WSIB lifts lid on drug secrecy for hurt workers; Board promises to increase transparency following criticism from out-of-pocket injured workers

Sara Mojtehedzadeh
The Toronto Star , Jan. 24, 2017

The list of drugs covered by the province’s compensation board is now publicly available, after years of criticism from labour advocates who claimed the board’s secretive drug policies put injured workers at risk.

The change, implemented Monday, makes the Workplace Safety and Insurance Board’s extensive drug formulary readily accessible to workers and their doctors through an online search engine.

“By publishing the formularies, we hope to provide more information to physicians and pharmacists to assist them in making decisions about an injured worker’s health care,” WSIB spokesperson Christine Arnott said.

The change means that when injured workers are entitled to benefits, it will be easier for doctors to prescribe treatments that are eligible for coverage. As previously reported by the Star, advocates had long claimed that employees hurt on the job sometimes had no idea whether their treatments would be subsidized until they turned up at the pharmacy – meaning some ended up paying out of pocket for medications.

“There’s a huge history behind this,” said Jessica Ponting, a community legal worker with Industrial Accident Victims’ Group of Ontario (IAVGO), a Toronto-based legal clinic. “It took years to even get this (information).”

The clinic has been battling for access to WSIB formularies since November 2013, out of concern for clients it said experienced difficulty accessing treatment. The board initially rejected the request. The province’s privacy commissioner was expected to rule this month on a freedom of information appeal on the subject.

In a letter to IAVGO on Monday, Ashleigh Burnet, a freedom of information specialist with the board, said improving service in the drug benefit program was “a priority.”

“Today, as part of our ongoing efforts to improve transparency, the WSIB has published its drug formularies and made them available in a digital, interactive web-based platform,” the letter said.

Maryth Yachnin, a lawyer with IAVGO, called it a good first step, but said the clinic “remained very concerned with the WSIB’s approach toward health care generally.”

The WSIB’s overall spending on drug benefits has dropped by more than 30 per cent since 2009, statistics requested by the Star show, from $93.63 million seven years ago to $62.34 million in 2015. The board
attributes this decline to the shrinking cost of generic drugs, a decrease in the number of claims and a crackdown on narcotics prescriptions.

Tom Teahen, the board’s chief executive officer, has previously told the Star that his organization is “committed to ensuring injured workers have the right medication, at the right time, for the right purpose.”
“No injured worker should be denied medication necessary to treat a work-related injury or illness,” he said.

Yachnin said many of her clients were having their treatment cut off too soon because of unrealistic recovery guidelines, set by the board’s own staff or independent medical consultants hired by the WSIB who don’t personally examine claimants.

“They say you should be better – if you’re not better, it’s not our problem anymore. And injured workers are cut off health care at that point,” she said.

“Many of our clients are relying on (drug) samples from their doctors or paying out of their very limited welfare. Or doing without,” she added.

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