Systemic concern revisited – chronic pain disability

In 2014, the Commission advanced a systemic concern about how the
WSIB handles chronic pain disability (CPD) claims. Several workers and
representatives complained to the Commission that the WSIB refused to
provide decisions on CPD without a medical diagnosis.

At the time the Commission raised the issue, senior management at the
WSIB confirmed that they would issue clear instructions to staff on the
process. However, in 2016, the Commission received similar complaints.

The Commission’s review and inquiries revealed that, once again, some
WSIB staff were telling workers that a diagnosis was required before a
decision on CPD could be made. The Commission spoke with an executive
director, who confirmed that there had been no change in the way such
claims are to be adjudicated. A decision can still, in fact, be made without
a medical diagnosis.

The WSIB has reminded its staff that they are required to use the
information in the claim file to decide whether to allow the claim.