Can You Count on WSIB?

It is a scary thought for Ontario workers: the idea that the WSIB might not have enough money in reserves to pay out all potential future claims. For many years, WSIB has been operating with an unfunded liability (UFL) in the billions, but the Board says it’s now close to eliminating that deficit — years ahead of schedule, to boot.

Good news, right? Not when you consider how the WSIB got to this point.

Since 1999, the WSIB’s revenue (from employer premiums and investment returns) have fallen short of covering the full funding costs of the system. In 2012, the province passed legislation saying that the WSIB must eliminate its debt by 2027. This resulted in WSIB premiums being “artificially high”, something that workers’ organizations acknowledge as a regrettable but necessary step.

But groups like the Ontario Construction Employers Coalition (which is made up of 30 associations representing more than than 7,400 small, medium and large Ontario businesses and over 125,000 skilled tradespeople across the province) say that employers won’t be able to tolerate this level of over-collection much longer.

The reduction in WSIB’s UFL is not just due to aggressive collection of premiums. The Board purports that a new focus on recovery and return-to-work programs, investments in healthcare treatments, technology and improved processes all contributed to the decrease in UFL. The WSIB says these steps are working so well that they anticipate being free of debt five years ahead of schedule.

There is another part of the picture that has not received as much attention as it should. Workers compensation lawyers have seen up close what the WSIB’s aggressive plan to eliminate the UFL has cost injured workers, as benefits have been rolled back, and systems put in place to make benefits as difficult as possible to obtain.

For example, it has now become routine for WSIB to overrule workers’ own physician recommendations. In fact, last November, a group of healthcare professionals held a press conference to raise public awareness of this practice, releasing a report called Prescription Over-Ruled: How Ontario’s WSIB Systematically Ignores the Advice of Medical Professionals.

The WSIB also implemented an insurance model for claims adjudication. It says that the reason for the recent sizable reduction in benefits paid out is due to better working conditions resulting in fewer accidents, and better healthcare and return-to-work programs for injured workers. The truth is that they embrace the same culture of claims denial as the auto insurance industry.

Meanwhile, injured workers pursuing appeals at the Workplace Safety and Insurance Appeals Tribunal (WSIAT) face unacceptable waits for their hearing dates, which have more than doubled from a 6-month wait in 2010, to a 17-month wait in 2015.

According to MPP Taras Natyshak, “I say that strictly from the sheer volume that we see coming to our office in terms of injured workers, who are in crisis mode . . . people are falling through the cracks. We get calls all the time — non-stop — and it is not getting any better.”

Despite the rosy picture that the WSIB paints, the system is a disaster. UFL levels are not a representative or accurate measure of how well the WSIB is serving injured workers in Ontario.