By Wendy Ma

If you had $1,000, how would you spend it? This sum is equivalent to five months of Wang Cunbo’s living expense in Singapore, as he spends only $200 per month. He sends the remaining $1200 of his monthly salary back home in Zhengzhou, China, so that he can build a house for his wife and children.  Yet a clinic quoting a heart-stopping rate of $1,016.50 is about to slash his plans. Yet, without the medical report, he would not be able to demand compensation for permanent incapacity under the Work Injury Compensation Act (WICA).

It all traces back to Oct 10, 2012 when a six-meter steel bar fell on his hand, fracturing Wang’s left thumb. His company sent him to Singapore Sports and Orthopaedic Clinic for treatment. However, the employer did not make an accident report at the Ministry of Manpower (MOM). As a result, the work injury compensation process (WICA) was not triggered.

Like many migrant workers, 42-year-old Wang himself was ignorant of the WICA process; he did not know that lodging a report was a necessary route to compensation. Unaware of the importance of reporting and having documents relating to his injury and treatment, he was quite content that the company let him rest for one month without formal medical leave.  “I wasn’t upset because I didn’t have to work, so I didn’t go to another hospital for MC.”

Eight months later, on 11 May 2013, Wang was transferred to another construction site where he was tasked to carry heavy steel. This brought back the pain in his previously injured left thumb. “I press my thumb and it hurts,” he tells TWC2, demonstrating the tender spot several times during the interview.

Once again, he was referred to the clinic for treatment. This time, he recalled that there was an X-ray report and other medical documents, but these were taken from him by his work supervisor. Wang protested, to no avail.

Around the same time, Wang heard about the injury compensation process from a fellow countryman who had received $10,000 for some permanent incapacity. Wang then approached Singapore Sports and Orthopaedic Clinic to retrieve his medical record in order to make an accident report but was unsuccessful.

On 27 May 2013, seeking advice from MOM, an officer there confirmed to Wang that he would need to submit either a medical leave document or a medical report to initiate the WICA process. The same day, Wang made a second attempt to retrieve his medical records from the clinic. According to him, the clinic said it would only release the records in the presence of his supervisor.

So, the supervisor was called, and arrived soon after.

“I can’t even understand what they were saying.” Wang complains that when the supervisor arrived, he and the clinic staff used English as the medium for their discussion. Whatever they said, the discussion left him empty-handed just as before, and by this point, Wang was becoming indignant.

Wang then approached Transient Workers Count Too, having seen our poster at a church.

The following day, TWC2 social worker Raymond Ang accompanied Wang to the clinic to request for the medical report once again. A staffer there said it could not be made available immediately as it would have to be compiled by her supervisor, named Huishan. Again, Wang left the place without satisfaction.

wang_cunbo_quotationRaymond had to follow up for a few more days until 30 May when he was informed that a formal written request by Wang would be necessary. This was quickly arranged and faxed over to the clinic on 31 May. In return, the clinic provided an Invoice (functionally a quotation) stating the cost of the “specialist medical report” to be $1,016.50 inclusive of Goods and Services Tax

Raymond then rang the Singapore Medical Council (SMC). He cannot remember the name of the person he spoke to, but in response to Raymond’s question whether the SMC had pricing guidelines, this person said no. Having such guidelines might be tantamount to price-fixing, he explained. At this point, Raymond mentioned the specific price being quoted, and this person said something to the effect that such a figure seemed really excessive. Raymond was advised to go personally to SMC with the documents so that the council could look into the matter.

Simultaneously, Raymond contacted the clinic and protested the proposed charge. Shortly after, the clinic reduced it to $428 — less than half the original figure.

“Even $428 is very high,” says Raymond. “At restructured [public] hospitals, workers are usually charged $80 – $90 for a medical report.”

Debbie Fordyce, TWC2’s head of direct services, adds: “Actually,  the specialist medical report is not necessary to prove that one has an injury. Hospitals and clinics are expected to release without charge documents such as discharge certificates (when a patient is warded) and tax invoices (showing procedures and costs) which indicate the nature of the injury. If Wang had these forms, he wouldn’t need a specialist medical report, even one costing only $80.”

However, not wanting to delay Wang’s claim any longer, TWC2 decided to pay it for him. “$428 is still a lot of money for a construction worker like Wang Cunbo,” Raymond explains.

Wang should be able to claim it back from his employer eventually.

Meanwhile, Wang misses very much his wife and children, a 13-year-old boy and 10-year-old girl. He calls them every night. When asked if his family knew about his situation, he heaves his shoulders as if carrying a huge load, which he is — on his mind. “They know about the accident, but I haven’t revealed that the injury is permanent.”