Consent form decision imposes strict transparency requirement for handling employee medical information

Disputes about employer medical information consent forms are now common. It’s not hard to pick apart a form, and employers tend to suffer “cuts and bruises.” In once such case an arbitrator has recently held that an employer must identify “anyone with whom the information would be shared” in a consent form. The arbitrator also held that an employer must subsequently (and seemingly proactively) give notice of who is handling information:

I agree with the employer that it is not practical to obtain a new consent every time a manager or HR Specialist who is absent is temporarily replaced. However, the employer must advise the employee of the employer’s need and intention to share health information with a replacement and identify that individual by name and title. This would enable the employee to revoke the consent if he/she does not wish the health information to be shared with the individual replacing the manager or HR Specialist. If and when it becomes necessary to share health information with HR or legal services in order to seek advice, or to obtain approval from senior management with delegated authority, the employee should be informed of the title or office only of the person with whom information will be shared. The employee’s consent would not be required for the employer to be able to do so.

While there’s no debating an employee’s right of control, the degree of transparency required here is very high and operationally challenging in the least. “Person-based consents” (as opposed to “purpose-based consents”) can also restrict important flows of information in subtle yet problematic ways.

The best argument against person-based consents is one that refers to the public policy that is reflected in the Personal Health Information and Protection Act (which does not govern employers acting as employers except via section 49). Even in the health care context – where the standard should be higher, not lower than in the employment context given the limited range of information processed by employers – consent is deemed to exist for a certain purpose and information can flow to any health care provider for that purpose. This is subject to a “lock box” that gives patients the ability to shield their information from specific individuals, but the lock box essentially functions as an opt out. (For the nuances of how PHIPA’s “circle of care” concept works, see here.) Transparency is satisfied by the publication of a “written public statement” (a policy really) that “provides a general description of the custodian’s information practices.” There’s no reason to require more of employers.

OPSEU and Ontario (Treasury Board Secretariat), Re, 2017 CarswellOnt 11994.

Privacy and accommodation of disability in Ontario

Last week I sat on a panel about privacy and the accommodation of disability. I sat opposite union counsel Andrew Astritis from Raven Cameron, and Emma Phillips of Goldblatt Partners moderated. Andrew and Emma both know privacy law well, and we had a fun, engaging and even balanced discussion! I’ve put my “paper” and speaking notes below.

Wellness be dammed – universal medical assessments not allowed

On November 12th, Arbitrator Dorsey held that an employer could not implement universal “fitness for duty” testing.

The program would require drivers responsible for carrying liquid and compressed gas to be tested once every five years. The employer framed the testing as fitness for duty testing, but the program featured urinalysis and bloodwork to look for “disorders, including anemia, infection and leukemia.” In other words, the program looked (at least partly) rooted in the promotion of wellness, though requiring employees to participate in a wellness program with an (invasive) medical assessment feature is aggressive by Canadian standards, if not unprecedented.

Arbitrator Dorsey appeared to appreciate this problem, and decided the matter by finding that the particular collective agreement provision upon which the employer relied did not have the “clear and express language” necessary to authorize universal testing. He also said that truck transportation is not so safety sensitive an endeavour “regardless of the nature of the product being transported” to justify an exception to normal preference for individualized, for cause testing.

Teamsters Local Union No 213 v Linde Canada Limited, 2015 CanLII 73757 (BC LA).

Arbitrator awards damages for substance abuse counsellor’s indiscretions

On June 15th, Arbitrator Michel Picher awarded damages to three employees for the indiscretions of a substance abuse counsellor retained by an employer to provide treatment as part of its substance abuse program. Arbitrator Picher:

  • awarded $5,000 to an employee because the counsellor disclosed his cancer diagnosis to the employer without justification and because the counsellor had counselling sessions with the employee in various public places (including Tim Hortons and Home Depot);
  • awarded $2,500 to an employee because the counsellor answered a telephone call and engaged in a discussion about “sensitive matters” while sitting with another employee (also a client); and
  • awarded $1,500 to the employee who overheard the telephone call because it “would undermine [his] expectation of privacy and confidentiality in communications with [the counsellor].”

The employer argued it hired a reputable provider and was unaware the serious allegations made agains the counsellor until after the union filed a grievance. Arbitrator Picher’s response reflects the approach taken in finding employers liable for workplace harassment (see Robichaud). He said, “The employer cannot disavow or escape responsibility for the actions of its chosen agent and must bear liability for any violation, in the course of his duties, of the rights of the employees in the bargaining unit for which he was responsible.”

Halifax Employers Assn. and ILA269 (2014-L-39), Re, 2015 CarswellOnt 10497.

Ontario arbitrator partly allows medical information management grievance

On October 8th, Arbitrator Goodfellow partly allowed a grievance that challenged various ways in which an employer administered its sick leave program. In doing so, he held that:

  • absent an express prohibition in a collective agreement, an employer is entitled use a third-party disability management administrator; and
  • absent specific collective agreement authorization, an employer cannot deprive employees of sick pay pending proof of entitlement as a matter of routine.

Arbitrator Goodfellow also made the following statement on the application of Ontario PHIPA to employers:

We agree with the Employer that it is not bound by PHIPA in its relationship to its employees. Qua long-term care provider the Employer is a “health information custodian”; qua employer it is not: see e.g. City of Kingston and Canadian Union of Public Employees, Local 109, supra.  The same is therefore true of Acclaim. PHIPA is aimed at health care providers, not employers. Neither of the cases referred to by the Union establish otherwise. While both discuss the statute, and while Sanofi Pasteur appears to accept its application, there is no indication that the matter was the subject of any submissions in those cases as it was here and in City of Kingston. Having said that, like those arbitrators, we would view the terms of PHIPA as reflecting the kinds of privacy interests to which the Employer may be held accountable under the terms of the collective agreement.

This is a helpful statement given the confusion in the case law to which Arbitrator Goodfellow refers.

Revera Long Term Care Inc (Stoneridge Manor) v Canadian Union of Public Employees, Local 2564, 2014 CanLII 58768 (ON LA).

Arbitrator orders damages for employer’s unauthorized call to personal doctor

On September 25th the Grievance Settlement Board ordered the province to pay $2,500 in damages for making an authorized call to an employee’s personal doctor. Vice-Chair Fisher based the award on the province’s failure to respond appropriately to the breach and evidence of mental distress:

However the Grievor is also entitled to a further remedy for this serious breach of the MOS. I am deeply troubled by the fact that Ministry apparently made no attempt to ascertain who in fact made this improper phone call. One would think that the Ministry would have some interest in trying to determine who in fact made such an inappropriate phone call, but apparently they did not.

The Grievor indicated that these series of events caused him distress and that he felt disgusted by the actions of the person whom made the call to his doctor without his consent. The Grievor is entitled to monetary damages for his distress. Although he did not receive any medical attention for this distress, it does not mean that his distress was not real.

The Union proved the call and not the identity of the caller, but the province did not take steps to rebut the inference that the call came from someone in its employ. The caller obtained information about appointments the grievor had attended from a medical secretary who was subsequently reprimanded for her breach.

Ontario Public Service Employees Union (Spicer) v Ontario (Labour), 2013 CanLII 72580 (ON GSB).

Case Report – Order to attend assessment following employee’s aggressive outburst not discriminatory

Yesterday, the Court of Appeal for the Yukon Territory affirmed a decision of a Yukon Human Rights Board of Adjudication. The Board had held that an employer did not discriminate against an employee with a bipolar condition by suspending him pending a medical assessment. It held that the employer ordered the assessment based on an observation of objectively concerning behavior rather than on any stereotypical assumptions about the employee’s disability:

Whether Mr. March’s conduct was disruptive and inappropriate or not was a question of fact. The evidentiary facts were largely undisputed and the primary task of the Board was to resolve the conflicting interpretations and decide whether Mr. March’s conduct was disruptive and inappropriate. The issue involved an individualized assessment of particular facts. The Board heard the evidence and concluded that Mr. March’s conduct was disruptive and inappropriate and the respondents acted reasonably in the circumstances in removing him from the workplace pending a medical assessment. The action taken was temporary and responsive to the disruptive conduct and not an arbitrary reaction attributable to a discriminatory stereotyping of his disability. Instead, it was directed to ascertaining the cause of his conduct, and deciding how it should be addressed.

Though employers do have a general right to request medical information in circumstances similar to those demonstrated in this case, the employer here had accommodated the employee for years and further helped its case by making a genuine expression of continued support for the employee at the same time as making its direction.

March v. Yukon (Human Rights Board of Adjudication), 2010 YKCA 3.