Thank you, Mr. Speaker.
Conflicting Medical Opinions
A good deal of discussion during our public hearings centred on the role of the medical advisors in the workers' compensation system, and in particular on what happens when their opinions conflict with the opinions of outside physicians. As the workers' advisor told us, the issue of "objective medical evidence" accounts for about 60 percent of his caseload. It is also a factor in many of the WCB's long-unresolved claims.
As the report states at paragraph 157, "the medical advisors' views carry considerable weight with caseworkers, claim managers and the Review Committee. In addition, the Appeals Tribunal considers the medical advisors views to be important evidence." The committee heard that the WCB routinely accepts the assessments of its medical advisors, who, they argue, are experts in what causes injuries, over the assessments of one or more specialists. Many injured workers find this especially difficult to accept, as often the WCB's medical advisers will make an assessment based on the file alone, without conducting a physical examination of the worker. Medical advisor Dr. David King explained to us that he and his colleague are able to provide objective evidence of the possibility of a claimant's injury being caused by his or her workplace based on reviews of scientific literature. In Dr. King's view, this science-based evidence should be given more weight than personal or professional opinions. The workers' advisor challenged this method, which, from his perspective, also contains a frailty in that examinations of scientific literature may be as subjective as clinical evidence; for example, more emphasis may be placed on some studies than others.
If there is one area of common ground among those involved in this process, it is the frustration that some claims have remained outstanding for years because of the inability to resolve conflicting medical opinions. It is also an area of considerable debate in WCB circles across Canada. We are not alone in this.
The committee agrees with the Auditor General's finding that a better process is needed to resolve conflicting medical opinions. We would add that this process must be independent, must provide finality, and must reflect the principles behind the workers' compensation system, and in particular the presumption in favour of the injured worker.
Recommendation
The Standing Committee on Accountability and Oversight recommends that, as a priority, the Minister work with the Governance Council to develop options for an independent means of resolving conflicting medical opinions that provides finality, and that reflects the basic principles of the workers' compensation system and in particular the presumption in favour of the worker.
Conclusion
The committee looks forward to continuing to work with the Minister, Governance Council, WCB, workers' advisor and Appeals Tribunal, toward achieving a more effective and responsive workers' compensation system.
Recommendation
The Standing Committee on Accountability and Oversight recommends the government provide a comprehensive response to this report within 120 days.