Overview of Adjudication Process for Asbestos Related Diseases

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					Overview of Adjudication Process
 for Asbestos-Related Diseases


       Presentation to Asbestos Symposium
                 November 4, 2011
            Irene Dias, Director ODSBP




    Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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                   Service Excellence


■ The Occupational Disease & Survivor Benefits
  Program is committed to providing service
  excellence.
■ This includes fair, timely decisions and the
  compassionate delivery of services to workers
  and their families.




          Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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        Experience With Asbestos

■ The WSIB saw an increase in claims for cancers
  attributed to asbestos exposure in the 1970s, a
  time when a more generalized awareness of the
  hazards of asbestos exposure began to emerge.
■ Cases of asbestos-related diseases being seen
  today largely relate to exposures from many
  years ago, some from as long ago as 30-40
  years.



          Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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                     Legal Framework
■ In deciding entitlement to occupational diseases,
  including asbestos-related conditions, WSIB
  decision-makers rely upon the provisions of the
  WSIA and WSIB policy.

■ Section 2(1) and 15 govern the WSIB’s general
  approach to occupational disease adjudication.




          Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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                     Legal Framework

Schedule 4 of the WSIA directs decision-makers to
  presume a relationship to work in cases
  involving workers with mesothelioma and
  asbestosis who were employed in a process
  involving generation of airborne asbestos fibres.
■ Schedule 4 applies to cases with diagnosis
  dates on or after May 28, 1992.
■ The presumption of work-relatedness afforded
  by the Schedule 4 entry cannot be rebutted.

          Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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                    Policy Framework
 The WSIB has policies for a number of asbestos
  related diseases.
 Policy provides:
    a general framework for decision-making.
    decision timeliness, consistency and quality
 Policies are inclusive, not exclusive.
 Adjudicators are charged with considering
  entitlement on the individual merits of the
  particular case when the policy framework does
  not apply.

          Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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     Case-by-Case Adjudication

• Disease covered by policy but specific case
  falls outside policy parameters.

• Conditions known to be associated with
  asbestos exposure in the scientific literature,
  but not addressed in the above
  schedules/policies e.g. pleural plaques.

• Asbestos exposure is the attributed cause in
  claims for conditions not known to be linked
  with asbestos e.g. prostate cancer.

        Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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       Adjudicative Challenges

Long latency aspect of some diseases present
adjudicative challenges recreating exposure
environment, obtaining employment records and
medical histories.
  -Employers no longer in business
  -Work processes have changed
  -Co-workers no longer available
  -Medical records extensive and/or no longer available



         Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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                         Worker Benefits
Workers suffering from an occupational disease
  are entitled to a range of benefits that include:
■ income replacement (loss of earnings benefits)
■ a non-economic loss benefit to recognize the
  worker’s physical or functional permanent
  impairment
■ health care and medical costs
■ travel expenses
■ labour market re-entry assessment or plan


           Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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      Benefits to Severely Impaired
Additional supports are extended to severely
  impaired workers:
■ independent living allowance
■ personal care allowance
■ home modifications
■ assistive devices and other measures to improve
  quality of life




          Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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                     Survivor Benefits
The surviving dependants of workers who die as a
  result of a work-related injury or disease are
  eligible for:
■ Reimbursement of burial costs.
■ One-time lump sum payment .
■ Lifetime monthly periodic benefits
■ Financial support for dependant children through
  completion of post-secondary education.
■ Bereavement counselling offered.
■ Work reintegration offered to spouse to enhance
  skills and return to work, if desired.

          Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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        Asbestos-Related Claims

■ Claims for asbestos-related diseases have been
  increasing over the years.
■ This increase in volume is not expected to peak
  until almost 2020.
■ Exposures of the past have a long reach into the
  future.




          Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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         Asbestos-Related Claims
■ Over the past 20 years the WSIB has
  allowed close to 5000 claims for asbestos-
  related disease
  – Almost 1200 were for mesothelioma
  – Over 700 for lung cancer
  – About 650 for asbestosis

  Additional conditions compensated include pleural
   plaques, other cancers and COPD


           Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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                   WSIB Partnerships
■ The WSIB works closely with various health and
  safety partners, including labour representatives,
  employers, Occupational Health Clinics for
  Ontario Workers and Ministry of Labour to help
  identify and compensate cases of asbestos-
  related disease.
■ Need to support partnerships to address
  underreporting of OD
■ Partnership with health care practitioners for
  earlier recognition.

           Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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                                          Next Steps

■ Opportunity to work together:
  – to provide better information
  – to increase awareness and address underreporting
  – to deliver quality support to workers and their families




           Workplace Safety and Insurance Board | Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail
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