Introduction Worker Employer WCB Care Provider

Submit Register Initial Adjudication Pay Manage Return to Work

Submitting a Claim Fax Mail Online Telephone- Inquiry Line

Duty of Employer to Notify Board of Injury Duty of employer to notify board of injury 52 Within five days after the date on which an employer becomes aware of an injury that prevents a worker from earning full wages or that necessitates medical aid, the employer shall notify the board in writing of: (a) the nature, cause and circumstances of the injury; (b) the time of the injury; (c) the name and address of the injured worker; (d) the place where the injury happened; (e) the name and address of any physician who attends the worker for his or her injury; and (f) any further particulars of the injury or claim for compensation that the board may require.me and address of the injured worker;

Medical Report or Invoice Registering a Claim W1 E1 Key information: SIN, PHN, DOB, Phone Number Medical Report or Invoice

Arising out of employment? Initial Adjudication Arising out of employment? Happen at a time and place related to employment and; Be the direct result of an activity performed for employment

Initial Adjudication Is the cause of injury the same as provided by worker and employer Compare the diagnosis with description of the injury Is the cause and effect probable; What is the extent of the injury

Initial Adjudication Pre-existing Conditions, POL 01/2000 Operations staff must determine the answer to a number of questions of medical fact: The extent of the work injury, which is essentially a matter of diagnosis. Whether or not the worker has recovered from the work injury, and Whether and to what extent a pre-existing condition has been aggravated or accelerated by the work injury.

Paying a Claim Wage Loss Travel Expenses Prescriptions Personal Care Prosthetics

Managing a Claim Promoting Recovery and Return to Work Gathering and Assessing Information Defining the Extent of Injury Making and Communicating Decisions Expediting Medical Care

Dealing with complications Managing a Claim Dealing with complications Diagnostic Changes Pre-existing Conditions Barriers to Recovery Barriers to Return to Work Chronic Disability Risk Factors

Managing a Claim Second Injury Fund Shall be used to pay part of the cost of the claims of workers’ which have a greater detrimental effect because of a pre-existing disability or condition. The costs are borne by the industry as a whole rather than by an individual employer or a class or sub class of employers.

Hierarchy of Return to Work Options Pre-injury Employer Pre-injury Job Pre-injury Employer Similar Job Pre-injury Employer Different Job Different Employer Similar Job Different Employer Different Job

Return to Work Leveraging Existing Skills and Abilities Consider Labour Market Trends Assess the Workers Interests Weighing Options Making the Best Choice

Earnings Replacement Partial or Full Return to Work Earnings Replacement Partial or Full Determined After all efforts to fully eliminate the worker’s wage loss benefits have been exhausted Based on expected earning capacity until the worker reaches age 65 Physical restrictions, age, local, qualifications and job markets all factored into decision

In Summary Adjudication is not an exact science It’s important work we do and how we do it matters It could not be done without the efforts and collaboration of the care provider, employer, worker, and the WCB When “I” is replaced with “We”- even illness becomes Wellness

QUESTIONS