HomeMy WebLinkAbout1984-0241.Peters.87-03-05IN THE MATTER OF AN ARBITRATION
Under
THE CROWN EMPLOYEES C'jLLECTIVE BARGAINING ACT ,. _
Before
THE GRIEVANCE SETTLEMENT BOARD
BETWEEN:
OPSEU (Susan Peters)
Griever
Before:
For the Griever:
For the Employer:
Hearings:
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The Crown in Right of Ontario
(Ministry of Health)
E. B. Jolliffe Vice-Chairman
I. J. Thomson Member
G. Peckham-~ Member
. .
N. Roland
COUtlSel
Cornish & Associates
Barristers & Solicitors
J. Zarudny
Counse 1 Crown Law Office, Civil
Ministry of the Attorney General
June 13, 1985
September 11, 12, 13, 26, 27, 1985
October 17, 18, 1985
November 28, 29, 1985
.Tanuarv 15. 16. 17. 1986
Employer
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Between:
IN THE MATTER OF AN ARBITRATION
Under
THE CROWN EMPLOYEES COLLECTIVE BARGAINING ACT
Before
THE GRIEVANCE SETTLEMENT BOARD
Before:
OPSEU (Susan Peters et al)
- and -
The Crown in Right of Ontario
(Ministry of Health)
Edward B. Jolli.ffe, Q.C.
I.J. Thomson
George Peckham
For the Grievors; Nelson Roland -- Cornish h Associates
Barristers & Solicitors
Ministry of the Attorney General
For the Employer: -- John Zarudny
Crown Law Office, Civil
241/84
Grievor
Employer
Vice-Cha~irman
Member
.-Member
Counsel
Counsel
Hearings at Toronto: -
June 13, September 11,12,13,26 and 27, 1985 October 17 and 18, 1985 November 28 and 29, 1985
January 15,16 and 17, 1986
February 11,12,19,20 and 24, 1986
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DECISION
The Grievor in this case, Ms. Susan Peters, was one of
eight clerks at the London~ District office' of OHIP in the
Ministry of Health who grieved in Nov,ember, 1982, that their
positions as Clerk 3 General in the Out-of-Province Claims Unit
(hereinafter called the "OOP" unit) were improperly classified.
They requested that their positions be re-classified Clerk 4
General, retroactive to October, 1979: Exhibits 2 and Exhibits 4A
to 4G inclusive. 'i..
The consensual basis for such claims is to be found in
Articles 5 and 27 of the collective agreement between Management
Board of Cabinet and Ontario Public Service Employees Union,
Exhibit 1, (said to be effective from January 1, 1982 to December
31, 1983) and in succeeding agreements. There is also- a
statutory basis for such claims set out in subsec.,tio~n 18(2) of
the Crown Employees Collective Bargaining.Act, as follows:
In addition to any other rights of grievance under a
collective agreement, an employee cl&ning,
(a) that his position has been irrproperly classified
. . . . . . .
may process such matter in accordance with the grievance
procedure provided in the collective agreement, and failing final determination under such procedure, the matter may be
processed in accordance with the procedure for final
determination applicable under section 19.
The matter did not come on for hearing until June 13,
1985, and further hearings were continued from time to time until
February 24, 1986. After protracted correspondence between
counsel and the ~Registrar of the Board, a "procedural agreement"
was reached and filed as Exhibit 3 on the first of 19 hearing-
days. The importan t paragraphs of that agreement are as fol .lows:
The parties in this matter (namely, OPSEH representing
eight individual employees and the Ministry of Health)
hereby agree as to the following on a without prejudice and
without precedent basis:
1. The Final Decision of the Grievance Settlement Board in
respect of the Classification Grievance pf Susan Peters,
dated November 19th, 1982 will be.binding on all
parties to the extent that the award determines the proper classification of Sue Peters, in respect of the
follwing classification grievances:
i) Jccelyn A. Marier - Grievance dated Nov. 19, 1982;
ii) R. Sue Macpherson - Grievance dated Nov. 19, 1982;
iii) Debra J. Lydestad - Grievance dated Nov. 19, 1982;
iv) Lynne L. Byblyk - Grievance.dated Nov. 19, 1982:
v) Silvia A. Weinhardt - Grievance dated Nov. 19, 1982;
vi) Comelia Voorhaar - Grievance dated Nov. 19, 1982; and
vii) Joanne Gatt - Grievance dated Nov. 29, 1984
The result in the Sue Peters case, in terms of whether or
not Sue Peters is properly classified as a Clerk 3 General as opposed to a Clerk 4 General, will be binding upon the
parties as if there had been separate arbitration hearings
and awards in the seven cases noted @ve.
2. The employer will waive its right to make a preliminary
objection as to the jurisdiction of theBoard based on any
argument that there has been noStage 2 meeting in the Sue
Peters case.
3. The employer will provide OPSEU and Sue Peters through
their counsel with at least one week's notice prior to June
13th, 1985 (namely, no later than 5:00 p.m.,~June 6th, 1985) with respect to any preliminary objections relating to
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arbitrability which will be raised by the employer -
otherwise, the employerwillbe deemed to have waived its
rights in respect of any such preliminary objections.
4. The counsel for OPSEU and Sue Peters will provide the
employer's counsel with at least one week's notice tie. no
later than 5:00 p.m., June 6th, 1985) with advice as to
whether or not there will be any "usage" issue in the Sue
Peters case and, the title of the position involved, the
position number and the name of the Ministry and incumbent
involved.
Ms. Peters testified for nine days, concluding on
November 28, 1985,and again in reply on February 12, 1986. She
had served withOHIP foralmosteightyears, including five as an
"Out-of-Province' claims clerk. The only other witness called by
her counsel was Dr. Peta Tancred-Sheriff,. who has written
extensively on women's work, classification and bureaucratic
organization.
Witnesses called by the Employer's counsel were Mr.
Wayne Ferris, who'has served since 1979 as Group Supervisor and
latterly Group Leader of the OOP unit at London, and is now
classified Clerk 5 General; Mr. J.M. Delaney, the OHIP District
Director since June, 1983, and Mr. Bryan C. Neale, Regional
Personnel Administrator with the Ministry'of Health.
Throughout the course of hearings more than 75 documents
were tendered in evidence, some more important than others.
Certain exhibits include several hundred pages, adding to the
bulk of material requiring consideration. The .Board is grateful
to witnesses for their explanations of such documents, without
which many would have been incomprehensible.
The Ontario Health Insurance Plan, generally known as
OHIP, functions as a Division of the Ministry of Healthy by
authority of the Health Insurance Act and then Regulations
thereunder. -The OHIP headquarters is, at Kingston, but there are
District Offices in London and eight other cities as well as
"Satellite Offices" in 10 locations such as Sarnia.
In the District Office at London, the Plan's work is
carried on by information and assistance clerks and those who
process medical and hospital claims from within Ontario, but
there'is --- or was in November, 1982 --- a group of eight
exclusively concerned with claims for services outside Ontario.
Broadly speaking, the Grievors in this case are engaged
in answering inquiries, as well as investigating and processing
claims and authorizing payment to~or on behalf of Ontario
residents (of their district) with QHIP coverage who incur
medical and/or hospital expense while away from Ontario. The
protection afforded by OHIP is not exactly the same for Out-of-
Province claimants as for those in Ontario and the conditions and
procedures for making and proving claims are necessarily
different. For these reasons specialized OOP units were
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established some years ago at London and other District Offices.
They receive claims originating in all parts of the world,
approximately as fol~lows:.
(a) From other Canadian provinces: 10 per cent
(b) From the U.S.A.: 75 per cent
Cc) From elsewhere abroad: 15 per cent
Obviously there are wide variations in procedures and
problems ,among the three groups above. The law may be different
in other provinces: certain matters are dealt with under inter-
provincial agreements or understandings, but their fee scales and
hospital charges are comparable to those in Ontario and on the
other hand; claims originating in the U.S.A. are characterized by
billing practices and higher charges which vary from state to
state (oreven between institutions) while professional standards
and practices are somewhat different from those in Canada. Other
problems naturally arise in connection with claims originating in
Europe, Asia or Africa. Another feature of foreign claims is
that many Ontario residents while abroad are. covered by "travel
insurance" policies and are not entitled to recover from OHIP
that part of their expense payable by~an insurance company or
plan.
The OOP unit at London in 1982 had a Group Leader with
supervisory responsibility. Doubtful points could be referred to
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him or occasionally to the 'Medical Consultant or even the
District Manager. In the great majority of cases, however, the
processing clerks work independently, relying on their experience
and judgment, fortified by a large stock of reference material to
which they have access. The issue here is whether their work is
underclassified at the level of Clerk 3 General.
It is not for this Board to fix the standards whereby
employee positions should be classified. Counsel were in
agreement that written standards for Clerk 3 General and Clerk 4
General already exist and must be respected. They were created
by.the Employer, which is exclusively authorized by statute ~to do
so. Subsection29(1) of The Public Service Act provides that the
Civil Service Commission (subject to the approval of the
Lieutenant-Governor in Council) may make regulations "prescribing
methods of evaluation and classifying positions" and "prescribing
classifications for positions." Further;. Section 7 of the Crown
Employees Collective Bargaining Act provides that "upon, being
granted representation rights, the employee organization" --- in
this case OPSEU --- "is authorized to bargain with the employer
on Terms and Conditions of Employment, e>cept as to matters that
are exclusively the function of the employer under subsection
18(l)..." Subsection 18(l) is as follows:
Every collective agreement shall be deemed to provide that
it is the exclusive function of the employer to manage,
which function, without limiting the generality of the
foregoing, includes the right to determine,
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(a) employment, appointment, complement, organization,
assignment, discipline, dismissal, suspension, work
methods and procedures, kinds and locations of
equipment and classification of positions: and
(b) merit.system, training and development, appraisal and
superannuation, the governing principles of which .are
subject to review by the employer with the bargainlng .
agent,
and such matters will not be the subj,ect of collective
bargaining nor come within the jurisdiction of a board.
Thus the merits or demerits of a classification standard
or standards are not subject to review by this Board.
Nevertheless, the application of the existing standard or
standards t,o a given position can be correct or incorrect, and it :.;~.y. :.
is the application which often becomes controversial, sometimes
resulting in arbitration by this Board of a grievance alleging
that "my position has been improperly classified," which simply
amounts to saying that the Employer's standards have been
incorrectly~ interpreted and applied in respect of a particular
position. The Standards themselves, although striving to be
comprehensive and precise are clothed in general language,
characterized by brevity. On the other hand, in a case like
this, there is a massive body of ev,kdence relating to the
position's requirements, duties and responsibilities, many of
which defy brief description.
The claim here is that the position has not been
correctly classified in accordance with the existing standards.
The object of reviewing and analysing~ the evidence is to
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ascertain whether the position, as it existed in November, 1982,
"fits better" in one standard than in the other. A.perfe'ct fit
in any standards is unlikely.
The starting-point must therefore be the text of the
Clerk General series, at least as far as the level of Clerk 4
General, which is the level claimed by the Grievors.
As previously stated, the OOP clerks consider their . ..*.;
positions to be wrongly classified Clerk 3 General and seek re-
classification to Clerk.4 General. The series, Exhibit 50,
defines standards for five.different clerical groups: general,
clerical typist, typist, clerical stenographer and secretarial.
The only paragraphs which need be quoted herein are those in the
preamble and in Classes 1 to 4 relating to the General Clerical
Series, as follows:
KINDSOF~PKCOVEPED: ---
These five series cover all office positions and office
supervisory positions that are not covered by a specialized
clerical, technical, equipment operating, or professional
class series.
GENERAL ctERIcAL SERIES - 7 CLASSES: --
This series covers positions where the purpose is to perform
clerical work entirely or in combination with incidental
typing, stenographic or machine operating duties. Where
exclusion of the latter would significantly change the
character of a position, or where they occupy a large
proportion of the working time, the position should be
assigned to one of the specialized classes, e.g. Clerical Typist. Positions for which specialized clerical series
exist,, e.g. Clerk, Mail and Messenger, Clerk, Filing, etc.
should not be assigned to this series. Group leader
responsibility normally begins at the third level, while the
fourth and above usually cover positions ~involving line
supervision; however, non-supervisory positions can also be
included.
51000
CL!Wil, GENERAL
CLASS DEFINITION:
Employees in positions allocated to this class perform elementary, routine clerical tasks, which require little lmowledge of office procedures and can be learned within a few hours. Assignments that are not self-checking are preceded by detailed instructions and
are checked on completion. Although, in some positions, employees
may assist others by performing parts of more complex assignments, they are not themselves responsible for the satisfactory completion of the overall tasks.
This is a terminal class for persons continuously performing simple clerical activities. It may also cover positions of employees
in training for higher level clerical work.
QUALIFICATIONS:
1. iGrade 10 education, preferably Grade 12; working knowledge of
arithmetic, spelling, punctuation and grammatical usage; some
familiarity with elementary methods'of checking names and
numbers and of sorting and filing.
2. Preference may he given for some satisfactory previous work
experience or training. . .
3. Ability to understand and carry out simple work instructions in an office setting; ability to learn to USC simple office
equipment.
Revised, December, 1963
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CLERK 2, CENFXAL
CLASS DEFINITION: ,i_
bployees in positions allocated to this class normally
perform a number of clerical tasks of limited complexity according to established procedures, where the prime responsibility is for
accuracy and an acceptable rate of production. Decision-making consists of determining whether material conforms to specific,
set-out procedures or standards and requires little background knowledge of regulations or statutes. tiployees may initiate
standardized letters involving little original composition.such as form letters,acknowledgments, reminders, etc. .~ They may slso assist with the training of junior staff. Assignments of unusual
difficulty are preceded by-detailed instructions or are carried
out under close supervision. The work is reviewed for adherence
to procedure and acceptable standards of accuracy @volume.
QUALIFICATIONS:
1. Grade 10 education, preferably Grade 12; working knowledge of arithmetic, correct punctuation; spelling and grannnatical
usage; some knowledge of common office practices.
2. At least,tuo years satisfactory experience as a Clerk 1, General, or an equivalent combination of experience and
education.
3. Ability to follow specific clerical instructions; ability
and willingness to perform clerical work of limited complex- ity at acceptable standards of speed and accuracy.
Revised, December, 1963
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51004
cm 3. CENEXAL
CLASS DEFINITION:
Employees in positions allocated to this class, as ojourney- man clerksfit, perform routine clerical work of some complexity accord-
ing to established procedures requiring a backgT.ound knzwledge of spec-
ific re,tiations, statutes or local practices. Decision-making involves
some judgment in the selection of, alternatives within a comprehensive framework of guidelines. Lnitiative is in the form of following up.errors
or omissions and in making corrections as necessary. Doubtful matters
not covered by precedent are referred to supervisors. Pluch of the work
is reviewed only periodicGUy, principally for adherence to policy and procedures.
Typical tasks .at this level include the preparation of factual
reports, statements or memoranda requiring some judgmentin the selec-;
tion and presentation of data; assessment of the accuracy of statements
or eligibility of applicants, investigating discrepancies and securing~~
further proof,or documentation as necessary; overseeing, as a Group Leader, the work of a small subordinate staff by explaining procedures, assigning and checking work.
.
This is a terminal class for many positions involving the competent
performance of routine clerical work common to the office concerned.
QUALIFICATIONS:
1. Grade 12.or an equivalent combination of education, training and
experiexq .
2. About three years satisfactory clerical experience.
3. .4bility to understand and explain clerical procedures and require-
ments; ability to organize and complete work assignments within prescribed time limitsr 3bi3,ity to maintain good working relation-
ships with other employees and the public served.
Revised, December, 1963
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51006
CLERK 4. CEWRAL
.CI.AS?i DEFINITION:
BnZnployees in positions allocated to this class perform a variety of responsible clericel tasks requiring a go+ background knowledge of specific re@ations; statutes or local practices.
Decision-making involves judgment in dealing with.variations from established guidelines or standards. h'omally, employees receive specific instructions only on unusual or special problemu as the
work is performed under conditions'that permit little opportunity for direct supervision by others. '~stters involving decisions that
depart radically from established practices are referred to super- visors.
Tasks typical of this level include the evaluation or assess-
ment of a variety of statements, applications, records or similar
material to check for conformity with specific regulations, statutes or administrative orders, resolving points not clearly covered by these instructions, usually by authorizing adjustments or recommend-
ing payment or acceptance; supervising a small group of njourneyman
clerks' or a larger group of,clerical assistants by explaining pmce-
dures, assigning and checking work and maintaining discipline.
QUALIFICATIOKS:
1. Grade 12 education or an equivalent combination of education,
traintilg and e.xperience. ~*', ?',I '..
2. About four years of progressively responsible clerical exper-
ience or ah equivalent combination of experience and higher
educational qualifications.
3. Ability to communicate clearly both orally and in writing; _ ability to instruct and supervise the work of subordinates. ~w
Revised. December. 1963
The progression of responsibi lity and skills required
may be seen in the stand~ards for classes 1 and 2, but of course
the most important are the. standards for 3 and 4 quoted above.
In Goobie 240/84 (Verity)
grievance alleging improper classifi
it was pointed out that a
cation may succeed before the
Grievance Settlement Board on either of two grounds:
(1) The measurement of the Griever's job against the
wording of the applicable class standards, the so;;
called "Standards Test," or -
(2) On proof that, notwithstanding the wording of the
class standards, other employees performing
equivalent duties are classified at a higher level
--- known as the usage approach.
The principlesabove were established by the Board over
a period of years and received judicial approval in the Brecht
case (1982) 40 O.R. (2d) 142 (Divisional Court).
_e
The usage approach was referred to in paragraph 4 of the
procedural agreement, Exhibit 3, quoted above, but it was not
resorted to by counsel for the Grievors. The Grievors' case
rests soiely on the language of the standards compared with facts
established in ~evidence.
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Among the numerous documents in this case is Exhibit 51,
the "Position Specification and Class Allocation Form" said to
apply to fh,e~Grievors' positions. Effective April 1, 1982, it,
gave the Class Allocation as "Clerk 3 General" for the following
reasons:
Journeyman clerical work of some complexity requiring a
background knowledge of the Health Insurance Act and
Regulations as applicable to Claims and Enrolment portions.
Decision-making and initiative involves appraising amount of
claim for payment, determining cause for rejected claims and
taking remedial action.
Apart from the reasons given, the specification contains
what purports to be a lengthy and detailed description of the job
including its purpose, a "summary" of duties and,responsibilities
(with percentage estimates of the time required for each
function)- and the "Skills and Knowledge Required." The previous
title of the job is given as "Claims Clerk" and a hand-written
amendment makes the new title "Claims Processing Clerk."
The remarkable featu~re of Exhibit 51 is that there is
nothing in a lengthy description to disclose that the Grievors
are exclusively engaged in processing out-of-province claims or
answering queries about coverage abroad. The only words giving a
clue to those essential feature of the job are in paragraph 3:
- maintaining records of in/out of province/country
medical/paramedical/hospital accounts by sources
documenting each account and maintaining log;
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Such words suggest that the processing of forei
is no different from processing Ontario claims, which
far from the truth.
gn claims
would be
The result of serious omissions is that Exhibit 51 does
not describe fairly or accurately the job being considered now.
It is apparent-that its language derives from earlier descript-
ions written when OHIP was attempting to have all claims pro-
cessed by one group of employees. The attempt was abandoned and
separate specialized units were organized for OOP purposes. The
classification system simply failed to keep abreast of an import-
ant organizational change. In many cases the position specifica-
tion has been an important and helpful part of the evidence, but
that is not so in this case. We find Exhibit 51 to be of little
value.
The grievances of Ms. Peters and seven other OOP clerks
were presented in November, 1982. There was no Stage 2 meeting
as required by the collective agreement; but that procedure has
been waived by the Employer in Exhibit 3. The next development
was a Job Audit, Exhibit 54, undertaken-by the Ministry. It is
said on the cover-page to have been carried out on February 2 and
3, 1983; the Director's stamp acknowledging receipt was dated
June 13.
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The auditor was Ms. Sally Kelly, Personnel dfficer in
the HumanResources Branch of the Ministry. She was charged with
auditing both the "Pay-Subscriber Group" and the OOP unit, but
she overcame the deficiency, so apparent in the Position Specifi-
cation of April 1, 1982. In doing so, she interviewed incumbents
and supervisors separately, reporting in Part A of her audit on
the Pay-Subscriber Group and in Part B on the OOP unit. In this
case of course we are concerned only with Part B.
,Ms. Peters was interviewed as a representative incumbent
of the OOP unit. On the right margin of the report appear
"Corrections/Additions" in her handwriting a,nd also what appear
to be comments or corrections by Mr. J.M. Delaney, the District
Director.
Before this Board Ms. Peters testified in detai 1 and at
length. To review all her testimony would require a book-length
decision, which is not really necessary. However, on the last ".;
page~of the job audit there appears the following statement,
signed by Ms. Peters:
. .
With the noted corrections or additions, I agree
that this. is an accurate description of my duties.
Mr. Delaney testified briefly before the Board on
January 17, 1986. He had signed the job audit under the
.following statement:
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With the noted corrections or additions I agree
that this is an accurate description of the
requirements of this position.
It thus becomes clear that there is a certain degree of
agreement between the parties, or at least between Ms. Peters and
the District Director. They agree about most of the facts but
not necessarily about their significance in light of the class
standards.
We propose to quote the au'dit report, Part '!B ,'I
paragraph by paragraph, taking note of all "Corrections/
Additions" marked on the margins, although the identity of the
commentator is not always certain and the meaning of the comment
is sometimes obscure. It may also be appropriate at some points,
to mention explanations Ms. Peters or Mr. Ferris made in giv~ing
their testimony. We are. numbering the paragraphs --- from 1 to
42 --- quoted hereafter.,
As one of seven staff assigned to the only Out-of-Province
Group, the incumbent is responsible for processing claims made against OHIP for hospital and medical services performed out-
side Ontario ie. in other Canadian provinces, within the United
States and other foreign countries - all out-of-province claims
for subscribers residing in the London District are processed by the Group.
The reference above to "seven" incumbents seems mistaken.
Eight incumbents, including Ms. Peters, had grieved in November,
1982, only a few weeks before the audit.
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Beside the reference to "other Canadian provinces," there is
a pencilled comment --- possibly made by Mr. Delaney: "fading," ,
followed by three question marks. lie may have had in mind
arrangements with other provinces to honour certain accounts, at
least up to the OHIP scale. Another comment immediately below
the pencilled query appears to be in Ms. Peters' hand: "Still
med elms out patient elms"
2) 'Ihe out-of-province claims prccessing group does not operate on
a fixed cyclical basis, but rather, claims are processed in
date order and input to the computerized system for payment on
a continuous basis; subscribers are routinely advised that a cheque normally takes from 4-6 weeks to process thereby
establishing an averaging processing time limit for the Claims Clerks: however claims can be processed in as little as 3 weeks .,~_ or t&e as'long.as 8 weeks during the peak workload periods occurring during the winter months ie. clerks process
approximately 15 claims per day except during February to July
when they will process approximately 30 par day.
3) The Group Leader has assigned claims to the clerks on a
subscriber-alpha basis; the incumbent interviewed is
responsible for all out-of-province/out-of-country claims for
subscribers with surnames beginning with the letters R, P and
K.
The incumbent interviewed was Ms. Peters.
4) The approximate breakdown of the out-of-province clerks function is 59% - assessing and processing claims, 40% -
inquiries and public relations, and 1% miscellaneous duties.
5) The clerks within the group take turns sorting and distributing
the mail on a time-allows basis; each clerk priorizes his/her own work, however, hospital claims are usually processed first
as payment is expected within 30 days.
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All clerks within the group were females. The'Group
Leader, classified Clerk 4 General at the time of the audit, and
since re-classified Clerk 5 General, was Mr. Wayne Ferris.
6) ~Claims are usually received in the form of letterhead accounts
(ie. statements from hospitals or medical practitioners); the
Claims Clerk prepares an index card by subscriber'alpha with
copies of all documentation attached: the index card is kept in
the clerks'.current file foroneyear - this provides a ready
reference and allows the clerk to keep track of duplicate bills
eg. subscriber and hospital both submit the same statement; as well as monitoring OHIP residency requirements (ie. must reside
within Ontario for four months each year) - in cases of
suspected abuse, the Clerk will send a 'proof of residency'
cardtothe subscriber requesting details of their continued
Ontario residency: in cases of continued abuse, the clerk will
refer the ~case to the 'Special Committee', Customer Service
Department .for resolution;~ if the subscriber has moved out of
Ontario permanently, the Claims Clerk will request a ruling
from Head Office regarding cut-off date for processing claims
on the subscribers behalf. The original documents are numbered .by a rotating clerk and sentto microfilming; these documents
can then be assessed on the microfiche by using the assigned nwnber.
Comments were made on the statement above that a ruling
is requested from Head Office "regarding cut-off date..." In
pen, Ms. Peters appears to have written: "this was in effect at
the time of the interview because of organization problems."
Next, it was commented in pencil: "cancellation is worked out
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with Cust Svcs." Then - in ink - Ms. Peters wrote "changed
lately was in effect of time of audit," and beside that comment
she wrote "normal procedure."
7) Upon receiving the letterhead accounts, the clerk will check
for the CHIP number and if missing, will attempt to obtain from the alpha-microfiche of subscribers: if problems are still
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encountered, the clerk will either call or write to the
subscriber; where the-subscriber haa not provided any address
or phone number, the clerk will direct an appropriate ,form
letter inquiry to the physician and/or hospital involved.
81 The Clerk ;will then review the letterhead account to ensure
that all the necessary information has been provided by the
subscriber; in terms of personal information the claim must
include the subscriber's surname, initials, OHIP number,
Ontario address, address to which the payment is to be sent,
patient's name, date of birth, etc.; claims must also include .~_ such professional information as the physicians/practitioners . . .~ full name, initials and.address, diagnosis, description of
medical services performed, dates and number of services, fees
charged for each service, etc. - where any of the required
information is missing or incomplete the Claims Clerk will
follow-up with the subscriber, physician/practitioner or
hospital as appropriate to obtain the required or clarified
information; indoing so the clerk has a number of form letters
at his/her disposal to avoid the delays encountered in creating
original correspondence or may also make inquiries by phone
where appropriate; approximately 55% of claims require follow-
up action of this type; this may involve requesting admitting
reports, operative reports, etc.
Booth in examination and cross-examination Ms. Peters
gave an extremely detailed explanation of all the steps which
must be taken and other steps it may become necessary to take
after an account is received. These are briefly described in the
Job Audit above. An attempt was made.on behalf of the Employer
to show that there is an established routine or procedure, that
there are few variations and that proble?s can be easily referred
to the Group Supervisor. In short, the Board is asked to believe
that the processing of foreign claims is relatively simple,
falling within the Class 3 reference to "routine clerical work of
some complexity."
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Ms. Peters' testimony was supplemented by that of Mr.
Wayne.Ferris. Significantly, he was in 1982 "Group Supervisor"
and saia his duties have been "the same since 1979". However, he
is now "Group Leader,ll classified Clerk General 5. He had
undoubtedly been under-classified Clerk 4 General< He has not
processed claims himself since 1974.
Much thatMr.Ferris said was informative,butwe do not
find substantial disagreement between him and Ms. Peters as to
the clerks' work. One difference between them was probably
natural. Ms. Peters .tended to minimize the degree of supervision
required by the clerks; Mr. Ferris tended to maximize it. The
truth probably is that a clerk as experienced and able as Ms.
Peters requires little or no supervision: a newcomer would
require much supervision, even if experienced in processing in-
province claims.
On the whole, the testimony of Mr. Ferris and evidence
later by the District Director, did nothing to persuade us that
the processing of foreign claims is "routine clerical work." On .*
the contrary, it is extremely complex and calls for good judgment
and discretion as well as communication skills.
It is now necessary to continue quoting the Job Audit.
- 23 -
9) 1520% of out-of-province claims must be translated:, there are
a number of staff in the District Office with second language
capability whose services may be used for translation, however,
where this is not possible the claim documents are forwarded to
Translation Services at CUeen's Park; depending on the volume
and complexity of material attached to a particular claim, the
Claims Clerk may attempt to decipher the information through
the use of multilingual dictionaries, thereby avoiding the
significant delays which can be encountered in arranging full translation;
A marginal comment in pencil --- referring to the first -
_,
line above --- is: "overall only 5% sent out." This probably
means that only 5 per cent were sent away for translations. More
were translated 'within the London office, as the next following
words explain.
10) In addition to requiring language translation, claims also
involve many different currencies which the Claims Clerks must
convert prior to the actual claims assessment process: all
currericies are converted into Canadian dollars using the exchange rate quoted by the subscriber or, if not indicated,
the Royal Bank exchange rate for the day the service(s) was
rendered; hospital claims from the U.S.A are paid in American
funds but medical claims from the United States
(physician/practitioner) are paid in Canadian funds as are all
types of claims frcm outside of North America.
11) One clerk within the Out-of-Province Group handles 'lost' out-
of-province claims for surnames beginning with ‘M’ and 'N'
which have been submitted to the OHIP-Read Office without any
reference to the subscriber's Ontario address; the clerk will check the on-line SAS system for the subscriber address and if
not available willordera microfiche copy of the last claim
processed for the subscriber: theclerkprocesses any claims
belonging to the London District Office but refers other claims to the appropriate District for processing with an SAS payment
history transcript attached.
-24-
Some one struck out the word "lost" in the first line
above and pencilled "unidentified" on the margin, below which in
pen are initials which appear to be those of Mr. Delaney.
12) Medical Claims - physician/practitioner/labs
The Claims Clerk reviews the medical claim to determine the
.place of origin (using an Atlas, if necessary); determines
where the service was rendered eg. physicians/practitioners
office, health spa, clinic, etc - the clerk must ensure that
the claim is an original itemized bill-statement from the
service provider: the clerk also establishes if payment is to
be made to the subscriber (usual) or physician/practitioner eg.
physicians/practitioners across Canada and the United States :~
cyan submit a claim agreeing to accept the fee per OHIP Fee'
Schedule; these physicians/practitioners can order OHIP claim
cards or the subscriber can prov,ide a blank claim card
(available in the OHIP Travellers Guide brochure); in this
case, the Claims Clerk must write to the service provider
detailing the OHIP Fee(s) payable for the service(s) rendered
and requesting confirmation that the fee is acceptable to the
service provider and that no request for additional payment
will be made to the the subscriber.
The OOP clerk must be vigilant in identifying the
eligibility of the person.providing service and the need for such
service. Certain services are not covered by OHIP,..e.g. medical
examinations required for-applications for employment or t.he
continuance of employment, life insurance, or admissions to
-- universities, colleges, camps or recreational activities.
13~) The Claims Clerk transfers information from the letterhead
accounts onto an OhTP claim card using dummy numbers indicating
province, state or world remaining, as well as a number
indicating the physician/practitioner specialty eg. a general
assessment performe$by a general practitioner is paid under OHIP Fee Schedule guidelines at $31.90; a general assessment
performed by a cardiologist is paid at $39.00 - the clerks have
- 25 -
lists of physicians by specialists but quite often must call
OHIP Head Office for more up-to-date information in .this
regard: allmedicalclaims are processed for payment to pay-
subscriber or pay-physician in the same way as the claims
referred to inPart Aof this audit report ie. assessment and
coding of claim cards, batching, numbering, microfilming,
keytaping, in-house edit and resubmission, mainframe edit and
payment/resubnission.
14) The process differs somewhat in terms of the approach to
assessment and medical review ie. mainframe resubmission, which
must be taken on the part~of the Claims Clerk and the degree of
researchrequired - medical claims are paid at the OHIP rate
for a similar service in Ontario; in many cases it is difficult
to directly relate a service or procedure to the Ontario Schedule of Benefits; the Claims Clerk must use his/her
discretion in terms of "ballparking" claims where the medical
terminology and fees vary from those listed in the Fee
Schedule; the Claims Clerk must be reasonably flexible in
interpreting claims and will normally award the benefit of
doubt in favour of the subscriber - in terms of medical claims
within Canada, the clerk is able to refer to Fee Schedules from
other provinces which are maintained for this purpose; in some situations the~claims Clerk must assess a claim without the
benefit of an operative report which would be essential and
requested for a comparable in'-province claim; these cases
arise frequently with claims from European countries which, may not only be in a foreign language, but may be far from adequate
in terms of providing accurate diagnostic and treatment infor-
mation: in these situations the Clerk must use her discretion
in determining whether or'not to pursue the matter by composing
and arranging for translation of an appropriate letter to the
service provider involved or "ballparking" the claim; the Clerk
would normally seek confirmation of her decision from the Group
Leader who may in turn suggest referring the claim to the
Technical Assistant or Medical Consultant; all claims for
plastic surgery/complicated surgeries, claims which cannot.be
identified within the Fee Schedule or claims which involve
unusually high fees eg. $2;000.for an appendectomy are referred
for adjudication by the Medical Consultant; approximately 10
claims per week will be referred in this manner by the Group Leader: the out-of-province claims clerks have the capability
of.assessing operative reports, however, claims in excess of
$3,000 must be approved by the Claims Production Manager and
the Medical Consultant.
15) Laboratory fees which are paid to the OHIP Fee Schedule are
submitted (original bill) by and paid to the subscriber.
- 26 -
16) HCSPITAL CLAIMS
In terms of assessing hospital claims, theclaims Clerk must
determine if the treatment was the result of an emergency and therefore medically necessary: if such is the case, the clerk
will process the claim for 100% payment, otherwise the claim is processed at 75% of the standard ward rate: in certain
situations a non-emergency hospital claim can be processed by
the Clerk at 100% eg. subscriber is out of the country as a
student, on sabbatical or business: the emergency vs. elective
nature of a hospital claim can be readily determined in most
instances, however, if in doubt the Claims Clerk may contact
the subscriber or hospital for further information eg. a sub-
scriber living in the Windsor area has an accident resulting in
treatment at a Detroit hospital- the clerk will correspond
with the Detroit hospital in an attempt to discover if the
accident took place in Detroit - in which case OHIP pays 100%
or the accident took.place in Windsor but the subscriber
elected to be taken to the Detroit hospital, therefore treat-
ment is considered elective and OHIP willonlypay 75% of the
claim.
Perhaps the most important limitation on coverage abroad
is the 75 per cent rule. In short, for example: a subscriber may
not take advantage of the plan by choosing to have elective
surgery atan expensive hospital in Florida when he could just as
well have had the same operation at an excellent facility in
Lon,don before going south. However, the OOP. clerks are often
called on to deal with borderline cases where it is not crystal
clear whether admission to a hospital was elective or emergent.
Judgment, discretion and tact are then required.
.$“”
171 A reciprocal arrangement exists between provinces in Canada
regarding hospital claims; hospitals providing in-patient
services to an out-of-province Canadian will bill their
respective Health Plans which, in turn, bills the subscribers
Health Plan - these claims are processed by OHIP Head Office:
hospital out-patient claims are ,processed by the District
Office at a reciprocal flat rate.
-.27 -
For obvious reasons, the processing of claims
originating in other provinces is much simple,r and more
expeditious than processing claims from foreign countries. But
claims from other provinces amount to only about 10 per cent of
the total; 90 per cent originate in the U.S.A. and other foreign '
countries.
18) U.S. hospitals submit separate claims for technical services
eg. X-rays versus professional service (physicians/practit- ioners); this is the only instance where the professional
portion of a procedure is paid at the same rate as the hospital
claims ie. 100% emergency and 75% elective, regardless of the
fee set for similar procedures in the GBIP schedule of Benefits.
19) The Claims Clerk completes a Form 120 for each hospital claim
received; the Clerk must determine if the subscriber has paid any portion of the hospital bill eg. some U.S. and European
hospitals require a deposit prior to admission; the clerks will
deduct from the hospital bills any charges that are non-insured
services under the CHIP plan eg. semi-private or private room charges, telephone, television charges etc. the subscriber is
. ..personally liable for these charges directly to the hospital or
in the event that the subscriber has paid a portion or all of
the hospital bill the non-insured services will be deducted
from OHIP payment to the subscriber.
20) If the hospital claim involves charges for blood transfusions,
the clerk determines if the hospital concerned is a member of
the AmericanRed Cross in which case the blood is replaced by
the Canadian Red Cross in a reciprocal arrangement otherwise
OHIP will cover the cost of the transfusion. .w
21) 'Ihe Claims Clerks also examine hospital claims and/or invoices ~ for any recording of an additional insurance carrier; in
certain instances hospital documents indicate a primary carrier
other than OHIP eg. Medicare, which could be evidence of fraudulent use of 0~1~; in these situations the clerk will
write to the hospital or Medicare requesting a statement of the portion of the claim paid by Medicare to determine OHIP's
portion of payment, if any.
- 28 -
Being on the alert for evidence suggest ing possible
fraud is not a characteristic of "routine clerical work." Even
if there were no fraudulent intent on the part of a subscriber,
carelessness or ignorance could lead to duplicate payments (to
lerk is expected the subscriber) for the same account. The OOP c .i
to make sure that this does not happen.
22) If the hospital services rendered are as the result of an
accident, the Claims Clerk ensures that a copy of Form 120 is
sent to the OHIP Subrogation Department and if the subscriber
is also insured under Blue Cross (Canadian Supplementary
Insurance) a CODY of Form 120 indicatincl OHIP payment is
forwarded to this-organization.
A marginal note in ink by Ms.Peters wou Id add the wprds
"or personal injury" to the word "accident" in the first line
above. The concluding lines --- beginning with the words "is
also insured" have been,struck out with a pencil. A marginal
note in ink --- not Ms. Peters' writing --- appears to be "no
sub," to which Ms. Peters added "actually to the sub."
23) "Hospital" claims may be received from clinics, institutions or
spas which are not.covered by OHIP; the Group maintains a record indicating the status of known-facilities relative to
OHIP coverage: as the Claims Clerks are made aware of new institutions, etc., the Group Leader will obtain a ruling of
their status from-the Medical Consultant eg. OHIP does not
consider treatment at Dr. Buyrzinski's cancer clinic in Texas
an insured benefit: in some cases OHIPmay cover a portion of the services provided by an institution .eg. initial
assessment.
--
- 29 -
The OOP clerk must exercise caution in identifying an
institution providing service, by whatever name it may be called.
OHIP coverage does not extend to health spas or similar
facilities, or to admissions for cosmetic surgery. There are
other limits: fo.r example benefits at the approved rate (up to
60 days' care) are provided only if an acute attack requires the
subscriber to be admitted into a tuberculosis sanatorium or
psychiatric hospital outside Ontario.
24)
25)
Receipted medical and hospital claims submitted tcgether by a
subscriber~'can be paid on.one cheque eg. a subscriber was
treated as an out-patient in the emergency department of a
hospital and has paid for emergency out-patient service plUS
the attending physician's fee - the Claims Clerk completes a
claim card including both medical and hospital charges: the clerk then uses a dummy diagnostic code on the claim card in
order that the claims will reject from mainframe review thus
producing a resubmission document and patient history: the
Clerk manually assesses the resubmission document in the
appropriate currency in order that.the subscriber will receive
payment for both hospital and mediFa,l, claims on the same cheque.
Hospital claims are numbered and filmed in the microfilm unit,
keyed in data entry onto a magnetic tape for processing through
the mainframe computer system in Toronto; a hospital claims
payment listing is produced which is circulated to the claims
clerks by a group 1eader;the clerks identify their claims by
subscriber surname and note on their corresponding subscriber index cards, the claim number and the date of payment; all
unpaid/rejected hospital claims are &turned to the Clerk as
resubmission documents: the clerk identifies the reason for
rejection from codes on the hospital claims payment report,
which may necessitate pulling the original documentation; the
Clerk will correct and process if possible eg. data entry
error: if the claim has rejected for reasons of eligibility eg.
coverage lapse, the claim/letterhead account and any
accompanying original documentation is returned to the
originator (subscriber or hospital) explaining the,reason for
rejection: claims may also reject if they do not conform to the
Medical FuAes programmed into the computer eg. daily payment to a hospital cannot exceed $1500.00.
- 30 -
An example of recorded hospital accounts appears at page
6 of Exhibit 24. It will be seen that patients' names are
deleted, payments were made to hospitals in Iowa City and Paris,
France, and one payment reimbursed a subscriber.
DATE I 23/05/(15
WOSPITAL CLAXHS STSTEH
OUT OF PROYINCE
CANAOIAN PAYMENT LIST
HElllO
PAY WEOISTERED - OAK” TYPE T
"OSP DHIP; AIWUUY mmn4t GIVN PdTIfNT imy lO"I, DISCW
No No PAID OlLLEO Nb,lE SURNA”E DATE DATE DATE
9991 55.65 sa.7t
PAYANE ,O t (MIV OF IOWA HOSPITALS AW CLINICS
PPPl m3.92 E63.92 1407 0903a5 040305
PAYABLE TO t 52 6LENAN AVE TDRONYO ONY
9991 6,105.94 11,957.92 2zoa 120205 1**5a5
PAYASLE TO t ~INSYIYUT GUSTAVE RO4tWf 94665 “ILLEJVXF CEDEX PARIS FRANCE
TOTAL AH0W-T t 8,X5.51 11,726.S6
26) All claims which pass through'for payment result in the
issuance of .a cheque to the subscriber,
practitioner depending on the nature of the claim.
hospital or
27) Subscribers do not receive a breakdown of fees paid on their :.*. behalf as the only receipt provided is the cheque stub which
shows only one claim number and the date of the initial service
covered by the claim payment; where subscribers have extended
health coverage through a private agent eg. Blue Cross, Mutual
of Cmaha, Confederation Life, etc. they are compelled-to
contact the District Office to obtaindetails of the payment
for referral to the private carrier to determine payments owing
under the extended health coverage - these inquiries which may
be by phone, in writing or in person (walk-in inquiries)
require that the originating Claims Clerks retrieve all
documentation surrounding the~claim and develop an itemized
account of all services, fees claimed and amounts paid by OHIP; these itemizations and copies of any bills are forwarded by- the
- 31 -
Clerk to the private insurance carrier; these inquiries may
also be received by phone or in writing directly from the
insurance carrier and, in these situations the Claims Clerk
will respond directly to the carrier ; the Claims Clerks have
regular contacts with insurance agencies to provide information
with respect to itemizations and to discuss and/or provide
additional details surrounding all information forwarded on behalf of individual subscribers.
The last few lines of the paragraph above were amended
in ink, substituting "sub" (subscriber) for "insurance carrier"
and 'carrier" and substituting "inquiries from" instead of
"regular contacts~ with." However, all the words inthe last few
lines --- beginning with "these . itemizations" --- have been
framed with a pencil and marked "out" apparently by Mr. Delaney.
There is also a comment in very different pencilled handwriting:
"Check with hospital administration frequently."
28) Itemizations may also be requested by lawyers eg: where death
i hae occurred out of the country and an attorney is settling an
estate: the Claims Clerks will respond directly to these
inquiries obtaining the necessary authorizations where they
have not been provided.
29) Itemizations can be very time consuming depending on the number
and complexity of services covered by an individual payment: each Clerk will complete approximately 20-25 itemizations per ~'
month. .*
Beside thee above paragraph was the comment in ink: "some
are informed as opposed to typewritten" --- but these words were
stru,ck out by an unknown hand.
- 32 -
30) Claims Clerks within the Out-of-Province Group are also
responsible for dealing with a variety of telephone and written
inquiries; each Clerk will handles approximately 100 written
and 170 oral inquiries per month; inquiries may relate to (a)
general questions regarding out-of-province claims eg. services
covered and not covered, procedures for making claims, whether
ornotservices provided byaparticularclinic or spa are an
insured benefit, etc.: (b).the status of a particular claim or
problems surrounding payment eg. cheque not received, payment
made to the wrong party: subscriber not being aware of certain
payment policies which have resulted in the reduction oft the
expected payment: (c) calls f rom out-of-province practitioners
and hospitals concerning OHIP's policies and procedures and
liabilities for payment: and (d) telephone inquiries from
M.P.P. offices on behalf of constituents concerning the status
of particular claims; all responses to specific inquiries
regarding individual OHIP contracts are handled within
confidentiality and Security guidelines.
The Ministry has published a booklet entitled "The
Traveller's Guide to the Ontario Health Insurance Plan," Exhibit
29. If all residents leaving Ontario were to obtain and study
it, no doubt their claims would be submitted in better order and
:they would have fewer inquiries and complaints to make. It is
clear from Ms. Peters' testimony that many claims are defective
when submitted and many~ subscribers do not understand what their
rights are.
Exhibit 29 explains clearly "How to Claim Benefits."
There is an explanation of "Insured Benefits Outside Ontario" and
its limitations, a list of "Services not Covered" in Ontario or
elsewhere and a list of benefits covered only in Ontario.
Moreover, there is a salutary warning at page 9 headed
"Important!' a.+ follows:
- 33 -
Since by law, the Plan cannot reimburse you for more
than the amount it would have paid for the same services
in Ontario, all of your costs may not be covered. This
is of particular importance in some centres'ifi the
United States where professional fees may be much higher
than in Ontario. The possible advisability of extra
coverage from private insurers is discussed onpage 5.
claims for physician and practitioner services are reim-
bursed in Canadian funds in accordance with the fees
listed in the OHIP Schedule of Benefits. ,
At page 5 travellers are advised that "extra coverage is ~'1~
insurers, several of whom have plans for available from private
just that purpose."
31) The Claims Clerks will attempt tohandle allcallsand refer
only those which are outside of their terms of reference to the
Group Leader; calls will also be referred to the Group Leader if the caller is particularly irate or requests to speak to
saneone in higher authority.
32) '. Contact with the public (ie. subscribers, physicians.,~.
practitioners and hospital/clinic representatives) is an
ongoing and regular feature of the'cut-of-Province Claims
function; the Claims Clerks must exercise tact and diplomacy in
dealing with inquiries in a number of potentially difficult
situations eg. (a) the subscriber is not familiar with and/or .I-.
is not prepared to accept OHIPpaymentpolicies; (b) the sub-
scriber is upset because payment is being unavoidably delayed :-*..
due to the need to obtain moredetailed information.from the
service providers: or (c) the person making an inquiry has
limited command of the English language and/or has difficulty
in comprehending the advice being offer-ad.
A pencilled comment was made beside the opening words Of
the paragraph: "Common to all on different basis.“
- 34 -
33) Inquiries may lead to the cancellation of a cheque or recovery
of funds eg. (i) a subscriber may not have advised OHIP of a
change of address; cheque has not been returned and must be considered lost (ii) payment has been sent to a hospital when,
in fact, the subscriber had paid the bill upon being discharged
therefore the Clerk must write to the hospital requesting a
refund on behalf of the subscriber: a Cheque Registry (subscriber payments) and the Hospita1.Claim.s Payment listing
are utilized by the Clerks in researching the status of
payment: the Clerks can also obtain copies of cancelled cheques
where necessary by contacting the Insurance and Accounting
Office.
34) Walk-in inquiries normally cover similar topics as phone and
written inquiries, but may also involve taking submissions from subscribers eg. a subscriber may gather all claims accumulated
over an extended period and personally deliver them to the Office upon returning to the Province; the Claims Clerk would
examine all documentation for accuracy and completeness and assume responsibility for processing the claim.
35) Production Reporting
The rate and volume of production is not a critical feature of
the Out-of-Province unit, however production reports are maintainedby the Clerk on a daily basis; the daily reports
provide a count of claims processed (divided ,into out-of-
province and out-of-country), claims referred to the Technical
Services Department for adjudication, eligibility rejects,
researches conducted, resubmission and adjustment documents
processed, form letters, and composed correspondence sent out,
walk-in and telephone inquiries received and number of
microfilm copies ordered.
36) Actirq Assignments
The Out-of-Province Claims Clerk willactas Group Leader in
his/her absence: the Claims Processing Supervisor will normally
assign one out-of-province Clerk to deputize for the Group
Leader if the absence is for one day; for lengthier absences
caused by illness, vacation etc. each of the out-of-province
Clerks will be assigned specific duties of the Group Leader position.
Whatever it may mean, an asterisk (in ink) appears at
the left margin of the words "out-of-province Clerk to deputize
- 35 -
for the Group Leader" and on the right (also in ink) is a scrawl
which appears to be initialling by Mr. Delaney. It is not clear
whether he wished to emphasize the point or question it.
371 Allout-of-province Clerks have input regarding'the review,
correction and revision of Cut-of-Province forms and documents
in order to provide a more efficient flow of information.
There was a comment in pencil beside the a~bove
paragraph: "not necessarily," but it has been struck out in ink.
Ms. Peters then wrote in ink: "This would apply to all elms elks
if requested." A further inked comment in different.hand-writing
was
"worked as a group for new payment letter used throughout
Dist. office."
38) Clerks Within the O&of-Province Group may be required to work
in any of the other claims processing~groups during peak workload periods; the reverse dces not hold true.
The las~t words above --- "the reverse does not hold
true” --- were struck out in pencil, but beside them appear in
pencil "can be.” Above that comment it appears that Ms. Peters .*
or an associate wrote in ink: "We believe the reverse can happen
but the incumbent does not agree fully i.e. hospital claims."
The point at issue here is whether in-province clerks
are qualified to process OOP claims without a period of
"training" or "donversion". Ms. Peters does not think so and Mr.
- 36 -
Ferris, the Group Leader failed to contradict her.
explanation is in the next paragraph.
39) Skills and Knowledge -
The out-of-province Claims Clerk undergoes three months of
training to reach the full working level of an Cut-of-Province
Claims Clerk however, the incumbent interviewed and the Group
Leader indicated that this training period is premised on a
clerk being fully trained @one of the other Claims Processing
Groups (Pay-Physician, Pay-Subscriber); previous experience Of
this nature provides the background knowledge of the OHIP Fee
Schedule, International Classification of Diseases, Health
Insurance Act, medical and computer terminology plus the
overall policies and procedures related to claims processing trhich provides a basis for the more flexible treatment of
claims in the Out-of-Province area; training in the position
would then involve interpreting unfamiliar medical terminology
in order to relate services/procedures performed to equivalents within the OHIP Schedule of Benefits; learning to deal with
~claims involving foreign ianguages and currencies and devel-
oping a sound working knowledge of the policies and procedures
governing out-of-provi~nce claims in order to respond
effectively to a variety of inquiries.
The
In the above paragraph the words -II training" and "full"
have been struck out i,n pencil (probably by Mr. Delaney
pencilled replacement "a period of conversion," below
Peters wrote "except agreed training for hospital"..
with the
which Ms.
The word
"training" when used again was struck out and replaced by
"convers'ion." A pencilled comment (again probably by Mr.
Delaney) was "could take a elk off the street and take the usual
22-24 months training O.K." after which an unidentifiable,
commentator wrote: "This holds true any position (not
realistic)"
- 3-l -
40) ,The Out-of-Province Claims Clerks acting as direct
representatives of the Ministry of Health in their daily
interaction with the public must ensure gccd public relations
are maintained: in order to be effective in this regard the
Out-of-Province Clerks must not only have an extensive
knowledge of theOHIPSchedule of Benefits, Health Insurance
Act, etc. but also be conversant with International Laws
pertaining to collection, assignment of rights and a variety of
other Health Insurance Plans eg. Medicare, Blue Cross, etc.
The words "direct representatives" has been circled in
ink and "the Ministry of Health" has been amended in ink to read
"OHIP." On the right Ms. Peters seems to have written "applies
to all elms processing clerk." On the left, half-way down the
paragraph is another mysterious asterisk. In the last clause
"International laws" is amended to read "International payment
policy," apparently initialed by Mr. Delaney. In a different
hand, the words added at the end of the paragraph are: “Social
Service Benefits of other countries Medical Plans." On the right
areseveral illegible words written in ink by an unknown person.
41) The Out-of-Province Clerks must maintain harmonious
relationships with out-of-province service providers to ensure
that future patients will not be denied access to health
services. -
. . :,..
On the right someone has written in ink "too dramatic"
followed by two question.marks and the words "covered above.”
Further comment by an unknown hand is i llegible except for'the
last two words-:. "processed promptly."
- 38 -
42) The position also requires the ability to function effectively
in a group/teamwork setting and the ability to process assigned
claims while dealing with a fluctuating volume of telephone
inquiries from a variety of sources.
There were no comments on this paragraph but an asterisk
appears to the left of the word “abi
lity."
In the foregoing revie.w o: E the -Job Audit all legible
comments (under the heading "Corrections /Additions") have been
reproduced verbatim. Most are not of great importance and reveal
no serious differences as between the incumbent and management.
It is fair to conclude that the text of the Job Audit, subject to
very few exceptions, represents ag~reement by the parties as to
the duties, responsibilities and requirements of.the position.
These are the facts to be tested against the language of the
standards for Clerk 3 General-and Clerk 4 General.
It is necessary to compare certain words in the Clerk 3
General Standard with the corresponding words in the Clerk 4
General Standard. Such words represent an atte,mpt to provide
indices whereby the two Standards may be distinguished from each;
other. It must be kept in mind, however, that & certain amount
of "overlapping" is inevit&Qe because some of the essential
requirements are found in both. It is also obvious that there
may be room for legitimate differences of opinion in assessing a
posit,ion. For example, any job has its "duties" and its
"responsibilities" --- which may or may not have equal weight.
The value of a "duty" is easier to judge. The value of a
"responsibility" may vary with the nature of a particular
position. It is clear that some jobs --- whatever the skills
required --- carry much more "responsibility" than others,
although the difference is not always recognized in a "Position
Specification and Class Allocation."
It may be useful to re-read the first paragraphs of the
two standards, side by side and thereafter compare the key words
or indices:
Class 3
Bnployees in positions allocated to
this class, as "journeyman clerks",
pefonn routine clerical work~of some
complexity according to established
procedures requiring a background
knowledge of specific regulations,
statutes or local practices.
Decision-making involves some judge-
ment in the selection of alternatives
within a conprehensive framework of
guidelines. Initiative is in the
form of following up errors or anis-
sions and in making corrections as
necessary. Doubtful matters not
covered by precedent are referred to
supervisors. Much of the work is re-
viewed only pericdically, principally
for adherence to policy and procedures.
Class 4
Fmployees in positions allocated to
this class perform a variety of
responsible clerical tasks requiring
a good background knowledge of specific
regulations, statutes or local practices.
Dscisionmaking involves judgment in
dealing with variations fron established
guidelines or standards. Normally,
employees receive specific instructions
only on unusual or special problems as
the work is performed under conditions
that permit little opportunity for direct
supervision by others. Matters involving
decision5 thatdepart radically from
established practices are referred to
supervisors.
class 3 Class 4
"routine clerical work of sore "a variety of responsible clerical
complexity according to established tasks”
procedures"
- 40 -
It can be argued of course that both versions fit the
nature of the work performed. Nevertheless, on all the evidence
before us, we think the Class 3 version does not fit the OOP job
and the Class 4 version does. We reach this conclusion princi-
pally for two reasons. The word "routine" is in our opinion
inappropriate and inapplicable. Secondly, the evidence estab-
lishes that there are indeed procedures set out in various
regulations, bulletins and memoranda --- scattered widely: ,.
throughout scores of hand-written, typed and printed documents
--- which are subject to variation and frequent revisions. Thus,
there do not exist "established procedures" in the proper sense . .
of that term. More important are weighty reference books such as
the "OHIP Schedule of Benefits Codes," Exhibit 9, listing code
numbers for hundreds of medical procedures together with the
"OHIP Schedule of Benefits" which (after a lengthy explanatory
preamble) specifies the amounts payable for each of the numerous
and varied kinds .of services performed by physicians, all coded
for computerization. Attached are also schedules of benefits
recognized by OHIP for Laboratory Medicine, Chiropodists, Podia-
trists, Chiropractors, Osteopaths and Physiotherapists. All
these are bound together as Exhibit 9 andformthebasic scale of
OHIP bqnefits in Ontario, which, however, are modified to some
extent in respect of services rendered abroad. Another volume of
importance to OOP clerks is the "CPT" or "Physicians' Current
Procedural Terminology", published by the American Medical
.,
- 41 -
Association. It specifies the U.S. code numbers for a great
variety of medical services, using terms which are often differ-
ent from the terms recognized by the profession in Canada --- and
by OHIP. It is understood that physicians and hospitals render-
ing accounts from off ices in the U.S.A. would not know the OHIP
codes or terminology --- or the benefits payable. Their language
and their codes must be translated from one system to the other;
a function of the OOP clerk which certainly cannot be described
as I1routine." Another text quoted in Exhibit 25 is the "Manual
of the International Statistical Classification of Diseases,
Injuries and Causes of Death" published at Geneva by the World
Health Organization, a United Nations Agency.
On the other hand, we conclude that the applicable words
in the Class 4 Standard do correspond to the real nature of the
work: "responsible clerical tasks." In short the work is not
.n
routine" and it is both "responsible" and "clerical."
..>7-?
Class 3 class 4
"requiring a background knowledge "requiring a gccd background kncxJledge
of..." of..." --
We have no difficulty in arriving at a conclusion about
this index. It is clear from the many documents put before,us --
and from the testimony of witnesses on both sides --- that the
work requires not merely "a background knowledge" but rather "a
- 42 -
good background knowledge of specific regulations, statutes of
local practices." Indeed, the knowledge of "practices" required
is not really local but extends to practices in many different
jurisdictions throughout the world and particularly the U.S.A.,
which does have insurance plans of various kinds both public and
private, but nothing comparable to OHIP.
Class 3
Qcision-making involves sane
judZpnent in the selection of alternatives within a ccmprehen-
sive framewrk of guidelines"
Class 4
"Cecision making involves judgrrent in
dealing with variations fmm established
guidelines or standards."
There is indeed a "comprehensive framework of
guidelines", but --- as previously explained ---~ they are
embodied in such a massive body of docu~mentation that they are
encyclopaedic in scope. Moreover, some were framed in the
Ontario context, while many others relate to special problems
which arise in processing med,ical and hospital claims from any
one of 50 Amer,ican states or from elsewhere in the world.
Exceptions and variations abound, as for example in OHIP's
special relationship with a hospital i-n fiichigaQ&nd with the
Mayo clinic. Having regard to foreign termino'logy and foreign
practices, which vary from'place to place, the judgment required
is more than the "selection of alternatives." That term might .be
applicable when processing claims from other Canadian provinces ~7..
(all o'f which are under t~he umbrella 6f'a federal statute, 6he
- 43 -
Medical Care Act) but it is not appropriate when dealing with
claims from abroad.
An attempt was made to show that there is no need for
OOP clerks to exercise "judgment in dealing with variations." It
was alleged that they have easy access to the Group'Leader and
that difficult or doubtful problems can always be take.n up with
the Medical Consultant. We are not persuaded that the
allegat ,ion is well-founded.
There would certainly be no access to the Group Leader
whenhe is away. Whenthatoccurs, as it must from time to time,
one of the Clerksbecomes acting supervisor of the unit, which
suggests that they are all deemed capable of actin~g in that
capacity, even if it be only temporary. As for access to the
Medical Consultant, it occurs occasionally when a new or
., exceptional problem arises --- which may even be referred to OHIP ."
headquarters at Kingston --- but it is clear that the Medical
.Consultant's primary function is not to supervise processing
clerks.. He is, as his title suggests, a consultant. ..,
.
The crucial point is that "variations"~are inherent in
the nature of claims submitted by subscribe.rs who have been
served.by physicians, hospitals, clinics or laboratories 'abroad.
Such claimsmust be supported by letterhead accounts of various
kinds from medical offices and/or hospital accounts which some-
- 44 -
times include medical fees and other charges. These procedures
are very different from those prevailing in Ontario, where both
physicians and hospitals are familiar with OHIP requirements and
render accounts on standard forms, so that "variations" ought to
be minimal. Such uniformity cannot be expected of individuals in
the U.S.A. or Europe or Asia, most of whom have never heard of
OHIP.
Finally, since OHIP has its own rules in respect of
foreign claims as well as those from Ontario, the OOP clerk~,is
constantly responsible for recognizing a "variation" when she
sees one. This in itself requires considerable experience and
judgment.
Class 3
"Initiative is in the form of
following up errors or anissions
and in making corrections as necessary. Doubtful matters not
covered by precedents are referred
to supervisors."
Under Class 3, the first sentence undoubtedly applies to
_.
Class 4
"Normally, employees receive specific
instructions only on unusual or special
problems as the mrk is performed under
conditions that permit little opportun-
ity for direct supervision by others."
one~aspect of the Grievorsl work. Many claims are received with
"errors or omissions", lacking the necessary supporting material.
It then becomes necessary for the clerk to "follow up".by writing
or telephoning the subscriber. It is often also necessary to
contract a foreign doctor's..office or a hospital or clinic to .P
clarify or supplement the information appearing on an account,
- 45 -
and thereafter decide whether such information meets OHIP
requirements and whether the account is payable in whole or in
part.
It is not always true, however, that "doubtful matters
not covered by precedent are referred to supervisors." The
matter may be "doubtful" --- and often is --- and it may or may
not be covered by precedent --- of which hundreds are referred to
in bulletins and in notes maintained by the clerks for several
years past. Not infrequently the clerks consult each other. The
'.evidence shows that although there may not be a precedent exactly ' Jo; 'l..
in point, the clerks usually have sufficient knowledge and
experience to understand what would be acceptable and what would
-not be acceptable to OHIP. It is when differences of opinion .:
arise that the clerks or the Group Leader would be most likely to
.~"F;"*-:'refer the problem to the Medical Consultant.
In the opinion of this Board the whole of the sentence
under Class 4 above clearly applies to the OOP clerks.
.*
The nature of the work is such that "direct" or
continuous supervision is obviously impossible. Medical claims
in excess of $3,000 must be approved by the Group Leader and the
Claims Production Manager, and unusually high fees are referred
to the Medical Consultant for adjudication. The clerks process
about 15 claims a day except during the busy period between
- 46 -
February and July when they process approximately 30 per day.
When volume is that high and many steps must be .taken in dealing
with each claim, it is possible for the Group Leader to observe
the unit from his desk but clearly not.possible for him to follow
what they are doing. His real function appears to be the
approval of claims already processed; If direct supervision were
actually required, he would need several deputies. However, in
the words of the Class 4 standard, "the work is performed under
conditions that permit little opportunity for direct supervision
by others."
Class 3 Class 4
"Much of the mrk is reviewed only "Matters involving decisions that depart
periodically, principally for radically fran~established practices
adherence to policy and procedures" are referred to supervisors."
What is said under Class 3,above is consistent with
"routine clerical work," done in accordance with well-established
procedures, so that periodic reviews or "spot-checking~" is
adequate to satisfy supervisors that all is well. In our view it
does not correspond to conditions in the oOP unit. .
On the other hand the statement under Class 4 above
fairly describes. what happens in the OOP unit, It is only'when a
claim raises the possibility of a radical departure from
established practices under OHIP regulations or policies that the
matter is referred to the Group Leader and/or the Medical
illustrative, and therefore helpful. . .
Class 3
Typical tasks at this level include
the preparation of factual reports,
statements or memoranda requiring sare
judgment in the selection and presen-
tation of data; assessment of the
.accuracy of statements or eligibility
of applicants, investigating discrep-
ancies and securing further proof or
dccmnentation as necessary; overseeing,
as a Group Leader, the work of a small
.subordinate staff by explaining pro-
cedures, assigning and checking work.
. . . . .~
- 47 -
Consultant. Claims originating from abroad can raise a great
variety of~questions, but the COP unit is expected to resolve
most of them without resorting to supervision.
EXAUPLBS
The next paragraph in the Standards is of much less
importance. The first paragraphs attempted (as precisely as
possible) to define the class by d.escribing the a.ppropriate
indices.. The second paragraphs, however, used the term "typical
tasks," clearly signifying that the words following represent
exam-, -- as counsel have recognized in many classification
cases. "Typical tasks", being.only examp~les, are neither
exclusive nor comprehensive. Nevertheless, they are
Class 4
Tasks typical of this level include
the evaluation or assessment of a
variety of statements, applications,
records or similar material to check
for ccnformity with specific regula-
tions, statutes or administrative
orders, resolving points not clearly
covered by these instructions,
usually by authorizing adjustments
or recommending payment or accept-
ance; supervising a small group of
"journey-man clerks" or a larger
group of clerical assistants by
explaining procedures, assigning
and checking work and maintaining
discipline.
- 48 -
Under Class 3 the first example given (down to the word
"data") does not apply to the OOP unit, although clerks occas-
ionally make recommendations or suggestio~ns~ for improving
procedures. The reference to "assessment of... eligibility 'of
applicants..." ,.,does apply to the OOP unit. Finally, the clerks
do act as Group Leader temporarily when he is absent, but of
course it is not a normal part of their work.
Under Class 4, the examples given clearly apply to the
OOP unit, at least down to the word "acceptance." Authorizing
adjustments or recommending payment or acceptance are tasks at
the core and centre of the positions occupied by the Grievors in
this case. Supervision of course is minimal, although all clerks
are qualified to substitute for the Group Leader when required.
On the whole, the "typical tasks" mentioned in the
second paragraphs of the two Class Standards demonstrate some
",overlapping," a not unusual phenomenon in a class series.
Under the heading "Qualificafions," educational and
other requirements are specified. It appears,, however, that
these have now been "superseded" by "Staffing Standards" issued
-by the Civil Service Commission almost 16 years ago.. In a
memorandum issued to all Deputy Ministers on June 24, 1971
(Exhibit 68) Mr. W.A.B. Anderson, Chairman of the Commission,
- 49 -
referred to a new Manual which he said "contains staffing
standards for the various classes in the Civil Service of Ontario
which replace and supersede the qualifications sections in
existing class standards."
Finally, it may be noted that the Standards discussed
hereinwerelastrevisedinDecember,1963, when the OOPunitdid
not exist.
A review of the class standards would not be complete
without reference to the testimony of Dr. Peta Tancred-Sheriff
and Mr. Bryan Neale, Regional Personnel Administrator with the
Ministry of Health.
Mr. Neale's experience (Exhibit 66) includes service
with the Department. of Tourism and Information from 1965 to 1972
as a Personnel Officer, with the Ministry of.Colleges and Univer-
sities; from 1972 to 1976 as Service Classification Officer, with
the Civil Service Commission from 1976 to 1978 as a-classifica-
tion Officer, then a Category Officer, then for two years as
Standards Officer u~@'il 1982 as Category/Module Officer within
the Civil Service Commission. He gave "general comments on Job
Evaluation, Exhibit 67, in part as follows:
Ihe purpose of any job evaluation system is to determine the
relative worth of jobs within an organization.
In the case of bargaining unit positions within the Ontario
Public Service, the system in use to accomplish this task is
- 50 -
the "grade description" system. Briefly, this system groups
together positions that are sufficiently similar in nature
to enable relative worth comparisons, into "job families" or
"class series." Levels or "grades" of whole job difficulty
are narratively described ranging from the least demanding
to the most difficult work. Each level of job complexity is
described in a class standard and the process of evaluation
requires a tihole job comparison to be made between.the total
position and these descriptions of job difficulty.
In job evaluation it is the requirements of the job that are
considered and not the competence of the individual in the
job. As a resulTone must always attempt toabstract the
individual from the job, since it is the responsibilities
demanded of the position that are being evaluated.
. . . . .
Ingradedescription systems, elements that contribute to
relative job complexity are identified and described and it
is these collective.'"compensable factor" descriptions within'
the grade levels when considered against the, j.ob
requirements as a whole, that determine the~approprfhte
classification level. Although we can, and usually do,
break down the standards into their compensable components
for the purpose of analysis, we must finally relate the
totality of the standard to the totality of the position since a whole comparison between the job.demands of the
position and thelevelof job complexity described within
the standard itself has to be made.
This is an important point - because grade description
systems consider the difficulty or complexity of a job as a
whole, the individual compensable components are unweighted.,..
Thus different jobs at the same level may exhibit various
strengths of one particular component. For example, while a
job may be weaker in the knowledge component than another at
the same level it may be stronger in the decision making
component to the extent that on a whole job comparison basis
they are still judged to be relatively equal.
Referring to Classes 3 and,?4 Mr. Neale said:.
In my opinion, it is significant in the context of the
present position under consideration, that certain elements
of possible job complexity are not identified as compensable
factors within the Clerk General series. The existence of
any such elements in this position cannot as a result be
taken into account in assessing the position against these standards.
- 5 l-
It is difficult to accept the "opinion" expressed above.
The plain language of the definitions for Classes 3 and 4 clearly
'.identifies factors connoting the degree of complexity, not
"possible complexity" but actual complexity. The only~reason for
identifying such factors i'sto aid in evaluating the job.
Indeed, the Class 3,definition uses the words "of,some complex-
ity." Mr. Neale repeatedly used the term "compensable factors,"
but that term does not appear in the series. If the components
identified in the definitions are not "compensable," what is the
purpose of formulating any definition?
Of course some of Mr. Neale’s remarks were said in the
context of earlier testimony by Dr. Tancred-Sheriff who had
referred to "undervalued and invisible skills", which she con-
tends are often overlooked or ignored in,evaluating positions
usually held by women. The crucial point, however, is whether
such skills are required by the inherent nature of the components
identified in a definition. For example, even if the'~ ability to
read,~ write and make a coherent telephone call is not mentioned-
in the definitions, such basic skills are so inherent in the
nature of the components specified that-it must be assumed they
are necessary, on which Mr. Neale's comment is:
Yet if we examine the Clerk General series we find that it
is not drafted in a fashion which addresses training time,
rate of knowledge base change, range of information to be
synthesized, or tension management and communication skills
as elements in determining a position's relative worth - in
fact it is not a skills oriented series.
- 52 -
Some.of the statements -quoted above are simply not
consistent with the language of the standards. Mr. Neale said
the Series, does not address "training time." Actually, the
Standard for Clerk 1 General, says that job, the lowest in the
series, "can be learned within a few hours." Mr. Neale said the
Series does not address "rate of. knowledge base change."
Actually, Class 3 requires "a background knowledge" and Class 4
re.quires "a good background knowledge." Similarly Class 3 and
Class 4 recognize a difference in "the range of information to be
synthesized." As for "tension management. and communication
skills," other evidence makes clear they are essential due to the
inherent nature of the work performed.
The Board must find there is no support for the sweeping
statement that the Clerk General series "is not.~a skills oriented
series." Such a statement suggests that all clerks in the series
.fall into the category of unskilled labour, a reductio fi ;.:.<:.
iew of clerical work. absurdum re'vealing an unduly narrow v
Incidentally, if the Clerk
skills oriented series" (as Mr.
General series "is not a
Neale claimed) then an .*
explanation-is due for the words appearing in~:large print as a
:. paragraph heading in Exhibit 51, which is the form known as
"Position Specification and Class Allocation FormrW authorized by
the Civil Service Commission with which Mr. Neale served for six
years. The heading is: "Skills and Knowledge Required to Perform
.~ ,i
- 53 -
the Work." This seems to represent a more realistic approach to
job analysis than that taken by Mr. Neale. Moreover, the answer
given in Exhibit 51 by the then District Directory, Mr. J.M.
Davis, and two other evaluators was as follows:
Proven clerical experience; knowledge of Health Insurance
Act and Regulations as applicable to claims functions:
ability 'to communicate both orally and in writing:
knowledge of medical terminology preferable.
After his analysis of the language in the standards, Mr.
Neale summarized his conclusions as follotrs:
What emerges when we consider the 3 and 4 standards as a
whole is: ~The Clerk 3 typifies a position where the work is
of some difficulty, with decisions generally encompassed by
guidelines and procedures, recourse to a supervisor is
available for the referral and resolution of doubtful
matters not covered by precedent or apparently
necessitating variations from guidelines or procedures, whose work is checked, not regularly, but only periodically
for adherence to procedures and policy.
Whereas the Clerk 4 is performing the work where decisions
are generally not governed by guidelines and procedures or precedent since it is regularly required they exercise
discretion in dealing with variations from them, within an
organizational environment where advice and consultation
from a supervisor is provided only on unusual or special
issues and to whom only those matters requiring a decision
involving a radical departure from practice are referred.
We share the view expressed by the majority of another
panel of this Board in Goobie 240/84 (Verity and Craven) at page
31:
- 54 - I
Having reviewed the Grievance Settlement Board's existing
jurisprudence, and after careful consideration, we find that
we cannot accept Mr. Neale's characterization of the Clerk
General Class Standards in terms of narrowly-construed
"compensable factors" which exclude consideration of factors such as the exercise of communication and relational skills
which we have found to be central to the Grievor's job.
Dr. Tancred-Sheriff is Associate Professor of Sociology
at McMaster University and an Editor of the Canadian Review of
Sociology and Anthropology. She won a doctorate from the London
School of Economics for her "Study of the British Civil Service
against the background of French experience." She has also
received several academic awards and authored several books and
many papers on bureaucracy, career patterns and women's work.
As .we understand her testimony, Dr. Tancred-Sheriff did
not really mount an attack on the la.nguageof the class standards
'but rather on an unconscious male bias in the interpretation
thereof. All society, she said, has "a tendency to diminish the
value of skills brought to work by women." This was of special
importance in the clerical series where (as Mr. Neale concedes)
the vast majority of employees are women. In evaluating work,
she uses five tools: .w
(1) the knowledge required;
(2) the degree of autonomy:
(3) the degree of responsibility in the light of
possible consequences;
,
- 55 -
(4) the oral and written communication content of
the job;
(5) the level of "tension management required."
'L, j.'..,
The witness mentioned the speed of technological change,
pointing out that word-processors were not in use when the
clerical standards were last revised in 1963. In this area of
work, she believes, invisible skills such as tact in dealing with :>':.,
clients or the public are important but are "usually not taken
into account." She remarked, however, that there are often
"invisible skills" in jobs held by men. She discussed the words
in the standards for Classes 3 and 4 and concluded by saying the
difficulty is that "certain skills are taken for granted."
Mr. zarudny, counsel for the Employer, had withdrawn his
objection to Dr. Tancred-Sheriff's testimony, but argued there-
after that it is not relevant. All that matters, he said were
two tests: what the standards require and what are the actual
duties of the position.
In the view of this Board, .t-he points made by Dr.
Tancred-Sheriff are not necessarily excluded by or inconsistent
with the language of the standards. In practice and by tradition
her points are sometimes disregarded by those charged with inter-
pretation and application of the language in the standards. This
I. phenomenon may,:be analogous to "the inarticulate major premise"
- 56 -
attributed to some other judges by the late Mr. Justice Oliver
Wendell Holmes of the United States Supreme Court.
Mr. James M.
Delaney has been District Director at
London since June, 1983, which was after the preparation of the
Job Audit. He has served 28 years in the Ministry of Health,
most of it with OHIP or its predecessor. For the assistance of
the Board he had prepared Exhibit 63, a booklet entitled "An
overview of the OHIP Administration London District Office Claims
Services.' Much of it explains the organization of the District
Office, but he also described "The OHIP Philosophy." He wrote
that the OHIP Mission is "to facilitate access to a defined set
of Health Services for all residents of Ontario." Among "Program
Goals" he specified "assistance to client groups to obtain
access to.-insured health care'services inside or outside
Ontario," and "prompt, accurate payment for eligible health care
services."
_ .M.r. Neale had sought to show that communication skills
are not part of the requirements of the OOP clerks' positions.
By way of~contrast, Mr. Delaney~defined one of the "Divisional
Objectives" as follows:
&rvice:
To provide prompt,~accurate, sensitive and
courteous service to the public and to providers.
- 57 -
Another objective was defined on page A-2 of exhibit 63:
To promote a favourable internal and external
perception of OHIP.
These seem to be examples of the so-called "invisible
skills," inherent in the nature of the job, which Mr. Neale
claimed cannot be taken into account. There might be something
in his argument if the clerk were required to do only paper work
at a desk, without ever speaking on the telephone or writing a
letter or meeting a member of the public to answer an inquiry or
explain a decision, but such is not the nature of the OOP clerks'
positions. The requirements of their work, as set out in the
Class Standards, make itessential for them to possess and use
communication skills as well as completing their paper work.
Mr. Delaney agreed that he had read the Audit Report and
did n.ot dispute it except for certain corrections or additions.
He said that as between himself and Mr. Ferris he "would prefer
Ferris‘ account." As he had not heard most of the Ferris . .
testimony, it can be assumed he had in mind that.he himself,
being District 'Director, has not supervised the OOP clerks, as
Mr. Ferris has for several years. However, he certainly had
access to Mr. Ferris, the Claims Manager and the Medical
Consultant when he signed the Job Audit.
- 58 -
During the course of hearings we were reminded by
counsel of previous decisions in classification cases, with all
of which we are familiar.
Counsel for the Grievors cited the fo
of this Board:
llowing decisions
Borges et al 21/84 (Verity)
.: Lynch 43/77 (Adams)
Knudson 248/80 (Samuels)
Woodcock 564/81 (Samuels)
Campbell et al 451/82 (Jolliffe), upheld on review. --
Brecht 171/81 (Roberts), upheld on review. .
Parise et al 238/83 (Roberts) --
Beals et al 30/79 (Draper) --
Roy et al 174/81 (Jolliffe)
Berry et al 217/83 (Samuels)
Goobie et al 240/84 (Verity) at 25-34. --
i
- 59 -
Counsel for the Employer cited the fo llowing decisions
of this Board.
Pretty 64/77 (Swinton)
Wheeler 166/78 (Swinton)
McCourt 198/78 (Saltman) at 13.
Montague 110/78 (Swinton) at 8.
Parise et al 238/83 (Roberts) at --
Rae 289/83 (Verity) at 8-9. -
Keown 387/83 (Verity] at 8-9.
Ivan 755/84,(Verity)
Watterworth et-al 1109/84 (Delis --
9-10
.e)
We do not think the conclusions stated hereafter are
inconsistent with the principles established in the jurisprudence
of this Board; which have not been successfully challenged on
judicial review. Broadly speaking, there is no serious dispute
about those,governing principles. Different cases have had
different results by reason of the evidence relating to the
facts, as they have been assessed by various panels of the Board.
i
- 60 -
CONCLUSIONS
In this decision we have attempted to expla in the nature
of the work done by the OOP clerks at London: we have relied
heavily on the Job Audit of February, 1983, because, with few
exceptions, the facts stated therein were verified in writing by
both Ms. Peters and the District Director: we have compared those
facts with the indices setoutin the Standards for Classes 3 and
4; we have discussed the opinions and testimony of the Employer's
principal.witnesses as well as the testimony of Ms. Peters: ,we
have been obliged to consider numerous documents admitted into
evidence and we have indicated what can be deduced from many
aspects of the evidence. Finally, we have taken in'to account
decisions made in the past by this Board.
In our review of the evidence we have already indicated
the inferences to be drawn from the foregoing sources.
Notwithstanding the extraordinary length of testimony and the
bulk of documentation we have been obliged to consider, we do not
find substantial disagreement between the parties as to the facts
so fu,lly stated in the Job Audit. The difference between the
parties really arises from .differing interpretations of, the
agreed facts when the applicable language in the Class Siandards
is brought to bear. On balance, we find that the evidence
supports the Union's interpretation.
_
- 61 - ~. .-
The Board is satisfied, for reasons hereinbefore stated,
that these grievances succeed: the positions of the Grievors were
in November, 1982, not correctly classified as Clerk 3 General,
and the i
Clerk 4
r positions ought to have been correctly classified as I
General.
Turning to the question of the appropriate remedy, we
conclude that the Grievors are entitled to be paid at the Clerk 4
General level as and from the dates of their grievances. Ns.
Peters’ grievance and those of six others were dated November .19,
1982, and that of Ms. Joanne Gatt was dated November 29, 1982.
The Employer’s records will make it possible to
ascertain the amounts actually paid to the Grievors at the level
of Clerk 3 General, and also the amounts which would have been
paid them at the Clerk 4 level. The difference down to the date . ..e .,.. _,
they are reclassified will be due and owing to them. If any of
the Grievers have ceased to be employed as OOP clerks, for
whatever reason, on any date since 1982, entitlement in such
event should be calculated down to that day.
Counsel for the Union has requested the award of
interest on the amounts payable to ~the Grievors since November,
1982. We shave given the request careful consideration. It is
true that this Board has awarded interest where deemed
,pppropriate in a number of disciplinary cases and the Divisional
.L‘ 5.
- 62 -
Court has recently upheld the power to do so in R. v. O.P.S.E.U.
and the Grievance Settlements Board (Thibert et al) as yet unre-
. ported, applying Section 19 of the Crown Employees Collective
Bargaining Act. This, however, is a classification case, not a
disciplinary matter. It appears to us that in classifying the
Grievors incorrectly the Employer was not ~proceeding in an arbi-
tratrary or discriminatory manner, but upon its understanding of
the application and interpretation traditionally given to the
clerical series standards. In these circumstances, and consis-
tents with previous decisions of this Board, such as Goobie,
supra, we are not persuaded that this is a case in which interest
should be awarded. Nevertheless, if for-any reason, payment is
not made to any griever on or before May 1, 1987, the amount due :
shall bear interest thereafter at the cumulative rate of one per
cent per month.
We retain jurisdiction to hear. and determine at the
<y.y,
re,quest of either"party any problem encountered in implementing
this decision, 3 --Y
Dated at Rockwood this
5th ~day of March,.1987
Vice-Chairman ’
Member
,’ !!c,mbi!r