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HomeMy WebLinkAbout2004-153627 Benefits Claimant 04-07-06 Decision In the matter of an Appeal Before The Subcommittee of the Joint Insurance Benefits Review Committee Regarding Claim # 153627 Chair: Felicity D. Briggs Appearing for the Union: Hilary Cook Appearing for the Employer: Janice Campbell Included m the most recent collectIve agreement between the partIes are the followmg prOVISIOns Article 22 - Grievance Procedure Article 22.9 - Insured Benefits Grievance 22 9 1 An allegatIOn that the Employer has not provIded an msured benefit that has been contracted for m thIS Agreement shall be pursued as a Umon gnevance filed under ArtIcle 22 13 (Umon Gnevance) 1 Any other complamt or dIfference shall be referred to the ClaIms ReVIew SubcommIttee of Jomt Insurance Benefits RevIew CommIttee (JlBRC), establIshed under AppendIx 4 (Jomt Insurance Benefits RevIew CommIttee), for resolutIOn. Appendix 4 JOINT INSURANCE BENEFITS REV IEW COMMITTEE 1 Name of Committee The CommIttee shall be referred to as the Jomt Insurance Benefits RevIew CommIttee 2. Purpose of Committee The purpose of thIS CommIttee IS to facIlItate commumcatIOns between the Employer and the OPSEU on the subject of Group Insurance, mcludmg BaSIC LIfe Insurance, Supplementary LIfe Insurance, Extended Health Insurance, Long Term Income ProtectIOn Insurance, and such other negotIated benefits as may, from tIme to tIme, be mcluded m the Group Insurance Plane It IS understood that the Group Insurance benefits to be prOVIded to employees and the cost shanng arrangements between the Employer and ItS employees shall be as set out m any applIcable collectIve agreement or Claim #153627 2 arbItratIOn award, and the matters for consIderatIOn by thIS CommIttee shall be only as set out m these terms of reference 3. Composition of Committee The CommIttee shall be composed of an equal number of representatIves from the Employer and from the OPSEU, wIth not more than eIght (8) representatIves m total At meetmgs of the CommIttee, each party may be accompamed by an Actuary to provIde techmcal advIce and counsel. 4. Duties of the Committee The dutIes of the CommIttee shall conSIst of the followmg - Development of the specIficatIOns for the publIc tendermg of any negotIated benefits whIch may be mcluded m the Group Insurance Plan (to cover the bargamIng umt only), - DetermmatIOn of the manner m whIch the specIficatIons wIll be made avaIlable for publIc tendermg; - ConsIderatIOn and exarmnatIOn of all tenders submItted m response the specIficatIOns for tender and preparatIOn of a report thereon, - RecommendatIOn to the Government of Ontano on the selectIOn of the msurance carrIer or carrIers to underwnte the Group Insurance Plans, - ReVIew of the semI-annual financIal reports on the Group Insurance Plan, and ReVIew of contentIous claIms and recommendatIOns thereon, when such claIm problems have not been resolved through the eXIstmg admmIstratIve procedures. The specIficatIOns for tender WIll descnbe the benefits to be provIded, the cost sharIng arrangement between the Employer and ItS employees, the past financIal hIStOry of the msurance plans, the employee data, the format for the retentIOn IllustratIOn for each coverage and the financIal reportmg reqUIrements. Tenders shall be entertamed by the CommIttee from any mdIVIdual msurance carrIer actmg solely on ItS own behalf. ThIS shall not preclude such carrIer from arrangmg remsurance as may be necessary Claim #153627 3 The basIs for recommendatIOn of an msurance carrIeres) wIll mclude the abIlIty of the carrIere s) to underwnte the plan, complIance of the carrIer's quotatIOn WIth the specIficatIOns for tender, the carrIer's servIce capabIlItIes and the expected long term net cost of the benefits to be provIded. 1 Experience Review 2. Claims Review Subcommittee (a) There shall be a subcommIttee whose mandate IS to reVIew, and make decIsIOns on, complamts or dIfferences mvolvmg the demal of msured benefits under the Central CollectIve Agreement, when such Issues have not been resolved through the eXIstmg admmIstratIve procedures, save and except a complamt or dIfference ansmg under ArtIcle 22 9 1 (Insured Benefits Gnevance) of the Central CollectIve Agreement. The subcommIttee shall be composed of two (2) representatIves selected by the Employer, two (2) representatIves selected by OPSEU, and an mdependent thIrd party who IS agreed to by both partIes. (b) Appropnate ImpartIal medIcal consultants shall be avaIlable to the subcommIttee m an advIsory capaCIty to prOVIde mformatIOn on the nature of speCIfic Illnesses or dIsabIlItIes. (c) MembershIp on the subcommIttee shall be for one (1) year penod, and IS renewable at the dIscretIOn of the nomInatmg party, or partIes m the case of the renewal of the term of the mdependent thIrd party (d) DeCISIOns of the subcommIttee are final and bmdmg. (e) The fees and expenses of the medIcal consultants referred to m clause (b), and the mdependent thIrd party referred to m clause Claim #153627 4 (a), shall be dIvIded equally between the Employer and the Umon. Article 42 - Long Term Income Protection Total dIsabIlIty means the contInuous mabIlIty as the result of Illness, mental dIsorder, or mJury of the Insured employee to perform the essentIal dutIes of hIS or her normal occupatIOn dUrIng the qualIficatIOn penod, and dunng the first twenty-four months of the benefit perIod and thereafter durmg the balance of the benefit penod, the mabIlIty of the employee to perform the essentIal dutIes of any gamful occupatIOn for whIch he or she IS reasonably fitted by educatIOn, trammg or experIence Subsequent to the sIgmng of thIS collectIve agreement the partIes negotIated and SIgned terms of reference regardmg the establIshment of a subcommIttee to deal wIth dIsputes between the partIes regardmg Long Term Income ProtectIOn (hereInafter referred to as "L TIP") That memorandum stated. JIBRIC CLAIMS REVIEW SUBCOMMITTEE TERMS OF REFERENCE AUTHORITY The JIBRC subcommIttee IS establIshed under ArtIcle 22 9.2 and AppendIX 4 of the collectIve agreement between The Crown m RIght of OntarIo and the OntarIO Pubhc ServIce Employees Umon. PURPOSE OF SUBCOMMITTEE To reVIeW and make deCISIOns on appeals from employees on claIms mvolvmg the demal of msured benefits under the collectIve agreement whIch have preVIOusly been removed from JIBRC Claim #153627 5 REFERRAL TO THE SUBCOMMITTEE Employees wIth claIms that have been removed from JIBRC wIll be notIfied of such, m a tImely, manner by letter (referred to as the "NotIce Letter") to theIr last known address. An employee whose claIm has been removed, has 45 days, from the date of the notIce letter, to submIt a request m wrItmg to OPSEU askmg that OPSEU refer theIr case to the subcommIttee ThIS letter must be copIed to the Management Co-ChaIr of the JIBRC OPSEU has 90 days from the date of the notIce letter to adVIse the Management Co-ChaIr of JIBRC of theIr deCISIOn to agree or deny the request to appeal. If notIce IS not receIved from OPSEU WIthIn 90 days from the notIce letter then the claIm WIll be deemed to be WIthdrawn. SCOPE OF COMMITTEE The SubcommIttee represents the final stage m the appeal process. The SubcommIttee WIll clarIfy medIcal eVIdence as needed, WIth a medIcal consultant agreed to by both MBS and OPSEU DeCISIOns of the SubcommIttee are final and bmdmg. Upon receIpt of the deCISIOn, a Memorandum of Settlement (as attached) WIll be prepared and SIgned by the partIes and forwarded to the msurer SUBCOMMITTEE MEMBERSHIP. The subcommIttee WIll consIst of resource representatIves from OPSEU and MBS and an mdependent thIrd party "ChaIr" to be named by MBS and OPSEU Claim #153627 6 ROLE OF THE CHAIR To reVIew case representatIOns from MBS and OPSEU To make a determmatIOns III wrItmg wIth respect to each case DeCISIOns must be m accordance wIth the OPS CollectIve Agreement between the Employer and OPSEU and consIstent WIth the group msurance plans m place at the tIme facts gIvmg nse to the dIspute arose ROLE OF MEDICAL CONSULTANTS Appropnate ImpartIal medIcal consultants wIll be agreed by the partIes and shall be avaIlable to the SubcommIttee m an advIsory capaCIty If the partIes cannot agree on a medIcal consultant, the ChaIr may call on a consultant from a roster supplIed by the College of PhysIcIans and Surgeons. The medIcal consultants WIll prOVIde mformatIOn on the nature of speCIfic Illnesses or dIsabIlItIes The ChaIr may request an mterpretatIOn of medIcal reports, test results and other medIcal documentatIOn on file The medIcal consultant IS not a member of the commIttee and WIll not prOVIde an opmIOn related to a decIsIOn on the appeal. FEES Fees and expenses, as approved by the partIes, of medIcal consultants and the ChaIr shall be dIVIded equally between MBS and OPSEU FORMAT OF MEETINGS. Each appeal WIll be dealt wIth separately Both partIes, through theIr representatIves WIll prOVIde, full dIsclosure of the supportmg documentatIOn upon whIch they mtend to rely ThIs Claim #153627 7 dIsclosure wIll take place at least two weeks m advance of the meetmg of the subcommIttee dealmg wIth the subject matter of the appeal. If the ChaIr reqUIres clarIficatIOn of medIcal eVIdence, a meetmg of the SubcommIttee WIll be arranged wIth a medIcal consultant agreed to by both MBS and OPSEU, or faIlIng such agreement, wIth a medIcal consultant called by the ChaIr MBS and OPSEU WIll Jomtly present a statement of agreed upon facts (to the extent possible) for the appeal to the ChaIr ASIde from the ImpartIal medIcal consultant dIscussed above, no other WItnesses WIll be called, except by request of the ChaIr However, the mdIvIdual claImant WIll be allowed to file a wntten statement m lIeu of testIfymg. If the mdIvIdual claImant chooses to file a statement It must be prOVIded to the Management Co-ChaIr of JIBRC at the same tIme as OPSEU's request for appeal. MBS has the nght to mtroduce a WrItten response to thIS statement. OPSEU WIll present ItS posItIon on the case wIth supportmg arguments to the ChaIr MBS WIll present ItS posItIOn on the case wIth supportmg arguments to the ChaIr and WIll respond to OPSEU's posItIon. OPSEU WIll have rIght of reply PresentatIOn by both partIes WIll be based upon the mformatIOn/record on file before the msurance carrIer at the tIme the matter IS removed from the JIBRC, the employee statement If any and MBS' s response to the statement. EIther party may, If necessary request the attendance of the claImant, who shall be allowed a leave of absence wIthout pay, wIth no loss of credIts, to attend the sub-commIttee meetmg as an observer only The ChaIr WIll render a wntten decIsIon wIth supportmg ratIOnale FREQUENCY OF MEETINGS: On an as needed basIs as determmed by MBS and OPSEU Jomtly Claim #153627 8 The partIes agree to these Terms of Reference m support of the ImplementatIOn of ArtIcle 22 9.2 and AppendIx of the collectIve agreement. In the mstant matter, the partIes agreed to the followmg facts 1 Mr D.P was born December 23, 1954 He IS 49 years old. 2 Mr D.P was employed by the Mimstry of CorrectIOnal ServIces as a CorrectIOnal Officer 3 Mr D.P has been a member of the Ontano PublIc ServIce smce Apnl 7, 1980 4 Mr D.P's last day worked was October 18, 2000 He receIved short term dIsabIlIty benefits from October 19,2000 to February 25,2001 5 Mr D.P dId not receIve long-term dIsabIlIty benefits from Apn119, 2001 untIl December 18,2001 6 Mr D.P 's claIm IS for the penod Apn120, 2001 onward. 7 Mr D.P's claIm IS for the OWN OCCUPATION defimtIOn of benefits In the attendmg physICIan'S statement, dated December 21, 2000, Dr J.B SaId that the claImant suffered from a major depressIOn, leg pam (not yet dIagnosed), sleep dIsorder and rectal bleedmg. It was also stated that Mr D.P was on antIdepressants and It was unknown as to when he would be able to return to work at hIS own occupatIOn. On January 21, 2001, Dr J.H. wrote to the claImant's famIly physICIan and stated the followmg, m part. I am sorry about the tardy colonoscopy report, whIch mCIdentally was completely normal He hasn't had any anal symptoms smce thIS test was performed. If hIS symptoms recur, he mIght be a candIdate for a mIld anal dIlatatIOn. I realIze there are lots of other problems on hIS hands, mcludmg the fact that he's soon to be laId off WIth the closure of the Stratford JaIl and thIS probably has some bearmg on hIS general presentatIOn. Claim #153627 9 Dr J .H. also wrote to ManulIfe on March 7, 2001 m response to enqUInes. In that letter he stated. Thank you for your letter I enclose numerous reports regardmg two of hIS complamts VIS. rectal bleedmg and leg pam. Rectal bleedmg. ThIs gentleman ongmally underwent a hemorrhOIdectomy m March of 1999 and subsequently was back seemg me wIth a hIstory of rectal bleedmg. It was mvestIgated on the assumptIOn that he mIght be suffermg from a fissure but colonoscopy was basIcally unremarkable and hIS anal symptoms had subsIded by late January I have not seen thIS patIent smce that tIme Leg Pam. When I saw hIm ongmally m the office, January 1999 and subsequently m December of last year, no comments were made about hIS leg pam. I am therefore, unable to comment. F or the record, I should pomt out that of course that he IS know to suffer from vancose vems of hIS leg. He underwent, as you WIll note, a stnppmg of hIS long saphenous vem m the nght SIde In February of last year There was some correspondence between ManulIfe and the claImant about the amount of work, If any, he undertook as a manager of a Jumor hockey team. It IS not necessary to set out that area of dIspute as I dId not take It Into account m arrIvmg at my decIsIOn. Dr J.R., psychIatnst, wrote to the claImant's famIly phYSICIan on May 2, 2001 and stated the followmg Thank you for askmg me to see Mr D.P I had seen hIm m 1996 when he presented wIth sIgmficant problems m relatIOn to hIS marrIage and the emotIOnal consequences of that. I WIll therefore not go mto detaIls WIth regard to hIS early hIstory EssentIally m the last few years, Mr Claim #153627 10 D.P has returned to work and managed to work for a whIle However, he has had some mterruptIOns on account of surgery on hIS legs for vancose vems Smce October of 2000 he has been unable to work on account of severe problems wIth hIS legs for whIch he IS bemg mvestIgated. Mr D.P IS very preoccupIed wIth hIS Job, whIch he finds exrtremely stressful even m dIscussIOn. He seems to have developed some anhedoma and a sense of frustratIOn, uselessness and worthlessness. He IS not actIvely SUIcIdal He feels helpless often and does not wIsh to see any of hIS colleagues or others and prefers to stay at home m hIS own shell. He IS sleepIng reasonably well and IS able to look after hImself reasonably It appears as though Mr D.P IS expenencmg a number of depressIve symptoms However he IS not anxIOus nor IS he obsessIve compulsIve nor IS there any phobIa. There IS no element of pSYChOSIS nor IS there any cognItIve deficIt even thought hIS concentratIOn IS sIgmficantly affected. I agree wIth Mr D.P that currently he IS unable to return to any gamful employment on account of a number of health related and other Issues that seem to be overwhelmmg hIm. I have not changed hIS medICatIOn, whIch IS Effexor 75 mg. I have not gIven hIm any follow up appomtments at thIS stage as It appears as some one on one counselmg, SImIlar to the one that he was receIvmg In 1996, would be helpful to hIm. However, should there be any sIgmficant detenoratIOn, I would be happy to see hIm agam. After receIvmg the above medIcal reports ManulIfe mformed the claImant that he dId not meet the defimtIOn of totally dIsabled and therefore was not entItled to benefits Subsequently, an EMG report was sent to the carrIer regardmg the claImant's leg paIn. There were no abnormal findmgs therem. Further, a bone scan report was performed. In that report It was stated that there were degeneratIve changes m the metatarsal phalangeal Jomts, nght patella and both shoulders. In the follow-up letter sent from the radIOlogIst to the claImant's famIly phYSICIan dated June 6, 2001 It was stated, m part. Claim #153627 11 With respect to vocatIOnal Issues, degeneratIve changes m the feet would not ordmanly provIde the basIs for ongomg or permanent dysfunctIOn - partIcularly m the context of an approprIate course of conservatIve treatment. However, If return to work (RTW) Issues remam problematIc, It may stIll remam the most appropnate for thIS patIent to have an mdependent medICal exammatIOn. No such mdependent medIcal was undertaken. Indeed, there was VIrtually no further medIcal reports before me except a June 10, 2003 letter from Dr K.B, the claImant's famIly physIcIan m response to quenes made by the Umon. In that letter Dr J.B stated, In part. His dIagnosIs m March 2001 was pamfullegs, cause uncertam, and a mood dIsorder You lIkely have Dr C and Dr R's notes whIch speak to thIS m 2001 He had some hard eVIdence of degeneratIve changes m hIS feet on a bone scan. I am unable to comment on whether these condItIons remam the same today as I have not seem hIm smce November 2001 At that tIme, he was stIll havIng a lot of leg and foot pam aggravated by all the staIrs at work, for whIch work was unable to accommodate hIm. His mood dIsorder may have settled some, as I have not been renewmg hIS Effexor smce 2001 EIther that, or he IS suffermg WIth It untreated. His work restrIctIOns m Apnl 2001 revolved around domg staIrs m the JaIl Most Jobs reqUIred a lot of staIr work I understand, except for "the cage", whIch he only occasIOnally dId. All the staIrs and work on hIS feet aggravated the foot and leg pam. In 2000, he had mentIOned It got bad enough hIS legs were gIvmg out on hIm. AddItIonally, hIS mood was poor at the JaIl I belIeve there had been long, drawn out threats to Immmently close the Statford Jail, whIch would greatly dISrupt the lIves of the guards, partIcularly those who had long roots m the regIOn as they would eIther have to move a conSIderable dIstance or retIre ThIS created very poor morale, and a number of guards, Mr D.P mcluded, got burnt out WIth the chromcally stressful threat. With the above phYSIcal and psychIatrIC troubles he felt he was unable to contmue workIng there I am guessmg you possess the relevant copIes, but I shall re-copy them agam for your benefit. I saw hIm monthly m the office from Claim #153627 12 June to November 2001 to document hIS legs were not Improvmg and reVIew the enclosed specIalIsts' notes wIth hIm. I cannot comment on whether Mr D.P's condItIon was sufficIently dIsablmg to meet ManulIfe' s cntena for benefits, as I am a doctor not an msurance expert. I guess Mr D.P thought It was. There was no dIspute between the partIes that Mr D.P had a penod between February 25 2001 and Apnl 19, 2001 where he had no coverage and was not entItled to short term benefits It was the Umon's VIew that accordmg to the May 2, 2001 letter from Dr J.R., the claImant was totally dIsabled and so the appeal should be upheld. The Employer asserted that It IS eVIdent from the vanous documents that at no tIme was the claImant totally dIsabled. In my VIew, thIS appeal must be dIsmIssed. SImply put, there IS nothIng m the eVIdence before me that would have me find that the claImant IS wholly and totally dIsabled from performmg the essentIal dutIes of hIS own occupatIOn. The only ObjectIve eVIdence regardmg hIS leg pam was a report of degeneratIve changes However, It was make clear by the physICIan who performed the test that thIS condItIOn does not normally render one dIsabled. He suggested that an mdependent medICal exammatIOn be performed but that was never done accordmg to the file The objectIve eVIdence regardmg Mr D.P's rectal bleedmg was that after a colonoscopy m January 2001, hIS symptoms abated. Fmally, the report from the psychIatnst IS sIgmficantly short of establIshmg that the claImant was totally dIsabled. Indeed, he was seen only once His Claim #153627 13 medIcatIon was not altered and Dr J.R. decIded It was not necessary to contmue to treat the claImant. He suggest counselIng but agam, there IS no eVIdence that suggestIon was acted upon. The Umon suggested that, accordmg to the file there was no eVIdence the claImant was offered accommodatIOn. That mIght be so However, any Issue regardmg a faIlure to be accommodated IS properly argued m another forum. I am buttressed m my VIew that the claImant IS not totally dIsabled by the June 10, 2003 letter from the claImant's famIly phYSICIan. Dr J.B had not seen the claImant smce November of2001, had not refilled the prescnptIOn for antIdepressants and dId not report that any counselmg had taken place It IS worthy of note that the clImcal note Included m the eVIdence before me do not extend mto the penod for whIch the claImant IS askmg for benefits F or those reasons, the appeal IS dIsmIssed. Dated m Toronto thIS 6th of July, 2004 FelIcIty D Bnggs Claim #153627 14