By Liang Lei, based on interviews in June 2018
It is common knowledge that timely diagnosis and treatment of injuries go a long way in minimizing pain and speeding up recovery. In Singapore, the Work Injury Compensation Act (WICA) seeks to enable that, by allowing employees injured at work to file claims for, amongst other items, medical treatment that may otherwise be unaffordable.
But does it work?
Employer’s proposal: 15-day home leave
Miah Mohammed Rubel, a construction worker, suffered a two-metre fall at work on 10 May 2018, injuring his jaw and back. “Very pain, two teeth moving,” he tells me, pointing to the left side of his lower jaw.
He was immediately sent to a general practitioner’s clinic and was given medicine for his jaw. His back was not examined, he says.
A week later, Rubel visited a dental clinic, where the dentist suggested that he replace his loose teeth with implants. However, with his employer refusing to pay for the costly treatment, the recommended procedure was not done.
The biggest shock came on 29 May 2018, when the company offered him a 15-day leave to Bangladesh on a one-way air ticket, and two months’ worth of salary. Suspicious, Rubel checked on his Work Permit: it was cancelled.
Rubel subsequently went to the Ministry of Manpower (MOM) to make the accident report himself and thus to secure his stay in Singapore with a Special Pass. He is currently on medical leave and undergoing treatment in Tan Tock Seng hospital. Doctors at the hospital have found that his spine was affected by the fall too.
As at 5 July 2018, MOM’s work injury database shows that they are “looking into the validity of the work injury claim.” This appears to indicate that the employer has not yet confirmed to the authorities that a safety lapse occurred at site, injuring an employee, although it’s well past the 10-day period for notification.
So long as an employer has not accepted that a workplace accident occurred, MOM may be flummoxed as to whether such an incident happened. The rights that an employee should enjoy under the Work Injury Compensation Act are suspended until MOM can make a decision on this. Meanwhile, the employer cannot be pressured to pay for medical treatment or to pay medical leave wages. The injury may remain inadequately treated and the injured worker’s income stream reduced to nothing. This defeats the intent of the legislation.
TWC2 has proposed that doctors treating workers with traumatic injuries should be required to report such injuries to MOM. If the doctor says the injuries are consistent with the incident as described by the worker, MOM should make the rebuttable presumption that a workplace incident occurred. This way at least, the provisions of WICA are triggered to ensure medical care and medical leave wages for the worker.
Two months after accident, no report yet filed at MOM
Muthusamy Kasinathan, a construction supervisor hailing from Chennai, had the joint of his left thumb crushed while unloading a slab of marble meant for a wall cladding on April 8, 2018. When he informed his employer about the injury, he was told to simply apply medication.
When the pain did not subside three days later, Kasinathan visited a general practitioner’s clinic, where he obtained painkillers and a referral for an X-ray. The results showed that he had suffered a fracture at his left thumb.
Kasinathan diligently kept his employer in the loop for all his treatment and diagnosis in multiple scrolls of WhatsApp messages he showed me. The air of indignation was thus unsurprising when he laments: “Boss told me, go working.”
Luckily for Kasinathan, as an S-Pass holder, he had the option to resign and stay on to get a new job – a privilege in migrant worker circles that most, as holders of the less powerful Work Permit, do not enjoy by right. He quit on April 18, 2018 and sought treatment at Tan Tock Seng hospital.
Having worked in Singapore for years before his current stint, Kasinathan understands that employers should report workplace accidents. “I know, (within) ten days must tell MOM,” he tells me. However, he doesn’t know that employees can file incident reports too, though even if he knew that, he wouldn’t know how. Many migrant workers would be in the same position. It is one of the chief reasons why they readily engage lawyers.
As did Kasinathan.
In following up this story, we made two checks with MOM’s Work Injury database. On 19 June 2018, two months after his injury, there was no report against Kasinathan’s name. Unless there’s been some technical glitch, it suggests that no report had been made. Neither by the employer or by Kasinathan’s lawyer.
On 5 July 2018 however, the database had a record in place. Interestingly, it said “We have been informed of the work accident. If the employee wishes to make a claim under the Work Injury Compensation Act, please advise him to submit the application form to the Ministry.” This status statement can be parsed to mean that someone has notified the ministry of the incident. But it’s Kasinathan himself (or his lawyer) who has not yet lodged an insurance claim.
On the bright side, Kasinathan says he has secured his unpaid wages through the assistance of a lawyer, while his treatment costs at Tan Tock Seng hospital is covered by a Letter of Guarantee from his employer.
Is WICA effective?
What these two examples show is that an employer’s attitude makes all the difference. Kasinathan’s employer has come forward to shoulder his responsibilities. Rubel’s employer has not. Kasinathan is getting treatment. Rubel is struggling to get it.
Based on the cases TWC2 has seen, employers failing to lodge incident reports are quite common, despite the stiff penalty associated with non-reporting: a fine of up to S$5,000 for first offence, and a fine of up to S$10,000 and/ or a jail term of up to six months for subsequent offences. Perhaps enforcement by MOM can be stepped up.
Furthermore, if non-reporting is a systemic problem, it may suggest that MOM has an artificially low count of safety incidents and work injuries in Singapore, thus further reducing the political drive required to make the necessary improvements. See also the article Do MOM’s injury statistics hide more than they reveal?
Currently, doctors are not expected to make work injury reports on behalf of patients. Such a stand has merit, since doctors have no direct work relationship with patients. However, given their expertise in healthcare and neutrality in workplace interests, TWC2 believes that they have a role to play too.
Until then, our foreign workers will continue facing the brunt of irresponsible under-reporting.