By Fuxiong

“Now you see, my finger swollen,” says Arangulavan Sri Ram, “but no more appointment at Mount E.”

Mount Elizabeth Hospital at Novena was where he had been treated post-accident, but with no further follow-up appointments scheduled, Ram went to Tan Tock Seng Hospital instead last week.

Two fingers on his right hand have been partially amputated following a cable jack accident on 27 May 2013. Whilst nothing unusually problematic about his case surfaced from the interview, nonetheless, TWC2 feels it’s a case worth documenting for the way

(a) it illustrates a worker’s experience with medical services, and

(b) how his relationship with his employer sours.

The case reveals how little influence a worker has over the choice of hospital and the course of his treatment. Should he have fears that he is not getting adequate medical attention, it is not obvious to him what he can do to flag his concerns and look after his own best interest, without immediately triggering conflict with his employer.

In this sense, the “system” for providing medical care for workers is less than ideal.

The accident

Ram’s work site was adjacent to the National Heart Centre within the grounds of the Singapore General Hospital. He was working for U-Power Pte Ltd, a company that laid underground power cables. At 5pm on 27 May, the accident happened and safety supervisors were alerted. Three safety officers — two from the main contractor and the third from U-Power — put him onto a lorry and took him, not to Singapore General Hospital just round the corner, but to Raffles Hospital, about 3 – 4 km away.

There, all three safety supervisors got a chance to speak to the doctors, but not Ram. “Nobody ask me anything,” says the worker.

TWC2 does not consider such a situation correct. Medical records should be based on a history of the incident as told by the patient. Company officials may have their own interests as to how much information they want recorded, and doctors should avoid using them as sources.

Ram fingers were surgically treated the same evening and he was warded overnight. He was discharged around midday the following day. The hospital told him nothing about medical leave. “Only company supervisor tell me,” he says. “He tell me hospital only give one day MC.”

Nonetheless, the company allowed him to stay away from work for three months, with Ram resting in the company’s Yishun dormitory. This indicated that the employer was well aware that the injury was not a slight one.

There may be some significance to the one-day medical leave certificate (“MC”). Ministry of Manpower rules require that any incident in which an injury occurs necessitating at least three days of MC is a mandatorily reportable work safety incident. Whether the rule figured in the minds of the hospital and the company supervisors when deciding on the formal duration of the MC is unknown.

Ram had a number of follow-up appointments, not at Raffles Hospital, but at Mount Elizabeth Hospital (Novena). Eventually bandages and stitches were removed. Each time, he was brought to the hospital by company officials, and each time, “Doctor never ask any question. See my hand only.”

Three months on

Three months after the accident, in September 2013, the company asked him to go back to work. Apparently, his hand hurt and at about this point, Ram faced a dilemma. He didn’t know how the company would react should he tell them that he really couldn’t work with the loss of two fingers and developing pain. “That month, I try, but cannot work. Have pain in my hand,” he tells me. “I work only 50 percent on off.”

He didn’t know of any mechanism to get additional medical treatment without triggering conflict.

Resigned to conflict, Ram engaged a law firm to represent him — in TWC2’s opinion, an unnecessary move. He moved out of the company dormitory into cheap digs in Little India and sought treatment at Tan Tock Seng Hospital.

Salary paid

To assess if Ram had any reason to feel that the company was being unfair to him, Alex Au, TWC2 vice-president, suggested that I ask Ram about his income stream while he was laid up. According to the worker, the company paid him what he had earned in May (“about $900 total that month”)  and $418 each for June, July and August. He can’t explain the figure of $418, but it is close to the monthly basic salary stated in his In-principle Approval for a Work Permit, of $494 a month. Alex hazarded a guess: “Perhaps the company was paying the basic salary, less a deduction for meals,” he ventured.

If so, the company appears to have done the right thing, pay-wise.

Ram was unable to tell me whether the company had filed an accident report. Ram himself had no clue how to lodge such report, or how to initiate a claim for the loss of his fingers. As the reality of being unable to work sank in, this became an important concern.

So why move out?

Thus, Ram’s decision to break with the employer in September seems largely related to his need for additional medical treatment and his concern about getting compensation. He probably had a sense that the employer was not likely to open avenues for him for these two needs. Whether that conclusion is justified or not is impossible to say. Ram has by now cast his lot with his lawyer.

It needn’t have turned out this way, says Alex. It should not be difficult for the company to take a few more steps:

(a) continue to house him, as required under MOM rules;

(b) file an accident report and initiate the work injury compensation process;

(c) provide additional medical treatment that Ram needs.

Items (b) and (c) ought anyway to be covered by Work Injury insurance; the employer shouldn’t fear being out of pocket for these costs.