Doctor Fired For Not Giving WSIB The Answer They Wanted?

Toronto personal injury lawyer Albert Coforzi: An interesting case out of Hamilton, which throws some light on the behind-the-scenes workings of insurance companies and medical exams.

Doctor's Orders

If a doctor examines you and says you're sick or injured, it's the medical expert's opinion that counts, right? Perhaps not:

A Hamilton-area physician is suing the Workplace Safety and Insurance Board and her former employer for $3.2 million, claiming she was fired when she wouldn’t deliver a medical opinion that suited the WSIB.

Dr. Brenda Steinnagel, 50, is alleging in her statement of claim that she was terminated last April after the WSIB repeatedly demanded that her employer, Vaughan-based Workplace Health and Cost Solutions, change the medical opinion she authored on a hospital worker who was claiming benefits after suffering head injuries while trying to restrain a patient.

Steinnagel had concluded in late 2014 that the worker’s emotional issues could be related to his workplace accident, according to the statement of claim. Within two weeks of delivering her opinion, she alleges the WSIB requested clarification.

After further review, which included speaking with the worker’s family doctor, Steinnagel says she reached the same result in her medical opinion, but “the WSIB continued to resist her conclusion,” according to the statement, filed in Toronto Superior Court in July.

The doctor goes on to allege that when she refused to tailor her opinions to what the WSIB adjuster wanted, she was told that she was no longer going to perform such exams. She also alleges that WSIB pressured her boss (WHCS), reminding them of the volume of work the doctor's company did for WSIB. It is alleged that when the doctor still refused to change her medical opinion of the case, she was fired.

"Independent" Medical Exams

These allegations have yet to be proven in court, but I can assure you that every personal injury lawyer worth their salt is keeping a close eye on this case.

For those of us who do personal injury litigation, so-called "independent " medical exams by doctors hired by motor vehicle insurers are predictable to a very high degree: Dr. So-and-so hired by insurance company Such-and-such is going to give you outcome X. My colleagues and I often wonder whether the volume of work given to these doctors influences the outcome in the same manner as alleged in the article. That is, is there at least an implied message that if you want future files, you'd better provide satisfactory opinions.

I am going to watch this case carefully.

I am a personal injury lawyer with Pace Law Firm in Toronto. Contact me if you have any questions.

Are Your Medical Records Up For Auction?

Toronto personal injury lawyer Albert Coforzi: A hospital employee recently got caught with their hand in the cookie jar:

A former Rouge Valley hospital clerk has pleaded guilty to stealing thousands of patient records and selling them to financial brokers over the course of more than a decade. 

Shaida Bandali, 61, who worked at Rouge Valley from 1995-2014, accessed confidential maternity ward records, including the names and contact information of mothers as well as the names and birthdates of their babies, and sold them for between $1 and $2.75 each to salespeople of Registered Education Savings Plans, according to an agreed statement of facts read out in court Monday.

Apparently the leaking of personal, confidential information by Bandali was not itself a crime but the sale of the information created a breach of the Securities Act.

Hopefully hospital administrators and the law will continue to root out the sources of these "favours."

This reminds me of someone who came to see me at my office not too long ago. They described having been to the emergency room following a car accident. Nothing unusual there. However, the next day they were called by a clinic saying, “We are following up on your visit to emergency yesterday to arrange for your physio assessment.”

Assessment? Clinic? News to the patient.

I wonder how that clinic got the patient's personal information. I also wonder who received a little “show of gratitude” for the info.

Hopefully hospital administrators and the law will continue to root out the sources of these "favours."

I am a personal injury lawyer with Pace Law Firm in Toronto. Contact me if you have any questions.

Upcoming Changes To Accident Benefits: Insurance Companies Win Again

Toronto personal injury lawyer Albert Coforzi: The current government of Ontario, following in a long tradition of governments of every political stripe bending over backwards for the benefit of the insurance company lobby, has signaled changes to what constitutes a "catastrophic impairment." The changes come into effect on June 1, 2016.

Among the more egregious changes: the amputation of an arm as a result of a motor vehicle accident will be considered catastrophic while the amputation of a leg will not.

Missing leg? Not "catastrophic" enough

Under the current Statutory Accident Benefits regime, a person who has lost an arm or a leg has a million insurance dollars available for medical and rehabilitation benefits. This helps for such things as stump care and prosthetic limbs. The coming regime change will reduce that money available for a leg amputee as described in the regulation to $65,000 of combined coverage: medical/rehab plus attendant care.

If you've ever had $2000 worth of dental work for a root canal and crown, ask yourself how quickly 65 grand will go when you are recovering from a leg amputation and you need to learn how to use a prosthetic device.

Insurance industry wins another round

But hey, there's always someone available to pick up the short fall. Guess who that will be? Yes, the Ontario taxpayer. A careless motorist causes a victim to lose a leg and it's our healthcare system that will take on the financial burden of care and recovery, rather than an insurance company that actually plans for this type of event. Makes a lot of sense....to insurers, I bet.

I'll be posting more information on the insurance regime changes in the months ahead. Stay tuned.

I am a personal injury lawyer with Pace Law Firm in Toronto. Contact me if you have any questions.

Woman To Pay $30K For Air Ambulance Ride

Toronto Personal Injury Lawyer Albert Conforzi: A frustrating story from up north:

An Alberta mother says she is scrambling to pay a bill of up to $30,000 after a premature birth forced her to use an air ambulance in Northern Ontario. 

Amy Savill, from High Prairie, Alta., was visiting with family when her water broke — nearly two months early. 

She says she and her family jumped in a truck and rushed to the Timmins hospital, where they say staff weren’t equipped to deal with premature births before 32 weeks gestation. 

With the baby coming and no other options, an air ambulance was called in to transport Savill to the hospital in Sudbury, about four hours away. 

Before the helicopter arrived, Savill was told the flight would come at a price of up to $30,000. She said she didn’t have a choice.

Let me see if I have this right. A pregnant woman from Alberta is in Northern Ontario when her water breaks 2 months early. The hospital hasn't been given the resources to handle a high risk birth situation. They decide that this woman must be rushed to Sudbury for specialized care and that an air ambulance must be called in.

The province of Alberta *would* fund the trip if it had been in Alberta, but won't pay for any of the trip because she's in Ontario. Ontario, meanwhile, wants its money back notwithstanding that the mother had no choice but to follow the Ontario doctor's advice and get in the helicopter. Perhaps Ontario can use the 30 grand to update their Northern Ontario hospitals?

A pox on both their houses.

I am a personal injury lawyer with Pace Law Firm in Toronto, Canada. Please contact me if you have questions.