2. Introduction
Worker
Employer
WCB
Care Provider

3. Submit Register Initial Adjudication Pay Manage
Return to Work

4. Submitting a Claim
Fax
Mail
Online
Telephone- Inquiry Line

5. 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;

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

7. 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

8. 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

9. 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.

10. Paying a Claim
Wage Loss
Travel Expenses
Prescriptions
Personal Care
Prosthetics

11. 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

12. 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

13. 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.

14. 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

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

16. 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

17. 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

18. QUESTIONS