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37th PARLIAMENT, 2nd SESSION
Subcommittee on the Status of Persons with Disabilities of the Standing Committee on Human Resources Development and the Status of Persons with Disabilities
EVIDENCE
CONTENTS
Tuesday, April 29, 2003
¿ | 0910 |
The Chair (Ms. Carolyn Bennett (St. Paul's, Lib.)) |
Ms. Gretchen Van Riesen (Vice-President, Pension and Benefits, Canadian Imperial Bank of Commerce) |
Ms. Lynne Gutteridge (Manager, Health Services, Canadian Imperial Bank of Commerce) |
¿ | 0915 |
Doctor David Brown (Medical Director, Canadian Imperial Bank of Commerce) |
¿ | 0920 |
Ms. Gretchen Van Riesen |
The Chair |
Doctor Michael Schweigert (As Individual) |
¿ | 0925 |
¿ | 0930 |
The Chair |
Mr. Brian Masse (Windsor West, NDP) |
Ms. Lynne Gutteridge |
Dr. David Brown |
Ms. Gretchen Van Riesen |
Mr. Brian Masse |
Ms. Gretchen Van Riesen |
Ms. Lynne Gutteridge |
Dr. David Brown |
¿ | 0935 |
Mr. Brian Masse |
Ms. Lynne Gutteridge |
Ms. Gretchen Van Riesen |
Dr. David Brown |
The Chair |
Mr. Reed Elley (Nanaimo—Cowichan, Canadian Alliance) |
¿ | 0940 |
Ms. Gretchen Van Riesen |
Dr. David Brown |
Mr. Reed Elley |
Dr. David Brown |
¿ | 0945 |
Ms. Gretchen Van Riesen |
Dr. David Brown |
Mr. Reed Elley |
Dr. David Brown |
Ms. Gretchen Van Riesen |
The Chair |
Mr. Tony Tirabassi (Niagara Centre, Lib.) |
Ms. Gretchen Van Riesen |
Mr. Tony Tirabassi |
Ms. Gretchen Van Riesen |
¿ | 0950 |
Ms. Lynne Gutteridge |
Dr. David Brown |
Mr. Tony Tirabassi |
The Chair |
Dr. David Brown |
¿ | 0955 |
Ms. Gretchen Van Riesen |
The Chair |
Ms. Gretchen Van Riesen |
The Chair |
Ms. Gretchen Van Riesen |
Ms. Lynne Gutteridge |
Dr. David Brown |
À | 1000 |
Ms. Gretchen Van Riesen |
The Chair |
À | 1005 |
Ms. Gretchen Van Riesen |
The Chair |
Ms. Marie Clarke Walker (Executive Vice-President, Canadian Labour Congress) |
À | 1010 |
The Chair |
Ms. Maria York (President, Canadian Council for the Rights of Injured Workers) |
À | 1015 |
À | 1020 |
À | 1025 |
The Chair |
Ms. Maria York |
The Chair |
Mr. Randy Dickinson (Executive Director, New Brunswick Premiers' Council on the Status of Disabled Persons) |
À | 1030 |
À | 1035 |
À | 1040 |
The Chair |
Mr. Reed Elley |
Mr. Randy Dickinson |
À | 1045 |
Ms. Maria York |
Mr. Reed Elley |
Ms. Maria York |
À | 1050 |
The Chair |
Mr. Brian Masse |
The Chair |
Mr. Brian Masse |
The Chair |
Mr. Bob Baldwin (National Director, Social and Economic Policy, Canadian Labour Congress) |
The Chair |
Ms. Maria York |
À | 1055 |
The Chair |
Ms. Wendy Lill (Dartmouth, NDP) |
Ms. Marie Clarke Walker |
Mr. Bob Baldwin |
The Chair |
Mr. Tony Tirabassi |
The Chair |
Dr. Michael Schweigert |
Á | 1100 |
The Chair |
Dr. Michael Schweigert |
The Chair |
Dr. Michael Schweigert |
The Chair |
Dr. Michael Schweigert |
Mr. Randy Dickinson |
Á | 1105 |
The Chair |
Mr. Randy Dickinson |
The Chair |
Mr. Randy Dickinson |
The Chair |
Mr. Bob Baldwin |
The Chair |
Mr. Bob Baldwin |
The Chair |
Á | 1110 |
Mr. Bob Baldwin |
The Chair |
CANADA
Subcommittee on the Status of Persons with Disabilities of the Standing Committee on Human Resources Development and the Status of Persons with Disabilities |
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EVIDENCE
Tuesday, April 29, 2003
[Recorded by Electronic Apparatus]
¿ (0910)
[English]
The Chair (Ms. Carolyn Bennett (St. Paul's, Lib.)): We are pleased to call this special meeting to order as we continue our study on the Canada Pension Plan disability program. We are pleased to have our witnesses from the Canadian Imperial Bank of Commerce by video conference, though with time constraints, I understand. The transmission self-destructs at ten o'clock, is that right?
Voices: Oh, oh!
The Chair: We welcome the Canadian Labour Congress, the Canadian Council for the Rights of Injured Workers, Dr. Michael Schweigert, and our good friend Randy Dickinson from the New Brunswick Premier's Council on the Status of Disabled Persons.
Because of the time constraints, what has been suggested to me is that we begin with the CIBC witnesses and Dr. Schweigert. Then we will have a question and answer period with them, and then we will have a fresh beginning with the Canadian Labour Congress, the Canadian Council for the Rights of Injured Workers, and Randy Dickinson.
Begin with your short presentation, and then we can have time for questions.
Ms. Gretchen Van Riesen (Vice-President, Pension and Benefits, Canadian Imperial Bank of Commerce): Thank you, Madam Chair. I appreciate the committee's consideration in allowing us to attend by video conference to accommodate our inability to get to Ottawa; thank you very much for that.
I'm here with two of my colleagues, Dr. David Brown, who is the CIBC medical director, and Lynne Gutteridge, who is at the moment manager of health services at EDS. I am the vice-president of global pensions and benefits at CIBC.
What I'd like to do is start by just speaking to what we are going to talk about in our few minutes today, a process we have adopted at CIBC called coordinated return to work. I believe you have some material we sent you in advance, including some of our brochures in terms of this program and how it operates.
I would like to speak first to the fact that we started on this journey that led us to this process, this abilities-based model for dealing with disability management, by starting with some disability management principles in our organization. I am not going to take the time to walk through each of the principles, but they speak to treating disabilities on a case-by-case basis; to shared responsibility of both the individual and the employer; to continuum of support, making it as seamless as possible; and to accommodating needs in the workplace as the result of disabilities, having a focus on early intervention.
I would like to turn it over to Lynne Gutteridge, who will talk about the process itself, which we have called coordinated return to work. So, Lynne.
Ms. Lynne Gutteridge (Manager, Health Services, Canadian Imperial Bank of Commerce): Thanks, Gretchen.
Essentially, this is a communication process that involves a manager and an employee sitting down together to put together a return to work plan based on the employee's abilities as opposed to a medical diagnosis. At the centre of our process is a coordinator who determines when it is appropriate for the employee and the manager to sit down together.
The manager and the employee are brought together by a third-party facilitator, an independent, neutral person who assists the employee and manager in having an open, frank conversation about the employee's abilities--by that I mean their functional abilities--vis-à-vis the tasks of their job. As Gretchen said, the responsibility for the return to work plan rests with the workplace parties as opposed to third parties making decisions around functions they don't understand.
So at a high level it is the manager and the employee who have ownership, plus a coordinator who assists in bringing them together and removing any barriers that might exist, bringing in outside experts when required to help the process move along.
¿ (0915)
Doctor David Brown (Medical Director, Canadian Imperial Bank of Commerce): The key to that is of course the facilitator in the meeting with the manager, who makes sure the two parties stay honest, try to keep difficulties off the table, and stay focused on the abilities and the accommodation needs of the employee.
It turns out that in our program about 90% of our disabilities, the vast majority--and we deal with about 3,500 per year in the short term and about 300, for argument's sake, on the long-term side--really are solved by the manager and the employee with the assistance of the facilitator and the external coordinator as required. But as in all programs, we sometimes get down into a discussion about, maybe the person hasn't explained or doesn't understand their abilities as much as they might have, or there might be some disagreement about accommodation, and some form of adjudication has to take place.
I will just show you the page in our presentation I am on. We have a basic pyramid we work from. The traditional model sees you gathering information primarily from someone we would call a consultant--that would be the treating physician--and then you would start deciding whether the person was sick and whether they were getting the care they needed. Then you would start getting into, well, do they have the abilities to do the job or not? Then finally you would bring in the affected party's opinion as to what is actually going on.
Really, where our program goes and takes us is starting out with the people who know best, who are the manager and the employee, and their perception of what their needs are, what their abilities are, and what their ability to accommodate is. Then we move up to what we call the job-matching type of situation, where you look at job versus abilities. Then you get up into, can we manage the care of this individual better? Finally, we go to the opinion of the consultant, who would be the treating physician or an external party of some sort.
So really, the whole process focuses on the conversation that goes on between the two parties who know what is going on and on the ability to accommodate. Then it starts to get into a different form of gathering information and finally gets to the medical profession.
Now, this has been accepted. This has actually been proposed by the Canadian Medical Association, and really, what CIBC has done is to operationalize this. Everybody has described principles and the way to go forward. What we found is, with the coordinated return to work process, this is how you turn that into reality.
I'll go back to Gretchen's initial comment, which is, this is abilities-based as opposed to disability and the person's illness. Our opening position is that we accept that the person is sick and that they are probably getting the care they need; we only try to interfere with that if we suspect that things are not moving as quickly as everybody would like. We try to leave the medical system alone to do its own thing; we focus on our ability to work with the employee.
I understand you are going to have an interesting time translating this into the broader context of your work, but we would encourage you to focus on the ability side and focus on the two people who know best, one of whom is usually the person with the disability. They know what they can do, usually, and if you go back and look at the research done by the Institute for Work and Health and Liberty Mutual in the U.S. and at the Whitehall study in the United Kingdom, you will find repeatedly that the person's perception of their abilities is usually pretty accurate. Yet we so often go out and spend fortunes getting independent assessments and things like that to reaffirm what the person originally knew.
I'll hand it back to Gretchen to close.
¿ (0920)
Ms. Gretchen Van Riesen: Thank you, David.
I am just going to add onto the last point David made.
The research we have that convinced us to go in this direction is the evidence that the best determinant for an employee's return to work is not necessarily the medical treatment they are receiving but the relationship between the employee and the manager and the strength of that relationship. So our process coordinating return to work facilitates that, encourages that, and supports that.
In closing, I will just say that our abilities-based model is used in other organizations. It works in labour environments very well and it works in manufacturing and retail. We are probably the largest organization in Canada that uses this process to date.
We would be happy to answer any questions from the committee, and we thank you again for the opportunity to witness before the committee today.
Thank you, Madam Chair.
The Chair: Dr. Schweigert, maybe if you want to present , then we'll see what questions the committee have.
Doctor Michael Schweigert (As Individual): Thank you, Madam Chair. I say good morning and I thank the members of the subcommittee for allowing me to speak today.
I'd like to state that I am a physician, a specialist in occupational medicine. I am not a Canada Pension Plan expert, and I'm sure there are a lot of people in this room I could learn a great deal from with regard to that process. However, I think my perspective today as an independent occupational health physician comes from my being in the front lines of health and at the interaction of health and the workplace.
I'll just give you a sense of where I am coming from, of my perspective. I've been in the workplace for about ten years now, working primarily for larger and medium-sized organizations as well as providing some independent assessments of injured workers. I have an interest in work and health and have an interest in seeing the benefits. I have seen the benefits of active accommodation in the workplace for employers as well of course as for the employees who are accommodated.
I think that there is a common ground in that the interests of employers and employees do coincide in a great many aspects. I just hope I can offer my perspective, again, in the context of the workplace and can just let the members know that my experience is primarily related to people who have generally been previously employed and are looking at that return to work perspective.
I had an opportunity to look at the website of the subcommittee and I saw a lot of CPP stories. I think that the stories that tend to get put on the website are those of people who are generally feeling frustrated and are having difficulty negotiating the process with respect to CPP. What struck me was that the people who typically tell their stories give descriptions of non-work-related injuries or illnesses and the difficulties they are having.
It strikes me that there is a cultural as well as systemic difference in the way we look at--from my perspective--work-related and non-work-related injuries and illnesses. I think some employers are more progressive and tend not to see the difference, but I think we still see a great deal of difference in perspective as to what we need to do to get people back to work, people who have been injured or fallen ill at work versus those who bring their illnesses to the workplace.
What has been impressed upon me is that when there is a work-related injury--in Ontario it is the WSIB that becomes involved with respect to helping the facilitator return the worker to the workplace--there is an attempt to seek to reduce costs not just by terminating claims but by facilitating finding work for employees who have become injured at work. It is my impression that employers perceive costs as being higher and feel a stronger duty to employ employees when it is a work-related injury versus when it's non-work-related.
I'm aware of the human rights legislation we have in Canada, particularly in Ontario, but I don't see a strong link between that and the Canada Pension Plan with respect to the people. I guess the payer is involved in trying to be sure that people are being accommodated in the workplace as well. Certainly, if it does exist, I have not seen it.
Work for all of us is an important social role, and in terms of medicine we still tend to focus a great deal on disease. I think part of that is the training of the physicians, who for the most part are treating people. I also think it's a lack of time. Physicians are typically overworked and don't have time to see people and spend time dealing with these types of issues, which are usually complicated and usually come with a great deal of paperwork, often duplicated. They find that they are often in conflicting roles and often don't have the knowledge base to deal with many of these issues with respect to helping people negotiate the path back to work.
The employer, while very active in work-related injuries, is often not very active in a non-work-related injury.
It is not clear to me how physicians in many cases are able to translate impairment to disability. If impairment is considered to be a physiological or anatomical deficit, it is not clear to me how physicians are able to translate that into a loss of ability to perform an essential function at work. For example, somebody who perhaps has difficulty walking may be disabled as a forest logger, but they are likely not disabled as a programmer or writer.
¿ (0925)
A lot of these questions are not that clear, and I don't think it's fair to expect a physician to make a determination as to whether someone who perhaps has difficulty walking is going to be able to perform any other, different functions in our society as a result of a short, typically 10- to 15-minute, interview. I think the resources are missing in the process to help the medical community translate impairment and disability in the context of the workplace.
I see there are a lot of opportunities that exist. The literature supports that early--provided it's timely--return to work is going to be an important determinant with respect to long-term disability. This is true for almost any diagnosis, injury, or illness.
I have two stories. One is about a fellow who had a car accident in front of the plant where I was employed. He went on to develop chronic pain, and short-term disability became long-term disability. He was becoming quite dejected and repeatedly came to the workplace to try to find employment. We were eventually able to have him return under a transitional work program that included modified duties and shortened hours, and he was successful. While he was ultimately successful, I think the failure was that we weren't able to return him to work sooner.
A different story is about a motorcycle accident, this time with more significant impairments that would have required both an on-site physiotherapist to work with this employee and a helper for a period of time, probably a six-month transitional work period, with an uncertain outcome. We were not successful in returning this person to work, and I still regularly get calls from this employee, who definitely wants to contribute and is not happy to be at home and not be an active participant.
I think there needs to be more of a mechanism to facilitate return to work for non-work-related injuries, with graduated and transitional return to work; basically, just get the people in the door.
In summary, I'd just like to reiterate a few points. I don't see a connection between non-work-related injuries and return to the workplace. I'm not exactly sure what processes would be in place to do that, but I think there could be more work done to have that linkage with requirements for accommodation under human rights legislation with respect to return to work for non-work-related injuries and illnesses.
I think there could be more resources to determine what disability is in order to help physicians make these decisions, advise people, and help them return to work, and more resources to have the workplace more involved than it is in work-related injuries and illnesses.
There could be more help where the issues of return to work and transitional graduated work are relevant, having these brought to the start of the process rather than waiting until these people have been out for a period of time. They perhaps finally establish that they are disabled and then struggle to get back to work after they've already missed out on some valuable time in terms of both their own wellness and their being contributing members to society.
Again, I'd like to thank you, Madam Chair and the subcommittee, for allowing me to speak this morning.
¿ (0930)
The Chair: Thanks very much.
Mr. Elley, because the CIBC witnesses are just with us by video conference until 10:00, we are going to take questions now and then go to the next panel.
Brian, do you want to start?
Mr. Brian Masse (Windsor West, NDP): Thank you, Madam Chair.
To the CIBC, interesting program, that. I just wondered how long you've had that in place.
As to the relationship between the manager and the worker, is that the direct manager of that worker? Have you been able to set up a system for when there are concerns raised, whether it be the person's relationship with the manager for future promotion or other issues, and how does it all relate to the whole program for the long term? Has that been addressed, or is it still in the development process for workers?
Ms. Lynne Gutteridge: The program was implemented in February of 1999, and yes, it is the employee's direct supervisor with whom they meet in the facilitative meeting.
In regard to other issues such as workplace relationship issues that might present themselves and possibly prove a barrier to return to work, yes, we do have a process whereby we refer those issues to a special group of individuals within human resources who can assist in working through these problems with either the manager or the employee or with both.
Dr. David Brown: We act in the utmost good faith, and our fall-back position is that if the employee indicates there's a difficulty with the manager, we'll say all right, that represents a barrier; let's put in either a substitute manager or the one-up manager because we want to keep the communication going.
That's really what this is all about, not trying to speed somebody back to work. Well, yes, that's the nice end product, but what it's doing is maintaining the relationship between the manager and the employee once the employee is in this very difficult situation with reduced ability and then coaxing these people back.
You're quite right. If there are barriers, let's move them to one side and keep moving forward.
Ms. Gretchen Van Riesen: The other thing I would just add is that while the process has been in place for several years and is working very successfully in terms of returning people to work, we're finding we're returning people to work at times when they were just off in our old system. It really has had a dramatic impact.
It's a continual process of refinement too. We're learning things about the process, and as barriers in the workplace come up--and those tend to be our more complex cases--we're developing new methods of dealing with and addressing these proactively.
Mr. Brian Masse: Do you provide specific training for your managers on the program? Is there something they go through? I understand from your presentation here that you seek medical or third-party assistance after they've had a meeting, developing what they feel they can do and identifying where there might be a question mark. What type of training do your managers get to do assessments?
Ms. Gretchen Van Riesen: We provide what we call just-in-time training. When we launched the program, we went out to all managers to introduce the program. Over time we realized that until a manager faced the circumstance in their office, the in-depth knowledge of the system was not necessarily going to stick, so we have just-in-time training.
Did you want to add to that, Lynne?
Ms. Lynne Gutteridge: Yes. This is the role of the coordinator in this process, to support both the manager and the employee through the process, to let them know what's going to happen and how the coordinator can be of assistance. There's a coaching process, if you will, that occurs prior to the manager and the employee meeting so both parties know what to expect and understand their roles and the coordinator can support those roles.
Dr. David Brown: Also, within the meeting process there is on-site expertise in communication and recording of everything that goes on. By the way, both the manager and the employee walk away at the end of the meeting with the exact same information that has been documented by the facilitator. If there are questions, if maybe the coaching from the coordinator didn't stick or there was some confusion, the facilitator in the meeting actually has the ability to deal with that at the moment.
Yes, there's the general information for managers, there's the just-in-time coaching for both manager and employee, but also, if there's any question, the facilitator in the meeting has the knowledge as well. The facilitator does not have medical knowledge but he or she has communication knowledge.
¿ (0935)
Mr. Brian Masse: Have you had a situation where the assessment happened, the two individuals got together and developed a plan of action, but they found that some of the work duties were problematic or induced further injury? Who is responsible for that, and what is then the procedure if the situation becomes more complicated because there are further problems that weren't anticipated?
That becomes tricky at different times, and Dr. Schweigert also noted in his presentation that even physicians have a difficult time in their assessments with the limited synopsis they get from the workplace. Who is responsible for that and how does that play out if there is further injury?
Lastly, are most of your employees part-time or full-time?
Ms. Lynne Gutteridge: In terms of how that plays out, it really goes back to David's point that the employee is really the best person to understand what their abilities are. Suppose the manager and the employee sit down and put together a return to work plan and for some reason the employee can't fulfill the plan. Perhaps they're finding the tasks they had agreed to too demanding, for example, or perhaps there are other issues. At that point we'll reconvene the manager and the employee, revisit that plan, and make modifications or explore further accommodation the manager might make until the employee can function at that level.
Ms. Gretchen Van Riesen: It's all about facilitation. The facilitation doesn't end until the employee is fully back to work, that's the bottom line. As long as there are refinements to the work plan that need to be made, the facilitation--the meeting between the manager, the employee, and the facilitator--still goes on, with the coordinator looking on from on high or monitoring the case to make sure that the right kinds of accommodations and other inputs are being brought into the process to make it move forward. So yes, it totally deals with those issues.
On part-time versus full-time, most of our employees are full-time. However, we have a large complement of part-time employees, I think somewhere around 4,000 or 5,000.
David, did you want to add anything?
Dr. David Brown: Yes, I just have one very quick comment. We very rarely get a hole-in-one, as it were, where the people come along and have a meeting and it's all wrapped up in one meeting. In fact, our average is about three meetings per case. The understanding is that when the employee and the manager make that commitment, it's up for review on a regular basis until the person is back to full ability.
The Chair: We will go to the official opposition.
Mr. Reed Elley (Nanaimo—Cowichan, Canadian Alliance): Thank you very much.
Those of you who are far away won't realize that I was late for this meeting and will probably have to stay in after school because of it. Anyway, I may have missed something you said, and if you have already answered the question, my apologies.
We have heard from a number of companies that are doing similar programs to yours, and I'm wondering how you see your program in relationship to Canada Pension Plan disability, how those kinds of programs can work side by side. If you could make any comments on that, I'd appreciate it.
The other question I'd like to ask you is, is there any disability that is outside the scope of what you do with employees, or do you have a fairly inclusive list of disabilities?
¿ (0940)
Ms. Gretchen Van Riesen: Let me start with the second question, and then I'll let David speak to the CPP implications.
We define disability as anything that makes it beneath their ability to do the current job they have. In other words, we don't define it by disease. We do not have a list of illnesses that qualify as disability. It is really anything that impairs them and prevents them from actually doing their role, so it's very inclusive.
The process we've described is very much an employment-based system, one that is in the workplace. The applications with respect to CPP aren't directly apparent other than in the fact that by returning people to work before they get to long-term disability, before their eligibility for Canada Pension Plan disability kicks in, it works in favour of CPP because those liabilities don't come on the books.
David, did you want to comment more on the CPP connection?
Dr. David Brown: Yes. I was working with the Canadian armed forces in both Montreal and Ottawa last summer because the Department of Veterans Affairs has realized that from a military perspective, it's not all or nothing. A number of people were being moved to veterans affairs and essentially thrown on a heap of used soldiers--I apologize for the crassness of that comment. Veterans affairs realized there was an issue, and what they felt was that they had to back up into the workplace and install something like this coordinated return to work process with them.
Now, as to dealing with CPP, if I look at the way CIBC's long-term disability carrier comes to an end with an individual... We, by the way, return our people from long-term disability 47% faster than their general book of business. They have many fewer cases that actually go on to what I would call long-term disability.
But how they would bring people off disability is this. If the person has reached a point in their recovery where they can now supplement their income through work, based on their education and based on their abilities, then the insurance carrier says, well, I'm sorry, we've come to the end of benefits. I would actually suggest something very similar to CPP, where you say, based on this person's education and abilities, they should be able to earn, for argument's sake--the number comes right off the top of my head--70% of their previous income or something like that.
What you're doing is, you're changing the definition of... Instead of the person having to prove how sick they are to maintain their benefits, which actually... And again, I go back to the Whitehall study and say, if you repeatedly force somebody to prove how sick they are so they can maintain their benefits, you force them to be a patient. Then you end up in this vortex where you're trying to prove they are not sick, which is of course mindless, but that's where we are today.
The CIBC process says okay, we know you're sick; here are your abilities; can you, with your abilities and your education, earn 70% of your previous ability's income? Answer yes, well, then we don't need benefits anymore. Answer no, benefits continue. So it's not a medical argument anymore, it's an abilities-based argument.
I hope I answered your question.
Mr. Reed Elley: Yes, thank you.
You were touching there briefly on your success rates. You said you integrated them 47% faster. Tell us a little bit more about your success rates. Do you have any figures?
Dr. David Brown: Yes. For CIBC in the short term--which for us means zero to six months, that's what we consider short term--we have consistently maintained a reduction of 32% in our total disability days lost, and it's essentially been a fairly flat line since we introduced the program. In the year 2000 we went up by 0.8% and last year our days went up by--from memory--5.5%. We had a 32% drop when we introduced the program and we've come up by a total of about 6% since the program was introduced, so we changed the trajectory of our disability rate over time.
For our long-term disability, which is six months to age 65 if required, it's a little bit slower, but we're actually now starting to see a reduced head count on long-term disability. Our long-term disability carrier, as I said, reports that they are returning people to work 47% faster than their general book of business. And I want to emphasize “to work” as opposed to “off the program”, which in the traditional sense means you no longer qualify for benefits and--
¿ (0945)
Ms. Gretchen Van Riesen: --too bad.
Dr. David Brown: Too bad.
Was that helpful?
Mr. Reed Elley: Yes, it was.
We've had a number of companies talk to us about this and present to us about the success rates. I'm wondering, then, is there any role for the federal and provincial governments to play in terms of trying to standardize this kind of approach to disability right across the country? Should it be left entirely up to the workplace to do, or is there a role for government to facilitate this?
Dr. David Brown: Absolutely. There is a role for government in the same way CIBC set the principles, and this delivers under those principles in the same way the Canadian Medical Association has set up principles regarding return to work, and this sort of fits with them.
If you look at Bill 99 and the workers' compensation board in Toronto--and I stand to be corrected--and if you read the language of that, it puts the onus on the employer to facilitate a return to work through communication processes. So a template of the language already exists, obviously within the framework of our workers' compensation, but there is no reason on earth this can't be rolled up.
Ms. Gretchen Van Riesen: My comment would be this. It is certainly our view that the best thing the government could do would be to encourage and promote best practices as opposed to legislating that this is the way and the only way everybody will have this approach. We happen to believe it works and we hope other people adopt it.
In business, obviously, there are many reasons and there are many aspects and perspectives. I think the best thing would be to encourage people through best practices research or evidence-based results that encourage other employers and other organizations to adopt a similar approach rather than legislating or having some other kind of mechanism.
The Chair: Mr. Tirabassi.
Mr. Tony Tirabassi (Niagara Centre, Lib.): I'd like to welcome our witnesses, albeit by video conference, but it works and seems to work well.
My line of questioning is going to be much along the same lines, with regard to the process you have in place to assist employees get back to the workplace. I believe Dr. Schweigert gave us some information regarding an employer's tendency to deal with workplace-related incidents or accidents as opposed to non-workplace. I'm just wondering, is there any difference as to how your process works, depending on whether it's a workplace-related accident or a non-workplace-related one?
Ms. Gretchen Van Riesen: No, we don't discriminate. There is no distinction. Our process doesn't say, oh, this is a workplace one, so it has a different process. Our process is identical.
Mr. Tony Tirabassi: And I'm just wondering, what has the response been from fellow employees? Now, it may be a little naive, but to me, with a financial institution like the CIBC, I walk in and what I see is just what's in front of me. I really don't have an understanding of just how much physical or mental stress there is behind the scenes.
Let's say there's a manufacturing environment. There's this agreement struck and the person has returned to work. It's going to take some understanding and cooperation from employees around them. Now, in your environment--perhaps, again, I could be wrong--it's not so physical and it might not require the same level of cooperation. I don't know if I'm correct there.
I'm just wondering, is there a bit of conversation or dialogue with other employees who may be working with this employee coming back, and what's the overall reaction from those employees?
Ms. Gretchen Van Riesen: One of the reasons we started on this journey in the mid-nineties is that we did an audit and we were concerned about our long-term disability cases and the trajectory we saw of increased exposure for the organization to increases in short- and long-term disability. What we did was, we went out and said, what's wrong? What's happening interoperationally?
We found that employees felt lost, abandoned. They didn't feel there was a process that really helped them or was really supportive to them. They felt they were just kind of put into a black hole and they disappeared. Managers told us much the same thing. They said, I don't really know what to do; it just seems to be this medicalized process, and I can't really get this thing going.
What we found when we launched the program and we actually did some follow-up survey work was that both managers and employees found it enormously satisfying. That isn't to say, in terms of their participating...solving many of the issues that got us on the journey in the first place.
That is not to say there aren't issues. Again, with any human interaction there are going to be problems and there are going to be people who don't want to play ball, and we do have some. The beauty of facilitated return to work is, there's no place to hide. There's no black hole you go into, so issues come on the table and they're addressed. That's really what it does and what it forces in a very collegial, supportive environment. It doesn't allow you to sort of hide behind a doctor's note or some other piece of evidence or positioning. It really puts things on the table.
Did you want to add anything, Lynne?
¿ (0950)
Ms. Lynne Gutteridge: Just in terms of the perception of other employees in the workplace, one of the things we launched around the same time as the coordinated return to work process was a very inclusive accommodation policy at CIBC. CIBC goes to great lengths to promote accommodation in the workplace. In our health services unit we run an entire accommodation program, and there's a lot of education for other employees who have to work with individuals who require accommodation. So yes, that does get addressed.
I think that was what you were asking about, other employees who would be working with individuals.
Dr. David Brown: I have one final point. If you look at the presentation that went there, there's a piece on the manager's role. You'll see that the third point is that the manager is meant to represent the needs and constraints of the organization and the co-workers. Bringing somebody back just to do some menial task is not appropriate; when the person comes back, they do meaningful work. The co-workers can actually see that yes, David is in trouble, but he's doing this and he's not playing silly; he's helping us move forward.
But yes, there's a very fine balance.
Mr. Tony Tirabassi: Thank you.
The Chair: I thank you too.
I just have one final question. The work of the committee has identified the necessity of having a more flexible CPP disability program in terms of people on pay getting back into the workforce and perhaps even things like partial pay for people with cystic fibrosis, people who just would never, ever be able to work more than part-time.
For people who suffer from manic depression or multiple sclerosis, those kinds of disorders where there are well times and not-well times, do you have any observations from what's happened at CIBC that could inform our recommendations around that as to CPP disability? I refer to the experience you've had with people who actually were on pensions, should be on pensions, or could be on pensions, but because of the inflexibility there isn't that possibility for your employee.
Dr. David Brown: I understand your difficulty, but you see, the hole that's already been dug for you says that somebody has to prove they're sick, and if you waver from that, then you will lose your benefits.
But if you're actually talking about abilities and accommodation, then it's a much less confrontational approach. A lot of this, I can imagine, could be done by phone as opposed to calling people in for independent assessments and stuff like that, just phoning, checking what their abilities are, and allowing them to go in and out based on those flexible abilities. When the depressive person is down or when the cystic fibrosis is really acting up, well yes, you need to step back, and yes, CPP support would go up in those circumstances, but as their abilities returned, then they could go back out again.
If you change your definition for when you support benefits or not to one of abilities based on education and ability, then you have a much less contentious situation.
One thing I should add concerns litigation in CIBC. When we worked in the traditional model, I can guarantee you, from time to time we annoyed people and they sought legal counsel to sort us out a little.
With this model, because everything's documented and communication is absolutely clear, litigation goes way down; it's practically nonexistent. Any time we've gotten into trouble with litigation, it's essentially been from miscommunication.
¿ (0955)
Ms. Gretchen Van Riesen: It doesn't mean there aren't times when you actually have to cut off benefits. We have had cases where it reached the point where it was clear the person was able to work but was choosing not to; ultimately, that's when benefits would end. You do come to those difficult times, but it's through a different avenue than, well, the doctor said so.
The Chair: That just brings me to my question, which is about the relationship with your carriers. As a family physician I felt the pressure lots of patients were under in terms of having to apply for CPP disability because the long-term disability carrier insisted on it. Do you have any observations to share with the committee on the relationship between you and the carrier in terms of cutting somebody off benefits or the relationship between that carrier and CPP disability?
Ms. Gretchen Van Riesen: LTD is income replacement in the face of disability. Our policy is that if a person is eligible to receive Canada Pension Plan, that's a part of their income replacement, and CIBC wraps around and tops that up to the level we choose.
You know, ultimately this isn't a windfall situation. We have to make sure people are really just meeting the income replacement level we set as policy to be appropriate. I think the integration with CPP is important and necessary--if that's your question, although I'm not sure I've answered it.
The Chair: I guess we were worried about the undue pressure some of the carriers placed on patients to apply for CPP disability, maybe even when it was quite clear they wouldn't qualify, with the pressure that put on a patient.
Ms. Gretchen Van Riesen: Our policy is that it's important that an application be made because if the person is eligible, they have a right to that benefit. I don't know what the pressure is.
Lynne, do you know? Could you speak to what our process is for CPP applications.
Ms. Lynne Gutteridge: I would suggest it's a last resort in our model, because in our model the process we follow flows very seamlessly into long-term disability. In other words, there isn't a medical adjudication that occurs at the long-term disability point. Our long-term disability carrier continues to engage the manager and the employee in the same process.
With respect to Gretchen's point, I think that when we get to the stage where the person simply cannot work and is eligible for that benefit, the carrier asks them to apply, but it's not a pressure thing.
Dr. David Brown: We would actually view somebody reaching the state of CPP as a potential failure at our end. When I say that, I am including our insurance carrier, Canada Life. As Lynne says, it's seamless end to end, and we're trying to work the person's abilities until they have actually reached the point where we've met with them on a regular basis but their condition has either gotten worse or they have just not recovered. We do ask them to apply for CPP, but we view that as a casualty.
À (1000)
Ms. Gretchen Van Riesen: The other thing to point out is that we're self-insured. Our insurance carrier actually provides administrative services only; we have a health and welfare trust, so there is certainly not an insurance pressure here. We want to do the right thing and we're really focused on that.
The Chair: That helps a great deal.
Thank you very much for being with us virtually this morning.
If there are any other comments about anything you see on our website, anything you could add between now and the writing of the report, please feel free to let us know.
Thank you very, very much.
À (1005)
Ms. Gretchen Van Riesen: Thank you very much, Madam Chair.
The Chair: I would now ask for the other witnesses to come forward.
Dr. Schweigert, if you could stay, that would be great because I think a lot of what the others have to say will inform the discussion.
We're just suspending for a few minutes.
À (1001)
À (1005)
The Chair: We'll begin with the witnesses from the Canadian Labour Congress, Mr. Baldwin and Ms. Clarke Walker.
Ms. Marie Clarke Walker (Executive Vice-President, Canadian Labour Congress): Thank you very much, Madam Chair.
I am Marie Clarke Walker, the executive vice-president of the Canadian Labour Congress. With me today is Bob Baldwin, who is our director of Social and Economic Policy and our CPP guru.
First of all, I would like to begin my presentation by thanking the subcommittee for receiving our statement and inviting us to appear before you this morning. I also want to commend the subcommittee for the work it's already done in the area of disability rights issues.
The Canadian Labour Congress is an organization of approximately 65 unions with a membership of over 2.5 million women and men who work in all provinces and territories in all imaginable occupations.
Our primary goal today is to urge you to adopt certain views with respect to CPP disability benefits and related programs. I also want to reassure you that the labour movement has issues related to disabilities high on its agenda. The congress has a working group that deals with issues facing people with disabilities and with integrating them into the everyday work we do. We also have a member on our executive who represents people with disabilities, but that person was unable to be here today.
In recent years we have worked hard to give a voice to members with disabilities as they are best suited to speak on their own behalf. We have also done research on collective agreement provisions relating to persons with disabilities, and with the help of HRDC we now have a project underway in which we are developing collective bargaining strategies in support of persons with disabilities.
Our written statement has been with you for some time now, so I will just touch on the highlights. I'd like to begin with a few preliminary comments.
First, I think we need to be clear about the objective we would like to achieve. As we note in our written statement, in an ideal world, income and service supports would be in place to allow persons with disabilities to participate fully in all aspects of Canadian life.
Second, our present reality is a long way short of this ideal. The employment and income situation of persons with disabilities falls well short of this mark, and programs for persons with disabilities are uncoordinated and include perverse incentives.
Third, CPP disability is an incredibly important program, but even if it is reformed, it cannot address all the needs of persons with disabilities. Thus, changes to CPP disability need to be thought of in terms of how they relate to other existing programs and where we want to get to.
Finally, making progress on CPP disability and related programs is politically difficult. It requires federal-provincial cooperation and strong leadership at the federal level.
With this last concern in mind, the subcommittee was advised by Sherri Torjman of the Caledon Institute to take a stage approach to reform. We agree with this approach and have recommended both a short-term and long-term agenda of issues.
In the short term we are recommending that the subcommittee look at three administrative areas. The first is the involvement of persons with disabilities in decision making with respect to CPP. People with disabilities really need to be involved at all levels of decision making, particularly when it affects their lives.
The second is providing supports for groups that would support CPP disability applicants who wanted to appeal decisions. As we have been told, the system is extremely complicated and intimidating for some, and if there were people there to assist, it would be helpful.
The third is reviewing administrative decision making with respect to CPP disability to be sure that any current definition of disability is applied in an even-handed fashion.
We are also recommending two short-term items of work: number one, the possible creation of a federal-provincial support service program for people with disabilities, and number two, an expansion of the CPP dropout rules to cover periods spent caring for persons with disabilities.
In comparison with the prospect of setting up a comprehensive program of income and support services for persons with disabilities, this is a modest agenda, but establishing access to necessary support services for persons with disabilities is a crucial step in allowing persons with disabilities to participate fully in all aspects of life. Presently, access is often tied to being in receipt of income from particular sources.
À (1010)
Also, the proposed review of CPP disability administration is very important. As we pointed out in our written statement, administrative changes played an important role in limiting access to CPP disabilities in the mid-1990s. It is now important for the subcommittee to be satisfied that the current definition of disability is being applied in an even-handed fashion. More specifically, the subcommittee needs to be satisfied that the actual definition of disability is not being determined by the CPP disability budget.
In our statement we have identified a number of issues that should be taken up as part of a longer-term agenda. These include the CPP disability contributory requirements, the definition of disability for CPP, the amount of CPP disability benefits, the integration of CPP disability benefits with other sources of income, the method of calculating retirement benefits for recipients of CPP disability benefits, and the limitations on combined CPP disability and survivor benefits.
Members of the subcommittee will notice, I'm sure, that we are inviting you to undo cuts made to the CPP disability benefits in 1998. The CLC was critical of the cuts at the time and still regards them as regrettable.
As you will note in our written statement, the negative effects of the 1998 changes appear to have fallen hardest at the two ends of the age spectrum, the older workers and young workers. We would be pleased to discuss changes in each of these areas with you.
In our written statement you will also notice that we do raise questions about whether the CPP is the best vehicle for delivering income to persons with disabilities in an ideal world. Our conclusion is that there are reasons for dealing with this as an issue looking ahead, but until there is something better in place, it makes perfect sense to make improvements to the existing program.
Again, I want to thank you for hearing from the CLC this morning, and we wish you well in your work.
The Chair: Thank you very much.
We will now hear from the Canadian Council for the Rights of Injured Workers, Maria York and Stéphane Paquin.
Ms. Maria York (President, Canadian Council for the Rights of Injured Workers): I am the founder of the council, and I'm very proud to say this because I began working with the Ottawa and District Injured Workers Group about four years ago. I learned things I did not expect to learn about our country, about the way some injured workers were being treated by our country's workplace compensation system. I then discussed my concerns with my colleagues. Doug Perrault is the president of the Ottawa and District Injured Workers Group, and he is in the audience. We formed this organization hoping that maybe we would have a voice in the future so we could help the injured workers who are not getting any help.
The reason we are here is to discuss with you or to present our arguments regarding the Canada Pension Plan offset, because it is an issue that affects severely disabled people who become injured at work.
I perhaps approach the Canada Pension Plan from a slightly different perspective from what I see in the literature, where everybody talks about it as a social security plan. I look at our country from the point of view of an economist--I am an economist--and I look at the country as if it's a giant corporation. Canada Pension Plan is the pension plan of the citizens of the country in just the same way the pension plan of the Canadian Imperial Bank of Commerce belongs to the people who work there, employees of the bank.
Now, what we have is a situation where private corporations are in a sense distributing the Canada Pension Plan for their own financial benefit, and they can do it because there is no law, really, to stop them. Corporations are very creative. They have to generate profits. The same way they would do with tax returns, they look for the loopholes in our law to minimize their obligations.
By offsetting Canada Pension Plan from their disability benefits--and again, we're talking about severely disabled people, people who cannot work--they are really reducing the financial benefits payable to people who cannot earn income in any other way. Our concern is not whether or not they should be permitted to do this but that they should have certain guidelines and that the information provided to employees should be very clear.
The way it appears to be right now is that they are deceiving their employees in a sense, because when the employees sign up for their package of benefits, what they see in front of them is, I have 75% coverage in the event of severe disability. That means, if I cannot provide for myself and my family, this is what I will get.
When they become disabled--and severely disabled, again, because we're talking about the Canada Pension Plan, and you must be severely disabled--when they get to that stage and they can no longer earn income, they find out that actually they don't have this. All they have is the 75%, 60%, 55%, or whatever. Basically, it is too late for anyone who is severely disabled and unable to go to work. It's too late for these people, these individuals, to learn what kind of coverage they have.
We would propose that if corporations continue to incorporate or integrate the Canada Pension Plan, they disclose this information in great detail to their employees at the beginning so the employees know exactly what they will get if it happens. We don't have this right now in our country.
Incidentally, I'm not really following the written presentation because I know you don't have a copy; I'm just basing my arguments of what I've already heard here.
The second issue that is very concerning to us is specifically the Workplace Safety and Insurance Board in Ontario and then all other compensation boards across the country. We have a very complex system of workplace compensation. We have so many policies, so many laws, and so many different regulations that it's very hard for an average person to navigate through this process.
We don't believe that workplace compensation is the same type of social security system the Canada Pension Plan is or other provincial disability plans are. They are employers' insurance systems. They are systems that provide the employees with certain benefits and are a compromise. They cannot be sued by injured workers, and in exchange the workers receive benefits without apparently going through the lengthy process of litigation. Well, in real life it's not like that. Internal litigation within the workplace compensation system is very complex, and it's beyond the ability of an average working person to proceed.
À (1015)
Different workplace compensation systems in our country have different processes of offsetting the Canada Pension Plan; some offset it and some do not offset it. Basically, we don't believe they should be permitted to offset it, but if they are permitted to offset it, there should be the same rule that applies to every province. This is because the Canada Pension Plan is a plan created from the payments made to the plan by all Canadians.
What we have right now, let's say in Alberta, is that there is no offsetting of the Canada Pension Plan from the WCB out there. So basically, in a sense you have workers and corporations from Alberta contributing to the national plan, and the funds are then redistributed by an insurance corporation. Now, WCB in Ontario is a crown corporation; it functions like a business. Those funds, Canadian funds, are being distributed by a provincial system--there are one, two, or three different compositions of these systems--and no one seems to be paying attention to it.
In a sense there is no law, and when you have no law, it's just as if you are on the highway and there is no speed limit. You can go as fast as you want and you will never be penalized or questioned as to why you did it.
Again, we believe that the Canadian government has an obligation to the citizens of Canada to introduce a law that will allow citizens to understand what they are entitled to in a situation when they become severely disabled and cannot contribute to their families and to the country.
I want to emphasize this once again: severely disabled. That means a person who must be recognized by the government's authority, the officers of the Canada Pension Plan, as severely disabled. These people really cannot lie to obtain the benefits because their applications must be supported by a doctor's certificate. We might want to say that everybody's dishonest, everybody lies. Well, by the time the person gets to apply for benefits, somebody has told them yes, I consider you severely disabled, so go for it. Sometimes lawyers may confuse things because they say, well, you can do this and this and this. However, this is not my point.
Once they get to that stage, we are not talking about productive people any longer, we're talking about people who are sick. They may be 33, 45, or 55. In a sense, the way we see it, they are asking to benefit from an early retirement portion of their Canada Pension Plan.
You have to understand, we have to have some compassion; these people are sick. Will they live to 72 or 75, the expected ages for men and women? Will sick people actually ever reach the point where they can benefit from the plan at the time they are 65? I don't believe many people who are very sick will actually have any reason to have such lengthy, positive life expectation.
So basically, by allowing them to benefit from the plan when they can still enjoy their life and perhaps help their children to get their education, we are actually in some cases allowing them to take very early retirement under the Canada Pension Plan. In other cases, many people who are older, maybe 55, have great difficulty finding a job when that is combined with a disability. Basically, they will take early retirement because of their illness, because of their limitations.
At the same time, we have to remember that we have in our country people who are 70 years old who can and do work. I just printed an article from Benefits Canada this morning, actually. I was looking at it yesterday, and you may be surprised to hear that 75% of people plan to work or are working after they retire, which means after they start receiving Canada Pension Plan benefits.
So you have a group of people who are very capable of working after age 65 and no one questions their entitlement to benefits. Yet we have this large group of people who are severely disabled; sure, they are not working, but they are not working because they cannot work. We argue about how much money they should get. Should they get 100%? Should they get 120%?
If we stack the benefits, these people will be overpaid. Well, how can you overpay a person who is too ill to work, a person who has three or four kids at home and who has no other form of support? You cannot. But because maybe it would be unfair to other members of society...
We believe that current practices of the workplace compensation board, which limit the total income of a severely disabled person to 85%, are unfair. We believe that if there is any offsetting permitted by the Government of Canada when the rules are set--which, we trust, will happen at some point in time--a fair compensation will be to allow the person to remain in the same position the person was in prior to the accident.
À (1020)
The cost of living does not change because a person suddenly becomes disabled. If you have a $100,000 mortgage on your house on the day of an injury, the bank doesn't send you a letter saying yes, we recognize you are in big trouble; we're going to discontinue your payments; you will be forgiven 12 payments on your mortgage, and then we'll see how it goes. This does not happen in real life. Your car loan must be paid, your mortgage must be paid, and children have school expenses.
When they have been receiving disability payments from the WSIB and then are finally approved for the Canadian Pension Plan, sometimes this is the first time many people realize, oh, but I cannot add this money to my income. This is going to be taken away from me. So nothing changes in this person's life, nothing changes in the life of this person's family, and they are very disappointed. They are frustrated, they are sad, they are without hope, and they become mentally sick.
Many people who are disabled become more ill. They become a drain on our system of health care because many of them require long-term care. Many of them will require additional assistance from their doctors for mental illness, depression, frustration, or whatever.
So basically, from my perspective, I believe that by limiting the income of a person who is severely disabled we are creating a problem for our society in the long term. We don't want to see sick people around us begging for money. We want to see people who can be productive.
Now, somehow there is a preconception in our society that a productive person must be someone who is working and paying taxes. Well, the way we see it, a productive person who goes on holidays with their children contributes to the economy by buying airline tickets. A productive person can go to the cinema. A productive person can go and participate in the community by volunteering their time. There are many other ways for severely disabled people to be productive.
Unfortunately, it is unrealistic in our society, which is all about profits for the corporations, to expect that the corporations will open up their doors and say okay, come here; we're going to give you full benefits, full wages; you are a very productive person.
You have to understand that even some of the people who are disabled and are working are not as productive as an average person, yet because we have all these human rights laws and everything, some employers feel obligated to give them full salary and everything. But we have to look at it from both the employer's perspective and the worker's perspective. Workers don't want to be mistreated at work because they cannot produce. Meanwhile, employers have a right to expect productivity from their employees because they pay wages for it. That's why they are in business.
In a sense, when the government becomes involved, when the government says employers must employ everyone who's disabled and must provide everything for them, employers strike back. And how do they achieve their goals? By lying about the accidents, by trying to work around the laws, by trying to dismiss people and getting away with it, by treating them very poorly.
I asked Stéphane to be here because if you have any questions regarding what happens to a person after this person becomes injured at work and starts collecting benefits, about how employers can treat a person when they don't really have any way to accommodate the worker, and about what happens to the person's life, you can ask him and he will tell you his story.
À (1025)
The Chair: We would like to hear from Randy, and then we can take your other issues as part of the question period.
Ms. Maria York: Thank you very much.
The Chair: Mr. Dickinson.
Mr. Randy Dickinson (Executive Director, New Brunswick Premiers' Council on the Status of Disabled Persons): Thank you, Madam Chair.
First of all, I want to repeat the message from the Canadian Labour Congress acknowledging the other work of the committee. The recent efforts on the disability tax credit issue were of significant impact on and interest for Canadians with disabilities across the country, and we are hopeful that an outcome from that report will be a change in policy.
Indeed, here today as we speak to the issue of Canada Pension Plan disability benefits, there are a number of outstanding concerns we feel can be addressed while the sustainability of that system is maintained with some proper balancing between the interests of Canadian taxpayers and employers and the interests of injured workers and the people they represent.
We have submitted a brief to the committee, and there are quite a few issues we have identified in that brief. Time constraints today won't allow us to have a full discussion of all those, and I realize the difficulty of the committee's role in trying to be fair to all the presenters. But I urge the members of the committee and especially those who aren't here today to actually read the submissions.
I also want to acknowledge the positive methodology of using websites and electronic mail to allow Canadians across the country to make submissions to the process. But I would respectfully remind the committee that many persons with disabilities are not able to access the Internet because of the nature of their disability or because they can't afford computers and such technology.
Also, another point I think is very important is the issue that many persons, whether they are a beneficiary of CPP, they have applied for CPP, or they are in the process of applying for CPP, did not take advantage of the opportunity to submit their experience or their opinions to the committee because of a fear of repercussions even though they were guaranteed confidentiality if they wanted it. I think you should be aware that I have had many conversations with people who expressed a lot of criticism of the system, but when it comes time to put those comments into the system in a documented fashion, they choose not to because of the fear of repercussions, that they might lose benefits or that their claim will be handled inappropriately.
Just as a matter of interest with respect to our own brief, which was submitted to your committee and posted on your website, we received e-mails from the Office of the Commissioner of Review Tribunals critiquing our submission before we even had an opportunity to appear. It creates some concerns. I had some anxiety as to whether I should even appear here today, not because of any personal concern but because we often advise clients or are involved in writing letters of support for people. We are a little disturbed when participating in the public consultation process might send a signal and somebody is going to be following up on your concerns unless you are very complimentary.
I would point out that in our brief we did have a section that did make positive observations on some things that have been improved in the system. I wanted that in the record because we are not just criticizing for the sake of criticizing, but obviously our comments focus on gaps that still remain.
During some of the testimony of the Canadian Labour Congress and the group representing injured workers, I just wanted to jump in and say yes, those are the issues that need to be put on the table. I hope at some point down the road there will be other opportunities for a more extensive dialogue and follow-up on some of these things.
I think one of the things we have to recognize is that there's a difference of objectives as to what CPP disability benefits are trying to provide. Provincial social assistance ministries are trying to off-load clients onto the CPP program to avoid paying for them. Private insurers and workers' compensation boards also require people to apply for the CPP disability benefits. You pay premiums into the different programs and you pay taxes, but when it comes time to collect the benefits, suddenly you are moved all the way over to other, different programs; everybody is the payer of last resort.
My question is, if you pay premiums into more than one program, why is it you can't collect benefits from more than one program? Should your committee create a system that legislates a requirement to keep CPP separate and not deduct it from other benefits if you have paid premiums for it? Remember, you don't get CPP disability without having met the qualifying contribution level. Really, it is an insurance program that is being taken advantage of by private insurers, workers comp, and provincial social assistance programs, which off-load the responsibility to pay the person who qualifies for disability when the time comes to collect on the premiums they paid.
À (1030)
I would also want to reinforce the fact that there is an issue about the changes made in January 1998 in terms of the eligibility criteria, especially the qualifying period. This has had a disproportionate impact on some persons with disabilities, particularly older persons who would have difficulty reintegrating into the workplace because they would require retraining and new skills. It also affects persons who may have gone into self-employment and did not contribute enough to CPP because they were not earning enough during the start-up of their business. By the time they became disabled and couldn't continue, they didn't have coverage either privately or through CPP.
The other thing is, somebody in one of the presentations made the comment that getting CPP was like a windfall, and I won't mention CIBC by name. The rates paid under CPP are not that high. The minimum rate payment is $370.33 and the maximum is $971.26, but the average as of October 2002 is $718.90. That's not a lot of income if you are a single person or even someone in a previously combined two-income family.
The fact that a person is limited as to the amount of coverage... we really think the minimum rates should be examined and reviewed. There was a review of the sustainability of CPP, as you know, and we know that the funding is there to cover perhaps a reconsideration of the minimum level of $370.33, which is not adequate.
There are lots of other points I could make. I'm glad you mentioned the concern about episodic disability. You used the example of MS, and we're also talking about mental health problems.
One of the areas where we see a lot of problems in the claim process is with claims related to things like fibromyalgia, chronic fatigue syndrome, and environmental illnesses and sensitivity. These are conditions where the medical information has only more recently become available and a lot of physicians and practitioners are just not adequately trained to do proper assessments. They may not understand that people could walk in and present themselves on the day of the hearing but then go home and be in bed for three days afterwards because they have a chronic condition like that.
The case law, the tribunals, and the pension appeal board hearings... and by the way, I've participated in a number of those personally, and I've helped hundreds of people prepare their cases, so this is not something based on hearsay. We find that they are at a total disadvantage compared to people with a condition like a spinal cord injury, where you can clinically clearly show what the degree of disability is.
One of the other things I want to highlight is the issue about representation in the appeal process by persons with disabilities. The workers' compensation board in our province, for example, has workers' advocates who don't work for the compensation board. They work for the Department of Training and Employment Development, so they can act as advocates and assist people in the appeal process. They have the experience, they have the knowledge of the system, so it levels the playing field a bit when somebody's putting an appeal in for workers' comp.
With Canada Pension, however, you are required to bring your own advocate or to hire a lawyer, who may or may not have actually had previous experience at a tribunal hearing, especially at the Pension Appeals Board level. What we see is people being forced to spend thousands of dollars on obtaining their own counsel when in fact they might not even win their case, and they still have to pay the lawyer whether they win or lose.
One suggestion is, in addition to creating some sort of resource in the community that could provide technical advice and help people prepare their appeal packages, perhaps we should also examine the possibility of changing the program. Now, there are costs they have to undertake out of their own pocket, costs that are not recoverable from the appeal process, such as hiring a lawyer or paying for an advocate. If a person wins their appeal and gets their pension benefits, that amount of money should be deducted before the pension benefit becomes taxable. In other words, if they get $500 a month and it cost them $5,000 to win their appeal, they should have 10 months of their benefits come in that are not taxable income in order to offset the out-of-pocket costs.That way you could do it without adding to the costs of the system, but it would help the individual get some recovery.
I noticed one of the briefs from the Office of the Commissioner of Review Tribunals said, well, it's not much of a hardship to pay 2¢ or 3¢ a photocopy. The fact is, you can't go out in the community and buy photocopies for 2¢ or 3¢. If you have your own photocopier in your office, that's what it costs to pay for the service contract. But if you go out and buy a photocopy as an individual citizen on the street, you might pay 25¢ a copy, for example, and they have hundreds of pages they need to prepare in order to make a complicated claim.
À (1035)
We think there's also a problem in the process in terms of the amount of consideration for health professionals and other people who may be involved in the treatment of that individual. Right now there's just the physician who fills out the form or someone hired by the pension appeal board to do an assessment of the client, someone who may never have actually met the client before or who in some cases only looks at the documentation without even meeting the client. Instead of that, we think that if there's a physiotherapist, a speech therapist, or whoever has been involved, they should be able to submit information if they wish. Also, perhaps an advocate could put all that information together, combine it for its cumulative effect, and then have the doctor sign off as agreeing with the whole file.
The problem is, when you go into medical case files, the issue of their employability wasn't the concern when the person initially presented themself for treatment. The doctor only wrote notes based on the treatment of the disability because the person had not decided at that point whether they were going to apply later for Canada Pension. When they go back and get copies of those files, there's not enough information in terms of the assessment of employability. Then the physician often doesn't get the opportunity to go back, update that file, and say, if I had to make an assessment about employability, I would confirm that they do have a severe disability that is prolonged and would prevent them from having regular employment.
One of the things we're trying to say is, there has to be a balance of interests. We know that the public and the employers want to reduce costs and prevent escalating costs, but we also have persons with disabilities who need to have adequate income to meet their needs if they're unable to work. We need sustainability and we need fairness, but we also need the flexibility to understand, as I know you do, that not all people with a diagnosis of a certain condition are going to be the same and that not all people's capacity to work is just based on a functional assessment of the limitations of the disability.
I think we also have to be more clear in strengthening the provisions of some of the case law, which has only started to allude to the issues of education, skills, and the real opportunities for employment in the area in which that person lives. Then we can have some balancing of the interest of the individual with the interest of the system in determining whether it is realistic to expect that, in view of the combination of the different health problems and disabilities this person now has and in light of their age, their education, and the skills they have, they will be able to go back into the workforce on a full-time basis and be able to support themselves.
In my experience there have been a lot of cases that didn't get a fair assessment, especially those cases where the applicant didn't have an experienced advocate to help them present their information in a reasonable and consistent manner so the decision being made could be done based on the total package of evidence.
I believe that we do need advocates available to help those people. I think that the system has improved but that there are a lot of gaps in the system. People have to get off the idea that most people with disabilities are trying to rip off the system and win the jackpot, because when you're making $370 a month with CPP, it's hardly the 6/49 jackpot some people seem to believe it is.
I'll just quote the title of Charles Barkley's new autobiography. It's I May be Wrong but I Doubt It.
Thank you.
À (1040)
The Chair: Thanks very much, Randy.
Mr. Elley.
Mr. Reed Elley: Thank you very much, Madam Chair.
Thank you again for coming and presenting to our committee. We appreciate it very much.
A couple of submissions today have talked about the need for advocates, people who would come alongside people with disabilities and advocate for them through the CPP disability process or any other kind of process. We are parents of a disabled child, and we know what that means when you try to access help. It means going through multi-layered levels of bureaucracy, moving from building to building, and spending endless hours on phones trying to get through to people and all of this kind of stuff. My daughter is very fortunate to have parents who at this point advocate for her, but there are many people out there who don't have those kinds of support systems.
I come from the province of British Columbia, where there have been some pretty severe cutbacks in terms of provincial government help for people with disabilities. Unfortunately, when governments go through a lot of these cost-reducing measures, they seem to hurt the most vulnerable in our society.
One of the problems we've had in my riding in British Columbia per se is that the provincial government has cut back funding for citizens' advocacy groups who have helped out people. In particular, they may be people with severe disabilities who find themselves, if the disabilities are long-term and chronic, moving into lower socio-economic income levels. They don't have the resources they once had, and now they're being cut off from the advocacy groups who had done a lot of advocacy for them through the system.
Basically, my question to any of you is, if indeed we recognize the need for more advocates, whose responsibility is that? Is that a government responsibility? Is it an industry responsibility? Is it a union responsibility? Who should be supplying the advocates for these people?
Mr. Randy Dickinson: If I can give you my own personal opinion, if you look at the appeal tribunal system for Canada Pension Plan disability benefits or the Pension Appeals Board, at the tribunal level there's a person working for Human Resources Development Canada who sits there to represent the interests of the department. They've obviously had the opportunity to experience that process many times and therefore can represent the interests of the department. At the Pension Appeals Board level there's even a higher level represented because they have staff lawyers who only work on Canada Pension disability appeals. They're familiar with the case law and they're familiar with the procedures.
Therefore, again, if a person comes in who is only experiencing the system for the first time or they come in with an advocate who is only coming in for the first time, they are at a very great disadvantage.
I'll use the illustration I gave in my testimony earlier for the workers' compensation board in our province. They have workers' advocates who are funded by the provincial government; they work for the Department of Training and Employment Development, but they are available to work with the client. We do not see, for example, the Pension Appeals Board hiring advocates to help the clients.
It should be an outside, independent group or one funded by government so we can have the arm's-length independence necessary for the applicants to have confidence that the advocate is working in the best interest of the applicant and does not have the conflict of interest, real or perceived, they'd have if they were employees of the Pension Appeals Board system. The pension appeals system already has a system of paid, full-time representatives on their side, but there is no such help on the consumer's and applicant's side.
Just having an advocate who doesn't have experience or training isn't going to solve the problem. They have to be aware of the particular format and the particular process that are used in that type of system.
À (1045)
Ms. Maria York: I believe it's very important. I don't believe the government should be assisting people to apply for the Canada Pension Plan. It is an insurance plan, and of course the government wants to make sure that only the people who qualify receive the benefits. You cannot actually have an employee of the government, of the insurance plan, giving advice to the person applying for the benefits. Outside community groups that are well informed about the process should be able to provide this kind of assistance free of charge to the claimants.
I'm going to repeat it again: these are severely disabled people--at least, they believe they are. They have all the documents they require to apply. All they need is to put the package of documents together in such a way that the people who examine those documents get the message and say yes, I can see this person needs benefits; this person qualifies to receive benefits.
Because we don't have this kind of system in place, people may have to hire a lawyer. According to the study done by Environics—there was a study done for this committee by them—people who are represented by a lawyer have the best chance of getting their application processed. In fact, and this is in the study that is posted on your website, there was a direct relation between the amount of the fee paid to the lawyer and the success of the application.
Well, this is not what should be happening. Everyone who is entitled to the benefits because of the nature and the level of their disability should be able to receive it, again, without going through four different levels of appeals.
That would also be a saving in cost to the Canada Pension Plan. I wanted to bring to your attention the fact that the administrative cost of the Canada Pension Plan has risen much faster than its revenues since 1984, and this again is in the studies available on the website of the Canada Pension Plan. I think part of the increase is related to the fact that the cost of administering four different levels of appeal is excessive, but we could eliminate some of those appeals by simply providing a system of applying for benefits that explains everything up front to the doctors.
Some doctors are coached by the lawyers, you must know that, but other people who are applying for the first time for their disability benefits just go to see their family doctor and say, here's my form, please fill it in. If this doctor has never done this before, he will not know how to focus on inserting legal terms in language that would not permit the adjudicator, the person who reviews the applications, to say, well, it doesn't look like he qualifies. Unfortunately, this is the case.
The same thing applies to applications for other forms of disabilities. WSIB communicates with doctors and employers communicate with doctors, but of course a working person does not know the medical terminology and does not have the ability to explain to their doctor what needs to be in their application to make them eligible for benefits.
Again, many of these people who are applying for benefits are very sick, so by going through this very lengthy process of applying, waiting and waiting, and then seeing a lawyer, they basically become more frustrated and more sick.
Mr. Reed Elley: I'm going to ask you a supplementary on that, Maria. You said that you thought there should be citizens' groups that do the advocating and it should be free of charge. So who funds the citizens' group?
Ms. Maria York: Perhaps the government could consider this. Rather than spending millions of dollars on the four different levels of appeals, many of which I believe can be eliminated, give the money to the community groups. Train the people or give them money so they can hire experienced people, get them trained, and then offer this service free of charge to people who qualify.
Maybe it shouldn't be free of charge to everyone but at least free of charge to families, to people who don't really have additional disposable income. You have to understand that when they are, let's say, on workers' compensation, they are already living on a much lower income than they were receiving prior to their injuries. Some who come to our group are like Stéphane, who is on welfare right now. He's not applying for Canada Pension; we helped him to get a job. But other people who do come to our group would be in this situation, and they cannot be asked to pay for this service out of the benefits they receive in the future. That's very unfair.
There are other people who have many different sources of income, and they also qualify to apply for and obtain benefits. They're people who may have businesses or real estate all over the world, yet they are entitled to it because they paid into the plan. It's a plan, not charity. Therefore, these people will also receive benefits. But perhaps--
À (1050)
The Chair: I think we should move on because I am very conscious of the time. An important thing would be for other people to explain, if they have any experience, how it works with advocates--maybe Dr. Schweigert.
Before we go there, let's get Wendy Lill, Brian, or Tony to ask their questions; then maybe we will give everybody a chance to give their observations.
Brian.
Mr. Brian Masse: Thank you, Madam Chair.
There are two things I've pulled out. First, I spent about eight years working as a job developer for the Association for Persons with Physical Disabilities and also for Community Living Mississauga. One of the things I often ran into in assisting people was the Canada Pension disability pension issue over the three months and what happens if the job doesn't work out. Or, if we start to explore another career for them or another option that's not related to some of the barriers they face in the workforce, are we able to find that unique opportunity--often very unique--and will they have to gamble their security away and perhaps go back through a process?
For my second question, how do you feel about the three-month issue, whether it should be a year or perhaps indefinite, provided they could back into the system and be able to recover their benefits? The experience I had was that we could actually move people off the system in a way, but sometimes the specialty of the jobs and the relationships we were able to develop required quite a substantial risk. And if they lost that job--not where it was their own fault; it could have been a layoff or a whole host of different things, especially nowadays, when people need several careers during their working life--it made it more challenging.
What do you think about that concept in the sense of having more flexibility there?
The Chair: I think they call that automatic reinstatement or something. Could we just go across the panel. Is there a consensus that automatic reinstatement is a good thing?
I see agreement.
Mr. Brian Masse: And then second is the fact that the vocational rehabilitation program is in a surplus of $800,000 this year, according to our parliamentary report here. Should that be changed to operate on the basis of a break-even philosophy at the very minimum, and should there not be calculations of other medical savings from the people who are actually becoming employed back in there, probably using fewer services and having a better quality of life? Should that be calculated as to some of the savings involved too?
The Chair: Does the CLC have an opinion on that?
Mr. Bob Baldwin (National Director, Social and Economic Policy, Canadian Labour Congress): Yes, it should operate on a break-even basis, but the issues you're raising are also connected in important ways to the definition of disability under CPP.
The Chair: Maria.
Ms. Maria York: A vocational rehabilitation program and any money that's going into this program should really be examined very carefully because some of the people who are participating in the programs cannot benefit from the programs. When you have a severely disabled person with a certain level of disability, you're not going to get this person back to work by putting them through a six-, eight-, or nine-week program, hoping they will recover.
Unfortunately, we have so many new physiotherapy centres opening everywhere on the main floors of shopping centres—you must see this everywhere around you—and you often must wonder whether or not our society is actually benefiting from this. It is these people for whom these places are operating and providing services, but there are certain disabilities where we already know from the scientific evidence that there is no treatment for them. Just by putting people through the process of rehabilitation we're not going to get the benefits we hope for. We just have to allow them to live the way they are and hope for the best, allowing them to then function in society within their abilities.
Dr. Brown from the CIBC said himself—and this is a big bank, a big corporation; I'm sure they wanted to save money on their disability plans—that we must go by what the person tells us regarding his or her abilities. You cannot just send them for six weeks of therapy and say okay, now you're ready to go back to work. This is unfortunately what's happening, and other people are making money while injured people, disabled people, do not get any benefits. The Government of Canada pays for some of those programs, I understand.
À (1055)
The Chair: It's a big problem for lots of the insurance companies too, though, with a lot of the self-referral stuff that got put in place when they thought that keeping the positions or keeping referrals out was going to save money. When people get signed up for 52 weeks of maintenance, it's like Arthur Murray dance lessons or something. I find it's really, whatever they call it, des économies de bouts de chandelles. It's ridiculous and it's costing us a whole bunch of money, this sort of conveyer belt we're putting real people on.
Thank you for raising that.
Wendy?
Ms. Wendy Lill (Dartmouth, NDP): I just have a quick question.
I've been in another committee, and I apologize for not being here; I'm glad Brian has been here and been the ears for the NDP on this issue.
Yesterday I was at the day of mourning for injured workers that happened across the country; there are a lot of people who get injured or killed in the workplace.
I'm struck by the fact that given the new contributory requirements, there are so many young workers who will potentially never be able to take advantage of CPP disability if they get injured in the workplace within a year, two years, up to--what is the cut-off? Do they in fact have to have worked four out of six years? Does that mean that no one who has worked less than six years has a hope in hell of getting any kind of CPP disability assistance in their lives? If that's the case, this is a huge problem because we do see a lot of young people being injured and not being able to move anywhere at some point.
Could I have your comments on that, please.
Ms. Marie Clarke Walker: We talked about the 1998 changes and what's happening now, and I think that pre-1998 it was a lot easier for the young workers to qualify. The changes made it that much more difficult because of having to be four years in the workforce. A lot of them get injured less than four years into the workforce. The LTD programs seem to address those issues better than CPP does at this point. Your point is taken.
On the issue of advocates, I think what is really important is that when money is given to unions and community organizations to do that type of work, it should be given with a cultural sensitivity to the people who have disabilities and a greater understanding that particular people from particular cultures deal with these issues very differently.
I just wanted to make that point very quickly before I passed it to Bob.
Mr. Bob Baldwin: I'll just speak quickly to your point, Wendy.
It is typical under long-term disability programs to have a waiting period of only six months before a person becomes eligible for long-term disability benefits. On page 6 of our written submission we do have some data on the reduction in the number of CPP-D beneficiaries by age group. You will see that both men and women in the younger age group experience dramatic reductions in the number of beneficiaries following the changes in 1998.
The Chair: I am conscious of the time. I think you have a flight.
Tony Tirabassi, maybe you could go, and then we'll see if there's time.
Mr. Tony Tirabassi: Madam Chair, you always have to know where you stand with the system we have. I was just wondering if anyone on our panel has any comparators with other jurisdictions. It's not because we want to rate whether ours is better than or not as good as, but in going through an exercise like that we might find parts of another system that would help to improve ours.
First of all, do you look at the comparators, and is there any one or two things that could be adopted from another system to better improve ours?
The Chair: Dr. Schweigert, do you look at comparators from company to company?
Dr. Michael Schweigert: Yes, and I'm going to address the issue with respect to my experience from company to company. I think some companies do an excellent job of not discriminating between work-related and non-work-related issues.
I don't have any personal experience with CIBC, but we're talking about the issue of, let's just try to get everyone back to their best of their abilities. Let's not try to look at the question a lot of employers get stuck on, namely, tell me exactly what he can do now before I even bother to bring this person back to work. I think they have to get beyond that and not say, let's see what they can do.
As well, the issue comes up where a lot of patients will say, when am I going to be 100% again? When is someone going to find out what's wrong with me? We try to get beyond that mindset for people. Most people I've had experience with do want to come back to work and are interested in how they're going to get there.
When you have an organization that is receptive to that, to work with employees and have them come back, I think that's the approach that's most successful. They're willing to take the chance, willing to deal with uncertainty, just like with any business decision. There's no certainty here, so a lot of it is not a task, it's a process. Let's see what we can do in order to do the best we can to get this person back.
Á (1100)
The Chair: Maybe one of the things we've been struggling with as a committee is that too much emphasis is placed on a medical diagnosis as opposed to an ability assessment. Is there a way you would suggest we could address that in our recommendations?
Dr. Michael Schweigert: One thing a lot of organizations struggle with is the uncertainty around predicting the future. We expect too much of medical science, that they should be able to say what it is someone definitely can and cannot do, when they will definitely get better, and so on. There needs to be some system developed where people aren't penalized for trying to get better and attempting to enter the workforce.
Perhaps the best medical science can do is to set bounds and take what seems to be a reasonable approach for an individual. Every individual is different; for some there may not be an apparent best course, but for others there'll definitely be best courses of action of what's reasonable to try.
If I could, I'll just quickly follow up on the question of advocacy and who should be paying for it or where the responsibility lies. I think that in Ontario it currently lies with the Ministry of Health. My experience has been with physicians, and physicians who are really looking at the whole person spend a great deal of time advocating for their patients. I think that's an unfair burden to place on them, and it tells me that there's a real need out there.
When people are struggling, they typically go to their family physician. I've had a lot of family physicians call me up at the place I'm employed and say, you know what, this isn't really a medical issue, but I need help with this person; I'm struggling here, and what can you do? Usually it's, what can you do to get him back to work; what doors can we open up to help this person out there? They're really struggling; they're at a loss.
As Mr. Dickinson said, CPP is no windfall. They're not happy at home. They want to contribute. I'm not sure what percentage of the family physician's time is spent on advocating, but I'm sure it's quite high. I think it might be worthwhile to ask the Ministry of Health where to turn in terms of who really owns this rule.
The Chair: It comes out a different pocket of government.
Dr. Michael Schweigert: It's a hidden pocket.
The Chair: It's the 20-minute counselling--
Dr. Michael Schweigert: --that we don't capture. It's one of those hidden costs.
Mr. Randy Dickinson: If I can, I'll make a comment just on this issue. With all due respect to the doctor here, although we certainly recognize that doctors try to advocate for their patients, my point is that most doctors and physicians don't have the time or the expertise in terms of preparing the documentation. That expertise is necessary for them to know the format that is necessary and the emphasis that is necessary to be successful in assisting their patients in the appeal process if they are legitimately eligible for benefits.
The other thing I would point out is, even with advocate groups or whoever to help people prepare for appeals if they need help, we also counsel people who we think are not eligible for benefits. We can tell them right up front, you should not proceed with this appeal because, based on our knowledge and experience, you don't meet the eligibility criteria. It's easier for the consumer to accept and understand that coming from a third party than if the person from the department or the ministry tells them they don't qualify because they'll think the department is trying to deny them benefits to which they're entitled.
Á (1105)
The Chair: What, Randy, do you advise people who don't qualify for CPP?
Mr. Randy Dickinson: If we don't feel they qualify, then we immediately link them up with vocational employment training and placement programs to try to reintegrate them into the workforce by some other means and accommodate their disability with whatever things are required to overcome that.
I have just one other point about disability, something the gentleman mentioned. In our province, for example, it's not consistent, because under the collective agreement of the teachers' union, a teacher in our province who gets CPP disability benefits is able to keep the CPP disability benefits in addition to the long-term disability insurance from the carrier.
As I said earlier, however, what we see more frequently is off-loading, where private insurance, Canada Pension, workers comp, etc. pass the buck and the consumer does not get the benefit of the coverage for which they paid premiums.
Again, the public needs to understand that you're not getting Canada Pension disability benefits because you're trying to get a disguised form of unemployment insurance. You get it because you qualify, based on both the degree of your disability and the fact that you've paid in the necessary contributions and premiums. I think that's an important message.
The Chair: Please answer one final question if you would. Maria suggested that the number of levels of appeal should be compressed down and the resources from that given elsewhere. Panellists, is there a better way of doing this, in a front-end way, rather than having all of these various levels of appeal?
Mr. Randy Dickinson: As we said, if there's adequate representation and support to the applicant in the balance of power in the process, that is, at the same level as the support and resources for the people denying or approving the benefits, then you could probably go to better forms of binding mediation. Right now there's no disincentive to appeal right to the end of the process except for your ability to find the necessary resources and time it takes to complete the process.
We feel that in most cases, if you have timely decisions, even if you've been denied benefits, you'll be more likely to be successful in reintegration into the workforce before you become socialized into thinking that, because of the nature of the claim process, you have to prove you're disabled.
Some of the witnesses said earlier, you've convinced yourself that you're so disabled you can't go to work, so when you're denied benefits after three or four years of the appeal process, you still don't end up back in the workforce; you're just a bitter person back at home without any income.
The Chair: Mr. Baldwin?
Mr. Bob Baldwin: I want to make a point that was implicit in earlier remarks, one I want to make explicit, which is that good advocates can actually reduce administration and appeal costs. I think that's important, and it's one of the reasons it should actually be thought of as a legitimate administrative expense for the CPP.
I won't bore you anymore with that, but I did want to come back to this issue of comparative systems. When we think about CPP disability in this respect, it is always important to remember, though, that you're only dealing with a slice of “the whole system” here, right? You're dealing with a program that is currently only designed for people with severe and prolonged disabilities. This, by the way, is not by and large the group the CIBC was dealing with. That's why they sounded so much different from what we're used to.
That being said, it is also really difficult to compare systems internationally. I did some mucking around in this area because I'm very suspicious of the stability of CPP disability expenditures in recent years, frankly. I started looking at disability expenditures in different countries to see if the pattern of stability was common in other countries. While there are some problems with the data I looked at, I think the CPP is quite unusual in the stability of expenditures, and it doesn't pass a certain smell test of mine.
That being said, there is a real risk of comparing apples and oranges in this area. The disability benefit levels provided in this country are certainly low in relation to those in some international accounts of disability systems, as are total expenditures.
I'll just leave it at that.
The Chair: And with the levels of appeal, did you...
Mr. Bob Baldwin: On the appeals, as I said, I think the appeal system would actually be facilitated by advocates. I remember from my days with the CPP Advisory Board that the main reason decisions get turned around on appeal is because new information comes to light. In some cases it comes to light because people's conditions have changed, but more frequently it comes to light because after people have wrestled with the system for a long period of time, they finally figure out what information needs to be provided.
The Chair: Yes, and that's where an advocate does that.
Á (1110)
Mr. Bob Baldwin: Exactly. It helps you right at the front end and hopefully reduces a lot of that hassle.
The Chair: Well, thank you.
I think we have to go; I know I have to go to the health committee.
I can't thank you enough. As you know, we're coming to the recommendation piece of the study, and if you have any further thoughts after being here today, please stay in touch. We in our tiny, perfect committee think this is about building relationships with all the people who deal with this every day in their lives, and thank you so much.
I hope we'll see you all again. We do apologize that there's just always too much to do in too little time, but thank you so much.
The meeting is adjourned.