By Liang Lei, based on an interview in May 2017

Undoubtedly, Singapore can boast of a world-leading healthcare system that offers high quality medical treatment for a wide range of injuries, diseases and emergencies. Unfortunately, timely and trouble-free access to such services is frequently lacking for our foreign labor, when injuries occur at work. I speak to three foreign workers who were injured to find out more about the hurdles they face.

Employer withholding medical payments despite promises made

Boyati Lalon’s job was to spray-paint furniture in a workshop. As part of his job, he had to move heavy furniture around, and that was how he initially developed back injuries. Boyati (photo above, left) felt some pain in his back while carrying a long wooden table with a co-worker on 15 April 2016. After reporting this to his supervisor, he was told to visit the doctor at Raffles Medical clinic, where he was given five days of medical leave (“MC”).

However, after about a month, the pain relapsed with greater intensity. After visiting Raffles Medical again, Boyati was directed to a SATA CommHealth clinic, then finally to Khoo Teck Puat Hospital. From then on, he was given a series of MCs, the duration ranging from weeks to a month, as he continued to suffer from intense back pain that affected his sleep at night. Finally, the doctor at Khoo Teck Puat Hospital gave him a medical certificate for light duty, and told him that full recovery can be achieved in about a year’s time. Nonetheless, Boyati says his workload was not reduced and he was told to continue working as before, pain notwithstanding.

During his visits to the hospital, Boyati learnt that many of his medical bills — addressed to his employer as should be the case — remained unpaid. When he approached his manager about this, he was told that that the bills had already been paid. He was in no position to make sense of this contradictory information.

All he knew was that there were several occasions when the hospital informed Boyati that he had to pay for his treatment, since the employer was in arrears. Not wanting to forgo treatment, Boyati paid for those appointments out of his own pocket; he would claim reimbursement from his employer. It is not clear however whether reimbursements for these claims have come through as at the time of writing. As for the amounts the employer owed the hospital for earlier appointments, Boyati believes they still remain unpaid. For example, he underwent an MRI scan in 2016, which cost $1,300. The employer had provided the hospital with a Letter of Guarantee for the cost of this procedure, but Boyati says that the bill is still pending payment.

Boyati finally stopped working on 28 April 2017 — more than a year after his back injuries began — and he tells me that since stopping work, his back pain has faded somewhat. However, as his doctor had earlier warned, the pain has moved down to his legs.

His Work Permit was cancelled in May 2017 but his treatment still needs to continue, with several appointments at Khoo Teck Puat Hospital in the months ahead. He hopes they will be paid by his employer, but clearly, he isn’t sure of that.

No further treatment possible without payment

Rahman Mohammad Bazlur is in a very similar situation. He suffered a back injury in March 2017, was first treated at the company clinic, then went to see a doctor at Tan Tock Seng Hospital. As in Boyati’s case, the Tan Tock Seng bills remain unpaid, says Bazlur. He says he has been told that no further medical treatment at Tan Tock Seng Hospital is possible without payment of the outstanding medical bills.

Employer refuses to pay for medical assessment, nor fully refund earlier medical treatment

Madbur Anamul (photo above, right) worked in a shipyard. On 18 January 2017, while welding, he slipped and fell three metres, injuring his right knee and back. He was sent to the company clinic, which directed him to an orthopedic clinic in Gleneagles Medical Centre.

For his treatment at the orthopedic clinic, Madbur estimates he has paid $2,100 out of his own pocket, but only received S$867 in reimbursement from his employer. When he approached his employer about this discrepancy, he was told that all his medical expenses have already been settled and that he would not be getting any more reimbursement, nor coverage for future medical expenses.

Madbur engaged a lawyer on 14 February 2017 to help him with his case.

Hardly unusual

“Unfortunately, TWC2 hears from many workers that employers have failed to pay hospital bills,” says Alex Au, a senior member of TWC2. and “as a result, medical treatment has either been delayed or suspended.” This obviously prolongs the anguish experienced by the workers. Alex feels that MOM should be a lot more active in ensuring that employers do not use delaying tactics in such a way.

“Currently, many employers are allowed to get away with not housing their injured workers, so delay is cost-free to the employer,” Alex explains. “If employers had to pay for injured workers’ continued accommodation and their food — which anyway is the law — delay tactics will prove to be costly to the employer.”

Specific to Madbur’s injury case, I asked Debbie Fordyce, another senior volunteer, if employers are also responsible for workers’ medical expenses if they were directed from their company clinic to private hospitals.

“They should,” Debbie replied.

“But do workers end up paying instead?”

“If the employer refuses to pay, the worker may have no choice but to pay himself. Moreover,” she adds, “the employer is required to provide payment for medical treatment only once the validity of the injury claim has been established. This means that if the employer has not submitted an incident report to MOM or disputes the injury claim, he would not be held responsible for the medical treatment.”

Looks like there are plenty of ways for employers to escape payment.