Vocational Goals

Well over half of this study’s participants were not able to return to their pre-injury employers and/or occupations. When they were developing alternate vocational goals with their WCB Vocational Rehabilitation Consultants (VRC’s), five felt that their VRC’s offered them a limited choice of vocational goals, typically one of several occupations which had a very high labour market demand. Most of these five participants wanted to pursue different vocational goals they felt were more consistent with their skills, aptitudes, and/or previous work experience, and which they felt would provide them with greater long-term satisfaction than the goals presented by their Vocational Rehabilitation Consultants. Most of them also felt that their preferred vocational goals would provide them with realistic employment opportunities.

Most of these five participants eventually agreed to pursue training for one of the limited number of occupations recommended by WCB staff. VRC’s are skilled professionals with considerable experience, but it appeared, in some cases, that WCB staff had greater influence on the selection of claimants’ vocational goals than the claimants themselves. This finding is consistent with the findings of the Canadian Injured Workers Alliance’s 1995 survey of injured workers (CIWA, 1995b: 114-115).

RECOMMENDATION 12: That the Workers Compensation Board of Manitoba revise policy 43.00 to acknowledge that effective vocational rehabilitation recognizes and gives priority to workers’ personal preferences, independence, and accountability for vocational choices and the outcomes of those choices.

Education and Training

Three to five participants who had low earnings at the time of their injuries reported that the only training they received were short-term courses that provided them with what they felt was only a basic introduction to a new occupation. Following an unsuccessful job search period, more than half of those in this situation were deemed, and their wage loss benefits were reduced by the wage they would have earned if they were actually employed in that occupation.

One other participant who was being re-trained by the WCB reported he had learned of a WCB study that found that most employers were not hiring graduates of the technical school course he was attending.

RECOMMENDATION 13: That the Workers Compensation Board of Manitoba ensure that re-training provides claimants with specific skills and other relevant qualifications necessary to secure employment in the new occupation.

Employment Services

A recent article in the Workers Compensation Board (WCB) of Manitoba’s newsletter to employers projected that WCB Employment Services would help approximately 360 injured workers return to employment during 1999, an increase of almost 50 per cent from the previous year (Workers Compensation Board of Manitoba, 1999c). WCB Employment Services staff report having a placement rate of 95 per cent.

Approximately half of the study participants who had managed to become re-employed had received some assistance from WCB Employment Services, but more than half of them attributed their employment to their own efforts rather than to the assistance they received. At least six of the study participants who had received employment services reported that they had attended group workshops on job search skills, resumés, cover letters, etc. Group workshops are valuable because individuals often learn from each other, but three to five of the participants who attended Employment Services workshops had concerns about the purpose or timing of the workshops, and/or felt they were ineffective.

RECOMMENDATION 14: That Vocational Rehabilitation and Employment Services staff clearly communicate the purpose of Employment Services workshops to participating claimants.

RECOMMENDATION 15: That the Workers Compensation Board of Manitoba ensure that claimants with significant disabilities are referred to Employment Services workshops only after their injuries have stabilized and after receiving other vocational rehabilitation services (e.g. adjustment and assessment).

Many agencies which provide employment assistance to persons with disabilities work to provide persons with disabilities with the skills, confidence, and resources to conduct independent job searches. Individualized job search assistance—including creative job development and marketing to prospective employers—is more labour intensive and costly than group services, but these individualized services are also valuable, particularly to many persons who are changing occupations or who have not conducted a job search in many years.

More than half of the participants outside Winnipeg who received WCB employment services reported that a WCB Employment Specialist had provided individualized job search assistance and individualized marketing to prospective employers. Few Winnipeg participants reported receiving this kind of assistance. Instead, more than half of the Winnipeg participants who had received employment services reported that these services consisted primarily of workshops and use of the WCB Employment Services resource centre/library.

RECOMMENDATION 16: That the Workers Compensation Board of Manitoba review Employment Services’ caseload and staffing levels, and—if necessary—increase staffing to ensure that claimants with significant disabilities—particularly those in Winnipeg—have adequate access to individualized job search assistance.

Three to five participants reported that they were provided with lists of potential employers which they felt were outdated or no more effective than the Yellow Pages.

RECOMMENDATION 17: That WCB Employment Services review and update its list of employer contacts annually.

Deeming

Deeming is a controversial practice. Its critics argue that it penalizes injured workers who would prefer to be working, but have not been able to obtain employment. Proponents of deeming argue that wage loss benefits would provide a disincentive to working if there were no mechanism to limit the duration of compensation benefits and services.

Three to five of the injured workers with significant disabilities who participated in this study had had their benefits reduced by deeming. Three to five others had IWRP’s that provided for deeming if they were not able to find employment in the near future. All of these participants had Permanent Partial Impairment (PPI) awards of approximately 10 per cent.

According to WCB policy 44.80.30.20, “deemed earning capacity will generally be used as a last resort after all reasonable or available vocational rehabilitation/re-employment options have been exhausted.” Three to five of the participants who had been or were about to be deemed had received extensive vocational rehabilitation and/or job search assistance, but three to five others—typically those living outside of Winnipeg—reported that they had received limited services from the WCB.

The most common deeming scenario was when a claimant was not employed at the conclusion of his/her IWRP, but was deemed to be “employable”. Three to five other claimants living outside Winnipeg reported that they had declined WCB offers to relocate to Winnipeg, and had IWRP’s which provided for deeming after three years (see “Injured Workers Outside Winnipeg” below).

RECOMMENDATION 18: That the Workers Compensation Board of Manitoba truly utilize deeming only as a last resort, such as when a claimant (a) does not actively participate in his/her vocational rehabilitation, (b) cannot demonstrate that she/he is actively seeking employment, or (c) has completed multiple Individualized Written Rehabilitation Plans.

RECOMMENDATION 19: That the Workers Compensation Board of Manitoba conduct a study examining the post-deeming employment experiences of claimants whose benefits are reduced by deeming.

Injured Workers Outside Winnipeg

Three to five participants living outside Winnipeg reported that they had declined WCB offers to relocate them to Winnipeg. More than half of them had three year IWRP’s which specified that they would—at the conclusion of the plan—be deemed capable of earning the wage of a low skill job available in the larger Winnipeg labour market. All felt they had compelling reasons for declining to relocate to Winnipeg, most commonly a spouse with secure, well-paying employment in their rural community, school age children, and/or deep roots in their rural communities.

More than half reported that they had received little or no vocational rehabilitation or job search assistance since declining the WCB’s offers to relocate to Winnipeg.

RECOMMENDATION 20: That the Workers Compensation Board of Manitoba assist injured workers outside Winnipeg to qualify for and secure employment in or near their home communities.

All WCB staff are centrally located in Winnipeg. Approximately half of the study participants outside Winnipeg expressed some dissatisfaction with the vocational rehabilitation services they had received. The greatest level of dissatisfaction was amongst the three to five participants from Northern Manitoba, and their dissatisfaction was primarily concerned with their companies’ return to work programs.

RECOMMENDATION 21: That the Workers Compensation Board of Manitoba explore the establishment of a Northern office staffed by a person whose responsibilities would include the determination and approval of suitable modified/alternate work arrangements, as well as regular on-going monitoring of these arrangements.

Younger Injured Workers

The Apprentices and Youthful Workers policy acknowledges that the time-of-injury earnings of persons disabled by workplace injuries before their 25th birthdays often do not accurately reflect their long-term lost earning capacity. In addition to annual increases in wage loss benefits, this policy specifies that WCB vocational rehabilitation efforts will aim to qualify young injured workers for occupations at the industrial average wage, not young claimants’ actual earning capacities at the time of their injuries (unless their pre-injury earnings exceeded the industrial average wage).

Two study participants who were under 25 when their injuries occurred reported that (a) they were not aware of this policy or (b) that it had not been properly applied to their claim.

RECOMMENDATION 22: That the Workers Compensation Board of Manitoba ensure that the Apprentices and Youthful Workers policy (44.80.30.30) is applied to all eligible claimants.

Older Injured Workers

Three to five participants over the age of 50 felt that they were offered more limited vocational rehabilitation opportunities than younger persons. Two participants in their late fifties and sixties were relatively content not actively pursuing re-employment, and indicated that the WCB was supporting that choice by continuing to pay the participants’ their full wage loss benefits.

RECOMMENDATION 23: That the Workers Compensation Board of Manitoba provide vocational rehabilitation services to all injured workers with significant disabilities.

Injured Workers with Severe Disabilities

Compared to study participants with less severe disabilities, participants with severe disabilities tended to be less dissatisfied with the financial benefits and vocational rehabilitation services they had received from the Workers Compensation Board of Manitoba. Three to five were very satisfied with the supports they had received. These included persons with spinal cord injuries, brain injuries, amputated limbs, and multiple injuries.

From the comments of more than half of the study participants with high Permanent Partial Impairment (PPI) awards, the WCB appears to have a strong commitment to timely intervention, individualized services, claimants’ vocational interests and goals, flexibility, etc. for most claimants with severe disabilities. For example, none of the participants in this study with PPI awards greater than 10 per cent had had their benefits reduced by deeming, even those who had been receiving wage loss benefits for five or more years. Even amongst more than half of the participants with high PPI awards who had not returned to work, there was a relatively good level of satisfaction with the benefits and services they had received from the WCB.

More than half of the three to five participants who had managed to return to satisfactory and stable employment following their injuries were persons with spinal cord injuries or serious amputations. Three to five persons with severe disabilities who were not employed were in the midst of vocational rehabilitation plans. Three to five others were not actively pursuing re-employment, and more than half of them indicated that the WCB was providing varying degrees of support for other activities (e.g. volunteer work) that the participants felt were contributing to their overall rehabilitation and adjustment to their disabilities.

Facilitating the vocational rehabilitation and re-employment of some injured workers with severe disabilities can be very challenging. For example, two unemployed participants with severe disabilities did not complete high school, had worked in physically demanding occupations since leaving school, and had strong aversions to working indoors. Nevertheless, injured workers whose circumstances make vocational rehabilitation and re-employment particularly challenging should not be consigned to a lifetime of 80 per cent of their net pre-injury earnings.

The WCB’s Specialized Services Unit provides vocational rehabilitation and other services to many claimants who have severe disabilities. Additionally, two participants with severe disabilities reported that their VRC’s were able to assist them more effectively after their VRC’s attended training on the participants’ particular disabilities.

RECOMMENDATION 24: That the Workers Compensation Board of Manitoba continue specialized vocational rehabilitation services for injured workers with severe disabilities.

RECOMMENDATION 25: That the Workers Compensation Board of Manitoba provide Vocational Rehabilitation staff with training opportunities specifically for enhancing their abilities to provide effective vocational rehabilitation services to injured workers with severe disabilities.

Three to five participants with severe disabilities indicated that the WCB was supporting their choices to not actively pursue re-employment. One other participant with a severe disability, however, reported that she felt her VRC was pressuring her to pursue vocational rehabilitation activities which the participant felt were not in her long-term best interest.

RECOMMENDATION 26: That the Workers Compensation Board of Manitoba support the preferences of injured workers with severe disabilities who feel that re-employment is currently not a realistic goal, and/or not in their long-term best interest.

During consultations with community-based agencies, three to five agencies reported that they have contractual arrangements with the WCB to provide some vocational rehabilitation services to injured workers with the kinds of disabilities in which these agencies specialize. Two of these agencies noted, however, that the services currently contracted by the WCB were more limited than in the past. They felt that this reduction was a result of their agencies’ concern with the overall rehabilitation of the persons they assisted, which sometimes conflicted with the WCB’s greater emphasis on vocational rehabilitation and re-employment.

RECOMMENDATION 27: That the Workers Compensation Board of Manitoba strengthen its links with community-based agencies which have expertise in the vocational rehabilitation and re-employment of persons with disabilities.

Injured Workers with Less Severe Disabilities

Compared to most injured workers with severe disabilities who participated in this study, participants with less severe disabilities tended to be more dissatisfied, particularly persons who were earning relatively low wages at the time of their injuries. Some of the barriers to employment that some of them reported experiencing included: no adjustment services, no vocational testing, limited choice of vocational goals, training they felt was inadequate, and job search assistance they felt was insufficient.

Although their disabilities may not be severe, many injured workers with less severe disabilities still face considerable barriers and challenges. Some may actually face greater barriers and challenges than some persons with more severe disabilities. For example, three to five participants with permanent impairment awards of over 50 per cent were re-employed—and relatively satisfied—approximately one year after their injuries. Other participants with permanent impairment awards in the 10 per cent range had not worked in several years.

Accommodating a person with a severe disability may sometimes be less complicated than accommodating a person with a less severe disability. For example, the only major accommodations required by a person who uses a wheelchair may be a workplace with an accessible entrance and washroom. Even if more extensive accommodations are required, they are typically one-time adaptations. Persons with less severe disabilities often have varying degrees of limitation. They may be relatively free of limitations some of the time, but very limited or completely unable to work other times.

Injured Workers with Back Injuries

At least six of the study participants who had experienced major barriers to re-employment were injured workers with disabilities resulting from back injuries. Two had fractured or crushed vertebrae, but most experienced disk injuries.

A study of injured workers in Wisconsin found that back injuries often result in complicated disabilities because “the extent of impairment often is difficult to measure because objective symptoms do not always correlate to subjective limitations and pain” (Galizzi, Boden, and Liu, 1998: 5). More than half of the current study’s participants with back injuries had experienced medical complications. Three to five consented to surgeries that worsened their conditions. More than half continued to experience frequent pain years after their injuries. Three to five had attended pain clinics in and outside of Manitoba, but none had experienced significant reduction in pain or disability.

Returning to work can be a major challenge for persons with back injuries. The authors of several studies based on the 1989-90 survey of injured workers with disabilities in Ontario argue that other factors can interact with a back injury to exacerbate the degree of disability the injured worker experiences.

“Many workers with less than high school education work in physically demanding jobs…For a low-skilled worker, an episode of back pain is typically disabling because the usual work of such an employee is physically demanding and the worker’s ability to perform other jobs is limited by his or her lack of skills. Unless low-skilled workers are protected by seniority rules, such as those mandated by labor unions, those who can no longer perform physically demanding tasks because of a back condition have few opportunities to move to less demanding occupations. If their employers are unwilling or unable to reduce the physical demands of their usual jobs, these workers are likely to be totally work-disabled even though they are physically capable of doing many other jobs” (Butler, Johnson, and Baldwin, 1995: 462-463).

RECOMMENDATION 28: That the Workers Compensation Board of Manitoba conduct research on current best practices in vocational rehabilitation services for injured workers with back injuries.

Collaboration with External Resources

An educational workshop developed at the conclusion of this study was delivered to 75 persons from the Workers Compensation Board of Manitoba, unions, community agencies, advocates for injured workers, and persons with disabilities. During case study exercises, small groups with diverse participants generated innovative solutions to employment barriers faced by injured workers with significant disabilities.

RECOMMENDATION 29: That the Workers Compensation Board of Manitoba, in collaboration with the Workers with Disabilities Project, develop a regular forum for Vocational Rehabilitation and Employment Services staff to consult, network, and collaborate with community-based agencies, unions, advocates, and organizations of persons with disabilities.

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