LCQ1: Employees' compensation

     Following is a question by the Hon Pan Pey-chyou and a reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (December 8):


     Under the existing Employees' Compensation Ordinance (the Ordinance), an employer is liable to pay compensation in respect of injuries sustained by his employees as a result of accidents arising out of and in the course of employment; or in respect of occupational diseases suffered by his employees, which are covered by the Ordinance, and have resulted in incapacity or death.  However, the protection provided by the Ordinance does not cover mental illnesses directly caused by employment or mental impairment directly caused by an accident in the course of employment, making it difficult for the affected employees to obtain compensation.  In this connection, will the Government inform this Council:

(a) whether it knows, in the past three years, among the new psychiatric cases handled by the Hospital Authority (HA), the number of cases in which the patients' mental illnesses had been caused by the injuries of the patients sustained in the course of employment; whether HA, the Labour Department or other government departments have offered assistance to such employees suffering from mental impairment (e.g. providing continued care and rehabilitation services, and assisting them in seeking re-employment, etc); if so, of the details, and the number of such cases handled by the authorities in the past three years;

(b) in the past three years, among the employees' work injury cases assessed by the Occupational Medicine Unit of the Labour Department, of the number of cases which did not involve any physical injuries but only mental impairment; of the results of assessment of work injuries for such cases; whether the authorities will clearly define "mental impairment" and issue guidelines in this respect, so as to state clearly that in case an employee suffers from a certain type or certain degree of mental impairment arising out of employment, the employer must report the case as work injury and offer compensation to the employee concerned; if the authorities will not do so, of the reasons for that; and

(c) given that post-traumatic stress disorder has been included by the International Labour Organisation (ILO) in its 2010 updated list of occupational diseases, whether the authorities will follow such standard set by ILO and expeditiously amend the relevant provisions in the Ordinance by including in the list of occupational diseases mental impairment directly caused by an accident in the course of employment and mental impairment and illnesses directly arising out of employment, so that employees suffering from such illnesses can receive compensation; if so, of the timetable for introducing the relevant amendments; if not, the reasons for that?



     Under the Employees' Compensation Ordinance (ECO), employers are required to provide compensation to their employees who sustain injuries in accidents arising out of and in the course of employment, provided that it can be substantiated that the sufferings, including mental impairment, are related to the work accidents and have caused temporary and/or permanent loss of earning capacity to the employees. If the employees have health problems caused by prolonged exposure to hazards and contract an occupational disease specified in the ECO, resulting in temporary and/or permanent loss of earning capacity, the employees would also receive compensation.  Furthermore, irrespective of whether the employees have suffered from mental impairment owing to work injuries or mental illness related to their work, the Hospital Authority (HA), the Social Welfare Department (SWD) and the Labour Department (LD) provide a full range of medical, welfare, rehabilitation and employment services to assist them to recover swiftly and to integrate into the community and resume working. My reply to the three parts of the question raised by Dr Hon Pan is set out below:

(a) HA provides appropriate and adequate healthcare services to members of the public, including providing treatment to those who have sustained injuries arising from their employment. For patients suffering from mental illnesses, including those suffering from mental illnesses related to their work, HA provides a range of services including assessments on their conditions (such as mental conditions and the ability to manage daily living and to work) and  treatment and support (such as drug therapy, cognitive behavioural therapy, stress management skills and vocational rehabilitation) to facilitate their early recovery. HA has not compiled statistics on the causes of the mental problems among the cases handled by its psychiatry departments.

     On welfare and rehabilitation, SWD provides a series of services to support and assist those persons suffering from mental ordeal or emotional distress arising from their work in integrating into the society.

     At present, SWD and non-governmental organisations operate 61 Integrated Family Service Centres and two Integrated Services Centres throughout the territory to provide individuals and families in need, including persons suffering from mental ordeal or emotional distress arising from their work, with preventive, supportive and therapeutic welfare services.  

     SWD also co-ordinates a series of day training and vocational rehabilitation services for persons with disabilities aged 15 or above to improve their social adjustment capabilities and enhance their social and vocational skills.  

     On community support, SWD has implemented the Integrated Community Centre for Mental Wellness (ICCMW) to provide one-stop community support and integrated rehabilitation services for the discharged mental patients, persons with suspected mental health problems, family members/carers and residents interested in understanding and improving their mental health.  The services include outreaching visits, therapeutic groups, training and activities centre services, visiting occupational therapy and public education.  Through an integrated service mode, ICCMWs aim to enhance the resilience of service users, help them acquire social and vocational skills and raise public awareness on mental health.  Generally speaking, a substantial number of persons with disabilities receiving rehabilitation services are suffering from multiple disabilities.  Hence, SWD is unable to provide details by categories of the disabilities of persons with disabilities.

     The Selective Placement Division (SPD) of LD provides free employment service to persons with disabilities who are fit for open employment, including those with ex-mental illness, to find jobs in the labour market.  

     LD has not kept any statistics concerning the mental impairment cases caused by work handled by HA on which subsequent assistance on re-employment has been provided by SPD.

(b) According to the ECO, if employees sustain injuries in accidents arising out of and in the course of employment, employers are liable to pay compensation under the ECO.  Subject to the circumstances of individual accident cases, injuries sustained by these employees could include injuries to limbs and body parts, functional impairment of organs and mental impairment, etc.  In the past three years, among the employees' compensation claims processed by LD where employees' compensation assessments on mental impairment are required, the majority of them also involved injuries to limbs and body parts and/or functional impairment of organs to different extent.  There were very few cases solely involving mental impairment, including five cases respectively in 2008 and 2009, and four cases in the first three quarters of 2010. Examples of these cases included employees witnessing body falling from height or serious traffic accident in the course of their work, resulting in mental impairment. Depending on the circumstances of these cases, the assessed period of absence from work ranged from zero to 702 days and the permanent loss of earning capacity assessed ranged from zero to 40%. As clearly illustrated by these cases, if it can be substantiated that the mental impairment suffered by the employees are related to the work accidents they encountered, and have caused them temporary and/or permanent loss of earning capacity, the ECO already requires employers to provide compensation.

     On the notification of work injuries, employers are required to provide the Commissioner for Labour with information relating to the accidents in accordance with the ECO, including the course of the accidents, work being performed by the employees during the accidents, nature of the injuries and body parts injured, and types of accident, etc.  In respect of the nature of injuries, in making notifications, employers could make reference to relevant information such as impairments listed in sick leave certificates or medical reports, including mental impairment.  However, for cases involving mental impairment, especially those where symptoms only arise in a considerable period of time after the work accidents, employers may not be aware of the mental impairment caused to the employees at the time they submitted the notifications to LD.  In the course of sick leave clearance and arranging the employees to attend employees' compensation assessment, LD would clarify whether the employees are receiving treatment for mental impairment caused by the work accidents and, where necessary, seek for relevant medical reports.

(c) Post-traumatic Stress Disorder (PTSD) is one of the many types of mental impairment that could be caused by work incidents, and is usually the mental impairment caused by the encounter of serious work accidents, together with other bodily injuries and/or functional impairment of organs at the same time.  As mentioned earlier, the ECO has already provided mechanisms for handling injuries caused by work accidents to employees, including psychiatric impairment. Despite that PTSD is not prescribed as an occupational disease under the ECO, employees affected could in general claim compensation in accordance with the ECO if it could be substantiated that it is related to the work accidents concerned and results in temporary and/or permanent loss of earning capacity.

     The International Labour Organisation did list PTSD as an occupational disease earlier this year.  Nonetheless, countries which have prescribed certain diseases as occupational diseases, such as the Mainland of China, the United Kingdom and Singapore, have not added the disease to their list of occupational diseases.  LD will continue to keep in view international development in this respect and take account of Hong Kong's actual circumstances in considering whether it would be necessary to amend the ECO to prescribe PTSD as an occupational disease.

Ends/Wednesday, December 8, 2010
Issued at HKT 12:30