The Disability Experience – Whose Life Is It?

Written by: Janet Patterson, WELLS Director

This blog series is meant to cover all things related to Workers’ Compensation. It is managed by one of our WELLS Directors, Janet Patterson.

From most accounts, disabled people have made significant strides towards equality and inclusion.   

There is a line of improvement for “Persons with Disability”(PWD), from the UN Convention on the Rights of Persons with Disabilities in 2006  to “disabled rights” legislation in Canada in 2019. [1] There is even a growing academic field of “disability studies” which explores the challenges and achievements for PWDs with all types of disabilities – visible and invisible, inherited or acquired. 

But, as noted in recent book on the subject, The Disability Experience:  Working Towards Belonging [2], employment continues to be a most difficult issue for PWD. Statistics Canada reports that the PWD unemployment rate for those aged 25 to 65 is 55% [3]. And while some programs support PWD employment – typically subsidizing employers to give PWD some work experience – these  employment opportunities  typically disappear when the funding ends. The Centre for Research on Work Disability (CWRDP) provides a national focus on this issue and its web-site has many excellent resources [4]. But as all admit, the employment reality for PWD is difficult and often (but not always) grim [5].

In the Compensation Café, the focus will be on the one group which is often excluded from disability studies – workers who are disabled by a work injury, and who recover and return to work (RTW) under the guidance of the workers compensation system. Almost without exception,  those workers who are left with a permanent “acquired” disability must adjust to life and work that is different in every way. (Such  injuries are called “life-changing” for a reason.)   For these workers, their healing and RTW (whether to the same employer or to a new employer or occupation) is determined by a compensation system which, in B.C., is run by its own medical and legal rules.

I believe that the advances, lessons and successful programs from the disability movement are a good model for the reform of the WCB system.  While the  Workers’ Compensation Act does not define “disability”, “disability” is at the heart of the system and the disability movement offers several key tenets, which I have adapted to the WCB context. 

  • Define Disability: It is important for workers and advocates to understand how to define disability accurately because many financial supports, including compensation, depend on its definition.    It  is equally important who defines a disability status.  Both workers and employers have a big financial stake in this definition, but workers also have a life stake as well. 
  • Destigmatize Disability: There is a concept of “disability” as its own culture, with a collective voice which challenges historical practices of medicalizing, institutionalizing or stigmizing PWD.  A collective culture of disability replaces demeaning language (crippled, retarded, impaired) with more accurate, inclusive and people-first words.  A disability culture supports PWD having  choice, control and dignity in their lives, including in their RTW.
  •  Support Adjustment to Disability:   Injured workers need help to navigate the many changes that come with an acquired disability –  changes in cultural norms, relationships and identification as well as financial and vocational security. Left unaddressed, these changes can become overwhelming barriers to employment, recovery and quality of life. 

These are areas where the collective experiences of injured workers can inform the way forward towards supporting their honest, full and lasting recovery and  employment.

In the next few blogs, I will focus on two particular Board practices which currently impede the health and recovery of injured workers, and which must be improved [6]. (The equally important issue of compensation will be addressed in later blogs). They are: 

1. Dictation of Recovery Paths:  With its current use of the “case management” system, the Board inserts itself as the primary driver of recovery pathways for an injured worker.   In fact, this has so permeated Board practices, that the Board now seems to imagine itself as less of a compensation agency that also provides health care benefits,  and more of a health care agency that happens to provide compensation during recovery (as it defines it) [7].   Pre-determined   “recovery paths’ are adjudicated and driven by those with no medical licenses and no obligations under health care regulation.  Their mandate to enforce these recovery pathways often mean: 

  • Focusing on RTW vs actual recovery, slanting reports and statistics
  • Downplaying treating practitioners’ report
  • Justifying the view that all workers will  RTW  & engaging harmful practices to achieve this outcome
  • Paying little or no attention to the principle of informed consent

2. Bureaucratic Construction of “Disability”:The Board uses certain mechanisms to define permanent “disability” and control most of the evidence relevant to this finding. This means that RTW is often based on “disability” constructions, which may or may not be valid, and which are often incomplete.  With this approach, injured workers (and co-workers and employers and VRCs ) are denied the tools for a successful integration of a PWD into the work world, with the consequences of RTW failure visited primarily on the injured worker.    This is where the real life experiences of workers and their families are most instructive.  

In later blogs, I will explore different approaches to the definition of “disability” , and the contrast between the WCB determinations vs. the real life RTW experiences of injured workers. 

Let there be no doubt.  The legislative changes to WCB  in 2002 were devastating to workers [8]. But over the years, the Board has also evolved its role, the above practices have prevailed and injured workers now commonly suffer unnecessary and disproportionate harms in this compensation process.  This outcome is very far from the original intent of the Workers Compensation Act as remedial legislation and the Board’s true compensation role. The courage of injured workers to stand up, and demand better, must be recognized and followed.  

[1] Accessible Canada Act, June 21, 2019.
[2] The Disability Experience:  Working Towards Belonging.  Hannalora Leavitt, Orca Book Publishers, 2021. 
[3] The Disability Experience, page 67.
[4] The CRWD web-site is at www.crwdp.ca. The CRWD has also partnered with other organizations, including the Ontario Network of Injured Workers’ Groups, to form the Disability and Work in Canada (DWC) group that hosts a conference every year. The conference is recorded and available on the CRWD web-site.
[5] See “Mapping the Canadian Work Disability Policy System (Alberta and B.C.), CWRDP BC Cluster Project Report, Dr. S. Kimpson, May 2019. 
[6] The New Directions report makes 101 recommendations. A summary report by Kevin Love Workers Deserve Better is available at the WELLS or B.C. Federation of Labour websites.
[7] I wish to acknowledge that I am indebted to some particular consultations and submissions made to the Review; however, these comments are my own.
[8] Insult to Injury: Changes to the B.C. Workers’ Compensation System (2002-2008): The Impact on Injured Workers. This report to the B.C. Federation of Labour by Stan Guenther, Janet Patterson and Sarah O’Leary on April 22, 2009 is available on the WELLS WCB library.

Originally published September 14, 2021