The WSIB referrals - all investigation, none real treatment

Approximately two months after my accident, I was referred to a one-day assessment by a doctor chosen and paid by the WSIB. At the same time, I attended physiotherapy sessions and sessions with a neurologist, following a referral by my family doctor. As a result of the above assessment, the WSIB discontinued paying for my physiotherapy sessions.

Six months after the accident, my WSIB Nurse Case Manager called me and informed me of a new referral, made by the WSIB, this time to a three-week program at the Toronto Rehabilitation Institute. She said that the TRI was the best facility and had the best doctors who would be able to help me with my chronic post-concussion headaches. She made it sound as if this was a treatment.

My program at the Toronto Rehabilitation Institute started three months later and lasted three months (not on daily basis). It turned out to be another assessment and not a treatment. I was told by two doctors at the TRI that their role was not to treat me but to answer some questions for the WSIB. As a result of the effort and winter conditions, this "treatment" left me more sick than I had been before it started. It has also complicated my treatment and surgical procedures that resulted from a related condition that was aggravated by the pain medication I was taking at that time.

A few months later, my WSIB Nurse Case Manager called me again and informed me of a new referral to the Health Recovery Clinic in Mississauga. I have voiced my concerns over the assessment vs. treatment character of the previous referral. She replied that this time it was going to be a real treatment. The program at the Health Recovery Clinic began 18 months after the accident. During my initial assessment at the Clinic, two staff members confirmed that my program at the HRC was a treatment and not another assessment. The program was scheduled to last eight weeks (daily, Monday to Friday activities). It included stability exercises, biofeedback sessions, sessions with the psychologists, a medical component (new medication trial), massage, physiotherapy, sessions with the chiropractor, a "homework" component, and a number of record keeping tasks. The number of exercises, strategies, and record-keeping tasks was increasing over time.

After three weeks of the program, I noticed and reported to the staff at the Clinic that I was not able to cope with the increasing workload, especially with the daily homework component that I was expected to complete after returning home from the Clinic. The program was not adjusted to meet my tolerance and my limitations. The expectations kept increasing. Consequently, I fell behind with completing the tasks assigned for home. I reported this fact to the staff, too.

Some of the cognitive-behavioural strategies assigned by the psychologist did not help to reduce my headaches. At two occasions, I was told by a competent staff member that the program was not designed to reduce my headaches, is they were of a neurological nature resulting from the head injury. Based on my knowledge and experience in the field of rehabilitation, and based on the theory taught at the Clinic, I concluded that the program was aimed at reducing the secondary physical symptoms that resulted from the original injury and pain (increased muscle tension, decreased fitness and stability, stress, and depression.) I have discussed it with the psychologist assigned to my case.

Six weeks into the program - (two weeks before its scheduled conclusion), I was called to a meeting and reprimanded for not cooperating with the program. I was told that I was "not willing" to cooperate with the staff and that I did not meet the expectations. In a large part, the accusation focused on the fact that my pain still continued and was increasing, despite the wonderful cognitive-behavioural strategies recommended by the psychologist.

I replied that I did my best, that I did what I could. I repeatedly reported to the staff at the Clinic my difficulties, and the program was not modified to meet my abilities and limitations. I was told that only those patients who are able to meet the expectations fully, benefit from the program. I answered, "If I was able to meet the expectations fully on daily basis, I would not be at the Clinic because I would be able to work." Consequently, I was dismissed from the program in a way that sounded like a disciplinary dismissal.

I wrote a detailed report of my experience with the Health Recovery Clinic, including my dismissal, and hand-delivered it to the WSIB. I also sent a copy of this report to the Clinic.

For a few days, I tried to call my WSIB adjudicator to discuss the matter but she was not answering the phone and not replying to the message I left. I requested to talk to her superior. With his help, I was connected with the adjudicator. She said that she did not read my letter and that she was waiting for the official report from the Clinic. During this conversation, she repeatedly referred to the Health Recovery Clinic as a "return to work program."

Two weeks later, the WSIB adjudicator called me and stated that, according to the Clinic's report, I was able to return to work without any modifications of my duties and responsibilities. I asked her if she had read my letter. She confirmed but did not comment. Realizing that she was fully aware of my concerns, I stated that my headaches still continued and that this would greatly reduce my ability to work as a teacher and my ability to take responsibility for the safety of children under my care. I reminded her that, according to the Clinic's staff member, my program was not designed to reduce a chronic post-concussion headache. She ignored my concerns and replied that a recovery from a post-concussion headache may take a long time and that I was provided at the Clinic with strategies to help reduce my headaches. She then stated that she was arranging a return to work meeting with my employer.

During my entire experience with the WSIB referrals, I have reasonably developed a suspicion that they have nothing to do with real treatment and rehabilitation. In my case, the progression was as follows:

1. Initial medical assessment and investigation;

2. Detailed assessment and investigation of my functional abilities at the Toronto Rehabilitation Institute;

3. Return to work program designed to prove that a patient is able to return to work OR is "not willing" to cooperate. One way or another, the WSIB funded program at the privately operated Health Recovery Clinic enables discontinuation of the WSIB benefits.

During my last telephone conversation with the WSIB adjudicator (above), I mentioned my early dismissal from the program and the attempt by the Clinic's staff to make it look as a disciplinary consequence of my alleged lack of cooperation. The adjudicator answered that there was no indication of this incident, of my alleged lack of cooperation or my inability to meet the program’s expectations in the Clinic's final report.

In conclusion, I understand that the WSIB needs to conduct an assessment of the victim's medical condition and needs to investigate the progress. I just wish that it was done honestly and openly, without lies and false promises of "the best treatment available." Both, the Toronto Rehabilitation Institute program and the Health Recovery Clinic program did not address my headaches and were not designed to do so. Due to the effort, weather conditions, travel, and resulting stress, both programs have actually aggravated my headaches. The assessment/investigation/return to work push seemed to be the priority and the goal, even though they did not (in my case) help my main problem. Actually, they were conducted at the expense of my health and emotional well-being.

According to the WSIB, the programs were mandatory and constituted a condition for the continuation of benefits. This means that I did not have a choice - I had to follow the referrals and participate in the programs. Today, I consider it a waste of time, taxpayers’ money, and the patient's health.  ...7 months ago

Posted On : Aug 16,2009    Posted In : Accident & Injuries,Workplace Accidents    Post Comment (1)

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