Seriously injured worker received no support for retraining

Injured worker “Pauline”, who shared her story with us last week and who suffered a whopping 30% psychiatric injury in 2006, and was “compensated’ out of the system with barely two years income to support me was blocked at all attempts to get retraining. In her story, she shares a copy of one of her letters rounding up her effort on this front. Pauline is now homeless and deeply impoverished living on the disability pension.

Seriously injured worker received no support for retraining

Pauline’s story

I chased my insurance agent for over eighteen months to get retraining so that i could return to employment. I’ve attached a copy of one of my letters that rounds up my efforts on this front. After taking my complaint to the Minister, I was sent to an employment counselling outfit.

They told me that the Insurer (good old corrupt CGU) had told them they were not to write a report and nor were they to identify retraining courses for me. After this total sham and the long battle I’d had to get that far, my mental illness became so exacerbated that I ended up homeless and pretty useless for the better part of two years. Still homeless, but seem to be getting my ginger back.

In Victoria, Workover spends less than 1% of it’s massive profits on Return To Work. What a joke. It’s no wonder that in that state 25% of injured workers are not returning to work.

Pauline’s letter (Dated 2009)

Customer Service Resolution Officer
CGU Workers Compensation
GPO Box 2090S
Melbourne
VIC 3001

 

Dear  Z ,

 

Re: Injured Worker Pauline  Claim No: [XXX]

 

I acknowledge receipt of your letter dated 22nd July 2009. I did not receive it in the post until Tuesday [day] August, hence my delay in responding. Thank you for acknowledging my concerns which I have previously expressed in writing to CGU. I have no record of contact from CGU on the [date] 2009 as alleged in your letter. Could you please send me written advice as to the form and content of that contact?

I reject the suggestion that CGU has responded to my concerns over the past few months. Apologising for a delayed response, and parroting the same false explanation over and over is not the same as responding to my legitimate concerns. If it was, my concerns would no longer exist.

I am feeling bullied by CGU’s behaviours and responses in this matter, and I request that CGU cease and desist from these behaviours, as there is now ongoing symptomatic exacerbation of my compensable condition.

I am sure,  Z, that as you work in worker’s compensation services you are well aware that Worksafe Victoria defines bullying as:-

“unreasonable behaviour directed towards a worker or group of workers that creates a risk to health and safety. Bullying can occur wherever people work together. Under certain conditions, most people are capable of bullying.

Whether it is intended or not, bullying is an OHS hazard to health and safety.”

I experience CGU’s relational style as bullying. Furthermore, I believe that this relational style fits Worksafe’s own definition of bullying, and is therefore illegal. As I have informed CGU on several such occasions, their behaviour towards me causes severe exacerbations of my compensable condition. I have also provided reports from my psychologist and my doctor at various times to attest to the health detriments that are occurring.

As you are new to my case, however, I fear you may be unfamiliar with the history of this particular dispute. I will begin with a history of my contacts and communications with CGU so far in my endeavour to have the terms of my settlement contract fulfilled. I will relate some this history to those feelings that I have of being bullied by CGU, and I will explain how this bullying damages my being.

A history of CGU’s bullying

In late August 2008, I signed a settlement agreement with CGU in relation to my common law claim for compensation. I did this in the belief that it would be better for my health in the long run if I could take control of my weekly income away from the Worksafe system. I realised that I would need ongoing support with medical and therapeutic interventions for my injury, and that I would need retraining and employment assistance to achieve a successful return to work.

During October 2008 I contacted  X[1] whom I knew to be my Case Manager in CGU and with whom I have established an excellent rapport. X informed me that she could not deal with the matter as my case manager was now Y.[2] I spoke with Y by phone on two occasions. I told him that I had taken a settlement, and that I wanted some assistance with returning to the workforce. I explained that the settlement was of a finite nature, that my psychiatric condition still required two years uninterrupted treatment, and that I would need retraining to help me develop a new career to suit my impairments. I was hoping to begin retraining in early 2009. I envisaged that I would do my retraining and my remaining treatment in tandem. Y promised to seek out information regarding my entitlements and to get back to me.  It is important that CGU have and understand this information about me so that they can provide me with an appropriate level and type of service. However, providing all this personal history and information to a “new” Case Manager is a particularly humiliating experience for me as I have enormous trust issues resulting from my workplace injury.

When I rang him again later that month, Y claimed I had no entitlement due to the settlement I had accepted in August 2008. I knew this opinion to be untrue as I had made my acceptance of the settlement contingent upon the continuing availability of my access to employment training.  I had stressed this requirement to my legal representative as a condition of accepting the settlement, and it was incorporated into the contract under Clause 3.  A brief reading of that contract would have led Y to realise that access to employment training is a clear part of my contract of settlement, not something that is excluded from it as CGU claims. I wrote to Y to provide him with this advice. In retrospect, I find it strange that while Y gave me this reasoning to deny me access to support in returning to work, he, nevertheless, paid my requested refunds for other medical and like services during this period.

I did not hear from Y for some time and became concerned that time was passing and enrolment deadlines were approaching. On the [date]2008, I alerted CGU in writing of my desire to receive employment counselling to assist me in selecting a suitable career and retraining.

In that first letter regarding this matter, I requested that CGU provide me with information about any administrative requirements that have to be met in order for me to access employment services. I do not know the system and am reliant on my case management through CGU to provide me with such information. CGU did not even do this, and I was left without the information I needed to help me move forward on the matter. Weeks passed and I received no reply. I began feeling alienated and ignored. I didn’t know how to respond to this silence as it made me feel worthless, and reminded me of the bullying I had received in the workplace. My compensable condition became exacerbated and my symptoms began to manifest. I became depressed, and agitated with anxiety. The psoriasis, which had been in remission for two months, began to worsen. Other physical complaints e.g. stomach pains and wind, diarrohea, lower back pain, difficulty sleeping, arthritic joint pains also began to bother me. My daily life became more difficult to manage as I was hounded by periods of deep depression. I began to experience suicidal ideation again.

On [day] January 2009, in desperation, I wrote a second letter to CGU. I had rung my case manager twice and had discussions in which he promised to provide me with the information I’d requested in November “within the next week”. Once again CGU did not follow through on its’ promises. In this letter I informed CGU that their particular pattern of behaviour towards me was exacerbating my compensable injury.

Suicidal ideation is often part of any exacerbation of symptoms on my part. I have alerted CGU to this fact several times over the course of my case, and I expect them to take information regarding my health seriously. In this instance, CGU did not change its behaviour in response to my pleas regarding my deteriorating health. This act is an example of sheer negligence on the part of CGU.

CGU did not respond to my letter and left me feeling invisible, alienated, and worthless. This behaviour is a carbon copy of some the bullying behaviours that caused my workplace injury in the first place. When I was becoming disturbed by what was happening in my workplace, I kept writing to my employers, and calling them to tell them that my health was deteriorating. They too ignored my pleas and failed to respond to my communications.

During February, I called my Case Manager, Y., and later his supervisor[3] rang me to endorse Y’s promise that an appointment for employment counselling would be made that afternoon. I was impressed that the supervisor had been brought in to my matter, but again the promises were followed by a deafening silence.

On March [day], I finally wrote an official complaint which I also sent to Workcover Complaints. I was contacted by the Workcover Complaints officer, A. I was unwell and don’t have full recall of my communications with A, but I do recall him advising me that once a promise is made, it has to be followed through. These promises did not become reality as CGU continued its unreasonable course of behaviour towards me.

I received a written response from CGU to all my correspondence on April [day] 2009, seven months after my original verbal requests for assistance, and six weeks after the last of three written appeals from me. This response, which was from U[4], Team Manager, was a continuation of CGU’s denial of the content of my contract of settlement.

Some time after, I spoke to V at CGU.[5] V was assigned as my new case manager after Y disappeared. V refused to consider my issues. She spoke very slowly to me and continually repeated the same advice over and over. I was humiliated by this behaviour and what it implied about my mental capacity. I was also extremely frustrated by her refusal to listen to my reasoning regarding the contract of settlement and my concerns for my future if I’m unable to work. V’s communication with me proved to be a replication of the whole of CGU’s relational style towards me. Don’t listen to what I have to say. Repeat the same message over and over as if I am deaf or stupid. It’s as if CGU is trying to brainwash me, to overwhelm me with the weight of many people’s opinions. Unfortunately, all of those opinions are the same and they are all equally, legally wrong.

On July [day], I took the issue to conciliation, where I provided the documentation to show that Clause 3 in my contract of settlement does specify my ongoing entitlement to medical and like services.

CGU’s position in conciliation was cynical in the extreme. CGU’s representative, W[6] (?), refused to negotiate and continued to hold the line that employment services were not available to me because of the settlement I’d taken.

Why continue the bullying?

And now, X,[7] you have written to me on behalf of CGU. Through you, CGU continues to parrot that I cannot access return to work services because of my acceptance of the common law settlement. X, as a worker you cannot operate in a way that breaks the law. So here is the law regarding my entitlement. This information has cost me dearly to uncover. CGU, on the other hand has its own legal department, so the correct information should have been readily available to all those CGU employees who have been involved in my request to date.

  1. My entitlement to medical and like services is established under Section 99(1) of the Act. The particular entitlement that I’m seeking is “occupational rehabilitation” in the form of access to occupational rehabilitation services as defined under the act.
  2. My continuing entitlement to medical and like services post-settlement is established under Section 99 (13).
  3. My contract of settlement as supplied in conciliation establishes in Clause 3 my ongoing entitlement to medical and like services.

I don’t need you X to tell me what “pecuniary” means. I need you, as CGU’s latest assignee to my case, to respond to my request and provide me with my entitlement. The company that you work for is using its greater resource power to force me to accept this injustice. That is the behaviour of a bully. Please don’t think that because I have a psychiatric injury I must be stupid. I’m growing tired of faceless strangers speaking condescendingly to me. Please don’t add to the effects of all that I’ve described by doing some bullying of your own.

The problem is I can’t give up on my entitlement, because if I do that, I will give up all hope of having any sort of a future. I’m too poor not to work, and I’m too poor to meet the costs of paying for my own vocational rehabilitation
.

I cannot afford to pay more lawyer’s bills either, and CGU would be well aware of this. CGU would also be well aware that further adversarial engagement would continually exacerbate my condition and weaken my capacity to engage in a legal battle. I would refer you to a letter which I wrote to CGU on [day] April, 2007. In it I appealed to CGU to manage my case in ways which avoided exacerbation of my psychiatric injury. This latest long tussle over my entitlement to occupational rehabilitation is full of examples of CGU engaging in behaviours that I identified in this letter as triggers that exacerbate my condition.

CGU is bullying me and I want the bullying to stop!

It is bullying of CGU to block my access to my legitimate entitlements. It is unreasonable of CGU to make promises of service and then fail to meet the expectation that the promise has established. It is an abuse of the law for CGU to continue in this pattern of behaviour towards me because it is bullying. The availability of medical and like services  is clearly included in my contract. Given that I formally supplied this information to CGU in November of last year, it is unreasonable and bullying of CGU to have blocked my access to these legitimate entitlements for this lengthy period of time.

This neglect and denial by CGU of their legal obligations towards me has caused me to lose a year of income earning capacity from my return to work plan. Had CGU met the terms of our settlement contract when I first made my request, I would be more than half way through that course by now. In addition, as I have noted in my increasingly distressed letters to Y, CGU’s processes have severely exacerbated my work place injury which always leads to intensification of a range of very uncomfortable and disorienting symptoms.  I would like to know how this advice was made within CGU, particularly given that it is incorrect and that it has caused me a great deal of distress to date.

To dispute a legally negotiated agreement is adversarial in the extreme, and shows no respect for the binding power of legal contracts. CGU’s continuous blocking of my attempts at rehabilitation and return to work represents a flagrant denial of the objects of the worker’s compensation scheme under Section 3 (3)(b) of the Workers’ Compensation Act. What it shows is that CGU believe that they can succeed in denying me my right and silencing me simply by ignoring me. They can do this successfully because I do not have equality of access to the court system. Instead of taking care of me and helping me rehabilitate, CGU is continually subjecting me to bullying which has the effect of keeping me too unstable to study or to work.

What becomes of the seriously injured worker?

I signed the settlement contract with full advice from my legal representative.  What I’d like to explain to you is what that settlement means in reality. The reality I’m talking about is my reality, the reality of an injured worker. This is what you have to look forward to if you get injured at work: – poverty, misery, sickness. Six years after the occurrence of workplace injury, I took a settlement of $[sum]to compensate me for a financial loss and pain and suffering that I had assessed to be valued at over $1,000,000. I did not make that choice lightly or happily. I did it simply in the interests of my health since I recognised that staying in the workcover system was destroying my health and my future.  Once legal fees were paid, I received $[sum of 5 figures] net from my claim. I have been supporting myself and my son in rented accommodation on that sum of money for the past twelve months. What was once [sum]is now less than $40,000 and I am still no closer to returning to work than I was the day I took the settlement. That settlement is all the money I have apart from $10,000 in superannuation.

Prior to my work injury, I was paying a mortgage, but that home was lost to me during the early days of my illness when CGU’s denial of my claim left me without income and without adequate treatment for many months before I could successfully negotiate all the blocks that CGU placed in my way. I have no work capacity and it seems it may yet take two years before I am ready and able to work again. In order to be able to obtain employment, I have to have some training in the meantime. Do you really think it is reasonable to tell me that the compensation I’ve been given is a fair and just replacement of my loss of earning capacity for the next ten years of my life as well as compensation to me and my family for the pain and suffering that we’ve been subjected to in the past seven years?

I have personally spent thousands in pursuit of my own rehabilitation and re-education for the purpose of returning to work. Yet everything that I do to help myself get well is constantly undermined by the pointless torments that CGU calls “Case Management”.

My concerns are about my viability as a human being who is now unable to deal with the workplace. Do you have any idea of how distressing it is for me to contemplate a future without the income and self satisfaction and simple security that work provides? I was a good, productive worker when I worked. I was valued by the workplaces that I served in my capacity at a youth worker, a community worker and a teacher. My life has been gutted by the experiences of workplace bullying followed by workcover bullying and the psychiatric disability that the bullying has caused.

CGU as my Case Management agent for Worksafe Victoria has a responsibility to manage my case in a manner which facilitates my recovery from workplace injury and then supports my return to work. Yet, so far in my case, CGU has acted towards me in ways that have continually exacerbated my original workplace injury. This ongoing pattern of behaviour towards me has had had the effect of making it impossible for me to rehabilitate.

As well as keeping me in a state of incapacity, CGU has entirely neglected its duties towards me in regards to return to work, and by doing so CGU continues to cause me severe and unreasonable damage and disadvantage.
I request that CGU shows some integrity and honours its obligations to me by agreeing to meet the costs of my requested retraining without further bullying, and wasting away of my life.

Yours sincerely

Pauline



  • [1] X has been my case manager for some time, knew my illness, my particular impairments and my history. I felt safe with her and able to ring her up to discuss my progressing towards return to work. X was my first point of contact with CGU in regard to this matter. Prior to this phone call I had no notification of a change of case management.
  • [2] Y is my second point of contact.
  • [3] Y’s supervisor is the third CGU employee to communicate with me in relation to this request.
  • [4] U may also have been Arthur’s supervisor. If not Anil is the fourth CGU employee to communicate with me in relation to my request.
  • [5] V is the fifth CGU employee to communicate with me in relation to my request.
  • [6] W who’s last name I don’t recall was CGU’s representative at conciliation, she was also the sixth CGU employee to communicate with me in relation to my request.
  • [7] X is the seventh CGU employee to communicate with me in relation to my request.

 

We say shame on CGU and shame on Worksafe Victoria

 

http://wp.me/p1MA9G-32U

 

 



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8 Responses to “Seriously injured worker received no support for retraining”

  1. The stories are so similar, that it seems amazing our LEGALS cannot launch a suit encompassing them all,a group action,against Australian Government:
    BULLYING in AUSTRALIAN WORKPLACES
    I have spoken for the first time @ this amazing site.Im a little person who has naught left after a 30+yr career.
    ….
    [Admin has removed this comments due to privacy concerns for this person who tells us she has had all her social accounts hacked!]

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    • This is insane. Almost unbelievable, UNLESS you are a victim or have been a victim! We believe it, we believe it completely. The problem is, what can one person do? What can you do in this MINE-field planted for you? Have you been to a lawyer? Have you thought about Whilstle-blowing and exposing documents?

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      workcovervictim July 28, 2012 at 7:39 pm
  2. Has anyone tried reporting the agents to the state Ombudsman?

    This is all too familiar. I can see so many parallels, the exact same tactics are used by the insurer I have, down to the exact wording used by the case manager.

    I believe this bullying is a form of mind control designed to destroys people’s will to live.

    The insurers get huge financial rebates when an injured worker dies, don’t they?

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    • Annie, I don’t know if insurer gets a financial rebate if workers dies, they just don’t have to pay them anymore, so it’s more of a saving than rebate.  They are also not held accountable for causing “aggravated suicide” due to a failure to uphold their duty of care.  They only case I am aware of, where a judge attributed the psychiatric secondary injury to the insurer was the recent Cadbury Shweppes vs Davis.   If you watch the ABC report on the Late Rebecca Wallis, her mother discusses CGU’s and her employer’s bullying as the direct cause of daughters’ suicide.  There are so many examples but where are the lawyers willing to take on the class action!!!!    Having gone through this hell, I am motivated to finish my law degree and dedicate myself to helping victims of “the system”.  I wonder if the insurer will pay for that!

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  3. If you make ANY complaint against the education scumbags the above are very common tactics
    The dept is stacked with abusive criminal operators who don,t bat an eyelid when it comes to destroying peoples lives. they don,t give a shit and it is sad for people like us who won,t engage in their tactics
    Christineliz12 you,re not on your own I have had a hells job after my child was sexually assaulted at school
    Theres nothing that can be done to remedy our situation except to get on with what we have left and be vigilant in the future
    My thoughts and kind wishes go out to you.
    retro

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  4. This support of bullying and the feeding off seriously injured workers is systemic. The whole system supports it and/or turns a blind eye to it. I complained and complained until my mental health totally collapsed again. The bullying of injured workers, the discrimination against those with psychiatric injuries, it’s all built into the Workover law. The law gives leadership to bullying in the system and it’s followed by everyone from the insurer’s, to the legal people, and the IME’s.
    I do think a class action has to happen sometime. If it goes off in one state, that would put all the other states on notice to clean up their practices.

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    • Pauline, I’m going through it now.  Like most insurers I assume, they send you to IMEs until they get a biased report, something their legal team can use to terminate your benefits, and the procedural bullying by the Team Leaders, and “Technical” Managers (is this title a joke?), is rampant.  Constant threats of non-compliance, and yet when doctors report something they don’t like, they ignore them, and even bully your doctors. Doctor complains to WorkSafe and their “investigation” is so one sided it goes no where.    Some doctors just give up dealing with WorkCover altogether – they know how corrupt this system is.  Is that the plan?  Less and less support for the injured worker.

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  5. You would be suprised how deep bullying really is in society and so close to policy developers alone.
    In-fact the very own ‘worksafe’ departments are full of it themselves. That is, managers and employees of government departments who meet the criteria for bullying.
    This kind of experience i have come across gives me little faith in the greater employment population (private enterprise) let alone the insurance sector – when it comes to stamping out bullying in the workplace.
    I make a statement quite vigorously on too many occasions with my clients along the lines of: Any party who makes an effort to justify their wrong doing behind red-tape or unsubstantiated legislation is a bully.

    Such definition/s can be substantiated in a similar context to the variables of conflict of interest. It is well documented that perceived conflict has more adverse effects toward parties involved in the matter than actual conflict of interest. If when dealing with a matter a potential for conflict of interest to occur is declared to all parties involved from the outset, then when a question regarding such conflict of interest is brought up, all parties have had a prior exposure to the chances, tenure and severity of potential consequences. If the perception is not managed, then when there is a claim for conflict of interest under a ‘perception’ that has not been declared, we are generally dealing with a much more significant claim with varying levels of distress to parties involved.
    The same goes for bullying. If perceptions of bullying are not managed, then when an act of bullying is raised, the reactions of the bullyer (i.e. being accused) are much more defensive and not indicative of a therapeutic intervention to harness symptom reduction and resolution of claims. So this comes down to inter-relationship with colleagues and or managers and management styles.

    As far as substantiating claims toward insurer case managers, i’ve seen strictly defended insurers basically indicating that they are allowed to bully injured workers throughout their claims management and the worker not be compensated as it is not work related. This is a joke and there is case law to state otherwise referenced on this site. I.e. work is a substantial contributing factor given that the employer’s representative, eg. CGU, GIO, QBE are impacting on the worker’s health as a result of their employment with company A.

    The issue with the latter comment is that it is a discretionary power that insurers have in their roles to approve services. Acts of incompetence just do not pass by my standards as an excuse for not getting a job completed, such as approving a re-training submission. It is purely an act of bullying, intimidations and is clearly inappropriate.

    On an occasion in the above letter i note that you developed a good rapport with Case Manager X until he was taken off the case. This to me, is evidence that bullying can be managed and discretion is an avenue for insurer case managers to explore their bullying and intimidating traits which bring many injured workers unstuck. UNfortunately, it is not considered, reasonable and necessary across the board, for injured workers who are victims of the same to access treatment due to the claims management process. SOmething i strongly oppose and will fight until it is more broadly accepted.

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