I have received a variety of letters condemning high handed techniques by WCB. I read the letter below with a sense of sadness. I can’t imagine the desolation involved in living with chronic pain and dealing with the system. I hope this gives it a voice. It has left me with much to ponder. What is wrong with Saskatchewan and medicine in general? What can be done?
“I have read your website from start to finish. It truly amazes me with all the information you have provided. As an injured Saskatchewan worker, I ask why Sask WCB would not provide some of these tests for me. I have been returned to work on numerous occasions in severe pain and on naracotic meds that made my job dangerous not only for me but the general public.
Due to my injury not being fully diagnosed, and WCB convoluting the medical evidence of injury, I suffered further injury which went undiagnosed for a further 2 years. I only wanted to work so I could support my family, this has resulted in me becoming frustrated, angry and disgusted with almost everyone. My family has now lost their main source of income, the stress is monumental.. have been plunged into multiple WCB appeals and am tired of the mental games that WCB intentionally inflicts on injured workers, (it seems that the injured workers needing the most help are denied) my injuries are real, however WCB discounts the severity and when they receive a report from a specialist, they twist and rewrite the report to downplay the severity of the injury, this is just ridiculous, and is borderline criminal.. Throughout this whole nightmare that I have been made to endure, never once has WCB stated that they were wrong or that they were sorry, they have finally admitted to some of the injuries but continue to discount others and are now again trying to force me into a physiotherapy program, which yes I need, but cannot do if all my injuries are not being treated…This is unacceptable as I cannot do these exercises without causing further injury…in physiotherapy I tried to get these problems addressed and was told that I’m not here for these injuries, only the ones that WCB has accepted! So we are again at a mexican standoff…me needing help, WCB wanting to progress me through a physiotherapy program that will further injury me..I guess this is where a Attorney is needed, however as an injured worker with basically no money to hire an Attorney I am left at a distinct disadvantage……
WCB knows full well that they have the upper-hand and if I refuse to bend to their wishes they can just cutoff my benefits and plunge me into another round of appeals, again delaying medical treatment, diagnostic tests, and so-forth.. At this point, I am frustrated/angry/disgusted nothing is being done for my benefit,, everything that is being done, is for WCB’s benefit..YES, I want to work, NO, I don’t want to suffer further injury.
I am already on pain meds, that have had to be changed 3 times as they have lost their ability to quell the pain..I am in chronic pain and KNOW what needs to be done, HOWEVER, WCB continually and intentionally avoids addressing these issue’s.. It is a sickening run-around, that has left me without help on many occasions.. I just want to be fixed as best as I can so I can have some kind of life.”
I see some of the problems as being:
1) Opioids don’t cut it – There are some that use only opioids for chronic pain. During the days when opioids were “taboo”, I was using a variety of orthopedic medicine techniques and injections. This would give relief for some, though I have a resistant group of chronic pain sufferers that it only helps temporarily. When I started using opioids, I thought I would not have to treat the resistant group anymore. I was wrong. Opioids maybe give 20-30% relief but it is a far cry from “better”. These subjects would return for more work. Their over-reliance on opioids as a treatment platform does not give acceptable results in chronic pain. Exercise as treatment platform by itself may not do much if a prior bulletin posted here is accurate.
2) Need coordinated help and access to useful drug agents – There are a variety of techniques and procedures for chronic back and post-laminectomy syndrome pains. These are often unreachable because there is no pain clinic in Regina to coordinate such efforts. This is combined with the fact our drug plan and hence private group medical plans will not cover many of the medications required for aiding people with chronic pain. The latter has resulted from very poorly documented benefits of some useful agents. Going into that would take a whole review in itself.
Point is, there is need for a multi-disciplinary (many different facets need to be treated) pain clinic here and given that 1/5 – 1/3 people live in chronic pain, I believe the government needs to come forth and promote this. Others and I are hoping to lobby the drug plan (though more likely to get results from the government) to get access to some of these “experimental” drugs they will never cover because drug plan money was diverted by our last election posturings.
3) Lack of Medical Advocacy – Our worker’s advocate I feel has been rendered impotent by its lack of medical expertise to counter suppositions like “nothing was found [because we didn’t do much except an MRI]”. They also, I suspect, don’t have the manpower to handle the caseload. The patient is supposedly given the benefit of the doubt but it seems this wears thin after a while.
4) Stanford Prison Experiment alive and well –
This experiment is in all the psychology and sociology textbooks. In 1971 a simulated prison was ran where half the volunteers were prisoners and half guards. This got way out of line as the guards became suspicious and sadistic and the prisoners distraught and depressed.
- people working with insurers deal with people who are angry and demanding; this does not allow any job satisfaction = stage 1 burnout.
- This could very quickly lead to a degree of burnout where people can become treated in an alienated fashion. – “depersonalized.” = stage 2 burnout.
- Also, I have an expression – “once you’ve seen a faker, everyone looks like a faker”. Chronic pain is unmeasurable and often undocumented; it would be very easy to become suspicious of every WCB case. This leads to a situation called “adversarial help” which may be worse than no help at all.
5) No option but to go back to the old job? (NOT referring to this case)
I have seen patients return to a recurrently injuring job “because it pays so well and has benefits” rather than take initiative and find a new line of work, often requiring retraining. People in chronic pain are often too poor and ill able to do any retraining. WCB has said that is not their mandate to retrain – theirs is only to return the subject to their former occupation.
There needs to be political initiative to make this happen. Rather,however, there is a prevailing attitude that chronic pain is the patients fault – they are too deconditioned (not true), to fixated on their pain (others would be too if they, for instance, sat on a tack all day), too emotional (chronic pain and lack of sleep does wear you down) and so on. It should be expected by a certain point, certain people will become unable to do certain jobs and initiatives in place to move people over to less demanding jobs as a matter of course. If this is not part of WCB’s mandate, it will take political will to make it so.
Obviously, people in the system will see it better than I ever will. I would be interested in helpful suggestions…. nike thea schwarz nike thea schwarz