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| WCB Home > Corporate Overview > Fair Practices Office | |
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Fair Practices Office
The fifth full year of operation for the Fair Practices Office (FPO) saw a record number of 434 complaints and inquiries received. The Fair Practices Office was established in November 2003 and operates much like an internal ombudsman. The Fair Practices Officer reports directly to the Board Members through the Chairman. The Office has one additional staff member, an Intake and Inquiry Officer. The role of the office is to listen to client concerns, provide information on how the WCB system operates and try to resolve problems. Most files are resolved at the intake level but those requiring detailed review or investigation are referred to the Fair Practices Officer. Regular meetings are held with the Board Members to review the operations of the Office and to discuss concerns or trends that have emerged. Regular meetings are also held with the Chief Executive Officer, the Vice President of Operations, the Directors, team leaders and case managers. The Office continues to receive a high level of cooperation from staff of the WCB. The vast majority of our recommendations are promptly accepted at the Case Manager, Team Leader or Director level. In a few cases, responses are delayed or inadequate and these are taken to the Executive level for review. The Office provides service to both injured workers and employers. In 2008, over 83% of our contacts were from injured workers. The initial focus is on the specific inquiry or complaint received. There is also a role to look for systemic improvements that can benefit employers or injured workers as a whole. The ultimate goal is quality service for all WCB customers. Committee of Review - 2006 Report The Saskatchewan Workers' Compensation Act Committee of Review 2006 Report made one formal recommendation with respect to the FPO: "The Fair Practices Office formally adopt, adhere to and advertise its adherence to the International Ombudsman Association code of ethics and standards of practice." The Fair Practices Officer is now an Associate member of the International Ombudsman Association (IOA) and has adopted the code of ethics of the IOA . The standards of practice for the IOA do not permit members to conduct investigations or to keep formal records. The mandate for the FPO, however, requires that investigations be conducted and records kept in order to identify systemic issues. Following discussion with the WCB Board Members, it was agreed that it would be more appropriate for the FPO to develop its own standards of practice. An initial draft has been completed and is now pending final approval by the WCB Board Members. In its 2006 report, the Committee of Review commended the Board for establishing and supporting its FPO, but concluded it was too early in the life and experience of the Office to fully assess and evaluate its contribution. The Committee concluded the Office should continue and be supported by the Board with a clear mandate, evolving authority and security of tenure in appointment. A formal WCB Board policy establishing the FPO and its authority is under review by the WCB Board Members. The policy is intended to provide clarity concerning the mandate and authority of the Office and to address the issue of security of tenure in the appointment of the Fair Practices Officer. Code of Ethics The Fair Practices Officer is a member of the International Ombudsman Association (IOA) and adheres to the IOA code of ethics, including the following ethical principles:
Comparative Statistics Comparative statistics for the calendar years 2004 through 2008 illustrate that 2008 was the busiest year to date.
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Case Histories The following case summaries provide examples of the work of the Fair Practices office during 2008. Travel expense coverage too low An injured worker called the FPO to complain the WCB was not providing the full costs of his hotel expenses while he was attending tertiary treatment in Saskatoon. The worker noted the WCB had been paying full hotel costs when treatment started, but given the housing shortage in Saskatoon, most hotels had raised their rates, and the WCB was refusing to pay the increased rates. Initial review of this file confirmed the WCB was only prepared to pay the maximum rates approved by the Public Service Commission, and these rates had not been updated to reflect recent increases. The FPO located a recently approved WCB policy that did allow the WCB to pay the actual hotel expenses. The new policy was brought to the attention of the Team Leader, who subsequently agreed to reimburse the full costs of the hotel expenses while this worker was attending treatment in Saskatoon. A short time later, the Office received a similar inquiry from another worker in rural Saskatchewan. This worker was also not receiving full reimbursement for his hotel costs. He had been referred to the FPO by another FPO client. The second worker's file was handled by a different team. Upon review of this second claim, the FPO approached the Team Leader to bring the new travel expense policy to his attention. The Team Leader agreed that the new policy did allow for payment of the full cost of the hotel expenses and an adjustment was promptly issued. These complaints were received early in 2008 with no similar complaints being received for the balance of the calendar year. Cooperative effort assists widow It is not unusual for an injured worker to have more than one injury claim, or for the claims to be in different provinces. This was the situation with one of the first clients of the FPO. This elderly worker had long term claims in both Saskatchewan and Manitoba. Over the years, he had many questions about his benefits and was in frequent contact with the FPO and the Fair Practices Advocate in Manitoba. Each province has its own legislation and the differing benefits often confused this worker. The worker had frequently expressed his appreciation to the FPO for the advice and explanations the FPO was able to provide to him. Sadly, the FPO received a referral from the Fair Practices Advocate in Manitoba on behalf of this man's widow. The man had passed away, and his widow was inquiring whether she had any entitlement from the WCB in Saskatchewan. Initially, the WCB response was that she did not have entitlement in Saskatchewan as his death was not related to his work injury. Upon review of this file, the FPO noted the man had been in receipt of long term benefits and The Workers' Compensation Act, 1979 does allow for limited benefits to a widow in this situation. This section of the legislation was brought to the attention of the staff responsible for this case. The decision was subsequently reversed and the widow was found to be eligible for benefits for a period of 12 months. Too much stress! The FPO received a call from a worker who had filed a claim for a stress injury. She felt it was taking too long for the WCB to decide whether or not to accept her claim. Initial review of this claim confirmed the WCB staff responsible for this file was actively pursuing this claim and was attempting to obtain medical reports concerning the worker's injury and past medical history. The worker had been informed about WCB policy on acceptance of stress claims. The worker's report of injury and the employer's report were both on file. Given the ongoing efforts to develop this file no recommendation was required by the FPO. A few days later, medical reports from the worker's physician were provided. Following review of this information, a decision was taken to deny the claim. The worker was informed verbally and a letter was sent to her, explaining why her claim was not being accepted as a work injury. The initial question of a delay in reaching a decision had been addressed. However, upon review of the letter to this worker, the FPO was concerned about the reasons provided to the worker and how the stress policy had been applied to the particular circumstances of this claim. The FPO approached the Team Leader and asked for a review of the application of the WCB stress policy to this case. The Team Leader agreed that the WCB stress policy had not been properly applied and confirmed the claim would be accepted. It was noted the staff involved with this case was relatively new to the position. The right to be heard One of the critical elements in a fair process is the right to present one's case and have it heard fairly. If this opportunity is denied, an employer or injured worker will have difficulty accepting that the process or decision is fair. An employer approached the FPO because he believed he had been denied his right to be heard. He had been promised an opportunity to present evidence at a worker's appeal before the WCB Board Members, but a decision was made without his evidence. Review of this file confirmed that an injured worker had appealed the suspension of his benefits, and the appeal was denied by the Appeals Department. The worker submitted an appeal to the WCB Board Members through the Office of the Worker's Advocate. The employer was advised of the worker's appeal and the opportunity to provide written representation to the WCB Board Members. The employer requested a private meeting with the WCB Board Members, or an opportunity to participate in the hearing with the worker and the worker's advocate. The case became complicated when a new advocate was appointed by the Office of the Worker's Advocate and provided a detailed written submission to the WCB Board Members. The appeal hearing was then delayed as the worker could not be located. Eventually, it was confirmed the worker had relocated and the advocate advised the WCB Board Members to proceed with the appeal. The WCB Board Members made a decision based upon the documentation on file, including the submission by the Office of the Worker's Advocate. No hearing was held with either the injured worker or the employer. The decision was to partially accept the worker's appeal. Upon inquiry by the FPO, WCB staff indicated they did not believe the worker was still requesting a meeting after the written submission was provided by the second advocate. As no meeting was held, the employer was not invited to attend and a decision was made without his input. WCB staff understood why the employer would be unhappy, but because the WCB Board Members had already made a decision, they felt the only remedy would be for the employer to file his own appeal with respect to the decision. The employer did file an appeal on this decision. He was provided a hearing with the WCB Board Members and was granted cost relief for the additional benefits that had been awarded to this worker. Fairness was restored to the process and the employer was satisfied with the outcome. Am I in the right rate code? An employer representative contacted the FPO. The representative said an employer had recently reviewed her WCB rate code and questioned whether she was in the right one. The employer had purchased the business several years ago and it continued to be listed under a rate code for services that she no longer provided. She did not want to contact the WCB directly for fear she would be accused of previously misrepresenting her business to the WCB. The FPO referred the inquiry to Revenue and Employer Accounts (REA) for further review. After review by an REA supervisor, a WCB staff member contacted the employer to confirm the nature and details of the business. Based on this new information, REA agreed to do a classification change for this employer before the 2008 assessments were sent out. Maximum wage rate Most workers are not aware that there is a maximum WCB wage rate in effect until they experience a work injury and begin receiving wage loss benefits that are lower than expected. Section 38.1 of The Workers' Compensation Act, 1979 provides for a maximum wage rate for workers injured on or after September 1, 1985. Section 38.1(d) establishes the maximum wage rate applicable on and after January 1, 2005 is $55,000 per year. Given the recent economic boom in several industry sectors, many workers are earning an income in excess of $55,000 per year. The FPO receives this complaint with some regularity. Because the maximum wage rate is established by legislation, the WCB may not adjust the rate without an amendment to its legislation. The FPO is able to confirm current legislation and policy are being followed by the WCB. The Office is unable to recommend any changes to the legislation as this is a matter for the elected Members of the Legislative Assembly. Communication restrictions In a relatively small number of cases, the WCB has found it necessary to restrict the manner in which an injured worker or employer is able to communicate with staff of the WCB. Typically, this occurs where a person has been verbally abusive or otherwise threatening in communication with a staff member of the WCB. In these situations, the person may be restricted to communicating only in written form with the WCB. Several of the people who are restricted in their communications with WCB have approached the FPO for assistance in addressing specific issues. The FPO has continued to accept telephone inquiries from these individuals and has successfully responded to these inquiries. The FPO can provide information on the status of the file or a specific payment; explain legislation and policy and direct individuals to the appeal process where appropriate. The FPO cannot become an advocate on behalf of the person with the restriction, but a referral can be made to the Office of the Worker's Advocate. The role of facilitating communication between the WCB staff and a person with a communication restriction can be a challenging one, but it can also be productive. Claims issues and vocational plans still need to be attended to, even where communication restrictions are in effect. The FPO will continue to work with this group of people to assist in the administration of their claims. The FPO insists upon respectful communication with its clients and it usually receives the same respect in return. Back to Top |
Fair Practices Office