Compensation Board
2006 Annual Report
Mr. H complained to us that the Workers’ Compensation Board (WCB)
had acted unfairly by refusing to correct a mistake in
calculating how much disability pay he should receive. Mr. H’s
T4 slip, describing his earnings used to calculate a benefit,
was difficult to read with the result that a decimal point
appeared one place to the left. Mr. H told us that this mistake
had resulted in lost benefits to him.
When we investigated this
complaint we found that Mr. H had not asked for a review of the
original wage rate decision because he had not noticed the
error. When he noticed the mistake, Mr. H had asked for an
extension of time to have the wage rate reviewed, however this
was denied by WCB because the appeal period had expired.
We contacted WCB, provided it
with the information we had and WCB agreed to our office’s
request that it review Mr. H’s wage rate and if possible,
correct the error. WCB resolved the complaint by issuing Mr. H
retroactive benefits.
Woman upset to learn she was subject of WCB video surveillance
Workers’ Compensation Board
2006 Annual Report
We were contacted by Ms. O who was upset that the Workers’
Compensation Board (WCB) had covertly been using video
surveillance of her daily activities to assess whether or not
she was being truthful about her injury.
In addition to feeling that her
and her family’s privacy had not been respected, Ms. O felt that
the WCB had violated its own policies by not having reasonable
grounds to justify using video surveillance. We investigated
this to see if WCB had acted fairly by adhering to its own
policies regarding the use of video surveillance.
As part of our investigation, we
reviewed all file information on this case and spoke to a WCB
Case Manager, Field Inspector and Medical Advisor.
We found that in this case the
WCB had complied with its policy.
However, to ensure its policies
and procedures were clear, the WCB undertook to revise how its
substantiation for the use of video surveillance in the future
was documented.
WCB
medical assessments too much for injured man
Workers’ Compensation Board
2006 Annual Report
We received a complaint from a woman regarding the Workers’
Compensation Board (WCB) and the number of neuropsychological
assessments it was requiring her husband to take.
We were told that Mr. L had
suffered a brain injury as a result of a workplace accident. His
condition had deteriorated and he was experiencing fatigue in
part because he was subjected to so many assessments.
Ms. L complained that WCB had
not properly considered Mr. L’s condition in demanding all of
the assessments and had not consulted with their family doctor
to discuss the matter.
We discussed this situation with
WCB staff, who explained to us that in this case
neuropsychological assessments were necessary in order to
develop a proper treatment plan for Mr. L. However WCB agreed to
be more sensitive to the family’s concerns and postponed further
medical assessments for at least three months. It also agreed to
consult with Mr. L’s family physician and to provide him with
copies of WCB medical files on this case.
Ms. L notified us that her
communication with WCB had improved significantly since we
investigated her complaint and that she felt Mr. L was being
treated with more respect and was feeling better about his
situation as a direct result of these improvements.
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