Workplace injuries have the potential to significantly impact an employee’s life. Every situation is different – workers may require various types of assistance after the occurrence of a workplace injury depending on their circumstances. It is important to familiarize yourself with your rights, which is why the Workers’ Compensation Board – Alberta established the Code of Rights and Conduct in 2018.
Whether it is navigating insurance, premiums, and claims, or seeking recovery and back-to-work resources, our Edmonton work injury lawyers at Verhaeghe Law may be able to assist you. Addressing the needs of each individual client, they may provide necessary information to ensure you receive appropriate workers’ compensation.
To learn more, contact us today to book a consultation with our Edmonton WCB lawyers.
Coverage and Benefits
In Alberta, workers’ compensation is administered by the province’s Workers’ Compensation Board (WCB), which also provides support to those who have experienced a workplace injury.
The WCB functions in accordance with the Workers’ Compensation Act and three associated regulations: The Workers’ Compensation Regulation, the Medical Panels Regulation, and the Firefighters Primary Site Cancer Regulation. In Alberta, WCB coverage is obligatory for numerous industries.
Workers’ compensation benefits exist to help injured workers during their recovery and streamline their return to work. They may include coverage for medical treatment, rehabilitation services, expense reimbursement, disability benefits, and wage replacement (partial income replacement).
Occasionally, disputes might emerge regarding your benefit eligibility. These discrepancies may involve wage substitution, medical care coverage, rehabilitation assistance, or disability benefits.
Steps to Reporting an Injury
If you get hurt at work, it is your responsibility to take the necessary steps to report the injury and file a claim. First, the injured worker should inform their employer about the incident, telling them exactly what happened to cause the injury/illness.
If you require medical treatment beyond first aid or you cannot continue in your job because of the accident, the employer is then required by law to report the injury to the WCB within 72 hours. Then, the injured party should inform their health care provider, who is also required by law to report your injury to the WCB within 48 hours.
The next step would be to immediately complete a WCB report of injury, which will detail the injury/illness and how it occurred. This form is available through your employer, online, or at any WCB office. The WCB will use all this collected information to determine the classification and status of your claim.
Types of Claims
After reporting the injury, the WCB will register your claim as one of these three options:
- Lost-time claim: Through this process, your claim will be assigned to an adjudicator who will determine the benefits to which you are entitled. Your claim may be transferred to a case manager if additional rehabilitation is necessary to return to work.
- No-time-lost claim: This may be assigned to you if you did not miss any work beyond the day of injury. The process team will still monitor for medical treatment.
- Interjurisdictional claim: If you are not a resident in the province you get hurt in, you can decide to start a claim in the province of employment or your home province, depending on personal preference.
Some workers may require legal assistance when claims get complex. This may occur when there are disputes about the degree of the injury, entitlement to particular benefits, or the extent of a disability. Claims may get complicated when they involve multiple medical assessments or are multifaceted in nature.
Our team may be able to assist injured workers through difficult claims processes. Contact us today to learn more and speak to our professional team.
Claims Decisions and Disputes
Once submitted and reviewed, claims can be accepted, not accepted, pending (no decision has yet been made), processed (the claim has been registered and medical costs are being covered, but the claim itself has not yet been reviewed), or under medical investigation (additional medical assessments may be required). If your claim is accepted, the adjudicator will contact you to discuss benefit entitlement and other supporting services.
A claim may be rejected if it was determined that the injury was not caused at work, the claim was not filed within 24 months of the incident, your employer is not required to have workers’ compensation and did not purchase it, or if there was not enough information to support your claim.
If a claim is denied or disputed by the WCB, a lawyer may be able to assist you through the process of appealing a claim. They may also be able to review your case, compile other evidence, and represent you during hearings and appeals.
Recovery and Returning to Work
Each workplace injury claim is uniquely built to suit a person’s specific recovery needs. Benefits and services are determined based on what may be necessary to help a worker return to their job in a timely manner. Through the WCB, there are many treatment and recovery options available for those who need it.
Your adjudicator or case manager, employer, and health care provider work with you to develop an attainable plan for returning to work. Goals can be set along the way to help actualize your decided timeline. Then, your case manager will assess your medical reports to determine when you can safely start working again. Sometimes, workers may set up temporary job modifications so they can return to work while recovering.
Should disagreements arise concerning your plan for returning to work, necessary accommodations, or alterations to your job responsibilities following an injury, a lawyer can aid in discussions with the Workers’ Compensation Board or your employer.
Contact us at Verhaeghe Law to learn more about workers’ compensation rights, return to work plans, and how to appeal a claim.
Schedule a Consultation Today with Our Work Injury Lawyers
Although employers, associations, and governing bodies all strive to establish the safest working conditions, it is still possible to get injured at work. Familiarizing yourself with the WCB process may be helpful should you one day have to file a claim.
It is also important to know where to go if you need legal assistance with workers’ compensation. Even if your claim seems uncomplicated, pursuing legal counsel at the onset may be beneficial in the long run.
Verhaeghe Law lawyers are well-versed in workers’ compensation law and may offer counsel on your entitlements, clarify the procedures involved, and ensure that you are treated fairly throughout the entire claims procedure.
Contact us today to book a consultation and learn more about how we may be able to help you navigate workers’ compensation.
** Please note, this article is intended as a general overview on the subject of workers’ compensation, and is not intended to be legal advice. If you are seeking legal advice, please consult with an Alberta WCB lawyer.