Union claims vast majority of stress claim denials are ‘unjust’
The Ontario Public Service Employees Union (OPSEU) is calling for reforms to the way chronic mental stress is compensated in Ontario, claiming policies at the Workplace Safety and Insurance Board “lead to unjust denials, leaving workers without the benefits they deserve.”
The union issued a statement on its website highlighting language that has allowed the WSIB to deny more than 90 percent of chronic mental stress claims.
All in the wording
The staggering denial rate was first reported by the Toronto Star in the spring. OPSEU says the policy at issue hinges on the differences between the words “substantial” and “significant.”
The WSIB policy on Chronic Mental Stress (CMS) set criteria for eligibility requiring a “substantial” work related stressor. The policy states, “a work-related stressor will generally be considered substantial if it is excessive in intensity and/or duration in comparison to the normal pressures and tensions experienced by workers in similar circumstances”.
OPSEU says this acts as a barrier because “it creates a higher threshold for workers to meet; all other injuries only require work to be a ‘significant’ contributing factor,” reads the OPSEU statement.
The WSIB policy does not recognize the stress workers might experience related to typical workplace occurrences. “Interpersonal conflicts between workers and their supervisors, co-workers or customers are generally considered to be a typical feature of normal employment. Consequently, such interpersonal conflicts are not generally considered to be a substantial work-related stressor,” states the WSIB policy.
Reasons for denials
The policy also makes it clear that stress related to work changes and employer decisions will not be compensated. This includes actions like termination, demotion, transfers, discipline, change in working hours, or changes in productivity expectations.
“Claims for chronic mental stress due to toxic workplaces, harassment and/or bullying will be denied because WSIB states that these are interpersonal conflicts and/or an employer’s decision,” says OPSEU. How employers handle workplace toxicity can vary dramatically.
In a statement to Canadian Occupational Safety, the WSIB says it must operate within the bounds of its legislative requirements, which it says, “can be challenging and complex with mental stress injuries.”
It says 63 percent of ineligible claims involved an employer’s actions or decisions related to regular work functions or workplace interpersonal conflicts. The other 37 percent of denied claims did not meet the “substantial” threshold.
Option to appeal
“Our claims decisions include a detailed rationale to help people understand why a decision was made and how they can appeal if they are not satisfied. If someone is concerned about a decision or other aspects of their claim, we encourage them to speak with us,” reads the WSIB statement.
But OPSEU says the appeal process lengthy “often exacerbates the stress related symptoms workers are already facing. The failures of policy and compensation perpetuate the stigma around stress related illnesses.”
WSIB has accepted nearly 600 claims related to chronic mental stress since amendments were made to the Workplace Safety and Insurance Act in 2018.