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Doctors frustrated workers' compensation boards seem to ignore medical opinions, report says
They are the first port of call for workers hurt on the job. But when decisions are made about accident victims with complex injuries, a new study suggests doctors feel sidelined by workers' compensation boards.
The report, conducted by the independent, Toronto-based Institute for Work and Health, examined the role of doctors and other health care professionals in workers' compensation across four provinces, including Ontario. It found doctors treating workers with complicated or prolonged conditions were frustrated by an "opaque and confusing" system where their views on a safe return to work after an accident appeared to sometimes be ignored by case managers with no medical training.
"It quickly became clear that there was a significant amount of disagreement and confusion about what the role of health-care providers should be in the return-to-work process and in the workers' compensation system more generally," the report concluded.
Agnieszka Kosny, a scientist with the IWH who led the study, said doctors rarely reported encountering significant problems when their patients had visible, acute physical injuries. But that changed when workers had multiple injuries, chronic pain and mental health conditions.
In those cases, health care professionals expressed concern that compensation boards' return-to-work programs "might not be appropriate and could do more harm than good" and were sometimes motivated by "cost-containment" rather than the best interests of patients.
"Sometimes where things go off the rail is when a decision is made, and the health care provider feels like they have been excluded from that process. I think that further alienates them from the process," Kosny said.
In a statement to the Star, Workplace Safety and Insurance Board spokeswoman Christine Arnott said the board "values its relationships with heath care providers" and said the study "confirms the importance" of its return-to-work programs.
"There are valuable findings in the report with respect to improving engagement with health care providers," Arnott said, adding board staff will meet with the report authors to discuss the study later this month.