Does Workers' Compensation need a new "Grand Bargain"?

In a recent blog post, Robert Wilson (WorkersCompensation.com) concluded that workers’ compensation needs a new “grand bargain”.  He supports this conclusion by arguing that the exclusive remedy that is the main underpinning of the workers’ compensation system is under attack.  He cites three trends as evidence that the current arrangement is broken.   Specifically, he notes increasing exceptions to the no-fault aspect of the system, the erosion of worker benefits, and the increasing scope of coverage for co-morbidities and social issues as three categories of threat to the current system. 

Whether you call it a “grand bargain”, “historic compromise”, or  “historic trade-off”,  the current system of workers’ compensation is a social contract and it is under attack.  One need look no further than the daily news to see Bob’s issues in the headlines.  This morning’s Pro-publica / NPR article, “The Demolition of Workers’ Comp”  certainly supports the contention that the current system isn’t working.  They underscore the erosion of benefits for workers, the declining costs for employers,  and externalization of the human and financial costs of workplace injuries to workers, the taxpayers and society at large.

Bob pointed out strains on the original grand bargain.  It was based on principles and designed to apply in an economic and social context that was changing--not static-- at the time.  The basic principles have remained the same but the context has continued to change.  Science has advanced, we use new materials and processes, we have different stressors in our environment.  We understand today that many factors in the work environment can cause or be of causative significance of injury and disease. Workplace stresses including bullying, harassment and work overload are now known to be factors in mental injuries.  We now understand that PTSD is a real and serious consequences of certain work exposures.  We know or suspect strongly that  shift work  that interferes with circadian rhythms is a probable human carcinogen.   This changed context does not mean that the principles should change. 

We also know that workers and work have changed. A century ago, the argument against including farm workers in the scope of workers’ compensation coverage could plausibly be sustained because farms were mainly family operations and most of the workers were family.  That is not the case today.  I don’t see this change as the basis for throwing out the old paradigm.  In fact, exclusion of farms from the scope of workers’ compensation coverage makes less sense in the present context.  Many temporary foreign and migrant workers would benefit greatly from bringing farms under workers’ compensation rules.  It works in some states and provinces; why not make that coverage universal?

Workers’ compensation has always operated on the principle that we take the worker as we find him or her.  That principle includes many conditions that may make recovery from any workplace injury more complex or protracted.  The fact that the condition did not prevent work prior to the injury is not a reason to decry the current scope of workers’ compensation coverage.  This is not coverage “creep”.  It is, in part, a consequence of medical science enabling more of us to work despite underlying conditions that may be managed.  

Rather than a new grand bargain, why not try living up to the original one?  The  NationalCommission on State Workmen’s  Compensation Laws (1972) defined what living up to the bargain would look like.  Looking only at the main National Commission recommendations on temporary disability compensation, I found only a handful of North American jurisdictions that came close meeting the recommended standard.  The Pro-publica/NPR article found only seven states follow at least 15 of the recommendations.

Clearly, the current system of workers’ compensation is not working in most jurisdictions.  The fact that there are some examples in the US and Canada where the systems do provide something close to the National Commission’s recommended standard demonstrates that the underlying principles of workers’ compensation can achieve the social policy objective:    to protect workers from work-related injury, disability, illness and death in a compassionate and sustainable way that still allows the economic activity and innovation necessary for societies to operate and thrive.  

The failures are not in the foundations or underlying principles of the original grand bargain but in the proliferation of legislative and policy “reforms” that depart from them.  The National Commission defined in exquisite terms the minimum standards workers’ compensation systems ought to achieve.  It is against that standard that each workers’ compensation system should be measured and held to account. 

With apologies to Chesterton, the grand bargain that is workers’ compensation has not been tried and found wanting;  it has been found difficult and not tried.  Before we abandon the grand bargain and strike some new compromise, we ought to try living up to the current one first.   

Can a toxic workplace harm workers?

Most of us have heard of “toxic” workplaces.  The hallmarks of a toxic workplace typically include discrimination, back-biting, rumor-mongering, obsessive favoritism, repeated harassment, bullying and more.  As a result, workers may experience anxiety, become depressed, take sick leave or leave the company altogether.  Notice, the characteristics of a toxic workplace are all about behavior not intent. Regardless of the intent,  there is now compelling evidence that such behaviors by superiors and co-workers can harm and are harming workers.

Increasingly, workers’ compensation systems are accepting mental or psychological injuries arising from the work environment.  The trend is a natural consequence of research that has shown how stressors in the workplace can increase the risk to the psychological health of workers even in the absence of any physical trauma.  

Workers’ compensation systems have a long history of accepting psychological injury as a consequence of physical trauma.  Post-traumatic Stress Disorder (PTSD) is perhaps the highest profile diagnosis but clinical depression and anxiety are common and can become chronic sequellae to traumatic injury.  A single traumatic event without personal physical injury has also been recognized as creating a risk of psychological injury to workers.  First responders, disaster relief workers, and worker-witnesses to traumatic events are certainly at risk of mental disorders. 

What we now know from the research is that serious psychological harm in the form of mental disorders can occur from a single traumatic event or a cumulative series of significant stressors in multiple work-related events.  While the standard (and onus) of proof required for the acceptance of mental disorder claims varies across jurisdictions (from “causative significance” to “predominant cause”), the recognition of the risk puts an onus on employers and workers to take action to protect workers and stop behaviors like workplace bullying and harassment .  Failure to do so may well constitute a breach of the employer’s general duty to take all reasonable steps in the circumstances to ensure the health and safety of workers.

In BC, changes to the Workers Compensation Act recognized the evidence on mental injuries and the connection to toxic workplace behaviors such as bullying and harassment.  Prior to the changes contained in Bill 14, compensation was payable only where the mental stress was an acute reaction to a sudden and unexpected traumatic event arising out of and in the course of employment.  Under the changes that came into effect on July 1, 2012 “mental disorder” is recognized as a reaction to one or more traumatic events arising out of and in the course of the worker’s employment.    The amendment recognized that a diagnosed mental disorder may arise from a significant work-related stressor or a cumulative series of significant work-related stressors.

It’s more than a year down the road since the effective date in BC.  From published data and presentations we know that 3000 claims have been registered since July 1, 2012.  So far, nearly 500 claims have been allowed while 1400 have been disallowed or rejected and others have been suspended until a worker agrees to be diagnosed by a psychiatrist or psychologist. 

Not every work-related stressor causes a work-related injury.  The pressure of workloads and deadlines, the realities of labour force adjustments and the inevitable changes in job duties are intrinsic to many industries and work environment.  While the Bill 14 amendments prescribes some exclusions (such as discipline, termination and changes in the work to be performed or in working conditions), mental disorders that are a consequence of bullying and harassment are clearly within the scope   of coverage. 

The main objection to inclusion of mental disorders in the scope of coverage and instituting new policies that target bullying and harassment involves intentions.  I’ve heard a few employers say, “It’s not my intention to harass anyone…”, “I like to keep my employees off balance—it makes it easier to manage them” ,  “Sure I am hard on my staff but it is for the benefit of the team—we all win if we meet the deadline”, “I’m not harassing any one person… It’s not harassment if you treat everyone the same.”   Even if you think there might be some merit to any of the intentions, what really matters to workers are the behaviors they observe and experience. 

Behaviors  such as calling an employee in for a meeting without ever telling them in advance why , micromanaging, withholding critical information necessary to do one’s job, and playing one employee off another may be seen as ways to retain power, meet deadlines or exceed production quotas  but are really passive-aggressive behaviors that can increase the toxicity of a workplace.  

Physically beating subordinates is never justifiable to meet deadlines or production quotas; should behaviors that can inflict mental harm be treated any differently?  Clearly, the ends in either case do not justify the means. Behaviors, not intentions, are what workers observe and experience.  Not all the behaviors mentioned here are captured by the formal definition of bullying and harassment, but they are behaviors that can undermine confidence, heighten anxiety, foster depression and contribute to a toxic workplace. 

Not every worker who is bullied or harassed will develop a mental disorder;  that does not mean that the harassment and bullying can go on with impunity.  WorkSafeBC’s policies pursuant to the Occupational Health & Safety Regulation came into effect on November 1, 2013.  The policies define bullying and harassment; more importantly, they explain the duties of workers, employers, and supervisors to prevent and address workplace bullying and harassment.

No regulatory prohibition can eliminate all the characteristics of a toxic workplace.  Eliminating bullying and harassment is a good place to start.   

Is bullying or harassment just a school or workplace health and safety concern?

Edit ​Recent media coverage on bullying has focused on tragic cases like that of Amanda Todd, the British Columbia teen who ended her life after years of bullying. But the analysis and discussions over what we can do to prevent bullying has not been extended beyond the school system to a broader community: the workplace. A simple Google search shows that news stories on bullying in the workplace amount to less than a tenth of the volume of stories on bullying in schools. The relative silence on the issue of workplace bullying is somewhat surprising. Does the incidence of bullying dramatically decline after graduation? Maybe. However, there may be other explanations worth exploring.   One possibility relates to a societal tolerance or resignation that there is nothing that can be done about about workplace bullying. In 2008, WorkSafeBC did a survey on workplace bullying. While more than 54 percent of the 800 British Columbians surveyed agreed with the statement: “workplace bullying is a serious problem in British Columbia today," a much higher percentage (62 percent overall, 66 percent of women) said: "workplace bullying is an inevitable part of life in the workplace."   Another explanation may be the words we use to discuss this issue. A colleague and I looked at claims for workplace stress not involving a single traumatic event. What we found was a tendency for women to use the term “bullying” to describe behaviours male victims might describe as “harassment.” The legal term may be “vexatious conduct”; HR records might speak of “personality conflicts”; a colloquial definition might include “hazing” for acts that are more physical or “razzing” for more verbal ones. Perhaps the diversity of language is masking a problem that is much larger than media reports suggest.   Whatever words we use, the issue of bullying and harassment is not confined to the K-12 education system. Workers’ compensation systems are increasingly recognizing workplace injuries arising from bullying/harassment. This is not to say bullying is on the increase; it's an affirmation that workplace bullying and harassment can have serious consequences for the victim. It's also a wakeup call for all workplace participants to pay attention and stop thinking about bullying as something that stops when you reach 18 years of age.   The issue of workplace bullying and associated disability due to stress or mental injury comes up more often than any issue of traumatic injury or specific occupational disease from conference audiences I present to and from participants in courses I facilitate. Those who specialize in DM and RTW for employers almost universally report situations within their experience that meet the definition of bullying. They also report the challenges they face in accommodation and RTW in these cases. Having a policy that says, “thou shalt not bully” is not enough. A growing number of companies now carry out risk assessments, craft and enforce corporate policies against harassment, and provide training on the issue. Whether or not such actions are mandated by law or policy, they're the right things to do.   Acts of bullying or harassment extend beyond school and work environments. Playgrounds, sports venues, and even streetscapes are locations where the victimization of individuals occurs. Eliminating bullying and harassment in school settings and the workplace may not solve the greater societal issue but it is a step toward changing the perception that bullying is inevitable.

Is Bullying (Psychological Harassment) a workplace OS&H issue?

A recent article noted that threats and intimidation by supervisors have risen during the current financial crisis. Whether or not this true, threats of violence or intimidation should never be tolerated. Many jurisdictions rely on a ‘general duty provision’ in their occupational safety and health regulation to require employers to assess risks and protect workers from harms that would include violence. Other jurisdictions (Federal government, BC, Alberta, Saskatchewan, Manitoba, PEI, Nova Scotia and most recently Ontario) have gone further and created specific provisions regarding violence. Part 4 of WorkSafeBC’s Occupational Health and Safety Regulation defines violence this way:

4.27 "violence" means the attempted or actual exercise by a person, other than a worker, of any physical force so as to cause injury to a worker, and includes any threatening statement or behaviour which gives a worker reasonable cause to believe that he or she is at risk of injury.

More recently, the trend has been towards more explicitly dealing with the issue of what is commonly termed ‘bullying’. Quebec and Saskatchewan lead the way in this area with specific provisions that addressed ‘psychological harassment’. Bill 168, occupational Health and Safety Amendment Act (Violence and Harassment in the workplace) 2009 was given third reading by the Ontario legislature last week. Definitions in these provisions vary but the following extract from the Ontario Bill 168 captures the main elements:

"workplace harassment" means engaging in a course of vexatious comment or conduct against a workers in a workplace that is know or ought reasonably to be known to be unwelcomed.

Quebec’s provision in its Labour Standards 81.18 is even more inclusive:

"psychological harassment" means any vexatious behaviour in the form of repeated and hostile or unwanted conduct, verbal comments, actions or gestures, that affects an employee’s dignity or psychological or physical integrity and that results in a harmful work environment for the employee.

Saskatchewan’s definition is a little more complex:

(l) ‘harassment’ means any inappropriate conduct, comment, display,action or gesture by a person:
(i) that either:
(A) is based on race, creed, religion, colour, sex, sexual
orientation, marital status, family status, disability, physical
size or weight, age, nationality, ancestry or place of
origin; or
(B) subject to subsections (3) and (4), adversely affects
the worker’s psychological or physical well-being and that the
person knows or ought reasonably to know would cause a
worker to be humiliated or intimidated; and
(ii) that constitutes a threat to the health or safety of
the worker;

Note, these provision govern workplace safety and health; they do not speak to the issue of compensability of any psychological injury that may arise. By most definitions, "harassment" or "bullying" implies a series of actions or behaviours and not "an acute reaction to a sudden and unexpected traumatic event arising out of and in the course of the worker's employment", as may be required for a mental stress claim. (See Workers Compensation Act, section 5.1(1)(a).

Is an harassment provision more effective than the general duty clause? I don’t think there is a definitive researched, evidence-based answer to that questions. On the other hand, the issue of workplace bullying is real and increasing in profile as a workplace safety and health issue. Whether through specific regulation or active education, protecting workers from harassment should be a priority.