An article in the Straits Times, 9 November 2013, on workers’ injuries and medical leave prompted a small flurry of letters to the newspaper’s Forum page.
The initial article, headlined ‘Hospitals give too much sick leave for injuries: Bosses’ reported that
Bosses are crying foul that foreign workers are getting too much medical leave from hospitals, which in turn insist that their doctors are simply doing their jobs.
More than 10 companies in the marine and construction industries showed The Straits Times injury reports from the last two years of 20 foreign workers, who received several months to a year off for cuts and fractures.
The employers told the Straits Times that they believe workers exaggerate their injuries to fool doctors.
“Some of them can act better than film stars,” said Mr S. Jiwa, director of Mobco Marine.
One of his workers who received six days of medical leave from West Point Hospital after fracturing his hand in August, got almost four months’ leave from Tan Tock Seng Hospital (TTSH).
Hospitals contacted by the newspaper for their response insisted that everything is done objectively, and that they are not being too lenient with medical leave.
They also reviewed the medical certificates issued by their doctors for the above three cases, and found them to be appropriate.
“The duration of medical leave depends on the specialist’s clinical assessment of the injury, test results and relevant medical history available,” said Dr Andrew Chin, who heads the department of hand surgery at SGH.
“It also depends on what the patient has communicated to the doctor about his nature of work and environment.”
TTSH head of orthopaedic surgery Ganesan Naidu said: “Fractures of the hand would normally take a few months to heal sufficiently to allow for heavy duty work after surgery.”
According to the article, the employers have seen a rise in injured workers running off to get a second opinion.
The news story added,
Ms Debbie Fordyce, a volunteer at migrants’ organisation Transient Workers Count Too, believes some workers are advised by various parties to exaggerate their injuries to claim a bigger injury payout.
In other cases, workers end up making their injuries worse by moonlighting to earn more money even while on medical leave – a point also raised by employers.
She said: “Many injured workers are still in pain after a few days of medical leave. But they dare not tell their employers as they worry about being seen as skiving. So they decide to run away but have to moonlight to survive.”
TWC2’s Debbie Fordyce provides greater insight into what is really a complex situation
Debbie felt that the detailed answer she gave the journalist was over-reduced, such that it might give a misleading picture of where things really stood.
She wrote back and her letter was carried in the Forum page of 13 November 2013:
Reasons for compensation claims
In last Saturday’s article (“Hospitals give too much sick leave for injuries: Bosses”) about injured workers who lodge work injury compensation claims and feel compelled to leave the company dormitory, I was quoted as saying that the workers worry about being seen as skiving, and so run away but have to moonlight to survive.
Workers with injuries that are not expected to result in permanent incapacity are driven to lodge compensation claims through fear of repatriation, encouragement from staff at law firms and extremely low salaries.
Many injured workers are taken to doctors who give very short medical leave, and have a justifiable fear of being repatriated at the end of this leave.
Some staff at law firms specialising in injury compensation encourage injured workers to lodge claims, often promising high compensation rewards and housing in return for a cut of the compensation amount.
Once the employer receives a letter from the law firm, he is less willing to have the worker remain in the company dorm.
The worker feels compelled to vacate the dorm despite having no financial support for what may be months or years while waiting for the resolution of the case.
Even at the risk of being fined or jailed for “moonlighting”, the salary is usually several times more than what the worker gets from his legal employer, because the illegal employer is not responsible for the worker’s levy, insurance or housing. The salary is a necessity for workers to maintain themselves while waiting for the compensation.
Deborah D. Fordyce (Ms)
Transient Workers Count Too
Bosses avoid paying workers
On the same day, a doctor’s letter was also published.
Bosses should pay workers on light duty
Doctors now find themselves in a no-win situation when treating foreign workers (“Hospitals give too much sick leave for injuries: Bosses”, last Saturday; and “Docs told to give injured workers enough leave”, July 7).
I am a hand surgeon in private practice and a visiting consultant in a restructured hospital, so I am aware of the pressures doctors face from workers and their employers.
In private practice, I work closely with safety officers to get the workers back to work as soon as possible, to minimise their down time and loss of productivity.
The vast majority have only one finger or one hand injured. There is no medical reason why they cannot perform light duties immediately after their injury is treated, keeping the injured hand in a sling while using their healthy hand.
Decent employers get these workers to do light duties around the office or in the dormitory, and pay them what they would get if they were on medical leave.
Unfortunately, under the Manpower Ministry’s policy, unscrupulous employers have no obligation to pay them wages if no suitable light duties can be found. But if the workers were on medical leave, they must be paid basic wages.
This is the main reason why workers with hand injuries seek medical certificates after they have been given light duties.
In the restructured hospital, I issue medical certificates without hesitation to workers who complain they are not given light duties and are not being paid. If no suitable light duties are available, the worker is not fit to work and is entitled to a medical certificate.
I hardly ever see a representative of the employer in the restructured hospital. In a busy clinic, there is simply no time to call the employer to discuss the case, so doctors have to take the patient’s word.
The solution is simple: The Manpower Ministry should require employers to pay all workers on light duty, at least as much as if they were on medical leave.
Andrew Yam (Dr)
Hand and Peripheral Nerve Surgeon
Centre for Hand and Reconstructive Microsurgery
Gleneagles Medical Centre
Dr Yam hit the nail on its head. The problem, which doctors in the public sector realise, is that employers prefer their workers on ” light duty” rather than on medical leave, if they cannot be certified fully fit to work. “Light duty” is that grey area where employers think they have the freedom to either put the worker back onto the old (heavy-duty) job or if he can’t do the work, not pay him. To avoid aggravating the injury, it is medically more ethical to put a worker on medical leave unless the doctor can be sure that appropriate light duties are assigned to the patient.
Actually, Dr Yam’s understanding of MOM policy may be inaccurate. Not only should an employer respect the “light duty” certification and assign appropriate work, of no such work is available, then a particular stipulation of the Employment of Foreign Manpower (Work Pass) Regulations kicks in. In Fourth Schedule, Part III, Clause 4 (page 33), it says that:
4. Except where the foreign employee is on no-pay leave outside Singapore, the employer shall, regardless of whether there is actual work for the foreign employee but subject to any other written law, pay the foreign employee not less than —
(a) the amount declared as the fixed monthly salary in the work pass application submitted to the Controller in relation to the foreign
(b) if the amount of fixed monthly salary is at any time subsequently revised in accordance with paragraph 6A of Part IV, the last revised amount
In other words, it is exactly as Dr Yam argued: require employers to pay all workers on light duty. Why is it commonly not done? It is the lack of enforcement by MOM itself!
Lawyers not the only solution for injured workers
Adding to the debate, the Migrant Workers’ Centre, which is affiliated with the National Trades Union Congress, wrote to the Straits Times. Their letter was published on 15 November 2013:
Change in mindsets of employers, workers needed
The Migrant Workers’ Centre (MWC) agrees that there are many reasons why migrant workers run away and lodge injury claims against their employers.
From our experience, we can confirm that the grounds cited by Ms Deborah D. Fordyce (“Reasons for compensation claims”; Wednesday) are valid and we believe that only a radical change in the behaviours of stakeholders can break this vicious circle.
Employers must realise that our Work Injury System accords no fault to employers whose workers are injured.
The responsibility to report work injury for claims first lies on the employers’ shoulders, and they do not stand to lose much from reporting and claiming for work injury compensation on their workers’ behalf.
MWC has seen employers alienate an injury claimant after receiving a legal letter from the worker’s lawyer. Employers need to realise the high likelihood that their worker has been influenced by an unscrupulous lawyer who will stop at nothing to solely represent the worker.
Workers fear they may face abuse or illegal repatriation from the employer for making their claims. However, MWC has seen many cases where employers have demonstrated their concern and given the level of care required by law – providing adequate medical care, leave and wages and above all, giving the worker the reassurance that he needs so that he will not consider running away.
Workers must understand that the law has provided for their protection and care, and that lawyers are not their only solution if their employers refuse to lodge claims for them. MWC strongly urges such workers to approach migrant-worker non-governmental organisations which can help to convince their employer to do so, or failing that, help them lodge the claim.
MWC will continue to make representations to the Manpower Ministry and assist in expediting the compensation process. MWC will also continue to provide for the food and shelter needs of the worker to reduce the need to resort to illegal employment.
Some cases we see have also led us to believe that sometimes, workers game the Work Injury System to select employment of their choice as they have technically little to lose in doing so. This behaviour is socially unacceptable and can ultimately lead to tragic circumstances.
MWC cautions workers and employers alike to access the Work Injury System honestly and fairly so that it can provide meaningful compensation to workers who have suffered physical incapacity or impairment from legitimate injuries suffered in the course of their work.
Yeo Guat Kwang
Migrant Workers’ Centre
Part 2 illustrates the complexity of the problem by telling a story from an injured worker’s point of view. It is important to avoid demonising injured workers while overlooking the roles played by others in denying them medical care and support, and restricting their options. Or that of some opportunistic lawyers providing wildly optimistic estimates of compensation to already vulnerable workers.