Ramasamy Ayyasamy’s left hand is now virtually useless for work. Three fingers are stiff and there is still a metal splinter inside his ring finger. It’s not clear how he is going to continue earning an adequate income to feed his family. Yet, he is at risk of not receiving any compensation for the disability. His employer may have successfully beaten the system.

Several stories on this website tell of doctors in the private sector giving workers only one or two days’ medical leave despite workers suffering severe injuries. Sometimes, they reach the point of absurdity, as in Aktar’s story Hand smashed, needing three-hour operation, but no medical leave. More recently, we came across Murthy’s case — his story will be published soon — where no medical leave (“MC “) was given to him after surgery on his ankle. At one of his follow-up appointments, the company’s safety officer told the doctor that there would be “no need” for an MC.

The law does not require employers to report an accident to the Ministry of Manpower (MOM) unless the injured worker gets more than three days of medical leave. TWC2 sees many cases where private hospitals stay beneath this threshold, and in the article Difference in medical leave raises question about standard of care, TWC2 Executive Committee member Debbie Fordyce politely wondered, “whether this is in order to relieve the employer of the obligation to report the injury to the Ministry of Manpower”.

link_btwn_reporting_and_claimingIn July 2013, the Health Ministry sent a circular to doctors reminding them that their professional responsibility should be to the patient, not the employer. See Doctors told to give injured workers enough leave. Simultaneously, the Ministry of Manpower reminded employers not to interfere, see Don’t dictate sick leave, employers told.

In April this year, we reported on the Singapore Medical Council asking two doctors to face a disciplinary tribunal over a complaint initiated by Jolovan Wham of the the NGO Humanitarian Organisation for Migration Economics. In a Facebook post, Jolovan said the doctors were “notorious” for  “colluding with employers to give 2 days MC and light duty leave despite the workers suffering serious injuries (for instance, fractures and loss of limb).”

Yet, a steady stream of workers is still coming to TWC2, telling us of one-day or two-day MCs for quite bad accidents. This indicates that the problem is continuing and that action by the authorities is insufficient.


Second opinion

Many workers realise, within weeks, that they are getting inadequate treatment from their company-appointed doctor. They often make their own way to public hospitals to seek a second opinion. Typically, the doctor there notices the severity of the injury and prescribes a much longer period of medical leave, which then puts the first doctor’s company-influenced assessment into stark relief.  For the worker, however, getting a second opinion is not without cost. Firstly, he’d have to pay the public hospital for the consultation and treatment out of his own pocket, though future reimbursement may be possible. Secondly, such a move would so annoy his employer that he might have to decamp from the company dormitory, find his own accommodation elsewhere and pay for it. The worker would also have to write off any prospect of ever returning to the job even if his injury healed.

In Ayyasamy’s case, he didn’t take this step. He didn’t want to sever his relationship with his employer and job. “I have wife and family. I must have money send [to them].”

His work history might also have made him too trusting of his employer. He first came to Singapore in 2000, accumulating a total of twelve years (net of home breaks) working here. His previous employers have been good and when he started on a new job in July 2014, he had no reason to think that the new employer would have any less integrity.


12 July 2015

He was on this new job (with Yong He Fu Construction Pte Ltd) for less than a week before misfortune hit him. He was at a site in Punggol building HDB flats. It’s a big company, Ayyasamy tells us, with perhaps 500 employees. On that fateful day, prefabricated panels were being moved into position. The big concrete pieces would be hoisted by crane and carefully guided into position, but the medium-sized ones were to be moved by human muscle. He and two fellow workers were manoeuvering one such piece when one of the men lost his grip. Unable to support the entire piece by himself, the panel pressed against his hand holding it from below and crushed his fingers.

There is a fairly shocking story from the 17 hours following that 9:30am accident on 12 July 2015. We shan’t go into it in any detail, because, inhuman as it may be, it isn’t the point of this story. But very briefly, what followed was an inexcuseable sluggishness on the part of everyone responsible in getting him to a doctor. His hand bleeding, him reeling in excruciating pain, he was told to wait in a car. And wait. And wait. The main contractor’s safety officer came, took a look and mumbled something about it being his subcontractor employer’s responsibility. And went away.

It was only around 6pm, about eight-and-a-half hours after the incident, when someone came and took him to a small clinic in the Punggol area. The general practitioner took one look at the wound and said this was far too serious for him to try to handle. Take the worker to a hospital immediately, he ordered.

Much internal discussion followed, and another two hours passed before Ayyasamy was taken to what he remembers as “Island Hospital”. We later see from his documents that it’s the Island Orthopaedic Clinic, located within Gleneagles Hospital. He was operated on and a metal splint inserted into one of the broken fingers, but instead of spending the night in the ward, he was sent back to the dorm at 2:30 am, he said. The doctor prescribed two days’ medical leave, followed by 25 days light duty. We have seen the documents.

He would stay in his room, resting and recovering for 48 days. The company knew he wasn’t ready to resume work. But neither did the company pay him. “One dollar money also no have,” Ayyasamy says of his predicament. “My wife, baby, I must send money.”

If Ayyasamy had been issued MC for those days spent recovering, he should be paid for those MC days. If he did not have an MC, but the company didn’t assign him work, he should still be paid his basic salary for that period. It is not correct according to the law to not pay him on the basis that he was not called upon to work.


Back to work

But Ayyasamy didn’t know what his rights were. And soon, he felt he should recommence work to earn money for his family. None of the supervisors really wanted him in their teams, because his left hand was still out of commission. “Company send [me] go one site here, one site there,” he tells of those months. “I only one hand can work. Many things I cannot do.” Eventually, he was mostly tasked to sandpaper areas with rough plaster or putty — something he could do with just one good hand. But even to do that job, he’d have to carry his tools, ladder and a few other things with him. “After little bit work, many pain coming,” he says of a typical day.

At least he was paid.

Then on 18 August 2015, thirteen months after the accident, Ayyasamy was suddenly told he would be laid off. The company would be repatriating him. He asked about compensation both for the injury and for the remaining eleven months of his work permit, but got no satisfactory reply. So he sought out a lawyer.

And that’s when he discovered that there was a process for claiming compensation under the Work Injury Compensation Act (WICA). The problem? The process had not been initiated in his case and MOM’s website says no claim can be filed more than twelve months after the accident. He has to appeal to MOM to make an exception.

The matter is ongoing and it is not yet clear how it will turn out.

Meanwhile, he has sought a second opinion from Orthopaedic ‘A’ Care Service Pte Ltd. The specialist here gave him a letter saying he had “permanent disabilities in his left middle and ring fingers” and that he is “medically unfit to work in his previous job (i.e. be on medical leave), starting from the date of the accident (12 Jul 14) and extending to the end of his lifetime.”

This statement alone testifies to the severity of the injury.


The issue spotlighted

In a nutshell, this is the issue: Despite a serious injury, Ayyasamy was not given more than two days of medical leave. Nor was he hospitalised. Instead he was whisked back to the dorm right after surgery. If he had been given more than three days of medical leave or hospitalised for 24 hours, it would be mandatory for the employer to report the accident to the Ministry of Manpower. By successfully limiting the medical leave and denying hospitalisation, this accident slipped under the radar.

Ayyasamy was vulnerable because of his financial needs; he tried his best to work for slightly over a year after the accident. He was vulnerable because he lacked knowledge about the WICA process. It wasn’t until thirteen months later that he realised no claim had been filed.

It is hoped that MOM will be understanding of the circumstances and take his claim forward. If not, it would be a disgraceful example of an employer (in collusion with doctors) beating the system.

It is therefore also hoped that MOM and the Ministry of Health will draw the necessary conclusions from this example, and take a much sterner stand against any employer or doctor attempting to act in similar ways. Hardworking men, with families to support, are unfairly victimised if employers and doctors get away like this.