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Making a Claim on the State: the Experiential Accounts of Repetitive Strain Injury Sufferers in Different Policy Regimes

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Making a Claim on the State: the Experiential Accounts of Repetitive Strain Injury Sufferers in Different Policy Regimes Making a Claim on the State: The Experiential Accounts of Repetitive Strain Injury Sufferers in Different Policy Regimes by Friskjen M. van Veldhoven, B.A. (Hons.), M.A. A thesis submitted to the Faculty of Graduate Studies in partial fulfillment of the requirements of the degree of Doctor of Philosophy Carleton University Ottawa, Ontario March 17,2005 © Copyright 2005, Friskjen M. van Veldhoven Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Library and Bibliotheque et 1*1 Archives Canada Archives Canada 0-494-06747-0 Published Heritage Direction du Branch Patrimoine de I'edition 395 Wellington Street 395, rue Wellington Ottawa ON K1A0N4 Ottawa ON K1A 0N4 C an ad a C an ad a NOTICE: AVIS: The author has granted a non­ L’auteur a accorde une licence non exclusive exclusive license allowing Library permettant a la Bibliotheque et Archives and Archives Canada to reproduce, Canada de reproduce, publier, archiver, publish, archive, preserve, conserve, sauvegarder, conserver, transmettre au public communicate to the public by par telecommunication ou par I’lnternet, prefer, telecommunication or on the Internet, distribuer et vendre des theses partout dans loan, distribute and sell theses le monde, a des fins commerciales ou autres, worldwide, for commercial or non­ sur support microforme, papier, electronique commercial purposes, in microform, et/ou autres formats. paper, electronic and/or any other formats. The author retains copyright L'auteur conserve la propriete du droit d'auteur ownership and moral rights in et des droits moraux qui protege cette these. this thesis. Neither the thesis Ni la these ni des extraits substantiels de nor substantial extracts from it celle-ci ne doivent etre imprimes ou autrement may be printed or otherwise reproduits sans son autorisation. reproduced without the author's permission. In compliance with the Canadian Conformement a la loi canadienne Privacy Act some supporting sur la protection de la vie privee, forms may have been removed quelques formulaires secondaires from this thesis. ont ete enleves de cette these. While these forms may be included Bien que ces formulaires in the document page count, aient inclus dans la pagination, their removal does not represent il n'y aura aucun contenu manquant. any loss of content from the thesis. ■ * i Canada Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Abstract This thesis is a comparative analysis of workers who suffer with a repetitive strain injury and their experiential accounts of being faced with the process of claiming workers’ compensation in the Netherlands and Ontario. Comparative policy regime theorists tend to examine policies between jurisdictions at the structural or policy level. It is at this level that they assess social citizenship rights within social policy regimes. I argue, however, that it is misleading to observe the structural level alone. It is also revealing to examine the experiences of those who have the option of making claims on the state. The process of their claims-making activities qualifies the realization of social citizenship. Two social policy regimes are compared. Each approaches the issue of worker injury policies in a very different manner. The policies in place at the structural level differ in significant ways between these two jurisdictions. In the Netherlands the system seems relatively more generous. An injured worker, prior to accessing the workers’ compensation system, is afforded a paid fifty-two week waiting period. This is not the case in Ontario. Given this it would then be reasonable to expect that the process of claiming workers’ injury benefits would differ at the individual or experiential level across these two jurisdictions. A more detailed look at the experiential accounts of injured workers in both policy regimes, however, finds that workers who suffer from a repetitive strain injury and who opt to make a claim have similar experiences in both jurisdictions. This is accounted for by the practice that both policy regimes use medical gatekeepers to govern the access of injured workers to the process of making a claim. Based on this finding, I contend that researchers interested in comparative analysis of welfare states should not focus solely on the manifest policy differences at the structural level but should also investigate the processes by which individuals access policies and their experiences in terms of the procedural practices with these policies, so that a deeper understanding of barriers to the realization of social citizenship rights can be achieved. ii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Acknowledgements This project would not have been possible without the generosity of the injured workers who participated in the study. Their trust, candidness and cooperation are deeply appreciated. I would especially like to thank my committee for their help and direction, while at the same time challenging me during the research process and writing of the dissertation. To my supervisor, Dr. Wallace Clement I would like to express my sincerest gratitude for his guidance, understanding and encouragement during some very difficult times. As well, I thank Dr. Janet Siltanen for her insights, valuable comments, sensitivity and generous support and Dr. Gail Fawcett for her assistance, suggestions and contributions. A special word of thanks to Paul, my life partner, who stood by me throughout the entire process without fail and my two beautiful daughters, Nicole and Rachel, who believed in me. As well, I thank my parents, siblings and other family members who patiently gave me their support in many different ways. I dedicate this dissertation to my father Dr. Michael van Veldhovenwho will always be very special to me! iii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Table of Contents A b stract.................................................................................................................................................. ii Acknowledgements ........................................................................................................................... iii T able of C on ten ts...............................................................................................................................iv List of Appendices ..............................................................................................................................vi Chapter 1 - Repetitive Strain Injury Sufferers and Social Policy Regimes .....................1 Introduction .................................................................................................................................... 1 Overview of This Dissertation ..................................................................................................5 Repetitive Strain Injury - The Name Game .........................................................................12 The Research Process ............................................................................................................... 18 Interpretive Approach ...............................................................................................................20 Physicians: A Tension Between the Local and the Extra-Local.................................... 22 Organization of this Dissertation ...........................................................................................26 C laim s...........................................................................................................................................28 Chapter 2 - Locating This Dissertation .....................................................................................32 Introduction ................................................................................................................................. 32 Ruling Relations: The Local and Extra-local ...................................................................... 34 Social Problems Work and Claims Making Activities .....................................................36 Social Policy Regimes............................................................................................................. 39 Commodification/Familialization ......................................................................................... 44 Gender and the Welfare State ................................................................................................ 48 Alternative Formulations .........................................................................................................52 Disability......................................................................................................................................56 Path of Dependency ..................................................................................................................58 C onclusion .................................................................................................................................. 64 Chapter 3 - Methodological Considerations and Collection of the D ata .......................67 Introduction ................................................................................................................................. 67 Why Not Institutional Ethnography? ....................................................................................69
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