Injured worker gets back pay, apology after WCB ignores ruling

The Workers' Compensation Board of Nova Scotia has apologized to an injured worker and paid him back pay after ignoring the decision of an independent tribunal that ruled in his favour almost one year ago, after he recently told his story to CBC News.

Kevin Coward, 63, worked as a forklift operator, a job that required him to frequently get on and off the machine to adjust pallets or move stock manually.

The Dartmouth man injured his left knee in 2014 on the job and subsequently developed problems with his right knee. Despite recommendations from his physiotherapist and his doctor, WCB ruled in October 2015 the second injury was not related to the first one, which meant he wasn't eligible to receive benefits.

"What bothers me and disturbs me ... is that when they tell you go to see your doctor and they don't really take the opinion of the doctor and that's very troubling," said Coward.

A board spokesperson said that claims decisions are made by case workers, who rely in part on the opinion of WCB's medical advisers. Coward said these medical advisers never met with or examined him.

Coward made an appeal to a hearing officer with WCB and the decision was upheld.

He then appealed the board's decision to the Workers' Compensation Appeals Tribunal, which is the next step for injured workers who are unhappy with a WCB decision.

Tribunal sides with Coward

On Sept. 28, 2016, it handed down its decision, which didn't give any specifics about what the board should do, other than to reconsider its decision.

"The board is directed to reconsider the worker's benefit entitlement in light of this decision," ruled the tribunal.

The board then had 30 days to appeal the decision if it didn't agree. Otherwise, it was to follow the tribunal's directive.

Since then, Coward said he, his doctor and his physiotherapist contacted his WCB case manager multiple times, mostly without success. Coward only connected with her once in early October 2016, while the others didn't have any luck. Coward's case manager told him he was approved for physio, but she denied his claim for braces, which cost $1,800 each.

In light of the tribunal's decision, Coward also sought approval for back wages.

Recommendations by doctor, physiotherapist ignored

Both Coward's family doctor and physiotherapist repeatedly recommended the board provide him with knee braces. As well, an orthopaedic bracing specialist told WCB in July 2015 that braces were "mandatory" and should be used on a daily basis for everyday activities.

Coward is experiencing financial issues because he hasn't been able to work since March 2016, when his doctor placed him on stress leave.

"They [WCB] don't understand the pain and the stress that you go through with an injury," said Coward.

WCB changes its mind

Once CBC News contacted WCB, Coward received a call and apology from a manager. Last Wednesday, he received a letter from the board that approved payment for his his knee braces and and awarded him a portion of his lost wages dating back to March 2016. It isn't clear from the letter what percentage of lost earnings Coward will receive.

Coward's doctor, Howard Conter, said the board's delay in providing Coward with the required knee braces has impeded his recovery.

"This delays his ability to do his best at physiotherapy and it delays his ability to go out and do cardiovascular exercise to improve his overall health," Conter told CBC News.

He said it also makes it harder to determine whether Coward will be able to return to work.

'Service issue' responsible for delay

Board spokesperson Jody Thomson said the organization strives to provide quality service and timely communication, but said Coward's case doesn't reflect WCB's standards. She called it "a service issue" and said he should have heard from officials before now.

"We apologized directly to the worker," she said.

Until December 2016, Coward was also working with the Workers' Advisers Program, an independent part of the workers' compensation system that helps injured workers deal with the board.

Thomson acknowledged WCB didn't send a response to program officials.

"Unfortunately, no, these responses were not sent," she said. "Again, we apologize for this service issue."

Why were braces now approved?

The letter the board sent to Coward said the braces were now approved because he is now physically ready to use them.

"Based on the last progress report from your physiotherapist dated July 13, 2017, it appears you have plateaued in treatment, therefore, braces are appropriate at this time," said the letter.

The letter also said the board will review his file to "determine next steps regarding permanent impairment."

Coward is happy to finally have a decision from WCB. He said he hopes that speaking out will not only help him, but "make things better for everyone down the road."