Mining-Related Lower Back Injuries and the Compensation Process: An Injured Worker’s Journey

Abstract

Background: In Ontario, when an occupational injury occurs in the mining industry, there is often a need to interact with the Workplace Safety and Insurance Board (WSIB). During this process, miners experience economic, social, and mental health–related issues that can affect their overall well-being. This study aimed to determine the impact of a lower back injury and the WSIB claim process experience expressed by some male, underground miners in Sudbury, Ontario, Canada. Methods: A qualitative descriptive study design that utilized in-depth, individual qualitative interviews was conducted. Twelve male participants (underground miners) were interviewed in Sudbury, Ontario. Interviews were transcribed and thematically analyzed. Findings: The results emphasized the need for improved communication, the necessity for resources to be allocated to enhance public discussion about injury prevention, the social and economic burden that miners and their families face, and the power imbalances between injured miners and the companies that were meant to support them. Conclusion/Application to Practice: The findings indicate that several areas require improvement for an injured miner who submits a WSIB claim. Ideally, participants wanted an improved and streamlined process for reporting an injury and for WSIB claim management. These findings suggest that occupational health practices that foster a safe and healthy work environment in the mining industry must be promoted, which will help to guide future policies that enhance support for an injured worker and the WSIB claim process.

Introduction

Research studies have indicated that the risks and hazards associated with working in the mining industry are not only limited to physical injury, but also include biological, psychosocial, and ergonomic hazards (Amponsah-Tawiah & Menash, 2016; Donoghue, 2004). Those hazards could put employees at risk of injury. When an injury occurs, there is usually a need to work with various organizations to access services and prepare and submit Workplace Safety and Insurance Board (WSIB) claims. This process could prove tiresome and cause underground miners not only to struggle with physical recovery, but also to face economic, social, and mental health-related issues that could affect the overall well-being of an injured underground miner (Cacciacarro & Kirsh, 2006; Kilgour, Kosny, McKenzie, & Collie, 2015).

Background

Low back pain (LBP) and disability were considered to be major health and socioeconomic problems in most countries (Kloek, van Tilburg, Staal, Veenhof, & Bossen, 2019; van Tulder & Waddell, 2005). Furthermore, it was found that most individuals experienced lower back pain at one time in their lives and lower back pain was considered to be a frequent cause of disability in working-age individuals. A lower back disability has been associated with work absenteeism, socioeconomic consequences, and high health care utilization (Kigozi et al., 2019; van Tulder, Furlan, & Gagnier, 2005).

In Ontario, Canada, mining and mineral processing is one of the leading industries that provides many individuals with the opportunity to access employment opportunities that contribute to economic sustainability (“Economic Contribution,” n.d.). The mining industry, directly and indirectly, has created more than 78,000 employment opportunities since 2015 (“Economic Contribution,” n.d.). Research has shown that there is a need for increased awareness of how Ontario’s safety-focused organizations are best positioned to assist and protect an injured worker and identified a critical need for further improvement to prevent injury and support an injured worker, as they work toward recovery and eventual workplace reintegration (Amponsah-Tawiah & Menash, 2016; Donoghue, 2004).

Despite increased safety awareness and the recognition of the importance of adhering to safety guidelines in the mining industry, the incidence of injuries is higher compared with other industries, such as the pulp and paper and electrical (“By the Numbers: 2017 WSIB Statistical Report,” n.d.). As outlined in 2017 by the WSIB (“By the Numbers: 2017 WSIB Statistical Report,” n.d.), the mining industry reported 0.7% lost-time injuries or illnesses per year, compared with the pulp and paper industry that had 0.5% lost-time events and the electrical industry that had 0.4%. In 2017, 17% of all “high-impact” workers’ compensation claims (allowed claims with the highest life-time costs and average duration) that were submitted were for back injuries, as compared with 6% for shoulder injuries and 7% for fractures (“By the Numbers: 2017 WSIB Statistical Report,” n.d.).

This study aimed to examine the impact (economic and noneconomic) of lower back injuries and the experiences of some male miners in Sudbury, Ontario, Canada, with the workers’ compensation claim process.

Method

In undertaking this study, the researchers aimed to understand and possibly improve the WSIB processes and to identify the gaps in knowledge associated with an injured worker and the WSIB claim process experience. By doing so, the results might promote changes by the WSIB, the employer, and the union.

Twelve semi-structured interviews were conducted with male miners who sustained a lower back injury while employed in the mining industry and who were also involved with the WSIB claim process. Informed consents were obtained from the participants who received CAD$20 for their participation in the interview. Ethics approval for this study was received from Laurentian University Research Ethics Board #6013934.

A social constructionist approach was used as the theoretical framework for this study. This framework allowed participants to provide meaningful insights about their situations (Crotty, 2015). Creswell (2013) noted that this approach considers how an individual seeks an understanding of the world in which they live and work. In addition, one of the goals of this method of research is to rely as much as possible on the participants’ views of their situation (Creswell, 2013).

The ecological systems theory was used as a second theoretical framework to assist in understanding the themes that arose from this study (Johnson, 2008). These themes were all interconnected in the same manner as the interwoven system levels of the ecological systems theory (Johnson, 2008). Dembe (2001) noted that it is important to address the repercussions of an occupational injury beyond the boundaries of the victim (injured worker), the victim’s workplace, and the victim’s home using the ecological systems theory as a framework.

Sample and Setting

The recruitment strategy used for this study was purposeful sampling (Palinkas et al., 2015). Palinkas et al. (2015) indicated that this method of sampling allows for participant recruitment that provides information-rich data for the purpose of saturating the data for the study. Targeted participants were identified through a Sudbury-based union as having a lower back injury and were, or had been, involved with the Ontario WSIB for their injury. Participants were recruited using the existing United Steelworkers of America Local 6500 database (“Who We Are—USW Local 6500,” n.d.). A participation letter was developed by the research team and provided to a Compensation Officer at the Local 6500 Union Hall. A search within the union database revealed 44 participants who met the criteria for the research study. The participation letter and a union support letter were mailed to those participants. Participants were provided with the work phone number and email address of the lead researcher. Informed written consent was obtained from participants before commencing research. Participants were advised that they could withdraw from the study at any given time, for any reason, and without penalty.

Participants who could not give written or verbal consent were excluded from the sample due to the lack of cognitive abilities. The Compensation Officer did not know who did and did not opt to participate in the study.

Data Collection

Participants who consented were asked semi-structured and open-ended interview questions with additional probes, when required. Qualitative interviews inquired about the miners’ experiences working in the mining industry, the impacts of the injury, the miners’ experiences with the WSIB claim process, family experiences as a result of the injury and the WSIB claim process, the impact on family finances due to the injury, suggestions for other injured workers, and their demographic information. The interviews which were conducted in person and lasted about 90 minutes were held at the local union hall or a mutually agreed upon location (e.g., the researcher’s office). The timing of the interviews was determined by the extent of information sharing by each participant. All interviews were recorded, transcribed verbatim, and anonymized at the time of transcription.

Data Analysis

To ensure the trustworthiness, credibility, dependability, transferability, and application of the findings, all transcripts were read and reread (Colorafi & Evans, 2016). Dependability was achieved by using consistent procedures across all participant interviews such as standardized data collection (e.g., using the same interview questions in the same order) and clearly describing the researcher role within the study. Credibility was achieved by providing thick and rich data that were believable from the perspective of the research participants. Finally, transferability was accomplished by thoroughly describing the characteristics of the participants so that a comparison with other groups could be made.

Thematic analysis, to identify patterns or themes in the qualitative interviews, was undertaken by two research members following the steps outlined by Braun and Clarke (2006). These steps include (a) familiarizing oneself with the data, (b) generating initial codes, (c) searching for themes, (d) reviewing potential themes, and (e) defining and naming themes. Two research team members achieved consensus using samples of coding. Therefore, familiarization with the data occurred by transcribing verbatim and reading and rereading the transcriptions.

Once familiarization had taken place and an initial list of ideas was created, the production of the initial codes started. The codes were organized into meaningful groups. Coding was done manually by working systematically through the entire data set. Potential themes were identified and sorted using tables. Themes and subthemes were then identified for significance. Reviewing the themes in the next stage helped to further determine whether there were enough data to support themes.

The fifth stage involved defining and naming themes through the identification of the essence of what each theme was about. A theme captured the importance of the data as it related to the research question and represented meaning within the data set. It was essential to ensure that all the identified themes had sufficient depth and detail to convey the richness and complexity of the data. The themes were then reviewed as a method of quality checking. This was accomplished by checking emerged themes against the entire data set ensuring that the themes worked with the research question.

Findings

Participants were between 42 and 88 years of age (a mean age of 58 years), with a mean of 23 years of employment in the mining industry. Their education ranged between Grade 7 to some college-level schooling (Median Grade 10). The lower back injuries occurred between 1977 and 2017, and at the time of the study, six participants had open workers’ compensation claims with the Ontario WSIB.

Participants described in depth the implications of their lower back injuries and their experiences with the WSIB claim process. The overarching themes included extreme financial hardship, compromised family relationships, feelings of depression, concern with unsafe work environments, punishment for injured workers (e.g., denial of occupational injury, threat of job loss, and formal warnings), feelings of employer denial of illness and compensation, and a tough fight for compensation. The themes arose using an inductive approach to data collection and the repetitions and similarities that were found in the transcriptions.

Extreme Financial Hardship

During the interviews, the participants provided moving stories about the significant financial hardships they endured while working through a lower back injury and the WSIB claim process. They said that the complicated process of filing a workers’ compensation claim with the WSIB, awaiting financial support, and dealing with the employer often left them without money for months. Sudbury Worker 10 recounted,

I was on social assistance, I lost all my credit, and I had no money. I lost my van, and I had to buy an old car, and I had no money to get insurance. They did everything they could to break me, but they didn’t break me, I fought, thank God I had the family I had.

Overall, the participants who were involved with this study suffered some form of financial hardship while maneuvering through the complicated process of trying to obtain financial compensation from the WSIB. The financial losses were seen in the form of no compensation payment, delayed compensation payments, and bankruptcy. When participants finally received some form of financial compensation, they felt that the payment did not fully cover their loss of income.

Participants who lost income because their claim was denied, or because their eligibility was not recognized for the full period of their disability, expressed many negative emotions including anxiety over the inability to make payments for their homes or vehicles and even humiliation when they had to resort to asking parents or friends to help support them. Sudbury Worker 3 indicated,

My family helped me, well my dad. I moved out of my house and into his house because he was moving, so he said, “Live at my house and don’t pay rent, but when you get paid and when you have money just give me a little bit at a time.” I understood that because he was paying hydro and everything too and I didn’t want to live for free off him at my age.

Compromised Family Relationships

Family strain was identified as a significant impact that was associated with struggling with a lower back injury and the WSIB claim process. Many participants referenced the family dynamic as strained. Sudbury Worker 9 said,

It was horrible, I was very pain focused and I was in so much pain. It was like being single. I went from being the most involved spouse and parent to being totally focused on pain and work and how was I supposed to do this. They were stressing me out and how was I supposed to pay bills. I became my pain, and I didn’t know who I was without it. I lost friends, and we went through marriage counselling.

Feelings of being unable to participate in the normal family day-to-day routines including caring for children, contributing to household responsibilities, or partaking in activities due to physical limitations associated with the back injury were discussed. Participants felt as if they were sitting on the sideline. Sudbury Worker 8 said,

I could not do anything. I had to hire someone to plow my snow, had to pay someone to fix my house, and there was a period where I just had to lie in bed. It was hard because I am very active and like to do things and I could not play with the kids, could not go snowshoeing, and could not go sledding.

Some participants indicated that the time and energy required to fight for a WSIB claim and to deal with the injury pain became so overwhelming that it strained their ability to maintain a place in their family.

Feelings of Depression

Participants spoke about how their mental health was affected not only by the physical injury, but also the struggle to fight for a WSIB claim approval and remain employed in a meaningful way. Some participants suffered from depression and anxiety, some were actively treated by a physician who prescribed antidepressants, and some were also seen by either a psychiatrist or a psychologist. Sudbury Worker 10 reported,

I was on anti-depressants, seeing a psychologist, psychiatrist, doctors, councilors, specialists; I did everything. The biggest thing that was shared with me was when you have an injury that goes on for so long, either you give up and kill yourself, or you try to move forward.

Many participants discussed feelings of inadequacy because they were no longer able to perform their regular work duties after their injury. Participants felt that after they returned to work from an injury, they were not valued by the employer or their coworkers. Sudbury Worker 12 stated,

I went on surface for a year doing nothing, and it was not meaningful work. It was very depressive because you have nothing to do. You sit there for hours and hours, and people look at you like you’re faking.

Unsafe Work Environments

All participants interviewed described the work environment that an underground miner was subjected to in the mining industry. While the participants interviewed worked at different mine sites across Sudbury, Ontario, it was clear that mining was associated with many hazards. The environment was described as dark, damp, dirty, dangerous, and unsafe. Sudbury Worker 9 stated,

It’s still rough. In the longevity of things, the person who worked underground was probably going to get hurt because of long-term exposure to the mining environment. They were going to have problems with their lungs or joints or have back and shoulder problems. As far as I am concerned the money that you make underground is blood money; its blood money, simple as that.

Participants also shared that not only was the physical working environment challenging, but also that the work culture was toxic. Sudbury Worker 4 spoke about the environment and stated that the mine “was known to be run like a German camp.” This type of culture fostered feelings of anger and frustration by workers who believed that the employer did not value or respect the worker.

Punishment for Injured Workers

Many participants spoke about feeling punished simply because they suffered a workplace injury or filed a WSIB claim. Some participants were subjected to formal warnings from their employer because upon returning to work, they continued to struggle with their injury. Sudbury Worker 4 stated,

I was on compensation for five or six weeks. When I went back to work, the employer had a meeting, and they threatened to fire me or give me a step 4. They said they gave me a step 4 for not wearing my seatbelt and they gave me six months no scoop, six months no bonus, but keep training our young guys; so I shook their hand for not firing me.

Some participants felt uncertainty about their jobs when they eventually returned to work because the supervisors would threaten to send them home if they could not perform their duties. Sudbury Worker 6 indicated,

I had one boss who gave me a hard time. He told me they were going to let me go and I went to see my union. They wanted me gone because I was on modified work and they didn’t want anyone on modified work.

Some of the participants spoke about a stigma that was associated with being an injured worker. The term stigma could be defined as “negative attitudes held about individuals who are perceived to possess a trait deemed negative by the community at large as well as those with whom these individuals are associated” (Rintamaki & Brashers, 2010). Sudbury Worker 1 indicated,

There’s this one boss there; well, one guy told me that when I left a meeting after my injury, the boss said, “Check out that big lazy whatever.”

Denial of Illness and Compensation by the Employer

Participants spoke about a lack of recognition of their injury by WSIB, the employer, and their coworkers. Many of the participants continued to suffer in pain from their back injury. They felt that they had to legitimize their injury, even though they had been diagnosed or treated for the injury by a health care professional. Many participants stated that the company did not believe the extent of their injury or denied that the injury even took place at work. Sudbury Worker 4 stated,

Well you see with the company, they always say when you get hurt report it; so, you are dammed if you do and dammed if you don’t. So, if you don’t report you get in trouble and if you report it you have a meeting about the incident, and you get in trouble. I worry that my shift boss is going to flip on me and are they going to try and fire me; so, I don’t know whether to report my injury or not. If you have no witness, you’re in trouble, but as soon as you have a witness you seem to be safe.

In some instances, the employer reportedly advised the injured worker to lie about their injury to maintain their current job status. Sudbury Worker 3 said,

They wanted me to lie to my doctor saying that there was nothing wrong with me and that I should be going back to work.

Tough Fight for Compensation

Interviews with the participants revealed that being approved by the WSIB felt like an uphill battle. Sudbury Worker 9 stated,

Basically, they shut the door on you for everything. I have six years left and am not giving it up because I want my pension, and I am not giving that up. Compensation makes it very difficult for you. A system that you pay into your whole life is not about the worker, it is about the company.

Injured workers who applied for workers’ compensation insurance and were denied were subjected to delayed access to health care services such as physiotherapy or a psychologist. Without approval of the WSIB claim, those services were not covered, thereby putting the injured worker in the position to pay out of pocket for the services. Participants indicated that they had difficulty with the WSIB claim process when they could not access their WSIB claim adjudicator. Several participants stated that they would call and leave messages with their assigned WSIB claim adjudicator but would have to wait days for a return call. Sudbury Worker 4 reported,

I would leave my adjudicator messages, and after a month I found out that the adjudicator was gone on holidays for three weeks. You would think that the person who answered the phone would say she was gone on holiday.

While having to complete forms and justify their injury, some workers were also subjected to video surveillance either by the WSIB or the employer. The surveillance reports occurred in the mid to late 1990s. No participants reported surveillance in the 2000s. Participants felt that being watched further escalated their fears and led to social isolation. Sudbury Worker 9 indicated,

I was being watched by compensation and they had investigators on me. They had people videotaping me thinking I was faking, and I knew that because when I got my compensation file, it said it in my file. I didn’t want to leave my home because I was worried.

Even after the participants resolved their claim with the WSIB, they continued to feel the effects of being watched. Sudbury Worker 1 stated, “I still feel like I am being watched” and at the end of the interview stated, “I felt like maybe you are were a spy. I honestly I thought that.” The lasting impact of being watched was undeniable, and participants continued to suffer the consequences of being treated like a criminal.

Discussion

The findings in this study align with previous research studies that examined the impact of an occupational lower back injury and the WSIB claim process experience (Beardwood, Kirsh, & Clark, 2005; Kilgour et al., 2015; Lippel, 2007; Soklaridis, Ammendolia, & Cassidy, 2010; Steenstra et al., 2017; Strunin & Boden, 2004; Wall, Morrissey, & Olgoff, 2010).

Research studies have shown that workers who suffered a workplace injury and submitted a claim with a workers’ compensation board often felt like they were caught up in a vicious cycle that provoked depressive feelings, family strain, financial strain, and feelings of diminished self-worth (Kirsh, Slack, & King, 2012; Roberts-Yates, 2003). Overall, the participants in this study indicated that the impact of their injury was devastating across many domains, including the physical, family, social, financial, and emotional domains.

Within this study, the issue of mistrust and legitimacy of an injury resonated across several interviews. Many participants felt punished by the employer and WSIB for sustaining a workplace injury. Beardwood et al. (2005) indicated that even when an injured worker had a medically documented injury and the workers’ compensation board approved the claim, they were still subjected to disbelief in the workplace by their coworkers and supervisors. The authors also found that injured workers felt a sense of powerlessness in fighting against the “big” companies.

Research studies have shown that injured workers felt that they needed to strictly adhere to the requirements of tests and procedures that were part of the process of attempting to have their workers’ compensation claim approved (Friesen, Yassi, & Cooper, 2001; Robichaud, Truchon, St-Arnaud, & Nastasia, 2019). Soklaridis et al. (2010) observed that injured workers feared asking too many questions about their claim because they worried it could cause further delays or place them in a negative light. The participants in this study echoed similar sentiments and felt that if adherence to the WSIB rules was not evident, they would lose their disability benefits or financial compensation. Furthermore, participants found themselves returning to work still suffering from the pain associated with an injury because they worried about reprisal in the workplace. Baril, Clarke, Friesen, Stock, and Cole (2003) revealed that an injured worker did not complain or refuse nonmodified work because they felt pressured by management to return to work as quickly as possible.

Many participants in this study initially faced a denial of their claim by the WSIB. The process was felt to be challenging and unfair to the worker. Research studies found that the workers’ compensation claim process lacked a personal touch and that the claims adjudicators were not forthright with relevant information that would allow a worker to make informed choices (Kirsh et al., 2012; Roberts-Yates, 2003).

An injured worker requires more advocacy support throughout the process (Friesen et al., 2001; Robichaud et al., 2019). Therefore, further education should be provided to the employer, the union, and the WSIB so that they can act as a support system and not deter an injured worker from reporting an injury. Improved communication between the WSIB, the employer, and the union needs to be addressed, and supporting documentation should be created that clearly explains the processes that need to be undertaken by an injured worker when a workplace injury occurs (Friesen et al., 2001; Robichaud et al., 2019). In addition, resources should be allocated to enhance public discussion about injury prevention, the social and economic burden that miners and their families faced when an occupational injury occurred (Kosny, MacEachen, Ferrier, & Chambers, 2011; Trief & Donelson, 1995).

Soklaridis et al. (2010) noted that the power imbalances between miners and the companies meant to support them needed to be addressed. In addition, injured workers should be provided with the skills and knowledge required to minimize any power differences (Soklaridis et al., 2010).

Dembe (2001) indicated that injured workers suffer manifestations of reduced wages, psychological and behavioral responses (e.g., stress, depression, and anger), and social effects that include damaged family relationships and punishment from the employer and their coworkers because of an occupational injury and the workers’ compensation claim process. Johnson (2008) revealed that these manifestations victimizing an injured worker occur due to the ripple effect of the complex intertwined relationships between the macro-level, meso-level, and micro-level systems of the ecological systems theory. The ecological systems theory was developed by Urie Bronfenbrenner and focuses on the quality and context of an individual’s life in a system of relationships that form his or her environment (Rosa & Tudge, 2013). The ecological systems theoretical model comprises socially organized subsystems (micro-, meso-, and macro-level systems), and within each system, there are bidirectional influences that suggest there is an impact in two directions, both away and toward the individual (Johnson, 2008).

The results of this study exposed the challenges faced by miners who suffered a lower back injury and submitted a WSIB claim. These results have implications for further research and possible policy and process changes. In Ontario, the WSIB was designed to support injured workers (“WSIB,” n.d.). Unfortunately, it was not favorably viewed by the participants in this study; instead, it was seen as a barrier to obtaining financial and medical compensation for a workplace injury.

Limitations

This study was limited by the restrictions of collecting data from male participants only, by collecting data from one local mining company, by a small sample size, by the possibility of selection bias from some participants who were faced with negative encounters with the WSIB process, and by the experiences of some older participants that may not be representative of the current issues faced by younger participants. However, this study added value to the previous research in the area of an injured worker and the workers’ compensation claim process experience.

Conclusion

The findings in this study drew attention to several areas that require policy and process improvement for an injured worker who submits a WSIB claim. Ideally, the study participants wanted improved and streamlined processes for reporting an injury and dealing with the WSIB claim process. Further research should be undertaken to understand an injured worker’s perception of the support systems’ (e.g., union, WSIB, and employer) gaps and failures. Recommendations about policy and process improvements with communication between all stakeholders need to be addressed with all those involved when a miner is injured (Soklaridis et al., 2010).

Implications for Occupational Health Nursing Practice

Lippel (2007) indicated that the workers’ compensation system could have damaging effects on injured workers. Amicable relationships between the union and management, as well as positive communication and teamwork, were frequently mentioned as being important to the overall well-being of an injured worker (Friesen et al., 2001; Robichaud et al., 2019). Moving forward, workers’ compensation practitioners might find some aspects of this research study helpful. First, the development of a more cohesive relationship with an injured worker through information sharing could help to reduce tensions. Strunin and Boden (2004) noted that this would not only be beneficial to the worker but could also benefit the compensation claim practitioners involved with a compensation claim.

Employers could also benefit from formal communication training to further enhance their understanding about the importance of keeping the lines of communication open with an injured worker as they work through the return-to-work process. Frame and Brown (2008) revealed that an exchange of knowledge in a more interactive manner could help to open the communication channels between all the stakeholders involved with an injured worker. Participants in this study indicated that they wanted to know that the employer’s concern went beyond work production and also included concern for the workers’ overall well-being post injury.

Future research studies could focus on the development of resources for an injured worker, such as a manual of processes and steps outlining what is to be expected by the injured worker when dealing with the workers’ compensation system. Korzycki, Korzycki, and Shaw (2008) found that knowledge transfer is an essential element that helps injured workers become informed, understood, and able to make decisions in the process. Therefore, more opportunities for better information exchange and partnering are necessary for injured workers to take responsibility for managing the steps in their workers’ compensation claim.

Applying Research to Practice

The mining industry is dangerous and these workers are at risk for injury (Amponsah-Tawiah & Menash, 2016; Donoghue, 2004). When an injury occurs, an injured worker is responsible for working through the complicated and stressful process of submitting a compensation claim. This study identified themes that include extreme financial hardship, compromised family relationships, feelings of depression, concern with unsafe work environments, punishment for being injured, feelings of employer denial of illness and compensation, and a tough fight to obtain compensation. A deeper understanding of these themes provides opportunities to further promote occupational health practices that foster a safe and healthy work environment in the mining industry and help to guide future policies that could enhance support for an injured worker and the WSIB claim process.