"This Bill Means Reduced Treatment and Compensation"
Lapan is a community organizer with the injured workers' defence
organization the Union des travailleuses et travailleurs
accidentés ou malades (UTTAM)..
Workers' Forum recently spoke with him about the consequences that the Quebec
government's Bill 59 will have on injured workers if it is adopted. Due
to the length of the interview it will be published in two parts. Today
we are publishing information on the impact of Bill 59 on workers with
regard to the recognition of
occupational diseases and their entitlement to medical assistance,
treatment and rehabilitation services. We will publish information on
the impact on the right to monetary compensation in a later issue.
According to UTTAM's investigation, what consequences will the Legault
government's Bill 59 have on injured and sick workers if it is adopted?
Félix Lapan: Generally speaking, this bill means reduced
treatment and compensation benefits for injured workers.
example, the bill will make it more difficult to have many claims for
work-related illnesses accepted. It attacks the right to medical
assistance, the right to treatment, medication, devices like orthotics
and prosthetics that are supplied by the Labour Standards, Pay Equity
and Workplace Health and Safety Board (CNESST) and it attacks the right
to rehabilitation for workers who have suffered permanent disabilities.
With respect to victims of occupational diseases, barriers are being
created for people suffering from hearing loss and lead poisoning. It
will be much more difficult to have hearing loss and lead poisoning
recognized as occupational diseases.
The CNESST is being given regulatory power to add
barriers to the recognition of all occupational diseases, which is of
great concern to us. Moreover, the Ministry of Labour, in its document
on the impact of the bill, is projecting millions of dollars in savings
due to rejection of workers' claims for occupational illnesses and
injuries, hearing loss in particular. In introducing the bill, the
Labour touted it as a measure that will produce $4.3 billion over 10
years in "savings" for employers who fund the CNESST through their
So, for victims of occupational diseases, there is a reduction in access to treatments and compensation.
Once a claim is accepted, whether related to an illness or an
accident, the new legislation reduces the worker's entitlement to
medical assistance. What is included in medical assistance is changed.
There is an article in the current legislation that says that it is
the responsibility of the CNEEST to provide all medical assistance. The
currently pays 100 per cent of the cost of medication, orthotics,
prosthetics and a whole list of treatments in private clinics. Bill 59
changes this article, article 194 of the Act respecting industrial accidents and occupational diseases
(LATMP), which states that medical assistance is paid for by the board,
that no fees can be charged to a
worker for medical assistance needed as a result of an injury. The bill
removes this section and says that the CNESST will be entitled to adopt
a regulation permitting it to charge part of the medical assistance
costs to the workers. With respect to drugs, and this is a first in the
history of the plan, with this regulation they will no longer pay for
to the bill, only orthotics and prosthetics specified in a regulation
still to be created will be paid for, so not all necessary devices will
be paid for. The CNESST already applies internal policies
that limit access to medical assistance, even though the law does not
allow this, and these decisions are therefore often overturned
by the courts. Now it's not just going to be an internal policy, it's
going to be a regulation. Will the regulation be that they reimburse
drugs at 80 per cent like a private insurer? Are there going to be
drugs that are excluded from the plan? We don't know. The day after the
law is passed, the CNESST will be able to publish its regulations in
the Official Gazette
and specify how access to medical assistance will be limited. Anything
that is taken out of the law and put into regulatory powers for the
CNESST will be out of our control. They can change the rules of the
game at any time without going through a debate in the National
Assembly, without amending legislation. When a regulation is published
in the Official Gazette we have 45 days to comment on it, after which the regulation comes into force by a cabinet order.
With Bill 59 there are many things that move from the legislation to
regulations made by the CNESST. For example, the list of occupational
diseases that are protected by the Act will move from the legislation
into a regulation that the CNESST can amend as it sees fit. The
obstacles that workers face if they have claims for occupational
deafness and lead poisoning could be put in the way of workers with
many other injuries and illnesses. They have just set a blood lead
level, which has nothing to do with science, that must be reached to
have lead poisoning recognized. They could do the same thing for a lot
of metals, almost all metals, for many toxic substances. All of a
the CNESST becomes the legislator.
have a system that is supposed to provide treatment for workers'
injuries and illnesses. To put part of the costs of treatment
on sick and injured workers is unacceptable.
The scenario that we are currently seeing with the regulation on
medical assistance is the same scenario that was in the CNESST`s plans
in 2012. At that time it was Bill 60 which would have provided for
lump-sum treatment envelopes, a set amount for each illness or injury,
with treatment provided until the designated amount was spent.
[Bill 60 died when the Quebec government of the day called a general election -- WF Ed. Note]. We're going to possibly end up with a similar type of regulation.
WF: The bill also eliminates physical rehabilitation altogether.
FL: Yes, there is also an attack on the right to
rehabilitation. The current law provides for three types of
rehabilitation with specific programs. Rehabilitation is for workers
who have permanent after-effects. There is physical, social and
Physical rehabilitation consists of treatments after the treatment
of the injury itself is complete, treatments for permanent consequences
of the injury. These are no longer treatments to heal, but to control
and relieve pain, to reduce the consequences of a loss of quality of
life. The bill simply abolishes physical rehabilitation. In other
medical treatment, physiotherapy, occupational therapy or even
psychotherapy in the case of psychological injuries will only be aimed
at recovery or return to work. If a worker has permanent after-effects
from his or her injury that affect his or her quality of life, this is
no longer important according to the bill. That is the logic. There are
limitations to what can be received in terms of social and vocational
rehabilitation. Social rehabilitation concerns rehabilitation measures
such as home assistance, or home renovations, while vocational
rehabilitation concerns measures such as training for vocational
reorientation. The bill now provides for a specific list of measures
currently the list is qualified by the word "including," which opens
the door to other measures.
For us, these attacks on the rights of injured and sick workers are unacceptable and are deeply disturbing.
1. Hearing impairment caused by noise is one of the occupational diseases specifically named in the Act respecting industrial accidents and occupational diseases.
Currently, the only requirement to qualify for the presumption for this
disease is to have performed "work involving exposure to excessive
noise." With the amendments to the Act in Bill 59, it will now be
necessary to demonstrate exposure to a threshold of more than 85
decibels for eight hours per day, over a period of at least two years,
by means of evidence specified by the regulation.
A new condition is also imposed for the recognition of lead
poisoning. The only condition at present is that the person must have
worked in a job involving the use, handling or other exposure to lead
or its compounds. The bill now adds the condition of having "a blood
lead level equal to or greater than 700 g/L (micrograms per litre of
This article was published in
April 7, 2021 - No. 25