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Fair Practices Office
The fourth full year of operation for the Fair Practices Office (FPO) saw a record number of 401 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 2007, over 90% 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. The work of the office is driven by complaints received. Communicating awareness of the office to potential customers is an ongoing priority. Enhancements in 2007 to the WCB website made it easier for injured workers and employers to access information about the Fair Practices Office. Revisions to the Information for Workers handbook were completed and now include the Fair Practices office. A new publication, "A Guide to the Saskatchewan Workers' Compensation Board for Business", includes a section on the Fair Practices Office. The office participated in Compensation Institute in Saskatoon in March 2007, thereby increasing awareness of the office for all who attended. Communicating awareness of the Fair Practices office within WCB is an ongoing initiative. The Team Support unit worked with the office to prepare a case manager training package that is now available to both new and existing staff. The training package provides information about how the Office works as well as some proactive suggestions for avoiding problems with clients. In addition, a presentation was made at the annual WCB Vocational Services Conference in Waskesiu. To be effective, the role of the office must be understood by the staff of the WCB. The 2006 Committee of Review concluded that the Fair Practices office should continue and be supported by the Board with a clear mandate, evolving authority and security of tenure in appointment. The Committee recommended that the office "formally adopt, adhere to and advertise its adherence to the International Ombudsman Association (IOA) code of ethics and standards of practice". An application has been made for membership in the IOA. The code of ethics for the IOA can readily be adopted by the office. The standards of practice for the IOA would not allow for the office to conduct investigations as required by our mandate. A modified version of these standards will be presented to the Board Members for approval. The office is a member of the Forum of Canadian Ombudsman (FCO) which includes membership of all provincial ombudsman offices in Canada. Participation in conferences and training sessions sponsored by the FCO and the IOA assists the office in maintaining a professional perspective on our work. Networking with our counterparts from other jurisdictions assists in developing new strategies for being effective and proactive in our work. Comparative Statistics Comparative statistics for the calendar years 2004 through 2007 illustrate that 2007 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 2007. Decisions in writing Section 49 of the Workers' Compensation Act requires that "where the board is unable to determine an issue in favour of the person claiming compensation, it shall provide that person with written reasons for its decision." It is generally accepted within WCB that this expectation applies to all decisions where a benefit is either denied or reduced. A number of complaints received by the office involve either a delay in providing a written decision, or the absence of any written decision on a particular topic. Injured workers (or employers) find this very frustrating as they often do not understand why the benefit was denied. They may have been given the decision verbally, by phone or message manager, but until the written reasons are provided, the person may not understand the rationale for the decision. Fair process requires that a person be given an opportunity to provide his/her own information and to challenge the information in the decision maker's hands. If the written reasons do not take into account information that the worker has in his possession, there may be grounds for reconsideration or a formal appeal. The worker may also be able to supply additional information. Timely written decisions, with reasons, are an integral aspect of treating customers with dignity and respect. They are also essential to conducting business in a fair, open honest and professional manner. Notice prior to overpayment recovery Sections 115.1 and 115.2 of the Workers' Compensation Act provide WCB with the authority to collect overpayments to a worker or dependent. Overpayments can and do occur for a variety of reasons, often due to innocent error or oversight. Once WCB becomes aware of the existence of an overpayment, policy requires that the WCB notify the worker and recover the overpayment. In a couple of examples, recovery of the overpayment commenced immediately upon verbal notification that there was an overpayment. In one case, notice had been left on an answering machine and the cheque issued the following day was reduced by 30% due to overpayment recovery. This worker had automatic withdrawals taken from his bank account and ended up with NSF charges due to his inability to notify his bank or make alternate arrangements due to his reduced payment. The worker was extremely unhappy with his case manager and now several weeks later, a difficult working relationship remains between the injured worker and the case manager. The overpayment recovery procedure does allow for recovery as early as the first payment period after the initial verbal notice to the debtor. This same procedure, 01/2002, also provides for a demand letter that sets out the particulars of the debt, repayment options and a response within one month from the date of the letter. This procedure is confusing and contradictory. Concerns were submitted by the Fair Practices Officer to the Corporate Policy branch as the overpayment policy and procedures are currently under review. Discussions have also taken place with team leaders and directors to stress the importance of providing advance notice, preferably in writing, prior to commencing recovery of an overpayment. Treating people fairly is essential if WCB is to maintain an effective working relationship with its customers. Injured workers should be given adequate notice prior to any reductions in their payments. 07-333 - Oops, we missed it! The FPO received an inquiry from a worker who was upset with a decision to estimate his earnings. The worker had been receiving WCB benefits for a number of years related to a leg injury and had recently completed a retraining program. Further medical treatment had been recommended for the injury but the worker was unable to attend this treatment due to complications from a non-work related medical condition. Until the worker had medical approval to attend medical treatment for the work injury, the worker was estimated capable of working at a job he had been trained for. After a review of the file information, the FPO noticed that a specialist letter had been received, allowing the worker to attend this treatment. However, this report had come on file with a large volume of hospital reports and had been overlooked by WCB staff. This was brought to the attention of the Case Manager. The worker was placed back on full wage loss benefits pending attendance in treatment for the work injury. 07-98 - Good communication is always important A worker called and was concerned with the lack of vocational planning on his file. This worker had undergone three surgeries and was left with permanent work restrictions and could not return to his former job. Unfortunately, the lack of communication between the worker and WCB resulted in missed appointments and delays in receiving educational transcripts and medical records. The FPO was able to facilitate communication between the worker and WCB and encouraged clear expectations and a vocational plan. This resulted in WCB approval for additional vocational testing and the worker providing the necessary information to be reviewed. The worker has now found alternate work within his permanent work restrictions. 07-278 - Relationship Problems Some of the injured workers who contact our office report communication or relationship problems with staff of WCB. We can often work with the client and the staff involved to try to repair or improve the relationship. In some cases, we will suggest written commitments to re-assure the injured worker. In one case, a former client of our office called to request assistance of an unusual variety. He was being asked to sign an Individualized Vocational Plan (IVP). The purpose of the IVP is to outline the training program that WCB is sponsoring, including the costs and time lines for completion of the training. It outlines the responsibilities of both WCB and the injured worker. It is an important document and it is signed by both parties as a sign of their commitment to the training. As a result of his prior dealings with WCB staff in the past, this worker was fearful that WCB would not honor its training commitment to himself. The worker requested that the Fair Practices Officer be present for the signing of the IVP document. I obtained the consent of the WCB staff involved and agreed to participate in the meeting as a neutral observer. The meeting proceeded professionally and the IVP was signed by the worker. It is now several months later and the worker is progressing very well in his studies. The relationship with this worker has improved. The actions taken by the FPO in this case were unusual, but helpful in the situation. Back to Top |
Fair Practices Office