BC Amputees at risk when prosthetic contract ignores their voice
By Brian N. Forbes, Chairman of The War Amps Executive Committee & Annelise Petlock, War Amps Advocacy Program Manager
May 5, 2017 – This past year, The War Amputations of Canada was given a unique opportunity to review the draft of a new prosthetic contract between the Prosthetic and Orthotics Association of British Columbia (POABC) and WorkSafeBC. This exercise proved to be a marked illustration of how the voice of the injured worker – in this case the amputee – cannot be overlooked and must be considered when critical decisions affecting their well being are made by bureaucratic bodies.
The contract in question sets out the principles and rules that BC prosthetists (the medical professionals who fit amputees with artificial limbs) must follow when treating injured workers who lose a limb or limbs in workplace accidents. On first review, it was clear that should the intended contract be left as originally drafted, amputee workers would be negatively impacted by a document that was ostensibly meant to help but would inevitably fail to meet the needs of these seriously disabled individuals. There was also the significant concern that this flawed landmark contract between these two agencies, might be potentially referenced as a precedent by other provinces and organizations.
Believing it important to get the contractual relationship right, The War Amps made a series of comprehensive recommendations including amendments to terminology which addressed elements of the contract which reflected a lack of understanding of prosthetic care, the profession itself, and the prosthetic industry. Our initial proposals were critical of the fundamental standard employed in the contract which was based on the provision of the “lowest cost” prosthesis which, in our judgement, would have been incompatible with achieving WorkSafe BC’s mandate of ensuring rehabilitation and the return to work of the injured amputee. A further proposal pertained to the inclusion of “generic recommendations.” In this context, it was our strong opinion that Certified Prosthetists must conduct a clinical review of the prosthetic options available for each individual injured amputee to ensure the most medically appropriate artificial limb is recommended. In our considered and longstanding view, it is not possible to create a generic or “one size fits all” recommendation for amputees. This “generic” provision in the contract would prevent the prosthetist from collecting vital information needed to contribute to a sound prosthetic recommendation for each individual amputee worker.
Despite initial resistance, both POABC and WorkSafe BC responded collaboratively and, in the end, implemented, to a large extent, these specific amendments and indeed the majority of The War Amps recommendations were incorporated into the new contract which is now in effect in British Columbia.
In furthering our expanding commitment to represent all Canadian amputees, our goal in providing these recommendations was largely educational, shedding light on the unique needs of amputees identified in our 100 years of working in this very specialized field. It has been the experience of our Advocacy program, which was established to protect the rights of Canadian amputees, that regulating agencies often create and adhere to policies which do not reflect the reality of living with amputation. This prevents amputees from being able to access the specific artificial limbs and treatment medically prescribed to them. We are certain that many Canadians would be shocked to know that those who suffer the loss of a limb are not adequately covered by their provincial or insurance health plans, and that the voice of the amputee is often excluded from the dialogue.
In carrying out our crusade for reform, we have found that provincial agencies, government departments and insurance companies do not fully understand the total disability of amputation. Through Advocacy, we attempt to identify the gaps in support for amputees and work to effect change in areas such as insufficient prosthetic coverage, insurance and legal issues, human rights and government benefits to improve their lives. We also navigate and address the bureaucratic barriers and misunderstandings often confronted by amputees in Canadian society.
The opportunity to consult with POABC and WorkSafe BC and the adoption of several of our recommendations has been a significant step in the right direction. Unfortunately, not all of our concerns were addressed, and it will be very important for us to monitor the application of this contract closely in order to protect the interests of individual amputee workers in British Columbia. It is our fundamental position that it is unacceptable that a worker who has suffered an amputation in a workplace accident be given anything less by the province than the strongest support and necessary tools to return to a full and productive life.
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Executive Director, Communications
1 877 606-3342