Precarity is a type of insecurity which treats people as disposable so as to impose control. Precarity differs from misery in that the necessities of life are not simply absent. They are available, but withheld conditionally.The Institute of Precarious Consciousness
The self-declared social democrats of Australia continue to tighten their grip on services for the most vulnerable in the community, placing the perception of fiscal responsibility over the lives of workers. The premier of Victoria recently announced the state’s intention to restrict access to WorkCover payments for workers experiencing psychological injury as a result of their employment. Under these changes (to take place from 2024 pending the passage of new legislation), workers with psychological claims will no longer receive weekly benefits and will have payments of treatment for their injuries capped at thirteen weeks. They will also be shepherded back to the site of their injuries by the new agency Return to Work Victoria (which appears to be missing an exclamation mark).
A Monash research paper authored by Marianna Stylianou in 2011 provides a concise history of WorkCover in Victoria. The WorkCover scheme was established by the Cain government in 1985, as WorkCare. Crucially, it was born of compromise. The government had wanted to replace the private workers compensation sector with a public system, but was unable to get support in parliament to pass the version of the scheme they preferred, and employer groups were active in lobbying for the state government to act to reduce their insurance premiums rather than regulate their health and safety practices. Instead, they ended up with a government agency underwriting a private market, but with some limits on who could participate. At the time it was established there were nine private insurers, a vast contraction of the 60 + operating in the market in the 1970s; currently there are five (Allianz, CGU, EML, Gallagher Bassett and XChanging). In 1992 the Coalition under Jeff Kennett, motivated again by employer groups, restricted benefits and workers’ rights under the scheme in order to reduce business insurance premiums, replacing the WorkCare scheme with WorkCover.
So who is most at risk under the announced changes? A study from 2022 notes that Social and Care Work settings feature almost twice as many claims with the NSW work cover scheme ICare as other sectors. Researcher Alex Collie said in an interview with The Sydney Morning Herald that a large amount of labour is lost due to the time needed to recover from psychological injury, with ‘3540 lost full-time equivalent working years’ over the nine year period of the study. In 2015 Monash University conducted a study of Australian Education Union members which found that over half of respondents had experienced injury or illness due to workplace stress. More recent accounts indicate that up to half of teachers intend to leave the profession in the next five years. This indicates that the risk of psychological injury remains disturbingly high, and a consequence of this is a loss of experienced workers in areas of the economy where staffing shortages are already endemic.
Psychological injuries have historically been addressed poorly by WorkCover agents in any case. In 2016, Victorian Obmudsman Deborah Glass released a report in response to numerous complaints regarding WorkCover insurers. She found strong evidence to demonstrate that agents were ‘cherry picking’ evidence to lead to terminations and ‘doctor shopping’ for medical examiners who would give them the outcomes they wanted, and of financial incentives for agents to terminate WorkCover claims. A high number of these so-called ‘complex cases’ related to psychological injury, from stress, trauma and assault in the workplace, and spoke to a lack of expertise or interest on the part of agents in addressing these claims appropriately, driven as they were by the bottom line of the privately owned organisations that manage claims under the scheme. Meanwhile the skeleton government agency that provided oversight to the program was only able to audit a fraction of the cases, and might only become involved when a decision was disputed.
In a particularly chilling case included in Glass’s report, a participant in the scheme died by suicide shortly after their claim was reinstated by a medical panel. The insurer CGU had requested an independent medical review of the claim that this person (anonymous in the report) had ongoing incapacity resulting from a sexual assault in the workplace. The claim had initially been denied by CGU, and was only acted on after the claimant took the matter to the Magistrates Court. Subsequently, the treating psychiatrist requested participation in supportive programs, which triggered CGU to request this independent medical review. The reviewer provided a different impression to the treating physician and to previous medical examiners, but noted that they had not been provided with any of the historical information. On the basis of this review, CGU terminated the claim, and it was only after the person took the matter to conciliation and it was referred to a medical panel that the claim was reinstated. It would be crude to speculate on the extent to which these events may have contributed to the death of this person. CGU said of the incident that ‘the indications are that there are matters outside of just the work related component that may have contributed [to the suicide]’.
As a result of the report, the state government commissioned an independent review conducted by Peter Rozen QC. Soberly, Rozen noted that the scheme ‘is a hybrid of a private insurance scheme and a centrally funded scheme which has some of the worst features of each and few of the benefits’. Additionally, and crucially for the government’s claim of re-prioritising the financial health of the scheme, he wrote that ‘for too long financial sustainability has been prioritised over the health of individual workers’. Rozen also took on the question of psychological claims, coming to the conclusion that agents lack specific expertise managing claims of a non-physical nature. This is revealed in the obstinate use by agents of an outdated ‘biomedical’ model in assessment of psychological claims. By way of comparison, the report includes reference to the Transport Accident Commission, a parallel scheme which has remained firmly in state ownership. The TAC has adopted an interdisciplinary case management approach after reviewing its practices in regards to the kinds of sustained injuries which may occur indirectly as a result of road accidents. The difference in delivery model speaks to the value of having essential services that provide for the wellbeing of the population held in public hands rather than pawned off to for-profit insurers.
The purpose of workers compensation, at a fundamental level, is twofold: to provide workers with financial support to lead a dignified life when injured in the workplace, and to motivate employers to introduce protective mechanisms to prevent injury in the first place. The interests of business owners and for-profit insurers have ensured that these objectives have always been compromised, resulting in the government footing the bill for degrading treatment of injured workers by the private sector and no accountability for agencies to reform their practices to prioritise the worker. The contradictions of a workers’ compensation scheme which underwrites private insurers has been apparent since its inception, and the publicly owned model exemplified by the TAC proves that alternatives are within reach. Meanwhile, psychological injuries have expanded apace, particularly for those in the caring professions, who face ever higher burdens on their labour as the State and Commonwealth demonstrate their commitment to maintaining the status quo rather than to structural transformation.