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.”
My comments:
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 –
http://www.prisonexp.org/
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.
Consider:
- 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….
This is what an injured worker has to contend with, Saskatchewan WCB Regulations:
JURISDICTION
Jurisdiction
22(1) The board shall have exclusive jurisdiction to examine, hear and determine
all matters and questions arising under this Act and any other matter in respect of
which a power, authority or discretion is conferred upon the board and, without
limiting the generality of the foregoing, the board shall have exclusive jurisdiction
to determine:
(a) whether any condition or death in respect of which compensation is
claimed was caused by an injury;
(b) whether any injury has arisen out of or in the course of an employment;
(c) the existence and degree of functional impairment to a worker by reason
of an injury;
(d) the permanence of a functional impairment resulting from an injury;
(e) the degree of diminution of earning capacity caused by an injury;
(f) the average earnings;
(g) the existence of the relationship of any member of the family of a worker
and the degree of dependency;
(h) whether any industry or any part, branch or department of any industry
is within the scope of this Act and the class to which it is assigned;
(i) whether any worker is within the scope of this Act.
(2) The decision and finding of the board under this Act upon all questions of fact
and law are final and conclusive and no proceedings by or before the board shall be
restrained by injunction, prohibition or other proceeding or removable by certiorari
or otherwise in any court.
(3) Notwithstanding subsection (2), the board may reconsider any matter that it
has dealt with or may rescind, alter or amend any decision or order it has made.
1979, c.W-17.1, s.22; 1980-81, c.98, s.5.
Doctor, the assault is continuing against me and my family, have no doubt that WCB wishes that I am DEAD…as stated before…they only care about money their bottom line, (millions of dollars in the bank)
I have written to the Premier Calvert and Wall, the Ministers of Labour, NDP and the Sask Party, Ministers of Justice NDP and Sask Party, all reply’s that I have received are, (We can not intervene as WCB is set up as an ARM’S LENGTH ORGANIZATION.)
Where am I supposed to get help from, I received letters from Sask Health stating that they would not treat me as MY INJURIES are the responsibility of the Saskatchewans Workers Compensation Board….
This is just mind-boggling for an injured worker who is only trying to get help for his injuries, You are correct when you have written that opiates only quell 20 to 30 % of the pain, needle point injections do work but only offer relief for short periods and if aggravated injury becomes incapacitating
The WCB Assault on my HEALTH is being continued by a CASE MANAGER at SASK Workers Compensation Board Employee who is acting with malice, and has proven beyond a shadow of doubt that they do not have my best interests at heart.
FYI: When previously sent to Specialists all information regarding my injuries has not been provided, therefore HOW IN THE HELL can an informed decision be correctly reached? I am suffering 24/7 in chronic pain.
I am not a FAKER or a MALINGERER as WCB and some Physicians have portrayed me as, I presently have a physician who has referred me to a neurosurgeon and WCB will not expedite this appointment, they only seek to DENY me recovery for my work injuries. WHY? Because….there is no respect for the injured worker! Injured Workers are considered a liability and as such, a drain on WCB FUNDS.
I have been informed by WCB case manager that when I get into Physiotherapy the therapist will diagnose my injury? This is just ridiculous, and is paramount to saying that
these individuals are as well trained as Physicians and Neurosurgeons, and as previously stated when I had complaints and tried to get HELP, they were cast aside as could not address due to WCB having SEC 22. and their DENIAL of the injury.
I have been forthright with WCB from the get-go, they have broken many TORT LAWS and do not even follow their own legislation if it stands in the way of BOOTING an injured worker off claim…the way I have been treated by WCB is unreal…returned to my job against my Physicians wishes numerous times…
Look at this SEC. in the WCB Regulations:
Compensation for injury
28 Where, in an industry, a worker suffers an injury, he is entitled to compensation
which shall be paid by the board out of the fund.
1979, c.W-17.1, s.28.
Presumed out of and in course of employment
29 Where an injury to a worker arises out of his employment, it is presumed that
it occurred in the course of his employment and, where the injury occurred in the
course of his employment, it is presumed that it arose out of his employment.
1979, c.W-17.1, s.29.
WCB does not follow these Statutes or Acts if it supports the injured workers claim for benefits.
If you are injured at work, the employer can derail your claim, and even cause you to lose everything by stating that they believe that it is not a work injury.
Injured Workers are not given the benefit of doubt, this is an adversarial system designed to DENY the injured worker their health recovery.
WCB CASE MANAGERS are only to glad to help with the DENIAL of the injured workers claim, and actually act in a malicious fashion designed to DENY the injury claim.
This will all come out in 2008 as I will be seeking JUSTICE in Queens Bench Court. I have been to pushed to HELL and BACK from SASKATCHEWAN WORKERS COMPENSATION BOARD.
Dear Doctor:
I am desperately writing to you for advice, I suffered a multiple work injury which has not been fully recognized or treated and has left me in chronic pain. I am starting to fall into depression. I think about death as a way out of pain and a chance for my family to once again have a normal life. I cannot talk about my injuries as my family freaks out when they hear me mention WCB. My children cannot understand why their Dad cannot do things that we did together in the past. My friends and relatives constantly put me in positions that cause me pain, it is very hard for them to understand that I cannot sit for any length of time, and need to lay down for relief. My injuries are not recognizable as they are not visible to the naked eye, or even when I am naked. WCB is constantly trying to reassess the injuries that they have accepted, so that they can give me the boot off benefits. I would love to be at work, any job, however when you only sleep for 2-3 hrs. and then awake in pain, you are always exhausted. I recently started to take sleeping pills again to make me stay asleep but still awake in pain, but have had some success, as it is easier to get back to sleep. However the side effects leave me in a fog for several hours after awaking. I’ve tried to cut back the sleep meds but again end up exhausted from sleep deprivation. The stress that WCB has created for me is monumental and is hindering any recovery, it is a mental torture and leaves me exasperated. I cannot even look at my file anymore as it makes me sick, that I trusted so many with my recovery. I asked my physician for a referral to see a psychiatrist, hoping that this might be of help. He doesn’t think this is needed so I will not push for this help anymore. I would like to send you all my claim information ASAP, for your opinion as I want to go to the USA, maybe the Mayo Clinic or somewhere else that you might know about, my current physician has been extremely helpful, and knowledgeable in making me understand my injuries, however, WCB specialist’s reports are filled with inaccuracies blatantly made to minimize and marginalize my injuries. I have just read the latest report entered in my file and cannot believe that a professional specialist would stoop so low as to write about me and my injuries with such vile innuendoes. How can they look me in the face and say one thing and then write a report to WCB that is sent to my Primary Physician that they know is untrue and complete hogwash. I know you have a BIG heart as I have seen what you wrote about my entry here at ciws.ca…. I know that I may be in pain for the rest of my life, on meds that cause my brain to be fuzzy and in a fog, but I am determined to never give up and to try for a better life.
I found your blog via Google while searching for pain relief and your post regarding WCB troubles – What Needs to Be Done? looks very interesting to me. I have seen many sites before and most of them do not look this good. I cannot wait to let my friends know about this site. Thanks for the excellent content.
I found your blog via Google while searching for living chronic lower back pain and your post regarding WCB troubles – What Needs to Be Done? looks very interesting to me. I always enjoy coming to this site because you offer great tips and advice for people like me who can always use a few good pointers. I will be getting my friends to pop around fairly soon.
I found your blog via Google while searching for severe back pain and your post regarding WCB troubles – What Needs to Be Done? looks very interesting to me. I have a few websites of my own and I must say that your site is really top notch. Keep up the great work on a really high class resource.
Hi Bruce,
My heart goes out to you, because I walk in your shoes as well. And maybe hundreds if not thousands of people with back injury and the wsib or wcb. When I read your letter , I thought that it was my thoughts, my life you were talking about. The best of luck buddy, hang in there, we will get through this, praying helps, ask for knowledge from god, he has more answers than I compensations board.
Thank-you Ruth for your reassuring and comforting comments, I do ask Our Heavenly Father for his guidance and pray everyday to Our Saviour Jesus and our Sacred Mother Mary. Living in chronic pain is a challenge, that has changed my personality, many times I have wanted to throw in the towel and give my Sweet and Loving Wife a chance to live and laugh again. It leaves me in tears to think that she still loves me and has stood by me throughout this Horrible Nightmare.
I feel like a coward for NOT being brave enough or having the courage to end this nightmare. This feeling isn’t easy to talk about with anyone, especially my loving wife or children who have suffered immensely due to my situation.
I don’t know why Our Heavenly Father sent his ANGELS to save me and HELP me in my time of need, but am a firm believer that he has a plan for me.
GOD-BLESS the writer of this column for he has given HOPE to many with the information he has provided. Without this column Pain Medical Muse many of us would have also given up our fight to regain our HEALTH.
GOD BLESS YOU DOCTOR, AMEN
Thank-you Ruth for your reassuring and comforting comments, I do ask Our Heavenly Father for his guidance and pray everyday to Our Saviour Jesus and our Sacred Mother Mary. Living in chronic pain is a challenge, that has changed my personality, many times I have wanted to throw in the towel and give my Sweet and Loving Wife a chance to live and laugh again. It leaves me in tears to think that she still loves me and has stood by me throughout this Horrible Nightmare.
I feel like a coward for NOT being brave enough or having the courage to end this nightmare. This feeling isn’t easy to talk about with anyone, especially my loving wife or children who have suffered immensely due to my situation.
I don’t know why Our Heavenly Father sent his ANGELS to save me and HELP me in my time of need, but am a firm believer that he has a plan for me.
GOD-BLESS the writer of this column for he has given HOPE to many with the information he has provided. Without this column Pain Medical Muse many of us would have also given up our fight to regain our HEALTH.
GOD BLESS YOU DOCTOR, AMEN
I can only talk of myself: when I juried low back my Dr. during about six weeks I only was given x-ray’s and medication plus theraphy for the 12 MSA the treatment was laying on a bed with pillow under back of knee, i tryed to work with the nerve root problem that he never once imformed me I had, the injury happened Nov. 1981 Feb. 1982 when I first heard of a Cat Scan was on the new TV and newspaper it read WCB has C-Scan at Richmond office and will be used to stop fraud claims, I immediatily asked my Dr. to send me for C-scan Dr. did send me but never received Scan while at WCB, I was there 3hrs. aday for 3 days i never saw anyone that related to medical problems than I was interviewed by an adjudaciator that said I was to return to work, I asked what of the appointment for C-scan, see your Dr. he said, I saw Dr. right away and told what took place at WCB he told me to make another appointment, i saw him few days later meanwell I had received letter from WCB I took it to the Dr’s appointment on arrival I was told Dr. would not be seeing me anymore. I worked for CP Rail and I had all the insurance and yet this Dr. made sure I didn’t get the medical help that was needed. I immediatily found another Dr. who confirmed I had herniated disk with nerve root damage. My point I am trying to say is that My Dr. destryed my Claim you have to ask ones self Why. I know why now
i was hurt by a patient in 2004 and ended up with a total knee replacement. i have been diagnosed with ptsd. wcb has told me the injury was only a disruption to the knee surface, that the pt was sedated so i can’t possibly have pstd. that i was abused as a child. was promiscuious, a drunk, do drugs, and that my quality of life is not there problem. i have appealed through wcat and still been turned down because they only take the word of their hired psychiatrist. i have lost my home and all my belongings. i am now living with my daughter. is there any other avenue open to me now in b.c that you know of.
After reviewing my WCB file; (likely 100,000 pages;
I found;
1. WCB withheld x-ray report from assessment team;
2. WCB sent falsified x-ray, doctors report to assessment team;
After requesting copies of summary documents used at board members appeals;
Which WCB denied me, I hired an attorney to get them, that took 8 months;
(Summary Document is supposed to be a chronological history of claim file;
supposedly compiled from claim file)
I found deliberate lies and falsified entries by wcb;
The board members read the summary document then adjudicate the claim, without the injured worker being allowed to examine or know what is even in the summary document;
WCB sent falsified info to WCB medical consultant; Changed the diagnosis of injury to represent a total different injury which requires totally different treatment;
Everytime I catch WCB in a lie, they spew more lies to cover-up their previous lie;
After requesting wcb to change the falsified info, they refused, I requested WCB send me a letter with the corrections, they refused;
I asked wcb to send their medical consultant a corrected letter with real medical info, not the bogus crap they sent; they refused;
These WCB creepy people are not getting away with this crap any longer;
—————
Dear downed worker:
What I find disturbs me most is:
– although the patient is supposed to be given the benefit of the doubt, if ONE consultant, usually one that hasn’t actually touched the patient, says there is nothing wrong, then it is the tendency for WCB to deny a claim. A Consensus of opinion by a tertiary group that has no inkling of myofascial pain doesn’t make things any better.
– With benefit of doubt legislation, the opposite must be true – if ONE doctor says there is a problem, then that should be considered enough to continue coverage.
– The law stipulates WCB is immune from persecution which helps propagate abuses. Having said that, I believe WCB could be an extremely stressful field for a caseworker , and removing that safety net would make it impossible to operate. I doubt that a helpful caseworker could last more than one year. The expression “Once you seen a faker, everyone looks like a faker” would in itself burn case workers out. Frankly, I think case workers should be taken out of the field after a week and when started, not lectured that cost containment is their primary target.
– A separate ethics committee, not funded by WCB, needs to be in place. We do have a worker’s advocate – but I believe it is impotent – has no power, no medical expertise to make a strong case, and thoroughly overwhelmed by number of complaints.
-I feel for cases, that are first victimized by their injury, and then re-victimized by the case worker system. Once chronic pain centralizes, there is less chance of it going away, and vicitmization, with its rejection, worry, and anger substrates, will insure that never happens. Case workers, however, naturally assume the pain should go away and summarily discharge victims after a certain period of time.
– At one review of WCB, I contended specialists were really down on chronic pain patients – if there is nothing operable or no joint requiring work, then there can’t be anything seriously wrong with the patient. Several supreme court cases in Canada have contended otherwise and that chronic pain of unexplained nature does exist, but their findings are ignored.
-The review committee, to my shame, corrected me – it was family doctors that were the worst offenders – and I can see it – if people haven’t obvious pathology the are treated poorly they must be fakers- unfortunately:
-only 1/10 subjects with gross radiculopathy including numbness , muscle weakness and reflex loss will show up on MRI:
People With Longstanding Lumbar Nerve Root Problems Have “MRI Invisible” Lesions
http://painmuse.org/?p=594
and people with leg neuropathic pain don’t image either:
Primary Care Back and Leg Neuropathic Pain (thought sciatic) common. – MRI, and Straight Leg Raise Useless.
http://painmuse.org/?p=1365
And this is worse in the neck…
Also, family doctors will assume if someone does not get better, that it is a psychological pain. Well they are partly right – chronic pain imprints pain memory on the brain and that does not seem to be erasable but these subjects are not nuts. There are plenty of studies taking the poor copers (poor coping cases often have a mood disorder) with chronic pain and shown in “end stage settings” where they tend to accumulate, that there are major psychological issues. This does not represent the typical chronic pain patient. However, you would have to be crazy, not to realize it will make you depressed to be in chronic pain [did I just say that?]…
– It is said that in countries like India, opioid use is less because people expect pain to be their lot in life (sort of like the Russian saying – if you wake up and you are not in pain… you are dead). Sadly, radical acceptance of pain is necessary… “life sucks but that is ok because I can make the best of it”.. just don’t ask me to do it – fortunately there are more and more coping programs – even online – and I would appreciate people writing in their favorites for us – and what meaningful things helped them..
My heart goes out to you all – never think that nobody cares but it may take digging to find others who is not burnt out… Please seek out chronic pain groups – it can be such a relief to find others.
-admin