Grievance Case Summary - G-245

The member submitted a grievance against a decision denying him medical coverage for sunglasses. He had a prescription from a medical doctor and one from an optometrist. An ophthalmologist had diagnosed him as having photophobia and recommended that he wear sunglasses in bright sunlight, but did not issue a prescription. The Force found that the member was not entitled to sunglasses at Force expense, as he did not have a prescription from an ophthalmologist and he did not suffer from one of the listed conditions in the relevant policy for which coverage was provided. Both the Grievance Advisory Board and the Level I adjudicator agreed, and the grievance was denied.

On February 15, 2000, the ERC issued its findings and recommendations. The Committee found that, while the Force had denied the request for coverage on the basis of the Force's own policy on entitlement to medical benefits, which was not an issue that was referable to the Committee within section 36 of the RCMP Regulations, the matter did raise a question of occupational health and safety, which the Committee had jurisdiction to examine.

The Committee found that the member's occupational exposure to sunlight, in and of itself, entitled him to the eye protection envisaged in the Force's Health and Safety chapter of the Administration Manual at AM II.19.H.8. It should have been clear from the outset that he was entitled to at least the coverage offered to all of those members whose work is "outdoors for the greater part of a shift during daylight hours". This allowance comes directly from the Force's obligations to protect the occupational safety and health of its employees, and is not a question of entitlement to medical benefits coverage.

What should also have been examined was whether the member's light sensitivity and need for sunglasses were caused by, or exacerbated by, his exposure to sunlight while he worked on highway patrol, and whether the Force might therefore have an increased responsibility to ensure his safety by paying for prescription sunglasses in full. On this question, the Committee found that the evidence failed to establish that the member's light sensitivity and resulting prescriptions for sunglasses gave rise to any further obligation on the Force to provide coverage above that provided for at AM II.19.H.8. While there was a suggestion by the member that his optometrist had found that his condition resulted from eye damage caused by exposure to light, the ophthalmologist's report indicated that "no organic reason for the photophobia could be found". Therefore, while the member's photophobia undoubtedly caused him some discomfort, that fact alone did not make his condition attributable to an occupational health and safety hazard, and there was nothing to suggest that it might become one.

The Committee recommended that the member be reimbursed the purchase of UV eye protection in accordance with the provisions of AM II.19.H.8.a.6 up to a maximum of $25. This recommendation did not address any possible entitlement under the Force's Medical and Dental Treatment Programs chapter, AM II.18. By reason of the wording of section 36 of the Regulations, the Committee had no jurisdiction to make a recommendation on that issue.

On March 15, 2000, the Acting Commissioner Allen rendered his decision. His decision, as summarized by his office, is as follows:

The grievance was not referable to the External Review Committee under paragraph 36(a) of the Regulations. The grievance should not however, be returned without a decision being made. The member was entitled to reimbursement of $25.00 in accordance with the Force's policy on occupational health and safety.