Doing More in Work Injury Compensation for Migrant Workers
Parliamentary Speech for Work Injury Compensation (Amendment) Bill, 3 Sep 2019
Introduction
Mr Speaker, I support the Bill and commend the Ministry for giving broader coverage and higher compensation with the amendments, amongst other improvements to the work injury compensation process. Especially given that workplace injuries increased to 12,810 cases in 2018, a jump of 312 cases from the year before, with construction remaining the industry with the highest number of fatalities.
If we truly wish to provide workers with one of the safest and healthiest workplaces in the world as recommended by the Workplace Safety and Health (WSH) 2028 Tripartite Strategies Committee in April 2019, we must take into account their working realities. Especially our 970,000 migrant workers who form the bulk of our manual labour force and therefore most at-risk from work injuries.
I would like to raise three key concerns that are not adequately addressed by the Bill and propose additional measures accordingly.
Processing of Claims: Role of Insurers and other Challenges
My first concern, Mr. Speaker, is that the Bill proposes to let insurance companies handle the processing of claims rather than it being under the Ministry’s direct purview, for reasons of efficiency. I appreciate the intent but we will also agree that private insurers have no incentive to ensure workers are fully apprised of their rights and it is unclear which party is responsible for ascertaining validity and how a party can appeal the decision.
If it is to be private insurers making the decision, then there should be a rigorous Code of Practice for them to follow to ensure integrity and reasonable speed in the process. Such a Code should include procedures and principles that align with the fundamental rules of natural justice, which include the principles of impartiality and fair hearing. Arbiters must allow parties adequate opportunity to contest statements made by another party. This is especially important for workers, as employers may possess more documents and be able to withhold certain evidence more easily.
Migrant worker NGO, Transient Workers Count Too or TWC2, has seen cases where the employer may under-declare overtime hours and hence salaries of migrant workers. Take Bangladeshi worker Naseer. He had filed WICA and salary claims at the same time. While the WICA case was ongoing, TADM had found that he was incorrectly paid before the injury and computed the total underpaid amount as $13,000 over 12 months. However, he was told to wait for his WICA claim to be completed before proceeding with his salary claim. When the WICA compensation amount was offered nine months after the accident, it was based on the employer’s version of the Average Monthly Earnings (AME). However, he accepted the compensation because he did not want to wait much longer and still had an outstanding salary claim.
Hence arbiters must be trained to scrutinise the evidence presented. Under the Employment Act, employers are legally obliged to document working time records and payslips, and furnish these documents to the workers. Adverse inference should be drawn against the employer who failed to keep or furnish proper records. Recent amendments to the Employment Claims Act already mandate such inferences in salary claims. It would also be useful to have the WICA and salary disputes to be conducted in parallel, where there is a salary dispute, so that the AME can reflect the result of the salary claim process accurately.
Mr Speaker, as illustrated before, the processing of claims is seldom a straightforward application of formulae or medical reports. It is therefore imperative that the Ministry implements safeguards to ensure that the insurers will process each claim in accordance with the worker’s full rights and entitlements, including conducting spot checks on claims processed by insurers and monitoring the processing by insurers. This is crucial since the insurer is paid for by the employers, therefore stringent external regulation is needed to ensure that the insurer acts impartially.
The changes in these procedures must be coupled with efforts to inform low wage local and migrant workers of their insurance coverage and claims processes. Migrant workers, who rely on WICA for compensation, may be unable to push for their own interests if they lack a detailed understanding of the law. According to BMJ Global Health Journal, a 2016 survey conducted by medical practitioners with 433 migrant workers in Singapore found that only 61.4% of these workers were certain that they had medical insurance coverage”. Some workers mistakenly believe they have to bear their full medical expenses and avoid treatment, as they are not aware that it is mandated by law for employers to purchase WICA insurance.
Moreover, it is unclear how workers will receive information that a claim has been initiated by the employer. Workers do not automatically receive accident reports from the Ministry when their accidents have been filed by their employer and hence may not see the details filed that may be prejudicial to the worker. While NGOs can email the Ministry on behalf of workers to request for a copy, the Ministry charges a fee for this. In addition, the Ministry sends letters addressed to workers to the office address of the employer, but there have been cases where the employer has failed to pass these letters to the workers. I urge the Ministry to consider informing the workers immediately by SMS and letting workers opt to obtain a free copy of the accident reports and letters from a counter from the Ministry instead.
Delay in Medical Treatment/Liability of Insurer
My second concern, Mr Speaker, is the delay in medical treatment or services received by migrant workers because of their employer’s refusal to pay that essentially defeats the purpose of WICA which is to ensure that workers are able to receive proper, and certainly timely, medical treatment.
As we speak, a Bangladeshi worker, whom I will call Ahmad, is at risk of more damage from delayed treatment. Ahmad sustained a severe back injury at work when he fell while carrying heavy construction material 5 months ago. He required MRI scans for ongoing treatment but had to miss two scan appointments because his employer did not pay outstanding bills nor issue undertakings to pay for ongoing treatment. Without the scans, the specialists are reluctant to determine further course of treatment. Other health professionals like physiotherapists also cannot help in the absence of diagnostic imaging. Ahmad is currently supported by another NGO, HOME, to get his employer to provide the undertaking and we are hoping he will be third time lucky to make the MRI appointment.
A Chinese worker, whom I will call Liu, had an accident when he was hit in the eye by a large metal hook which caused a cornea rupture in two months ago. The doctor had indicated that he is mostly likely permanently blind in that eye. Yet, due to the lackadaisical approach to settling an outstanding bill of $200 by the employer, the Singapore National Eye Centre almost stopped Liu from seeing the specialist for follow up which may have caused further damage. Thankfully, HOME was able to support him through a kind donation.
Mr. Speaker, in case we think these are just a couple of odd cases recently, it’s far more common than we think because more than a considerable number of migrant workers are affected. I do urge the Ministry to study the prevalence of this problem.
In the meantime, to circumvent the challenge of employers promptly providing the Letter of Guarantee, I propose that workers be issued with insurance cards by the insurer that acts as a “Letter of Guarantee”, to facilitate easier and faster processing of medical appointments, medical procedures and scans. In the proposed Code of Practice, insurers must also fulfill target timelines and settle the claims expeditiously, so that the medical treatment of workers are not delayed. A 30-day target timeline is recommended to determine whether the injury is work-related and hence treatment should be covered under insurance.
The Bill also provides that, upon the employer’s insolvency, the insurer assumes quote “the same liabilities in relation to the employee as if the insurer were the employer.” unquote This suggests the insurer should pay for the medical treatment directly, and not merely reimburse the worker. However, Clause 18 of the Bill provides that all compensation payable should be paid by the insurer to the injured worker or their representative if they are under incapacity. It would be helpful if the Minister could clarify whether the insurers will pay for the medical treatment directly, or reimburse the worker.
Mental Health and Support
Lastly, Mr Speaker, I would like to highlight the urgent need to safeguard the mental health of our migrant workers. A 2015 survey of 605 Bangladeshi and Indian workers conducted by the Singapore Management University (SMU) found that more than 60 percent of respondents who had outstanding injury or salary claims were predicted to have serious mental illness.
A Bangladeshi worker, whom I will call Jamal, suffered work injuries in his hip and spine His employer refused to pay for the total hip replacement he needed. He sought help with HealthServe, another NGO, who provided him shelter and supported him with his case to get the surgery he needed. In that six months with HealthServe, Jamal suffered great pain which caused insomnia and depressive moods that later escalated when he met with a slew of major stressors. Including his father had a stroke, his wife left him, the loss of his home in Bangladesh due to flooding and the escalating debts….he thought of killing himself. HealthServe provided counselling to Jamal who reportedly cried several times. He was repatriated in May 2019, broken in flesh and spirit.
Again, Jamal is not alone, Mr. Speaker. I urge the Ministry to consider the following suggestions from the community:
- We must educate our migrant workers on mental health and provide peer support and/or mental health first aid training.
- We must provide easy access to counselling services for migrant workers in distress. To my knowledge, there’s only FASTCare by the Foreign Domestic Worker Association for Social Support and Training by MOM for foreign domestic workers but none yet for non-domestic and male migrant workers. I’m very happy to hear that HealthServe has plans to start a mental health programme but the needs are way more than what one NGO can handle.
- We could implement a structured intervention program such as a case management rehabilitation program, which can improve several aspects of the workers’ psychological wellbeing and quality of life. This will provide the motivation to not only prepare injured workers to return to work but more importantly to help them to adjust better and ensure sustainability in their post-rehabilitation work life. There are successful implementation of such programmes in Malaysia and Germany.
Last but not least, I urge the Minister to consider allowing workers who have had their permits cancelled prematurely by employers after they have suffered an injury, but are free from medical leave or light duty to look for new jobs instead of being sent back home unfairly. When they have recuperated.
Conclusion
Mr. Speaker, in that same report I mentioned at the beginning of my speech, the Tripartite Strategies Committee also recommended that Singapore must aim to be amongst the best in the world in our workplace health and safety performance. This is a worthy goal indeed.
Yet, as I recall how heartening it was to see the different migrant communities come together to support one another at the Migrant Cultural Show last Sunday, I cannot help but think that we must surely include in that goal above one that obliges us as a government and society to enable and support our one million migrant brothers and sisters to be the best that they can be — in total health and safety. For if they help us build our homes and take care of much of our needs for us to thrive, how can we send them back to theirs, broken and less?
Thank you.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Anthea Ong is a Nominated Member of Parliament. (A Nominated Member of Parliament (NMP) is a Member of the Parliament of Singapore who is appointed by the President. They are not affiliated to any political party and do not represent any constituency. There are currently nine NMPs in Parliament.)
The multi-sector perspective that comes from her ground immersion of 12 years in different capacities helps her translate single-sector issues and ideas across boundaries without alienating any particular community/group. As an entrepreneur and with many years in business leadership, it is innate in her to discuss social issues with the intent of finding solutions, or at least of exploring possibilities. She champions mental health, diversity and inclusion — and volunteerism in Parliament.
She is also an impact entrepreneur/investor and a passionate mental health advocate, especially in workplace wellbeing. She started WorkWell Leaders Workgroup in May 2018 to bring together top leaders (CXOs, Heads of HR/CSR/D&I) of top employers in Singapore (both public and private) to share, discuss and co-create inclusive practices to promote workplace wellbeing. Anthea is also the founder of Hush TeaBar, Singapore’s 1st silent teabar and a social movement that aims to bring silence, self care and social inclusion into every workplace, every community — with a cup of tea. The Hush Experience is completely led by lovingly-trained Deaf facilitators, supported by a team of Persons with Mental Health Issues (PMHIs).
Follow Anthea Ong on her public page at www.facebook.com/antheaonglaytheng