Confidence-destroying interactions with doctors leave Shamim with little trust in compensation system

Posted by on March 26, 2018 in Articles, Stories

 

By Alston Ng, based on an interview in January 2018

In the midst of casual conversations with some usual faces at Alankar Restaurant, Hossen Mohammed Shamim, a 29-year-old Bangladeshi who has not worked for about a year and a half, interjects, “You want interview? Come, I give you interview, you help me.”

Evidently not one for small talk, Shamim promptly sits down and, leaving no room for ambiguity, swiftly established the terms of our agreement – my “help” for his “story”. Such bracing confidence, however, usually conceals a pregnant desperation.

On July 7 2016, Shamim fell down the stairs while carrying some pipes. That night, he went to a clinic to have his back checked, only to be told that there was no issue at all. Unconvinced, he travelled to Tan Tock Seng Hospital the next day, but received the same response after an X-ray scan was performed. Shamim claimed that his doctor failed to understand him, and protested that he was summarily dismissed with a 5-day medical leave certificate.

With the unabated pain spreading to his legs, Shamim went to Teban Garden Clinic a few days later to seek a third opinion. Attempting an impression of his GP, Shamim shrugs, “No problem, no problem.” Again, Shamim was dismissed.

By now, his story begins to resemble the Sisyphean curse: each painful journey to a doctor ending in futility. Undeterred, Shamim made two more trips to Changi General Hospital. Despite his attempts at communicating a perceptible loss of sensation in his legs, no alarm was sounded.

At his second Changi appointment, he was finally recommended a MRI scan. It was then discovered that, if unoperated, he would be looking at lifelong lower-body paralysis and incontinence. Thankfully, Shamim’s discectomy proceeded as required. According to Shamim, he was discharged three days later.

“But I not okay,” Shamim’s protests fell on deaf ears. Shortly after disembarking from the taxi, Shamim’s wound reopened. Another hospital trip ensued.

At Changi’s Accident and Emergency (A&E) department, Shamim claimed that he was passed from one doctor to another, presumably because the attending doctor “don’t know how (to) help.” After five days of hospitalisation, Shamim was patched up and discharged.

Unsure about the offer

His story finally catches up with the time of its telling. But the sense of disorientation he faced when he first sought medical assistance remains no less palpable today. He shows me the compensation offer made to him — 25% permanent incapacity (PI). He expresses the view that this will not give him appropriate compensation in money terms. Given his experience of doctors missing out on diagnosis at first try, he hardly thinks that 25% PI is the correct final word on the matter.

Back in Bangladesh, his parents, wife and seven-year-old son are counting on him to put food on the table. Shamim is hopeful that his appeal for a reassessment will yield favourable results. After all, even a marginally higher PI rate will have an appreciable impact on his family’s finances. In his mind, a medical reassessment is the best and only logical course of action.

Like many other workers who maintain that an MRI scan is necessary for the injury assessment process when it really isn’t, Shamim does not know what he does not know. He does not appear to be aware that the assessment rating is not up to any doctor’s discretion, but is tightly guided by a published scale.  Consequently, his conclusion that subjecting himself to a reassessment is a risk-worthy venture neglects to take into account, for instance, that according to the guidelines, a 25% rating is already near the upper limit, short of paralysis, under the assessment guidelines.

His friend, Shemul

Our conversation then goes off in another direction. He asks me if I have any advice regarding how he will be assured of receiving the final pay-out, whatever the sum turns out to be.

He mentions a friend, Shemul, who could not receive his compensation award because his application for a visa to Singapore was not approved. Shamim’s telling of Shemul’s case is troubling, not least because it’s a more complicated story and one where he is failing to notice the pitfalls hiding in plain sight.

The complication centres around the mystery of why Shemul wasn’t in Singapore at the time. Injured workers are supposed to be remain in Singapore till the case is concluded. This difference from Shamim’s situation — Shamim is right here in Singapore — remains unexplained. but also makes it unwise for Shamim to rely on his friend’s predicament as a foretaste of troubles to come.

Another difference is that Shemul had a lawyer representing him, whilst Shamim does not. So, when Shamim says that Shemul was awarded $25,000, getting a little indignant that his friend should be getting all of it, he is failing to recognise that Shemul’s lawyer wasn’t working for free. In fact, according to the letter from his law firm, a 20% cut was already carved out for legal representation.

Yet, Shemul apparently never got a cent of it, all because of some visa problem. This can’t be right. There are means to transfer money (Shemul’s 80%) without having Shemul return to Singapore. As for why Shemul’s lawyer didn’t do this, or what the lawyer said to his client about it — was this a case of deception and cheating? — it’s outside the scope of this story, and anyway, Shamim himself does not really know.

All we can say to him is that there are bad apples among lawyers, and Shamim would do better to rely on TWC2’s guidance than hearsay. It’s heartening to know that on TWC2’s advice, he discharged two months ago the lawyer who was representing him.

Illusions

TWC2, like MOM, advise workers with work injury compensation claims that no legal representation is necessary through the process. But men like Shamim and Shemul come from a different society where institutions are corrupt and untrustworthy, and hence, whose procedural advice may not be reliable.

In Shamim’s case, this is compounded by his disillusionment from a needlessly tedious process of navigating what appears to be a Byzantine healthcare system. Perhaps too, inability to communicate effectively with the authorities reduces the credibility of whatever authorities may be trying to say.

So, many like Shemul choose to trust their instincts and what they hear from friends instead. Or they place their faith in whoever happens to speak their own language, such as the legal assistants ever so eager to win business from desperate injured workers. There are several law firms in Singapore who “specialise”  in work injury compensation, and who hire native-speaking Bangla and Tamil legal assistants to canvass for business. Observing the way these firms do business, TWC2 regards it as misplaced faith.

As in Plato’s Cave, the tantalising images presented before workers like Shemul and Shamim by others who speak the same language are but illusions. Yet, without active listening and effective communication by TWC2 and MOM, these illusions constitute the sum of their reality.

The writer referred Shamim to a TWC2 social worker. After discussing his options thoroughly with our social worker, Shamim has decided to accept the offered compensation. He has since gone home.

TWC2 is an organization that is dedicated to assisting low-wage migrant workers when they are in difficulty. We are motivated by a sense of fairness and humanity, though our caseload often exceeds our
means.

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