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Category: Workers’ Compensation

04/04/2023

Classification of Impairment

4 April 2023

I was lucky enough in my surgical training years to have most of a year working as neurosurgical registrar for Dr John Grant. He set up the 1st spinal Injuries Unit in Australia saying that while everyone was looking for a miracle cure that would allow injured spinal tissue to repair, most paraplegics were dying of bedsores or infections coming up their urinary catheters and much better practices and training was needed.

He went to England in 1960 and with Sir Ludwig Guttman started the Stoke Mandeville games, the precursor of the Paralympics. He developed the Paralympic Games to help his patients, who were mostly young men whose lives had been shattered after a catastrophic injury, often after doing something daring or unwise. Wheelchair athletics was a major part of this, as it gave the young paraplegic people something to strive for. John Grant became head of the Australian Paralympic movement and Chair of the Organising Committee of the Sydney 2000 Paralympic Games. My part was merely to help treat the spinal patients.

Later I moved into occupational medicine so as to fund my work in the anti-tobacco movement. There I found impairment from workplace injury and had to decide who could work and who could not. This got a nasty edge to it as insurers wanted people classified as fit, so that if they would not work their pay could be suspended. The Courts argued about this until the legal process was deemed so expensive that the American Medical Association worked with the insurance industry to devise a complicated medical examination which measured ‘Whole Body Impairment’ as a percentage. This was not supposed to simply translate simply into how much money an injured person was awarded, but of course that is exactly what happened. Since pain cannot be measured it had to be left out of the calculation, so you can have terrible pain, but if you have only lost a few measurable degrees of back movement, your percentage impairment may be minimal. The system also makes no distinction between an impairment and a disability. If you are a labourer and have a lower body injury and cannot work at all or are someone who works at a desk and can maintain their previous income, the impairment is the same. I have never learned the details of the system, as I think it a bad farce, but it is used to assess impairment in Australia, makes a lot of money for the doctors who do the medicals, and saves the insurers a fortune. Of course there are few who try to fake injury, but in my experience this is fairly rare, far rarer than insurance companies would have you believe.

But making an objective assessment of what a person can and cannot do is not easy, and so one is to pity the classifiers who want a level playing field by classifying people for the Paralympic Games. Given that each country wants to pick a team of winners and they classify their own athletes, it is little wonder that in some countries ‘intellectually disabled’ are as smart as anyone else, or that you cannot even notice a limp in some of the runners.

The 4 corners of Monday 2 April looked at the whole Paralympic Classification system and produced damning figures that 10 of 12 of the gold medal winning Spanish basketball were not disabled at all, and that in some areas 69% of the winners had minimal disability.

As this sad farce continues there is a huge kerfuffle lest the tiny number of trans athletes with the genetic advantage of having had male hormones might get an advantage over females.

John Grant must be turning in his grave.

24/11/2022

iCare- a letter to the Editor of the Sydney Morning Herald

24 November 2022

Dear Editor,
iCare was set up by private insurers on their model with the NSW government keen to minimise costs, take profits and distribute them (just before the last election). So iCare delays or refuses treatments to the needy, and was very careless about what their Pre-Accident Average Weekly Earnings (PIAWE) were. Many accident victims complained that they were underpaid, and that was before their compensation was stopped or cut because they were certified partially fit to do jobs that could not be found.

The overheads of Medicare are about 5%, iCare about 38%, so it is totally inefficient as well as incompetent with bloated salaries for the top executives who think it is a financial problem rather than a medical one and hence are unable to solve it. The real solution would be to fund Medicare as the only medical system and let the insurers have widespread income-guarantee insurance.
Sincerely
Dr Chesterfield-Evans- works as a GP specialising in Workers Comp and CTP injuries.

Here is an article from today’s SMH

EXCLUSIVE
Injured workers to lose benefits
Adele Ferguson

Greg Dayman is one of almost 400 workers who will get a Christmas ‘‘present’’ they will never forget.

The Sydney construction worker was badly injured on a building site in 2013, which left him unable to work with chronic pain in his neck, the side of his head, down his arm, torso and leg.

In 2017 he was among thousands of employees whose compensation payments to cover wages were cut as part of controversial reforms to the state’s scandal-ridden icare organisation. Changes to the legislation terminated injured workers receiving weekly wage benefits after five years unless they met a whole body impairment assessment of more than 20 per cent.
However, he still received medical or health benefits. Now he has found out even these will be cut from December 25.

‘‘It’s another upper-cut,’’ he said. ‘‘And to do it on Christmas Day, that’s just cruel.’’

Dayman is one of 395 workers facing a grim future as a crisis at icare deepens, with a document prepared by the State Insurance Regulatory Authority (SIRA) revealing the workers’ compensation scheme ‘‘has deteriorated to the point the longer-term sustainability of the scheme is under threat’’.

NSW Auditor-General Margaret Crawford will hold a performance audit into icare next year that will examine how effectively key risks are managed, including the rising cost of workers’ compensation claims and its payment processes. Dayman said he lost everything after his injury.

‘‘I lost my health, my career, and financially I’m in a position that if my specs break I can’t afford to buy them. The system dehumanises you, so you give up.’’

He does now qualify for a disability pension but will have to rely on Medicare for future medical treatment. ‘‘I have been suicidal at times because of the system and the way it treats you,’’ he said. ‘‘My time is spent trying to survive.’’

In the executive summary of SIRA’s review into icare’s Nominal Insurer Improvement Plan, dated September 26, the authority said it had a ‘‘low level’’ of confidence icare’s strategy would improve return to work rates and overall performance.

In 2015-16, 93 per cent of injured workers were back at work 26 weeks after their injury, compared with 84 per cent in August 2022.
SIRA said it believed icare’s strategy ‘‘encompasses an increase in work capacity decisions to cease worker benefits instead of focusing on improving health and recovery through return to work’’.
Richard Harding, icare’s managing director and CEO, said it was the insurer’s role to implement the law, and legislation ‘‘does not give icare any discretion to act outside that’’. ‘‘Tailored and individualised support is provided to workers transitioning from the workers’ compensation scheme,’’ he said. ‘‘This may include support from NDIS, Community Support Services and Medicare in conjunction with their GP.’’

This masthead this week revealed a third underpayment scandal of injured workers and concerns raised by NSW Treasury in August that a deterioration in icare’s finances would require insurance premiums to rise 33 per cent by 2025, or $1 billion a year, to cover the shortfall.

Against this backdrop, the icare board granted pay increases to 116 of its executives, including Harding, making him one of the state’s top-paid public servants, earning more than $1 million a year.
Shadow Treasurer Daniel Mookhey said icare’s finances were in a catastrophic condition.

‘‘They’ve lost billions. They are planning massive premium hikes. And their next step is to expel even more injured workers from the system,’’ he said.

‘‘It is a ruthless tactic stemming from their financial desperation.’’
In a statement, SIRA chief executive Adam Dent said its views on the Nominal Insurer Improvement Plan in September were made with limited detail on how the plan would be executed.

‘‘Over recent weeks, SIRA has continued to engage with icare to address information gaps, including detailed briefings on managing IT and transition risks associated with the onboarding of new claims services providers.’’

But SIRA said poor return to work performance continued to be an issue of concern.

‘‘Icare’s targets for 2023 are lower than current return to work rates, and they are projecting a further decline of 2.5 per cent on 26-week return to work rates through 2023 and 2024 as the scheme transitions to new claims providers,’’ Dent said.

Icare said its focus was building injured workers’ capacity for employment using rehabilitation providers and associated vocational placement interventions. ‘‘This includes assistance with job seeking and vocational retraining. Work capacity decision-making is applied when the worker has a demonstrated capacity for work and has been provided the right support.’’
Lifeline: 13 11 14

20/05/2022

Government protects Bonuses of iCare Executives while workers are dudded.

20 May 2022

Some things make me unspeakably angry.

In the SMH online today the government giving bonuses to executives who presided over iCare cheating injured people out of their payments and treatments.

In my real job, I treat injured workers and motor vehicle accidents. Many wait more than a year for surgery- my longest was 9 years. They are subjected to Independent Medical Examinations that find any other reason than their accident for the cause of their pain. Age, previous injury and arthritis are the commonest ones. It is stated that they are fit for work, when they are obviously not, or that they can get another job when they obviously have no physical or mental capacity to do another job, let alone compete for one.

The ongoing inefficiency of the computer algorithms making decisions without even anyone being responsible was the brainchild of John Nagle, whose other bright idea was to change his KPI (Key Performance Indicator) from getting people back to work, to having them declared fit to be back to work. Nagle resigned after a bad day at a Parliamentary inquiry. All this happened while iCare was under Treasurer Dominic Perrottet.

A friend of mine injured his back lifting on a Friday. He called his GP and visited him on Saturday. He had an MRI scan on Monday which showed a bad disc injury, saw the neurosurgeon on Thursday, had a discectomy on Saturday and went home on Monday. All fixed in 8 days. That is what should happen. It never happens in the WC or CTP system.

The Workers Comp system takes 14 days to accept liability, then has to ‘decide’ if the treatment is appropriate, so weeks go by, and if they dispute it, years. People wait 3 months for the insurer’s medical examination, 6 weeks for the result of it, another couple of months for their specialist examination and a few months for the government medical to settle the dispute. And they blame the injured people for the worse results out of the system, and give bonuses to those who managed to reduce the costs. Given the huge administrative machinery, the clerk, investigators, extra medical examiners, lawyers, dispute resolvers and the rest, all the savings come from not treating people. And those responsible get bonuses, and the government, ever keen not to upset the private sector ring-ins makes sure that they are amply rewarded for this appalling situation. Perrottet, the most recent architect of iCare, had a 2^nd inquiry by McDougall to kick the can down the road, then rose to be premier before his report was out.

Here is the SMH article:

Government votes to protect bonuses for icare executives

By Lucy Cormack

May 20, 2022 — 5.00am

The Perrottet government has protected bonus payments for icare executives, rejecting a bid to ban the practice after revelations millions of dollars in bonuses were handed out while injured workers were underpaid.

The attempt to strip bonuses from executives at the state insurer was contained in Opposition amendments blocked in the lower house this week during a vote to amend the state insurance and care legislation.

Icare has been the subject of intense scrutiny since an investigation by the Herald and ABC TV’s Four Corners in 2020 revealed the underpayment of workers while senior executives claimed almost $4 million in salaries and bonuses.

The insurer, which provides workers’ compensation insurance to 3.6 million public and private sector employees in NSW, has since been forced to repay $38 million to 53,000 injured workers.

The scandal prompted the government to amend legislation governing icare, following a review by former judge Robert McDougall, QC.

More than 200 icare employees are entitled to bonuses, including chief executive officer Richard Harding, who is entitled to an incentive of $411,000.

Opposition treasury spokesman Daniel Mookhey said there was little justification for bonuses while the insurer continued to record billions of dollars in underwriting losses.

“Employers are staring down the barrel of a decade of rising premiums, yet the government is protecting bonuses for top executives at Australia’s most disaster-prone insurer,” Mookhey said.

“We intend to stand up for employers and injured workers. We will fight against lavish bonuses for icare’s top executives in the Legislative Council next week.”

During debate on Wednesday, Minister for the State Insurance Regulatory Authority Victor Dominello said the McDougall Review had not found executive bonuses at icare were excessive.

He said McDougall noted the benefit of allowing icare to set competitive salaries to “attract appropriate talent”

The Herald last year revealed icare hired 18 new executives with potential annual bonuses collectively worth more than $1.2 million, while employee operating costs have increased from $162 million to more than $200 million since 2020.

However, an icare spokesman previously told the Herald no executive bonuses have been paid in the past two years.

Unions NSW boss Mark Morey wrote to NSW MPs last week calling for reforms to address “repeated governance, financial and operational crises”, including ending executive bonuses.

Other proposed reforms included enforcing the same procurement laws that govern the NSW public sector, from which icare is exempt, and appointing an injured worker to the board.

Morey on Thursday said the government had missed an opportunity to “clean up” the state insurer.

“How can the premier justify continued bonuses for highly paid executives when sick and injured workers have been dudded and small businesses are paying increased premiums?” he said.

Other changes sought by the government included additional powers for the State Insurance Regulatory Authority and expanded access to commutation, which allows injured workers to negotiate lump sum payments and exit the system, rather than remain on weekly payments.

However, the government agreed to withdraw its proposal to allow changes to commutations via regulation and reconsider them in future legislation.

Opposition spokeswoman for industrial relations, work, health and safety Sophie Cotsis said she was pleased the government had agreed to consult further on lump sum payments, arguing that regulation should not be used to expand the system.

The State Insurance and Care Legislation Amendment Bill 2022 will now move to the upper house, where the opposition will make another attempt to ban bonuses.

08/04/2022

Bullshit Jobs

8 April 2022

The idea of bullshit jobs is not new. It comes from a book in 2018.

However, with employment supposedly doing well, largely because we have excluded guest workers due to Covid, it is worth looking at how many jobs are actually needed.

Everyone needs something to do and a reasonable income to live on. The status of having a job relates generally to its perceived income, though there is some ‘doing good’ status associated with jobs like nursing despite their being chronically underpaid.

But technology replacing people has not brought the expected benefits because there seems no plan to spread the benefits evenly, or look at whether what is being done has any social utility. Many jobs that need doing are not done. Many people who want to work cannot, yet much energy and money is spent doing useless things.

I waste about 80% of my time as I treat Workers Comp and CTP injuries. About 20% of my time is deciding what treatment is needed, and about 80% filling in paperwork or writing reports to try to get the treatments paid for. On the other side there are a phalanx of clerks trying not to pay and to transfer the costs elsewhere. (i.e. to Private Health Insurance, Medicare or the patient themselves). Many doctors and lawyers also strive mightily in this unproductive area. The bottom line is that while the overheads of Medicare are about 4.5%, the overheads of CTP are close to 50%,; i.e half the money goes in processing or disputing claims or in profits for the companies indulging in this nonsense. And since many patients often cannot get the treatment or suffer long delays because of their efforts, it is a really bad use of human energy.

Someone needs to look hard at what we do and where the benefits go. Assuming that ‘the market’ will fix it is about as sensible as saying that ‘God’ will fix it, and is usually espoused with the same uncritical zeal.

Here is Wikipedia summary of the book:

In Bullshit Jobs, American anthropologist David Graeber posits that the productivity benefits of automation have not led to a 15-hour workweek, as predicted by economist John Maynard Keynes in 1930, but instead to “bullshit jobs”: “a form of paid employment that is so completely pointless, unnecessary, or pernicious that even the employee cannot justify its existence even though, as part of the conditions of employment, the employee feels obliged to pretend that this is not the case.”[1] While these jobs can offer good compensation and ample free time, Graeber holds that the pointlessness of the work grates at their humanity and creates a “profound psychological violence”.[1]

The author contends that more than half of societal work is pointless, both large parts of some jobs and, as he describes, five types of entirely pointless jobs:

flunkies, who serve to make their superiors feel important, e.g., receptionists, administrative assistants, door attendants, store greeters, makers of websites whose sites neglect ease of use and speed for looks;
goons, who act to harm or deceive others on behalf of their employer, e.g., lobbyists, corporate lawyers, telemarketers, public relations specialists, community managers;
duct tapers, who temporarily fix problems that could be fixed permanently, e.g., programmers repairing bloated code, airline desk staff who calm passengers whose bags do not arrive;
box tickers, who create the appearance that something useful is being done when it is not, e.g., survey administrators, in-house magazine journalists, corporate compliance officers, quality service managers;
taskmasters, who create extra work for those who do not need it, e.g., middle management, leadership professionals.[2][1]

Graeber argues that these jobs are largely in the private sector despite the idea that market competition would root out such inefficiencies. In companies, he concludes that the rise of service sector jobs owes less to economic need than to “managerial feudalism”, in which employers need underlings in order to feel important and maintain competitive status and power.[1][2] In society, he credits the Puritan-capitalist work ethic for making the labor of capitalism into religious duty: that workers did not reap advances in productivity as a reduced workday because, as a societal norm, they believe that work determines their self-worth, even as they find that work pointless. Graeber describes this cycle as “profound psychological violence”[2] and “a scar across our collective soul”.[3] Graeber suggests that one of the challenges to confronting our feelings about bullshit jobs is a lack of a behavioral script in much the same way that people are unsure of how to feel if they are the object of unrequited love. In turn, rather than correcting this system, Graeber writes, individuals attack those whose jobs are innately fulfilling.[3]

Graeber holds that work as a source of virtue is a recent idea, that work was disdained by the aristocracy in classical times, but inverted as virtuous through then-radical philosophers like John Locke. The Puritan idea of virtue through suffering justified the toil of the working classes as noble.[2] And so, Graeber continues, bullshit jobs justify contemporary patterns of living: that the pains of dull work are suitable justification for the ability to fulfill consumer desires, and that fulfilling those desires is indeed the reward for suffering through pointless work. Accordingly, over time, the prosperity extracted from technological advances has been reinvested into industry and consumer growth for its own sake rather than the purchase of additional leisure time from work.[1] Bullshit jobs also serve political ends, in which political parties are more concerned about having jobs than whether the jobs are fulfilling. In addition, he contends, populations occupied with busy work have less time to revolt.[3]

As a potential solution, Graeber suggests universal basic income, a livable benefit paid to all, without qualification, which would let people work at their leisure.[2] The author credits a natural human work cycle of cramming and slacking as the most productive way to work, as farmers, fishers, warriors, and novelists vary in the rigor of work based on the need for productivity, not the standard working hours, which can appear arbitrary when compared to cycles of productivity. Graeber contends that time not spent pursuing pointless work could instead be spent pursuing creative activities.[1]

11/11/2021

iCare will repay 53,000 underpaid injured workers

11 November 2021

iCare, the State workers’ compensation insurer has admitted that it has underpaid thousands of workers and will now repay them, according to an article in today’s SMH.

This story has been leaking out in the media for ages. At a day to day level, my patients have always complained that they get a lot less in compo than they got before their injury. This has been even for workers on regular salaries. Those on casual work were in a worse situation as there was some argument about what their PIAWE (Pre-Injury Average Weekly Earnings) were, especially if they got variable hours from a labour-hire company.

When this scandal first broke, I tried to tell my patients to ask iCare if they had been underpaid and some did. It seemed that iCare could not work out what their PIAWEs were. It did not have the data. In that employers’ future premiums related to how much was paid out in claims, it suited both the employers and the insurers to minimise their PIAWE, so if a low amount was put in, there was little incentive to check it up. Now, a few years later, iCare would need a forensic accountant going through the employer’s books to get to the correct amount. This is unlikely to happen.

So while this promise is a start, it is hard to believe that it will be enough to see justice done.

Workers’ Compensation has always been seen as a cost for business rather than a moral obligation to pay for people injured at work. Generally it is about minimising the cost of the payout, rather than having an energetic injury prevention programme.

The Minister in charge is the Treasurer, so all of this happened on Dominic Perrottet’s watch. Matt Kean, the new Treasurer may be more sympathetic, and this will help, but we still need a lot better enforcement of safety to prevent accidents, and much more power to injured people to ensure that they are correctly paid.

It illustrates that active Unions are necessary to redress the power imbalances in the the system. Legislation without enforcement is just words on a page, just as apologies from banks and insurance companies for rip-offs are just sound vibrations in the air.

Here is the article:

‘My sincere apology’: iCare will pay back $38 million to 53,000 injured workers

Lucy Cormack SMH November 11, 2021

State insurer iCare will pay $38 million to 53,000 largely underpaid injured workers affected by historic miscalculation errors between 2012 and 2019.

An iCare review of 16,000 injured worker case files has revealed an average error rate of 3.5 per cent or an underpayment of $26 a week due to miscalculated pre-injury average weekly earnings.

“I would like to offer my sincere apology to any injured worker who has been affected by this calculation error,” said ICare chief executive Richard Harding.

Among the most seriously injured and affected are 523 workers underpaid a total of more than $3.9 million, or around $7500 each.

The mass pay-out follows a joint investigation by The Sydney Morning Herald, The Age and ABC’s Four Corners which last year revealed iCare had underpaid as many as 52,000 injured workers by up to $80 million in compensation.

ICare then disputed the underpayment figures, saying it believed only 5000 to 10,000 workers had been underpaid up to $10 million in total.

Chief executive officer Richard Harding on Thursday said affected employers and employees had been unable to provide the data to accurately assess underpayments. As a result, iCare conducted a “file by file review” of 16,000 cases as a sample to assess the scale of the errors.

“We’ve been advised there is a risk of overcompensation in this approach, but the desire is to get money back as quickly as possible,” Mr Harding said.

“I would like to offer my sincere apology to any injured worker who has been affected by this calculation error.”

The underpayments were caused by errors in the calculation of pre-injury average weekly earnings for injured workers dating back to 2012, when the insurance scheme was run by WorkCover.

Mr Harding said the average lump sum to be paid to the 53,000 workers will be around $700. However, some will receive thousands.

Affected workers will receive any money owed through an adjustment of their weekly benefits for the weeks already paid. Any historical overpayments caused by the same miscalculation error will not be recouped by iCare.

Revelations of financial mismanagement and widespread underpayment across the iCare stable first emerged last year, before a subsequent review into its culture and governance revealed systemic weaknesses and a failure to hold management to account.

Labor treasury spokesman Daniel Mooched said the announcement repudiated earlier claims that only a small number of people were affected.

“As always with iCare, the devil is in the detail. But today’s announcement is meaningful for the tens of thousands of people iCare underpaid”.

Mr Mookhey said the insurer must guarantee that it will not seek to recover the money from sick and injured workers through benefit cuts or employers through higher premiums.

Upper house Greens MP David Shoebridge said the pay-out to workers followed years of chasing by unions, injured workers and non-government MPs.

While he welcomed the payments, he said there was “no evidence from iCare that this payment goes anywhere near meeting their full obligation to injured workers”.

“We will continue to press iCare for a full accounting so that no injured worker is left short-changed,” he said.

Unions have described the decision to reimburse workers as a significant step but called for greater transparency about the process.

“This is hardly an organisation that can be taken at its word. iCare executives, who are better known for receiving fat bonuses, must detail their methodology,” said Mark Morey, Secretary of Unions NSW.

Last week, a budget estimates hearing heard iCare had reported a $1.4 billion underwriting loss in the past year, with the total accumulated loss of the past three years now exceeding $6 billion.

Treasurer Matt Kean, who is responsible for iCare, told the hearing new legislation following recommendations from another review prompted by the scandal would not be introduced until 2022.

21/07/2021

Privatised Job Services- Guess who benefits?

21 July 2021

Privatisation of job services was based on the concept that competition improves performances; hey we all run faster in a race than on a jog.

It takes the simple model and assumes that public servants do not work as hard as the lean, mean private sector workers.

I have worked in the public service here and the UK for some years. I defy anyone to say that salaried doctors do not work hard. How does a basic 60 hours a week, with a few hours of unpaid overtime a day and on call one night in two for ICU or ED sound?

I was at Sydney Water for 13 years. The clerical staff worked their 35 hours, but the professional staff were mainly there until 6pm, despite only being paid to 3.30pm. The clerks knew their jobs and did their jobs. They thought about their work, prioritised the important things and did them. Their jobs were safe, they were honest, and criticism of them was frankly misplaced. So was the idea that a ‘blow-in’ manager could do their jobs better than they could.

The assumption of privatisation of job seeking is that contractors would do better than the CES. The Key Performance Indicators were set up so that they go paid less for people who were easier to place and more for those who were hard to place. So it was presumably staffed as cheaply as possible, and the business model concentrated effort where the most money could be had for the least work. People who would have got a job without the providers help at all were money for jam. People who were very difficult to place were not worth spending time on. So instead of an ongoing effort to help people in whatever way possible there were distorting priorities- what do you expect? In this case you get what you pay for.

There was a similar nonsense when there was a privatised effort to lower unemployment, which was in the mid-1990s. This drive did not come with any more jobs, so the best hope was reclassification of people who were not working. Many people were sent to me as a doctor to fill in their Disability Pension forms, as the private sector were given bonuses to get people off the dole and putting them disability pension qualified as this. And they think that the public service does paper shuffling- they are amateurs!

After they had expanded the Disability Pension numbers a few years went by and Morrison decided that there were too may people on this, so he would make it tougher to get. He boasted that only a third as many people were put on the disability pension in one year than had been the case the year before. I knew some of the people who could not get the disability pension. There were not enough jobs for healthy people, let alone unhealthy ones. They were demeaned and humiliated, with supposed ‘mutual obligations’. They had to waste their time writing job applications for jobs that they had no chance of getting, and presumably the bosses wasted time either reading them, or just binning then without bothering.

When NSW passed legislation that Workers Compensation would only be for 5 years and then they would have to apply for a disability pension the object was to transfer the costs of injured workers from the State insurers’ premiums to the federal taxpayer. Centrelink was having none of that. Of the people kicked off Workers Comp, only about a third managed to get a disability pension; the rest were on ‘Newstart’ applying for jobs that they had no chance of getting and on far less money than before. Patients came to me asking for ever more elaborate reports to try to get disability pensions when they needed them.

One man, a 61 year old Middle Eastern man who had been on compo for 13 years and was carer for his disabled wife could not get a disability pension. He had chronic back pain and a limp. His English was poor, he was illiterate in English (and possibly Arabic) with a file two inches thick. I spent a lot of time writing a report for him. Centrelink thanked me but said they could only pay a small amount for such reports. So I will not do such reports again, and presumably neither will any of the other doctors- we cannot afford to work for free to fight a system with a different agenda.

Meanwhile the private providers are cream-skimming, adding another layer of costs. Because a market system transfers money upwards to those with more economic power who can control their pieces and costs, a government and a welfare system needs to transfer wealth both to everyone in society equally by building facilities everyone can use or by direct payments to those who are unable to get jobs or who are otherwise disadvantaged.

The problem is that jobs are being offshored to low wage countries or replaced by technology. This is national problem for high income countries. It is a problem for the whole country, but it affects some people directly. We are all lucky that our dollar is high and our goods cheaper because low wage countries make things cheaper. So we all should contribute to make our own country more equal.

Until we demand a fair system we will not get one. Stopping rip offs, and paying CES people a fair wage to do a fair job is a start.

https://theconversation.com/the-problem-with-employment-services-providers-profit-more-than-job-seekers-162421?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20July%2021%202021%20-%202008419727&utm_content=Latest%20from%20The%20Conversation%20for%20July%2021%202021%20-%202008419727+CID_fbb8f126a3150e0c593a044f9ebff43b&utm_source=campaign_monitor&utm_term=The%20problem%20with%20employment%20services%20providers%20profit%20more%20than%20job%20seekers

30/04/2021

iCare= Hopeless in Two Reports but the Bad Joke Continues

30 April 2021

Two reports on iCare have come out on the same day- how convenient, one lot of publicity rather than two.The report of the Parliamentary Committee was one report, the other was a report by Robert McDougall, a retired Supreme Court judge.The political report looked at the disgraceful evidence given by John Nagle which showed almost no care for the injured workers and an appalling attitude of entitlement in him and his crony staff. iCare had not even known what workers’ Pre-Injury Average Weekly Earnings (PIAWE) were, and had not tried very hard to find out so that they could underpay them and minimise their costs. They relied on computer algorithms rather than staff to manage the claims, only getting staff on the case if there were problems, which there usually were, as the poor patients were having their treatments delayed or denied.
The McDougall report had its terms of reference set by Treasury, who were also the department being investigated, and they also staffed the inquiry. The Treasurer, Dominic Perrottet did not agree to be interviewed by McDougall and got away with this. Is this some sort of bad joke? The McDougall report found incompetence etc, but no actual corruption that anyone could be charged with. As such, the McDougall report was a political success. It took the heat off the Treasurer from November to now, and will result in a bit of publicity, no serious recriminations and the usual promises of future action. John Robertson, an old union hack is the new CEO, so Labor will not criticise iCare now.
My poor patients will be mucked around, be underpaid and have their treatment denied as usual. And Treasurer Perrottet will sail on hoping to be Premier as Gladys falls. What a joke!

www.abc.net.au/news/2021-04-30/damning-reports-released-over-nsw-icare/100107076?fbclid=IwAR34I_blTADSxa2OoWxrzOpvgNPZ3KUFmhQmpSFZHd4LSOIVdof0nx8yMGs

05/04/2021

Labour Hire Companies facilitate Wage Scams

5 April 2021

When I was in Parliament the then NSW Labor Government had an inquiry into WorkChoices, which was the Howard Federal government’s preferred industrial relations model. It was, as the Liberals said, an political inquiry designed to criticise what Howard was doing. (Historians will recall that it cost the Howard government s lot of votes).

But both Unions and Employers came and lobbied me, as did Labour Hire business owners. The Labour Hire companies said that they could get a better deal for the employees as they were negotiating on their behalf with employers and if they had special skills the employers would have to pay for these. I asked them how much commission they took on this as obviously employers would have to pay their commission as well as the subcontractor’s payment. They were very reluctant to be specific on this point as it was ‘variable’. But it did seem to me that the chief objective was to make the worker a private subcontractor rather than an employee and thus remove award pay rates, holidays, sick leave, workers compensation, and bargaining power. The Labor Hire company was often just a commission agent, though some employed the workers.

It seems that this model of getting rid of direct employees has evolved and is now standard in many industries. I have seen a woman accidentally stab herself in the forearm while boning chickens at 3.30 am on a 12 hour shift, a man shoot himself in the heart with a nail gun trying to assemble flat pack kitchens alone and RSI in a hotel worker so advanced that it has made no recovery in 3 years, after being expected to clean high-end hotel rooms, including making the bed, vacuuming and cleaning the bathroom in 12 minutes each.

‘Subcontractors’ may have no awards, no unions, no OHS and no redress when people are ripped off. The lumbering ‘Fair Work Commission’, out of sight and out of touch seems to make very little difference to a Darwinian model.

Let us see if criminalising wage theft makes any difference. There are a lot of laws on the books that are never enforced.

https://l.facebook.com/l.php?u=http%3A%2F%2Fwww.smh.com.au%2Fbusiness%2Fworkplace%2Faustralia-s-shocking-wage-theft-scandals-keep-coming-by-the-truckload-20210312-p57a5p.html%3Ffbclid%3DIwAR3FoKWzuLj-nv9W5moUs7K-HmlfV8msxTXhOicq62KM83zMerzWwcFiJYM&h=AT3RrEZXGjEyZeQ7rNBoGGgl9Flo0_zzfDuqRAnUxguMlUcU-J9oiuQGDpT01vJnqPsdtFErgLw0g92bkmtQt_TQ-vPzVqPsWvYaVFbIYosdg1YBYAm5Fke4e4-OdaDB8JwYckGgwuhNR5mltMZO&tn=-UK-R&c[0]=AT2ipxj2y11laB8hdM-suLNA2ij5tamnMBYbjAGX5r25jhtlSzzvd-Dn6kj1lQ88fBiyw1dyFFnNXi8tEuTfOVY_74RgrorvDvqc2EuyAIWBJMbsZjzjqyCneyp7HOlhnr8r_bd9dZtlDER2pMrWsThzMw

07/03/2021

iCare Doesn’t Know and Doesn’t Pay Underpaid workers

7 March 2121

The incompetence of Perottet’s iCare never ceases to amaze.

It underpaid injured workers but was not sure how many. It was initially 240,000. Then it changed its to estimate to 52,000 people underpaid up to $80 million. Then possibly as little as $5 million. In March it is 23,000 and $20 million. They don’t actually know. After 18 months 25 have actually been compensated!!!
This is all treated as some of ‘management error’ as if this makes it OK. These are a lot of abstract words, but few concrete ones. The idea of abstract words is that the concepts can be discussed better. But mostly management words are so general as to be meaningless, and principally serve to make everything non-specific and also euphemistic. No one says, ‘They did not know or care and their incompetence led to immense suffering for the families who were underpaid’. It becomes, ’There was a lack of management understanding and focus and some workers may have been paid less than their entitlement’.
Naturally no one will be punished.
All I know is that even the routine service takes about 3 weeks to get anything done. I had a patient doubly incontinent after a spinal injury. It takes up to 10 working days to get a claim approved, then up to 10 working days for them to approve an MRI and a specialist consultation. This is normal. When they delay things it is worse, and sometimes they refuse to pay at all.
www.smh.com.au/national/nsw/scathing-icare-review-finds-a-need-for-cultural-change-20210301-p576tq.html

06/03/2021

Scathing PWC Report Finds Perottet’s iCare Incompetent

6 March 2021

A 100 Page report by consulting from international PWC (Price Waterhouse Coopers ) found weakness in performance and governance, and the Board did not hold management to account.

We might also consider that the Minister, Dominic Perottet did not hold the Board accountable, and appears to show no interest at all in the injured people for whom the whole scheme supposedly exists. We might note that no doctors or patients appear to have been interviewed either- Hey, it’s all about money you know! One could ask why PWC did a report when Justice McDougall was simultaneously doing one that it coming out in April? Perhaps he is a lawyer and does not know enough about money.

The bottom line is that it was run from the top by people who only knew about money with little input about its proper function from the people at the coal face, who presumably should have some knowledge of the people that they are supposedly helping. (I say that with reservation, as the case managers that I deal with have high turnover, little insight and seem to assume that a large percentage of their cases are fraudulent, the doctors are hell-bent on inventing pathologies to over-treat and they have to follow elaborate protocols designed to ensure that no one could under any circumstances get one cent more than was absolutely necessary).

So we digest the Management-speak of this report and await the McDougall report which had terms of reference that allowed little input from patients or doctors, held no hearings and seemed to exist principally to take the heat off the Minister from last August until its April release.

It seems that there has been a generic concept since the 1980s that managers know best, that other degrees and knowledge from lesser beings or lesser ranks and incomes are not of value or to be listened to. It has come unstuck in so many situations that its time that some little boy (or girl) points out that ‘The Emperors have no Clothes’. Then we can go back to an older time, where people had appropriate training, worked their way up, knew their jobs, were promoted on merit and had small salary increments reflecting their incremental status rise. But I suppose that this would rely on people having permanent jobs and depower the whole new managerial class and their symbiotic consultants and reduce the workplace ‘flexibility’ that allows the obscene salaries at the top and insecurity at the bottom.

If Anglo society does not want to fall to more realistic societies in Germany and Asia, there needs to be a large rethink of the Harvard 1980s management nonsense that is the foundation of these sort of debacles.

www.smh.com.au/national/nsw/scathing-icare-review-finds-a-need-for-cultural-change-20210301-p576tq.html