Speech by Mr. Louis Ng Kok Kwang, MP for Nee Soon GRC at the Second Reading of the Work Injury Compensation Bill (Bill No. 21/2019)
Sir, I stand in support of the Work Injury Compensation Bill.
We have made great strides in prioritising workplace safety and health (WSH). Our WSH 2028 strategy articulates a Vision Zero for all stakeholders to work towards preventing all forms of injury and ill-health at work.
While we work towards the WSH 2028 vision, the work injury compensation regime provides a safeguard for employees who unfortunately have suffered a workplace injury. In this distressing period, work injury compensation helps to alleviate some of the financial burden on employees and to ensure that they have access to the necessary medical treatment.
The Bill proposes an overhaul of the existing work injury compensation regime which on the whole benefits both employees and employers by expanding WICA coverage, licensing WIC insurers, and simplifying and expediting work injury claims processes. I applaud the ambition of the Bill.
I have the following clarifications and recommendations on how the proposed amendments will be implemented in subsidiary legislation and operational policy.
Improving the work injury reporting system
The problem of some doctors giving insufficient medical leave to migrant workers has been a recurring problem for several years. I would like to highlight 2 recent cases whereby doctors were suspended by the High Court for professional misconduct.
In the first case, Dr Kevin Yip gave two days of medical leave and light duties thereafter to Mr Zhang, a construction worker, despite the latter having a serious fall that resulted in multiple injuries such as a fractured collarbone and a few rib fractures.
In the second case, Dr Wong Him Choon likewise gave two days of medical leave and light duties thereafter to Mr Fan, also a construction worker, despite the latter sustaining hand and forearm fractures that required surgery after a fall from height.
Errant employers may influence medical practitioners to prescribe lesser days of medical leave and provide light duties in order to downplay the severity of an injury or to avoid reporting the accident.
I previously asked the Ministry whether the requirement for reporting work-related or workplace accidents can include cases where the employee is placed on light duties.
I understand that the reporting requirements for a workplace accident will be updated in subsidiary legislation. The criteria for reporting an accident will now be at least 24 hours of hospitalisation or any instance of medical leave or light duties.
This will help address cases of doctors under-prescribing medical leave to employees so that employers can avoid reporting an accident. I thank the Ministry for taking this step.
However, my concern is that doctors may now circumvent this requirement by not prescribing any medical leave or light duties at all. The Ministry has stated that the Singapore Medical Council has mechanisms to take disciplinary action against doctors who do so.
However, this requires a process of detection, investigation, and enforcement. The employee who has suffered a work injury may be denied access to medical documentation, proper and timely medical treatment and compensation in the meantime.
How will the Ministry monitor incidences of medical malpractice by doctors under the new reporting requirements?
Further, will the Ministry consider implementing a dual reporting system by both doctors and employers in the future?
Clarifying the definition of light duties
The Bill also extends compensation coverage to employees on light duties. This is welcome as it is now very common for injured employees to be prescribed light duties in lieu of medical leave.
However, I understand that there is a lot of confusion on the ground as to what constitutes light duties and when an injured employee can be prescribed light duties.
The SMC Ethical Code and Guidelines require doctors to ensure that there are appropriate light duties available to the employee at their work place before prescribing light duties. In practice, I understand that many doctors prescribe light duties when in fact there are no light duties available at the workplace. This leads to confusion for both employees and employers.
There are stories of employees who end up not working at all or employees who do heavy labour that is inappropriate for their physical conditions.
I appreciate that this is an issue that will have to involve the Ministry of Health, SMC, and doctors and return to work occupational therapists. Given that light duties are now more significant under the work injury compensation regime, will the Ministry work with the relevant stakeholders to shed more light on what constitutes light duties and when it can be prescribed?
Ensuring that employees receive notice of accident reporting and claim applications
The Ministry has stated that employees will receive notice of accident reports after they have been submitted to the Ministry. The amendments will also introduce an automatic claim application system for fatal or serious injuries.
The accident report and claim application state important details such as the location of the accident, the nature of the injury, and the Average Monthly Earnings (AME). These are key details that will affect the compensation assessment.
Can the Ministry confirm that the employee will receive notice of the accident report and claim application in all cases? Will the employee be given the opportunity to challenge the details stated in the accident report and claim application where filed by the employer or automatically processed?
Further, can the Ministry share how it intends to ensure that the accident report and claim application will reach the hands of a migrant worker whose address is likely to be office address of their employer? Can the accident report and claim application be sent to the migrant worker through existing mobile applications? Alternatively, do employees have the right to obtain copies of these documents directly from MOM free of charge?
Processing of work injury claims by insurers
Next, the Bill proposes for licensed insurers to process insured WICA claims. I hope this move will help to expedite the claims process and ensure timely payouts for employees. I have two points relating to processing of the claims by insurers.
First, can the licensing regime for insurers also include a requirement that insured employees be issued with insurance cards to facilitate faster processing of medical appointments and procedures?
I understand that injured employees are sometimes caught in limbo where their employer has not paid for medical treatment and refuses to provide a Letter of Guarantee for the necessary medical procedures.
Requiring that employees hold insurance cards not only benefits, it will also take some of the burden off employers and reduce the amount of bad debt hospitals face due to unpaid medical bills by employers.
Secondly, to facilitate the insurance payouts, can the Ministry assist injured migrant workers who do not have bank accounts in opening one?
I understand that the Ministry can issue a letter to help migrant workers open a POSB payroll account at the Kaki Bukit branch. The feedback from NGOs is that this is a good practice and some have suggested to me that we institutionalise this practice. This will also be of great assistance to insurers who can more easily make their payouts through bank transfers.
As a matter of standard practice, when commencing a work injury claim, can the Ministry issue such a letter to a migrant worker who does not already have a bank account?
Determining the AME
As insurers will now take over the processing of claims, the task of determining AME now falls to them.
I understand that determining the AME can be a contentious issue and there are incidents of erroneous, missing, and forged time cards and salary slips. This is a difficult enough problem for MOM with their statutory powers of investigation.
Can the Minister share how the Ministry intends to address the possible difficulties that insurers may face in determining the AME?
Where a dispute over the AME goes to the Commissioner, the Bill empowers the Commissioner to compute compensation based on a multiple of the employee’s basic monthly salary if there is no other evidence available.
Can the Minister share if it will issue guidelines for determining what this multiple should be or if the issue is left entirely up to the discretion of the Commissioner?
Ensuring provision of accommodation and food to injured migrant workers
Next, employers are currently required to provide adequate food and acceptable housing for migrant workers during the entire work injury compensation process.
However, it is not clear what adequate food and acceptable housing means. NGOs have shared with me horror stories where migrant workers are required to travel long distances to their work sites in order to get food when they should be resting, or where they are housed in accommodation with appalling conditions.
Can the Ministry look into providing guidelines on what constitutes adequate food and acceptable housing? While this will differ from employer to employer, we are not asking every employer to meet the standards in the exact same way. These guidelines will provide a minimum standard to ensure that employers cannot abuse the ambiguity of adequate food and acceptable housing.
Assessing current incapacity
Next, the Bill proposes for compensation to be assessed based on current incapacity (CI) to expedite compensation for the employee.
I understand that in practice when the injury is assessed is important because employers consider their responsibilities to be fully discharged upon assessment of incapacity.
Can the Ministry clarify where the assessment is based on the CI, will the employer still be responsible for medical treatment after the assessment? For instance, is the employer responsible for the cost of a follow-up treatment and for therapy after the assessment?
Can the Minister also clarify whether the Ministry’s intention is for migrant workers to be repatriated after assessment based on CI is done? My concern is that this will have the effect of denying migrant workers continuing care and rehabilitation that may be necessary until their condition fully stabilises.
Allowing change of doctors
It also is proposed that employees be allowed to switch assessing doctors to address cases of inadequate care of overly conservative incapacity assessments. The Ministry has stated that the Commissioner may allow employees to switch the assessing doctor in certain cases.
Can the Minister clarify under what circumstances the employee will be allowed to switch assessing doctors and whether the employee will be able to determine which doctor to consult?
Providing for exceptions to the one-year time bar
Lastly, the First Schedule of the Bill limits the compensation payable by an employer to the cost of medical treatment received within one year of the date of the accident.
However, it is plausible that bad employers may prevent or obstruct their employees from getting appropriate medical treatment in the first year after the accident.
In such cases, can the Ministry clarify whether the employee’s only recourse will be to seek compensation via the common law route? Can the Ministry introduce exceptions to the one-year time bar where the employer has actively sought to prevent the employee from getting medical treatment?
I hope the Ministry will provide the clarifications sought and consider my recommendations in subsidiary legislation and implementation of the Bill.
I stand in support of what is overall a positive step for strengthening our work injury compensation regime.
Watch the speech here
Watch the response by MOM here