Claim suppression study in B.C. finds under-claiming of work injury to be common

Joint study by Institute for Work & Health and Prism Economics and Analysis also finds employer pressure, inducement not to claim seen in four to 13 per cent of work injuries

Published: June 1, 2021

About half of British Columbia workers who have a work injury or illness that results in time away from work do not report the injury or illness to WorkSafeBC. The two most common reasons workers give are not knowing they are entitled to compensation or how to apply, and not thinking it’s worth their time to make a claim.

This is according to a recent study on claim suppression commissioned by WorkSafeBC and conducted by the Institute for Work & Health (IWH) and Prism Economics and Analysis. The study found an estimated four to 13 per cent of people with work-related injuries in British Columbia experience claim suppression—i.e. pressure or inducement from an employer not to make a claim.

The study was conducted using four data sources. They included:

1) a survey conducted in 2019-2020 of 699 B.C. workers who had experienced a self-reported, work-related injury or illness within three years before the survey;

2) a survey of 150 employers across the province, with those in the construction and transportation/warehousing sectors disproportionately over-represented;

3) a document review of 1,043 randomly selected no-lost-time claims filed between 2016 and 2019, conducted by WorkSafeBC staff who provided anonymized results to the research team for analysis; and

4) a document review of 601 claims that were rejected, suspended or abandoned, again done by WorkSafeBC and analyzed by the research team using anonymized results.

Findings from the study are now available in a policy briefing and a report.

In their report, the research team noted important differences between under-claiming, misrepresented claims and claim suppression. Under-claiming occurs when workers who appear to be entitled to workers’ compensation benefits choose not to submit or proceed with a claim. Misrepresented claims are claims that are submitted and classified as no-lost-time claims even though the injuries or diseases do involve lost working time. Claim suppression refers to any overt or subtle act by an employer to discourage a worker from reporting an injury or disease or from making a claim.

Workers’ reasons for not reporting

Among the 699 workers surveyed, almost six in 10 (58 per cent) had lost two or more days of working time due to a work-related injury. Among these, just over half (54 per cent) did not submit a claim to WorkSafeBC. Findings showed that under-claiming was more common among workers who were immigrants, had lower educational attainment, were not union members, were employed by small employers and worked on a temporary basis (directly or through temp agencies).

The main reasons given for not claiming were unrelated to claim suppression (see sidebar). The most common reasons included not knowing they were entitled to compensation or not knowing how to apply for WorkSafeBC wage loss benefits (40 per cent), and thinking it wasn’t worth the time to make a claim (36 per cent).

As for reasons indicative of claims suppression among those who were off work for two or more days but did not submit a claim, the top two were believing they would “get into trouble” (7.8 per cent) and their employer pressuring them not to apply for WorkSafe benefits (4.1 per cent). The survey also found 13 per cent of those off work for two or more days, whether they filed a claim or not, said their employer asked them not to report time loss and/or threatened them with repercussions if they did so.

In some cases, the claim suppression behaviour may have involved front-line supervisors who were acting contrary to the employer’s policy, says Dr. Ron Saunders, an IWH adjunct scientist and principal investigator of the study. About a third of the respondents who reported claim suppression behaviour also said that their employer assisted them in filing the report to WorkSafeBC.

Claim suppression appears to be higher in workplaces that offer rewards to employees if the workplace is injury-free, the survey results suggest. Among workers who indicated their employer engaged in claim suppression behaviour, about 41 per cent reported their employer operated an incentive scheme. In comparison, among survey respondents who did not indicate their employer engaged in claim suppression, 6.4 per cent said their employer operated an incentive scheme.

Employer perceptions

In the survey of 150 employers, the team found 6.0 per cent said they believed that, in their industry, lost-time injuries were “rarely or never” reported to WorkSafeBC. However, about 27 per cent of employers reported their belief that, in their industry, lost-time injuries were reported to WorkSafeBC as no-lost-time injuries “all the time or almost all the time,” and 25 per cent expressed their belief that no-lost-time injuries were “rarely or never” reported to WorkSafeBC.

The employer survey also showed that 72 per cent of employers provided a sick leave/disability plan, medical benefits plan or both. Roughly a fifth of these employers (21 per cent, representing 15 per cent of the total sample) allowed their employees to access benefits through one of these plans instead of claiming WorkSafeBC benefits. As well, 11 per cent reported that they provided a bonus or incentive to their employees to maintain an injury-free workplace.

From the analysis of no-lost-time claims, the team estimated between 4.1 and 12 per cent of these types of claims were misclassified—i.e. they may have indeed resulted in more than two days off work. From the analysis of claims that were rejected, withdrawn or abandoned, the team estimated between 12 and 19 per cent were “problematic” because documentary evidence in the claim file suggested a compensable, work-related injury or disease.

The fact that a file was problematic does not necessarily imply that the worker’s decision not to proceed with the claim was the result of undue pressure from the employer, says Saunders. However, some of the claim files did suggest the potential for employer pressure. For example, in 8.3 per cent of the files, the worker form (Form 6) indicated that the worker missed more than one day of work and sought medical attention, but no employer form was filed for the incident.

The findings of this study are in line with those of others looking at claim suppression or under-claiming in Canadian jurisdictions, says Saunders. Its findings were similar with respect to the approximate magnitude of under-claiming, of lost working-time incidents being misrepresented as involving no lost working time, and of claim suppression on the part of employers.