WORKING
TOGETHER
A LBE RTA WORKE RS’ C O M PE NS ATIO N BOARD ( WCB) RE V IE W
A GUIDE TO THE REVIEW OF THE
WORKERS’ COMPENSATION SYSTEM
2016/2017
TABLE OF CONTENTS
3 | MESSAGE FROM THE PANEL
4 | ABOUT THE WCB REVIEW
4 | ABOUT THIS DOCUMENT
5 | THE PURPOSE OF WORKERS’ COMPENSATION
Meredith Principles – The Historic Compromise
The WCB in Alberta
7 | THE WCB CLAIMS PROCESS
Determining a Claim’s Eligibility for Benefits
Determining an Accident Arose out of Employment
Specific Criteria for Determining Causation
Occupational Diseases and Psychological Injuries
When Determining a Cause is Impossible
Claims Involving Pre-Existing Conditions
Claims Management and Service Delivery
Medical Services
Resolving Disagreements About Medical Issues in a Claim
Returning to Work
Return to Full or Modified Duties at Original Employer
No Return to Original Employer
Investigations
16| WCB BENEFITS
Benefits Available to Workers
Loss of Earnings
Payments for Permanent Impairment
Spousal and Dependant Support
Economic Loss Payments After Retirement Age
Benefits Adjustments
Deeming Earnings
Non-Compliance and Effect on Benefits
Other Income Replacement Options for Workers 1 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
21 | REVIEW AND APPEAL OF WCB DECISIONS
The Disputes Resolution and Decision Review Body
The Appeals Commission
Alternative Dispute Resolution (ADR)
Reconsideration of Appeals Commission Decisions
Judicial Appeals and Reviews
Appointment and Funding of the Appeals Commission
Employer Appeals Consulting Service
Office of the Appeals Advisor
Privacy and Confidentiality
2 6 | WCB GOVERNANCE
Board of Directors of the WCB
WCB Corporate Objectives and Key Deliverables
Policies of the WCB
Review of the Workers’ Compensation System
2 9 | PREVENTION OF WORKPLACE INJURY AND ILLNESS
Role of WCB in Prevention
Certificate of Recognition
Safety Associations
Health and Safety Information
3 2 | FUNDING AND FINANCIAL SUSTAINABILITY
Employer Premiums
Industry Custom Pricing
Partnerships in Injury Reduction
The WCB Accident Fund
3 6 | Appendix
Appendix A: Workers’ Compensation vs Private Insurance
Appendix B: WCB Claim Statistics
Appendix C: Appeals Commission Statistics
Appendix D: Organizations Responsible for Occupational Health & Safety
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 2
MESSAGE FROM THE PANEL
As the members of the Workers’ Compensation Board (WCB) Review Panel, we are pleased
to invite you to engage in this review process. The last comprehensive review of the WCB
was conducted more than 15 years ago. The world has changed a great deal in that time.
The WCB provides coverage to over two million workers and thousands of employers across
the economy. Individual workers, large industries, small and medium-sized businesses,
unions, safety and industry associations, and other Albertans all have interests in the WCB.
Our Panel has extensive experience representing workers and employers through
Alberta’s workers’ compensation processes. However, as we work through many complex
issues, we need the input of Albertans to ensure we have a thorough understanding of
different perspectives.
In this Guide, we discuss many key areas of workers’ compensation in Alberta that are of
interest to stakeholders. The current state of legislation and policies are described as we
understand them to be. We know that workers, employers and other stakeholders have
many different views and experiences regarding how this is put into practice day-to-day.
Through this Guide, and its companion Workbook, we hope to gather and better understand
those different views. The information you share will guide our Panel as we further explore
the issues in the coming months.
We will be working hard to engage stakeholders throughout our review process. You all have
wisdom to share and unique ideas to provide about how the WCB should operate. By working
together, we will be able to develop recommendations for the Government of Alberta that are
practical to implement, meaningful to stakeholders, and productive in their impact.
We look forward to your submissions.
The WCB Review Panel
3 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
ABOUT THE WCB REVIEW
As part of the review of Alberta’s agencies, boards and commissions, the Government of
Alberta has appointed the panel to conduct a formal review of the workers’ compensation
system, which includes the Workers’ Compensation Board (WCB) - Alberta, the Appeals
Commission for Alberta Workers’ Compensation and the Medical Panel Office.
The review will help ensure that the WCB provides fair compensation and meaningful
rehabilitation in a way that is sustainable and affordable.
The WCB Review Panel will not be looking at specific claims as part of the mandate.
If you have questions or concerns about a specific claim, please contact the WCB at
www.wcb.ab.ca.
ABOUT THIS DOCUMENT
This Guide was developed to provide more detailed information about significant topics in
Alberta’s workers’ compensation system. The Guide is not intended to be a comprehensive
analysis of the workers’ compensation system. The content of this Guide does not reflect
existing or potential Government of Alberta policy.
You may find this Guide helpful in completing the WCB Review Workbook (available at
www.alberta.ca/wcb-review-get-involved.aspx). The Workbook is a companion document
that you can use to provide your views about Alberta’s workers’ compensation system.
To learn more about the WCB Review and its engagement process, visit
www.alberta.ca/wcb-review.cfm
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 4
THE PURPOSE OF
WORKERS’ COMPENSATION
Before workers’ compensation was developed, workers who suffered workplace
injuries or illnesses had to sue their employers for damages. Many workers were
not in a position to sue their employers or, if they did, were not successful. Under
the law workers could be denied any compensation if they were found to have
contributed in any way to their injury or illness. When a worker was successful
in suing an employer, the costs could impact the continued viability of the
employer’s business.
DID YOU KNOW?
There are a number of
differences between
workers’ compensation
and private insurance.
One example is that when
premiums are not paid,
workers’ compensation
remains available for
workers and employers,
and with private
insurance coverage
is cancelled. For more
details on differences,
see Appendix A.
MEREDITH PRINCIPLES
– THE HISTORIC COMPROMISE
In 1910, the Ontario government commissioned Chief Justice William
Meredith to produce a report on workers’ compensation for that province.
He recommended a program based on collective liability and a wage-loss
approach to benefits. Over time, provinces and territories created workers’
compensation boards based on this. Alberta’s WCB was created by an act
of the Alberta Legislature in 1918.
There are five basic principles that underlie most workers’ compensation
legislation in Canada today, including Alberta. These are often called the
“Meredith Principles”.
• No-fault compensation. This means workers are paid benefits
regardless of how the injury occurred. The worker and the employer
waive the right to sue. There is no argument over responsibility or
liability for an injury.
• Security of benefits. This means a fund is established to guarantee
that money exists to pay benefits.
• Collective liability. This means that, on the whole, employers covered
by the system share liability for workplace injury insurance. The total
cost of the compensation system is shared by all employers. All
employers contribute to a common fund. Financial liability becomes
their collective responsibility.
• Independent administration. This means the organizations
that administer workers’ compensation insurance are separate
from government.
5 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
• Exclusive jurisdiction. This means only workers’ compensation
organizations provide workers’ compensation insurance. All
compensation claims are directed solely to the compensation board.
The board is the decision-maker and final authority for all claims.
The Meredith Principles are a historic compromise in which employers fund
the workers’ compensation system, and injured workers in turn surrender
their right to sue their employer for their injury. 1
THE WCB IN ALBERTA
The WCB is a third-party, independent and neutral agency that is
responsible for the administration of workers’ compensation in Alberta.
The WCB operates under the authority of the Workers’ Compensation
Act and three regulations under that Act: the Workers’ Compensation
Regulation, the Medical Panels Regulation and the Firefighters Primary
Site Cancer Regulation. The Act and regulations are available through
the Alberta Queen’s printer at www.qp.alberta.ca/570.cfm?frm_
isbn=9780779787500&search_by=link.
DID YOU KNOW?
In 2015, there were
166,968 employers who
contributed $1.0 billion
in premium revenue
to the system. Their
contributions ensured
that 2,028,592 workers
across the province
would have access
to WCB benefits if
they were to have a
workplace-related injury.
Source: 2015 WCB Alberta
Annual Report
For many industries in Alberta, coverage by WCB is mandatory.
Employers in these industries must contribute to workers’ compensation.
Certain industries are not required to contribute to workers’ compensation,
but have the option to participate voluntarily. These industries are outlined
in the Workers’ Compensation Regulation. They include industries such
as accounting, photography and real estate.
Approximately 92.63% of all workers in the province are covered by the
WCB. 2 Statistics on the volume of claims processed by the WCB are
available in Appendix B.
1
Association of Workers’ Compensation Boards of Canada – About Workers’ Compensation
- “What are the Meredith Principles”? awcbc.org/?page_id=57
2
Association of Workers’ Compensation Boards of Canada (http://awcbc.org/?page_id=9759 )
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 6
THE WCB CLAIMS PROCESS
DID YOU KNOW?
The Workers’
Compensation Act uses
the term “accident”
as a basis for many
aspects of workers’
compensation. The Act
defines an accident to
include: disablement
(an injury), a disabling
or potentially disabling
condition caused by an
occupational disease (an
illness), a chance event
that has a physical or
natural cause, and even a
wilful and intentional act.
DETERMINING A CLAIM’S ELIGIBILITY FOR BENEFITS
When an injury or illness occurs in the workplace, a claim is submitted
to the WCB. Not all claims are eligible for the payment of workers’
compensation benefits.
To be considered eligible for payment of benefits, an accident must
meet two conditions:
• It must arise out of employment.
An accident arises out of employment when it is caused by some
employment hazard. An employment hazard is defined as an
employment circumstance that presents a risk of injury. The hazard
may be directly related to the industry or occupation (e.g., machinery,
chemicals, worksite ergonomics), or may be incidental (e.g., weather
conditions, third-party vehicles).
• It must occur in the course of employment.
An accident occurs in the course of employment when it happens
at a time and place consistent with the obligations and expectations
of employment. Time and place are not strictly limited to the normal
hours of work or the employer’s premises. However, there must be a
relationship between employment expectations and the time and
place that the accident occurs.
When the WCB is notified of an accident, it initiates a process to obtain all
relevant evidence. Based on the weight of that evidence, the WCB decides
whether the claim is eligible for payment of benefits.
DETERMINING AN ACCIDENT AROSE OUT OF EMPLOYMENT
For many claims, it is relatively straightforward to determine that the
accident arose out of employment. For example, if a worker falls from
a ladder while performing their duties at work and breaks their arm,
it is clear the accident arose out of employment.
In some instances, however, it can be more challenging to determine
that a worker’s injury or illness arose out of employment. For example,
a person may have a heart attack while at work, but that does not
necessarily mean the heart attack arose out of employment.
7 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
To determine whether an accident arose out of employment, the WCB looks
at three key factors. These factors help the WCB determine causation of
the worker’s injury or illness:
• Medical diagnosis – What is the worker’s diagnosis? Is it a recognized
medical diagnosis? Is the diagnosis clearly established in the worker’s
particular case?
• Work factors – What are the conditions at the workplace? What are the
worker’s duties? What are the physical demands? What type and extent
of exposures are there?
• Personal factors – Does the worker’s medical condition predate the
accident? Are there non work-related risk factors that may have caused
the injury or illness?
DID YOU KNOW?
In 2015, 66 fatalities
(52.8% of all
occupational fatalities)
were attributed to
occupational disease
and this is expected
to increase over time.
Source: Occupational Health
& Safety work.alberta.ca/
occupational-health-safety/
statistics.html.
In determining causation, the WCB uses a “but for” test. That is, would the
worker’s injury or illness have occurred “but for” the workplace exposures?
The WCB has used this test in practice for a number of years and has
recently incorporated the test within its policies.
There may be several causes that meet the “but for” test that interact in
combination to cause an injury or illness. Work does not have to be the
only factor, or even the primary factor, for a worker’s injury or illness to be
compensable. It must, however, be a necessary factor. Put another way,
if the worker’s injury or illness would have occurred anyway, regardless
of the work factor, then it is not eligible for benefits.
When adjudicating a claim using the “but for” test, the WCB weighs all of
the evidence (including accepted medical knowledge) and determines if
it is more likely than not that, but for the worker’s employment, the injury
or illness would not have occurred.
SPECIFIC CRITERIA FOR DETERMINING CAUSATION
The “but for” test is generally applied to all claims to help determine
whether an accident arose out of employment. However, the issue of
causation can be more problematic for certain types of injuries and
illnesses. (For example, psychological injuries.)
For certain types of injuries or illnesses, WCB policies set out specific
criteria for determining causation. These specific criteria need to be read
in conjunction with the general “but for” test. (See the next section on
“Occupational Diseases and Psychological Disorders”.)
OCCUPATIONAL DISEASES AND PSYCHOLOGICAL INJURIES
Occupational diseases can be a particularly challenging area when it
comes to determining causation. This is a challenge faced by workers’
compensation systems across Canada.
In 2015 in Alberta, occupational diseases represented approximately
10% of the claims accepted by the WCB.
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 8
DID YOU KNOW?
It is estimated that
approximately 2% to 8%
of all cancer deaths are
related to occupational
exposure. This translates
into 100-500 deaths from
occupational cancer
in Alberta. However,
far fewer than this are
reported.
Source: Occupational Health
& Safety work.alberta.
ca/occupational-healthsafety/industry-initiativeoccupational-diseaseprevention.htm
Presumptive Diseases
A list of presumptive diseases is set out in the Workers’ Compensation
Regulation. If a worker suffers an occupational disease, and was employed
in an industry listed in the regulation 3 within the preceding 12 months,
then the illness is presumed to have been caused by employment
(unless the contrary is shown).
The Workers’ Compensation Regulation currently reflects the state
of medical science as of January 1, 1982. 4 Some have suggested the
regulation should be updated to ensure it is relevant given the state
of medical science today.
Over time, the scope of presumptive diseases has gradually been
expanded through amendments to the Workers’ Compensation Act .
• In 2003, the Act was amended to include a specific presumption
relating to firefighters and certain types of cancers.
• In 2005, the Act was amended to include a similar presumption
related to myocardial infarctions suffered by firefighters when
occurring within 24 hours after attendance at an emergency response.
• In 2012, the Act was amended to provide that if a first responder
is diagnosed with post-traumatic stress disorder (PTSD) then it is
presumed the PTSD arose out of and occurred in the course of the
first responder’s employment in response to a traumatic event or
series of traumatic events. First responders are defined as police
officers appointed under provincial legislation, firefighters (both full
and part-time), emergency medical technicians and peace officers
who are authorized to use the title “Sheriff”. 5
DID YOU KNOW?
“Predominant cause”
means that the
occupational exposures
are the prevailing,
strongest, chief, or main
cause of the injury. It is
not necessary that the
proportion attributable
to the occupational
exposures is a certain
percentage (such as
50% or more), provided
that the occupational
exposures are the
strongest cause.
Some suggest that the entire scope of presumptive diseases should be
expanded, to better reflect linkages that exist between certain occupations
and certain injuries and illnesses. Others feel evidence does not support
the assumption that it is the type of occupation that should presume
coverage, but rather that coverage should be based on the incident
and whether it was the cause of the injury.
Other Injuries or Illnesses Covered by WCB
Other injuries or illnesses may be covered if the WCB is satisfied it is
caused by employment in an industry to which the Workers’ Compensation
Act applies. 6
Psychiatric and psychological injuries (including chronic onset stress) can
be difficult from a claims standpoint, because there can be many different
causes of these conditions (e.g., both work-related and non-work-related
causes). This makes it challenging to determine if the injury arose out of
and in the course of employment.
3
Workers’ Compensation Regulation, section 20
4
Mah, Doug, Workers Compensation Practice in Alberta, 2nd ed, 3-21.
5
Workers’ Compensation Act , section 24.2
6
Workers’ Compensation Regulation , section 20 (1)
9 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
The WCB will consider a claim for psychiatric or psychological injury when
there is a confirmed psychological or psychiatric diagnosis as defined in
the most current version of the Diagnostic and Statistical Manual of Mental
Disorders (DSM) and the condition results from one of the following:
• Organic brain damage,
• An emotional reaction to a work-related physical injury,
• An emotional reaction to a work-related treatment process,
• Traumatic onset psychological injury or stress, or
• Chronic onset psychological injury or stress. 7
For example, a claim for chronic onset stress will be accepted when:
• there is a confirmed psychological or psychiatric diagnosis
as described in the Diagnostic and Statistical Manual of Mental
Disorders (DSM);
• the work-related events or stressors are the predominant cause
of the injury;
• the work-related events are excessive or unusual in comparison
to the normal pressures and tensions experienced by the average
worker in a similar occupation; and
• there is objective confirmation of the events. 8
DID YOU KNOW?
Examples of normal
pressures and tensions,
which are not eligible
for benefits, include
the following:
• interpersonal relations
and conflicts,
· health and safety
concerns,
· union issues, and
· routine labour
relations actions
taken by the employer
(e.g., workload and
deadlines, performance
management, changes in
job duties, lay-offs, etc.)
Source: Policy 03-01 Part II
Injuries General
The state of policy today represents an evolution from the past.
Not long ago, the WCB generally did not cover psychological and
psychiatric injuries. Over time, workers’ compensation systems have
come to cover these injuries but struggle with these types of cases.
In the years to come, these types of cases will likely continue to be
challenging not only in terms of determining eligibility, but also in terms
of return to work and vocational rehabilitation.
WHEN DETERMINING A CAUSE IS IMPOSSIBLE
There are some illnesses where it is impossible to identify the actual cause.
An individual may have several risk factors for the illness, any one of which
could cause their illness (for example, many forms of cancer). In such a
situation, it is impossible to determine which of the risk factors caused
the illness in the individual.
For these situations, the WCB determines whether work factors contributed
to the risk that the individual would develop the illness. The WCB considers
all available epidemiological evidence about the illness and, based on
this, decides whether the worker’s occupational exposure materially
contributed to the worker’s risk of developing the illness.
7
WCB Policy: 03-01 Part II, Application 6, Question 1
www.wcb.ab.ca/pdfs/public/policy/manual/printable_pdfs/0301_2_app6.pdf
8
WCB Policy: 03-01 Part II, Application 6, Question 11
www.wcb.ab.ca/pdfs/public/policy/manual/printable_pdfs/0301_2_app6.pdf
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 10
DID YOU KNOW?
When there is medical
evidence of a pre-existing
condition, WCB may
relieve claim costs if the
pre-existing condition
causes an increase to
the period or degree of
disablement. The preexisting condition may
have been a separate
factor or aggravated
by the accident. The
resulting costs from
the prolonged period
are relieved from the
accident employer’s
experience account.
Source: WCB Policy 05-02-Cost
Relief Part II
CLAIMS INVOLVING PRE-EXISTING CONDITIONS
The WCB’s current policy provides that where a workplace injury causes a
pre-existing condition to deteriorate or become symptomatic, the injured
worker is eligible for payment of benefits.
• Medical evidence must show that the accident caused some worsening
of the worker’s pre-existing condition, at least on a temporary basis.
• It is not a requirement for the worker to have sustained a permanent
clinical impairment as a result of the injury to qualify for benefits.
• Benefits for the worker continue until the worker recovers to the point
that their remaining disability is due entirely to the pre-existing condition
or unrelated health problem.
CLAIMS MANAGEMENT AND SERVICE DELIVERY
If a worker is required to miss only the day of the accident as a result
of an injury, then their claim is considered a medical-aid-only claim.
These types of claims are typically handled by claims processing clerks.
If a worker is required to miss more than the day of the accident as a
result of an injury, their claim becomes a time loss claim. Short-term
time loss claims are typically handled by claims adjudicators. Where a
workers’ time loss is not short-term, their claim may be transferred to
a case manager following adjudication. The case manager makes all
subsequent entitlement decisions related to that claim.
• Case managers provide services to clients who require injury, medical,
vocational and/or rehabilitation management to help them return
to employment or employability. They are responsible for assessing,
planning and facilitating the right benefits and services to meet
return-to-work goals for injured workers. 9
• A case manager determines when a worker is able to return to work,
based on progress reports from the worker and their doctor and other
health professionals.
• If the worker has a job to return to, the case manager will work with
the employer (and union, if applicable) to arrange a gradual return
to work with light or modified duties.
• If a worker does not have a job to return to, the worker may become
eligible for vocational rehabilitation services through the WCB. The
case manager will develop a plan for return-to-work services to help
the worker return to employability.
Adjudicators and case managers have their work informally reviewed
by their supervisor whenever a significant decision is made, such as
acceptance or denial of a claim, or the creation of a detailed return-to-work
plan. In some circumstances, formal reviews are completed such as when
a vocational rehabilitation plan is developed.
9
https://wcb.ab.ca/assets/pdfs/workers/WCB-003_Worker_Handbook.pdf
11 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
Because of the key roles they play in managing claims and assisting
workers with their return to work, case managers need to be effective
in providing services to workers. Adjudicators and case managers are
expected to adhere to service standards.
Some have expressed concern that the WCB’s tests for claim eligibility
risk being interpreted and applied differently by different case managers
and decision makers.
This raises questions about what skills and competencies should
be required for case managers, and about the service experiences
(i.e., quality, effectiveness, timeliness) that workers and employers
currently have when they interact with the WCB.
DID YOU KNOW?
The WCB surveys
1,600 workers and
1,600 employers each
year for feedback
on timeliness,
respectfulness
and completeness
of information.
Source: 2015 WCB Alberta
Annual Report
When a person in Alberta has concerns about how the WCB is managing
(or has managed) a claim, they do not have a single window through
which to raise these concerns. Instead, they can raise their concerns
through the Alberta Ombudsman (for administrative fairness), the Office
of the Information and Privacy Commissioner of Alberta (for personal
information and privacy concerns), the Alberta Human Rights Commission
(for discrimination complaints), their MLA, and/or the Minister of Labour,
depending on the nature of their concerns.
The workers’ compensation organizations in Saskatchewan, Manitoba, and
Ontario each have a Fair Practices Officer that investigates service delivery
complaints and attempts to resolve them. The Fair Practices Officer is
a WCB employee who examines, investigates and reports on trends and
potential systemic problems to the board of the organization. The Fair
Practices Officer cannot change a WCB decision.
In New Brunswick the Issues Resolution Office offers a secondary review of
a claims decision and also acts as an ombudsman to help resolve service
issues. The Issues Resolution Office reports to the WorkSafeNB’s corporate
secretary and general counsel.
Some people have suggested that Alberta should have a mechanism in
its workers’ compensation system that provides a single point for people
to raise concerns about WCB claims management and service delivery.
MEDICAL SERVICES
The timely communication of accurate medical information can impact
decisions about a worker’s claim, how their claim moves through the
WCB process, and even the worker’s income. For example, employers and
those managing claims need to know the functional ability of the worker,
so that they can determine what work duties are available within the
worker’s abilities.
Physicians and other health providers are therefore key partners
in the workers’ compensation system.
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 12
Workers’ compensation is excluded from the provisions of the Canada
Health Act . The WCB negotiates with physicians and other treatment
providers, who have interests and expertise in work-related injuries and
issues, for access to their services. This sometimes enables the WCB to
have injured workers tested and treated faster than these services could
be accessed in the publicly-funded health system. The WCB pays these
service providers directly for these services. The benefit to this is the
reduced time it takes injured workers to be ready for employment,
and it reduces employer costs.
RESOLVING DISAGREEMENTS
ABOUT MEDICAL ISSUES IN A CLAIM
There can sometimes be disagreements about the medical issues in a
worker’s claim. For example, the cause of the worker’s injury, the worker’s
medical diagnosis, the worker’s treatment, and the worker’s ability to return
to work. These issues can affect a worker’s benefits. 10
In Alberta’s workers’ compensation system, Medical Panels are used to
provide an impartial, independent decision-making process to resolve bona
fide conflicts of medical opinions. For example, the Panel can resolve medical
disputes between a worker’s physician and a WCB medical consultant.
When the WCB or the Appeals Commission for Alberta’s Workers
Compensation (Appeals Commission) considers it appropriate, disputed
medical information can be referred to a Medical Panel for review and
recommendation (disputed information is considered in the context
of the entire medical claim file). The findings of the Medical Panel are
binding on the WCB and the Appeals Commission.
Medical Panels are composed of three physician members who are
recognized as experts in their field and who are independent from the
WCB. The panelists are chosen by the claimant (worker), the employer,
and the WCB, from a list prepared by the Medical Panel Commissioner.
The Medical Panel Commissioner is an independent officer who is not
a WCB employee. At the hearing, the Medical Panel hears from the
claimant and may conduct an examination.
Some have proposed expanding the role of the Medical Panel Office.
• Currently, the Medical Panel process can only be initiated by the WCB
or the Appeals Commission. Some have suggested there would be
value in enabling others (such as workers and employers) to initiate the
Medical Panel process.
• The Medical Panel process does not include any form of alternative
dispute resolution (ADR). Some have suggested that there might be a
role for ADR to provide an opportunity to resolve disputes before they
go to a more formal process,
10
Medical Panels http://work.alberta.ca/occupational-health-safety/medical-panels.html
13 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
• The Medical Panel Office performs an adjudicative function, but there
are suggestions it could play other roles as well. For example, some say
it might be valuable for the Medical Panel Office to provide educational
or consultative roles with respect to the WCB’s medical consultants.
RETURNING TO WORK
One objective of the workers’ compensation system is to help the injured
worker return to work. An injured worker’s return to employment can take
several forms:
• They return to full or modified duties at their original employer
(i.e., their employer on the date of accident);
• They are considered fit for employment and return to work
at a different employer;
• They are considered fit for employment but do not return to
their original employer, a different employer, or any employer.
RETURN TO FULL OR MODIFIED DUTIES AT ORIGINAL EMPLOYER
Ideally, when a worker is ready to return to work, they can go back to their
original employer. This might entail returning with modified duties based
on the worker’s abilities, which may be different than they were on the
date of accident.
DID YOU KNOW?
In 2014, the Medical
Panel Office received
44 requests to establish
medical panels from the
WCB and the Appeals
Commission.
DID YOU KNOW?
WCB claims are never
permanently closed;
new information is
grounds for the WCB
to re-open a file and
reconsider a decision.
Source: WCB
There is currently no requirement under Alberta’s Workers’ Compensation
Act for an employer to return an injured worker to the workplace. Under
Alberta’s human rights legislation, employers have a duty to accommodate
workers with disabilities, unless the accommodation imposes undue
hardship on the employer.
Alberta’s WCB does not handle disagreements or complaints about
non-compliance with human rights legislation. Worker concerns about an
employer’s failure to accommodate, or employer concerns about undue
hardship, must be filed with the Alberta Human Rights Commission.
Several other jurisdictions (British Columbia and Northwest Territories
are exceptions) have provisions in workers’ compensation legislation that
require an employer and worker to cooperate with return to work efforts.
Workers and employers in these jurisdictions can pursue their concerns
through the workers’ compensation system, rather than having to initiate
a separate process with a different body.
Some have questioned whether WCB should have more ability to influence
or compel the employer or worker to cooperate on return to work.
A worker’s return to modified duties can have financial consequences for
their employer. The employer may incur additional costs in adjusting their
staffing as part of the accommodation. There are questions about whether
the costs of providing modified work should be borne by the employer or
subsidized through the WCB.
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 14
NO RETURN TO ORIGINAL EMPLOYER
A worker may not be able to return to the employment they had on the
date of accident. Several factors that impact whether a worker can return
to employment are beyond the control of the WCB (for example, prevailing
economic conditions, the availability of work, business’ intent to hire
workers, etc.).
When an injured worker cannot return to their pre-accident position,
or where there is a permanent disability requiring a work modification,
the WCB may provide Vocational Rehabilitation Services. These services
are aimed at helping injured workers develop the skills and capabilities
that will assist them to reach a state of employability.
Vocational Rehabilitation Services can take a varying amount of time
to complete, depending on individual circumstances.
The WCB will assist a worker in assessing skills and abilities within their
anticipated work restrictions and will help them develop a long-term goal,
upon which a vocational rehabilitation plan will be based. Once the goal
and the plan are identified, the worker will start 12 weeks of assisted job
search, unless other skills or training opportunities have been identified.
Through the program the worker can access various services, such as
short-term skills training or assistance with developing a resume.
Potential earnings in the job are assessed using a survey methodology
(labour market research conducted by an independent firm). These can
be used to “deem” the worker’s earnings (and adjust their benefits),
if the worker remains unemployed.
INVESTIGATIONS
The WCB has a Special Investigations Unit (SIU) that was established
in 1994. The SIU investigates allegations of system abuse by employers,
service providers and workers. The SIU is granted Alberta Peace Officer
status under the Police Act and can lay charges under the Workers’
Compensation Act or the Criminal Code of Canada when appropriate.
Some wonder if the techniques and approach used in investigations may
adversely impact an injured worker. On the other hand, WCB must exercise
due diligence in ensuring fraudulent behavior and abuse of the system
does not occur.
Those who choose to intentionally abuse workers’ compensation face
the possibility of criminal and civil proceedings, as well as fines.
15 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
WCB BENEFITS
BENEFITS AVAILABLE TO WORKERS
LOSS OF EARNINGS
If a worker misses time from work beyond the day of the accident (a lost
time claim), an injured worker receives monetary benefits based on their
earnings as of the date of accident. These payments are non-taxable.
In 2016, injured workers eligible for temporary total disability (TTD) benefits
receive 90% of their net earnings, up to a maximum insurable earning of
$98,700 per year. The 2016 maximum insurable earnings amount translates
into weekly compensation payments of $1,225.61.
When a worker becomes capable of returning to modified duties, the
worker may be converted to temporary partial disability benefits if they
incur a wage loss. These are calculated based on the impairment of the
worker’s earning capacity. The average time from injury to first payment
for all new lost-time claims is 23.21 days. 11
DID YOU KNOW?
The WCB applies a
formula based approach
for determining maximum
insurable earnings (MIE).
The objective of this
formula is to ensure
that the annual MIE
adjustment keeps pace
with wage growth such
that the MIE covers the
full wage of 90 percent
of workers covered by
WCB in the province.
When the WCB deems a worker is fit to return to modified work duties,
the WCB assists the worker to secure that level of employment. The
WCB will then pay to “top up” the worker’s pay. (That is, WCB will pay the
difference between the worker’s modified work earnings and the worker’s
original earnings on the date of accident). If the worker’s restrictions are
determined to be permanent, a permanent clinical impairment will be
assessed and vocational assistance may be required to secure alternate
suitable employment.
TTD benefits may be available to a worker who is suffering from an
aggravation of a pre-existing condition (e.g., a chronic back injury). The
temporary benefits are paid until the aggravation has ended or reaches
a medical plateau, at which time the WCB will evaluate whether there
is any permanent impairment caused by the compensable accident. 12
There are questions about the WCB’s current limits on insurable earnings.
Some people have suggested that the current limits may be too low, given
that wages in several occupations can be much higher than the current
maximums. Others have suggested that the current limits should stay
the same, but that workers should have the option to purchase additional
coverage from the WCB for amounts that exceed the WCB’s current limits.
11
WCB preliminary 2015 results
12
WCB Policy: 03-02 Part II www.wcb.ab.ca/pdfs/public/policy/manual/printable_pdfs/0302_2_app1.pdf
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 16
PAYMENTS FOR PERMANENT IMPAIRMENT
In cases of permanent loss of function (e.g., loss of a finger), the WCB
operates a dual award system consisting of loss of earnings benefits
and non-economic loss payment (NELP). The NELP consists of a lumpsum payment intended to compensate for a permanent loss of function
caused by a work-related injury. 13 The payment is based on the degree
of permanent clinical impairment of the worker.
Legislation also provides for an economic loss payment (ELP) for an injured
worker with a permanent clinical impairment (e.g., loss of limb) who cannot
return to their previous employment. This is paid for the worker’s working
lifetime, or until the worker returns to the same level of earnings that they
had on the date of accident. 14
In circumstances where the worker is unable to secure suitable
employment following vocational rehabilitation services, the WCB uses
a “deeming” process 15 to determine the post-injury economic loss by
identifying “suitable employment”. Once the deeming process is complete,
a worker’s compensation is adjusted to reflect the difference between
the deemed earnings and the earnings on the date of the accident.
SPOUSAL AND DEPENDANT SUPPORT
If a worker dies as a result of an accident that is eligible for benefits,
the WCB pays compensation to the worker’s dependants and assists
with the payment of costs associated with the worker’s death.
The amount of compensation is based on the legislation in effect on the
date of the worker’s accident. In general, compensation for dependants
includes a pension and, for a dependant spouse (or adult interdependent
partner), may include appropriate vocational services. Depending on
the circumstances and date of accident, a variety of benefits such
as allowances and pensions may be paid to other individuals as well
(e.g., a worker’s dependant children and guardians).
The benefit structure for dependant spouses and dependant adult
interdependent partners has three main purposes:
• provide financial support to the worker’s dependant spouse or
dependant adult interdependent partner and dependant children
until the children are 18 years old;
• help the dependant spouse or dependant adult interdependent
partner become gainfully employed by providing vocational services
and financial support during the vocational training period;
• provide ongoing financial support to spouses or adult interdependent
partners who are not capable of becoming gainfully employed.
13
Workers’ Compensation Act , section 69
14
Workers’ Compensation Act , section 56(7)
15
Mah, Doug, Workers Compensation Practice in Alberta, 2nd ed, 3-12.4 The process of determining
impairment of earning capacity using “suitable employment” as a benchmark is sometimes referred
to as deeming.
17 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
To be dependent, a child must have been wholly or partially dependent
on the worker’s earnings at the time of the worker’s death. This includes,
for example, a child who was not living with the worker but was legally
entitled to support from the worker – even if the worker was not paying
support at the time of death. Dependant children are considered to be
dependent only until they reach the age of 18.
ECONOMIC LOSS PAYMENTS AFTER RETIREMENT AGE
The WCB may adjust a worker’s benefits when the worker reaches 65 years
of age, to reflect that the worker would have retired from employment.
(The WCB may not do this at age 65, if the worker can prove they would
have worked longer.)
The WCB uses a formula to adjust the benefits, which estimates the impact
that the worker’s disability had on their retirement income (i.e., due to the
worker’s reduced opportunity to contribute to retirement savings plans).
The adjusted benefits are generally payable for the lifetime of the worker.
BENEFITS ADJUSTMENTS
Benefits can be adjusted through cost-of-living adjustments that are
calculated by the WCB using a specific formula. The WCB Board of Directors
approves the adjustments, which are effective January 1 of each year.
The WCB’s cost-of-living adjustments are calculated on the basis of
the worker’s earnings on the date of accident. The adjustments do not
account for earnings increases a worker may have received due to career
progression. Some suggest that benefits adjustments should take a
worker’s potential earnings as well as career progression into account.
Others say this would not be practical, since it cannot be assumed a worker
would have progressed in their career or received earnings increases.
DEEMING EARNINGS
Based on the goal that is set for a worker as part of Vocational
Rehabilitation Services, the WCB will assess potential earnings in the
job using a survey methodology (labour market research conducted by
an independent firm). Select employers within each community where
an occupation exists are surveyed to determine what they would pay
employees hired into these occupations and how those earnings would
increase to reflect growing experience for the first five years.
If a worker remains unemployed, but the WCB determines they are fit and
ready to work in a potential position, the worker will be deemed capable of
performing this work and earning this income. The WCB adjusts the benefits
paid to the worker, to reflect the income that the worker is deemed capable
of earning. The deemed earnings incorporate increases based on career
progression that the worker would theoretically have in the deemed job.
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 18
DID YOU KNOW?
The Millard Health
Rehabilitation Centre
in Edmonton is operated
by the WCB. When it
opened in 1952, it was
the first facility in Canada
designed exclusively
for the rehabilitation of
injured workers. More
information is available
at https://www.wcb.ab.ca/
millard-treatment-centre/
Some people have suggested that this deeming process may not result
in successful employment outcomes for injured workers, because the
rehabilitation services provided may not have a connection to a worker’s
employment history nor be based on work realistically available in the
economy. Others have suggested that the deeming process makes sense,
since it is not always viable for a worker to return to their original position
or secure employment when they are ready.
NON-COMPLIANCE AND EFFECT ON BENEFITS
The process of addressing a worker’s injury is often complex. It can
involve a number of assessments and treatments to successfully return
the injured worker to work. This requires co-operation and participation on
the part of the injured worker. The WCB has developed a list of approved
treatment providers and will generally require an injured worker to see
one of these providers.
On occasion, an injured worker might refuse to participate or cooperate
with the WCB’s directions regarding medical treatment. This can happen
for various reasons. For example, the worker might not agree with the
treatment plan; they may wish to see a provider who is not on the WCB’s
approved list; or they may wish to explore other treatment options (e.g.,
acupuncture versus surgery). If WCB cannot resolve the issue and the
worker refuses reasonable medical treatment or engages in activities
that endanger recovery, WCB may reduce or suspend compensation.
The WCB may determine a worker is non-compliant when the worker
refuses to return to work even though the WCB has deemed them fit to
return to full or modified duties. This can happen for various reasons.
For example, their personal family doctor might disagree and advise
them they should not yet return to work. In these cases, WCB may
contact the family doctor to discuss the proposed work duties.
In instances where the WCB considers a worker to be non-compliant,
the WCB currently has the authority to suspend payment of the
worker’s benefits.
There are questions about what should happen, and what the WCB
should be empowered to do, in circumstances where a worker does
not cooperate with WCB directions regarding medical treatment or
refuses to return to work.
19 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
OTHER INCOME REPLACEMENT
OPTIONS FOR WORKERS
If the WCB declines the payment of benefits, an injured worker’s options
for income replacement can be limited. Some workers may be able to
access private long-term disability insurance. However, these plans
generally pay less than the WCB and the benefits they provide are taxable.
Long-term disability insurance may also be used to offset benefit costs
(e.g., pension, dental, etc.) as these are not covered by WCB.
Other income replacement programs such as Employment Insurance,
the Assured Income for the Severely Handicapped and Income Support,
and the Canada Pension Plan (CPP) Total Disability Benefit all have
specific criteria that must be met to qualify for benefits. Payments may
be less then what would be paid by the WCB and may be subject to time
limits. Currently, no workers’ compensation board in Canada provides an
emergency fund.
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 20
REVIEW AND APPEAL
OF WCB DECISIONS
The Workers’ Compensation Act establishes a review and appeal process in
the workers’ compensation system. The Act provides for an internal review and
an external appeal for issues brought forward by either workers or employers.
For example, workers may want to bring forward issues related to the level of
benefits; employers may want to have account decisions reviewed.
DID YOU KNOW?
THE DISPUTE RESOLUTION
AND DECISION REVIEW BODY
When a request for
review is made, 95%
are actioned in 40 days
from when the DRDRB
received the request.
The Dispute Resolution and Decision Review Body (DRDRB) is appointed
by the WCB Board, 16 and is a required step before a formal appeal may
be made. The members of the DRDRB are WCB employees.
Source: 2015 WCB Alberta
Annual Report
DID YOU KNOW?
There were 830 DRDRB
requests appealed to the
Appeals Commission and
346 DRDRB decisions
were overturned at the
Appeals Commission.
Source: 2015 WCB Alberta
Annual Report
A person with a direct interest in an adjudicative decision or an employer
account decision can request an internal review of that decision by the
DRDRB. A person has one year from the date a decision was issued 17 to
request a review by the DRDRB.
The DRDRB is able to review issues related to eligibility to benefits.
Generally the parties to a DRDRB review are the worker and the employer.
Parties to the DRDRB review are invited to make submissions. The DRDRB
will review the file material, gather information and submissions from
the parties, and attempt to facilitate a resolution. DRDRB decisions are
not binding on the WCB. Most reviews are handled informally. In-person
meetings to discuss resolution are offered on all review requests. In 2015,
DRDRB received requests for review on 2,258 claims. 18 Of those requests,
830 went forward to the Appeals Commission for external review.
Some have suggested the one year timeline for requesting a DRDRB review
is too short. Others indicate it is sufficient since there is an opportunity to
request extensions.
16
Workers’ Compensation Act , section 45(1)
17
Workers’ Compensation Act , section 45(2)
18
2015 WCB Alberta Annual Report
21 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
THE APPEALS COMMISSION
The Appeals Commission is a body established under the Workers’
Compensation Act 19 that is separate from the WCB. The Appeals
Commission has adjudicators appointed by the Government of Alberta
through a public recruitment process, as well as the Chief Appeals
Commissioner, who also acts as CEO of the Appeals Commission.
The Appeals Commission has the authority to examine, inquire into,
hear and determine all matters and questions arising under the Workers’
Compensation Act in regards to decisions made by the DRDRB. Workers,
employers or anyone with a direct interest in a decision made by the
DRDRB may appeal a decision to the Appeals Commission.
A written notice of appeal must be received by the Appeals Commission
within one year from the date of the DRDRB decision. This period may be
extended by the Chief Appeals Commissioner if there is a justifiable reason
for the delay. 20 The Appeals Commission may confirm, vary or reverse
a decision of the DRDRB, and it may entertain new evidence during the
appeal hearing.
There are generally two types of hearings: an in-person hearing, and
a documentary-only hearing. Approximately 87% of appeals are held
as in-person hearings, and 13% are held as documentary-only hearings.
Additional statistics on Appeals Commission hearings is available in
Appendix C.
The Appeals Commission is required to give all persons with a direct
interest in the matter an opportunity to be heard and to present any new
or additional evidence. 21 The Appeals Commission must permit the WCB
to make representation to the Commission as to the proper application
of its policies, the Act or regulations related to the matter under appeal. 22
It is unclear whether the WCB can attain full party status before the
Appeals Commission to present evidence and to be heard. 23
The Appeals Commission is required to follow the Workers’ Compensation
Act and WCB policies. 24
Presently, during a hearing the Appeals Commission limits its examination
to the matters that are the subject of the appeal. Some have suggested the
Appeals Commission should examine all issues impacting a claim, beyond
the specific matters under appeal, if it is possible to resolve the matter in
its entirety. Others say this would not be desirable, as it would raise the
possibility of the Appeals Commission wading into matters that neither
party wanted to revisit.
19
Workers’ Compensation Act , section 10
20
Workers’ Compensation Act , section 13.2(8)
21
Workers’ Compensation Act , section 13.2(6)(a)
22
Workers’ Compensation Act , section 13.2(6)(b)
23
Mah, Doug, Workers Compensation Practice in Alberta, 2nd ed. 2.4.1(d)(1)
24
A Guide to the Appeals Commission, www.appealscommission.ab.ca/howtoappeal/Pages/Guide.aspx
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 22
ALTERNATIVE DISPUTE RESOLUTION (ADR)
Some have raised concerns that the Appeals Commission process may be
too legalistic and daunting in nature, rather than an accessible process that
workers and employers can use without the cost of formal legal representation.
The Workers’ Compensation Act permits the Appeals Commission to
conduct a consensual resolution process (such as ADR) 25 during the
course of an appeal. It has been suggested that implementing this process
may alleviate the requirement to go to more formal proceedings. However,
no such process has yet been implemented.
Since the WCB Act already provides for a consensual resolution process,
a question that arises is whether the Appeals Commission should
implement some form of Alternative Dispute Resolution (ADR) to help
resolve disputes before they go to a more formal process.
RECONSIDERATION OF APPEALS
COMMISSION DECISIONS
The Workers’ Compensation Act allows for the reconsideration of Appeals
Commission decisions. A reconsideration is not an appeal. Currently,
there must be very good reasons for a reconsideration application to
be successful. These reasons include:
• the presence of relevant evidence that was not available at the
time of the appeal decision and which is likely to change the result
of the original decision; or
• a significant defect in the appeal process or the content of the decision.
Some have suggested that the criteria the Appeals Commission considers
for reconsideration of appeals may require more flexibility.
JUDICIAL APPEALS AND REVIEWS
The Workers’ Compensation Act provides that a decision of the Appeals
Commission may be appealed to the Court of Queen’s Bench of Alberta.
The appeal can only be on a question of law or jurisdiction.
A decision, acts or omission of the Appeals Commission (or the WCB)
can also be subject to judicial review by the Court of Queen’s Bench of
Alberta. A judicial review might occur in situations where the Workers’
Compensation Act does not explicitly provide a right of appeal. A judicial
review is not an appeal, and it is not the role of the reviewing judge to re-try
the case. The Courts have recognized that the Appeals Commission is a
specialized tribunal created to deal with disputes in the specialized area
of workers’ compensation, and are thus reluctant to interfere directly with
decisions of the Appeals Commission. 26
25
Workers’ Compensation Act , section 13.5
26
Boyd v JBS Foods Canada Inc, 2015 ABCA 380 at para. 54
23 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
Due to the deference provided by the Courts to the Appeals Commission it
can be challenging to have a decision of the Appeals Commission overturned.
This is why some have suggested the criteria for factors that allow the Appeals
Commission to overturn or reconsider a decision should be expanded.
APPOINTMENT AND FUNDING
OF THE APPEALS COMMISSION
The Chair and the members of the Appeals Commission are appointed by
the Lieutenant Governor in Council. The Minister responsible for the WCB
is also responsible for the Appeals Commission.
The Chief Appeals Commissioner and other commissioners are appointed
to either three-year or one-year terms. Those eligible to be appointed
for three years must be representative of either the interests of workers
or employers. 27 These appointments may be renewed up to a limit of
12 consecutive years, as provided for by the Alberta Public Agencies
Governance Act . 28
The Appeals Commission is funded through an annual levy on employers.
The funds are collected by the WCB and remitted to the Crown, which in
turn sends them to the Appeals Commission. This ensures there is no
direct financial relationship between the WCB and Appeals Commission,
helping provide independence to the Commission.
EMPLOYER APPEALS CONSULTING SERVICE
Employers in Alberta can utilize the Employer Appeals Consulting Service
(EACS). EACS is provided by WCB account managers.
EACS can help employers understand the facts, policies and legislation
used to make a specific decision, and help them determine whether to
proceed with a formal review or appeal.
EACS will not accompany or represent an employer at an appeal. EACS can
provide information that may help an employer resolve their issue, and
it can offer advice to an employer on how to present their position in an
appeal. Some people have suggested that employers should have access
to WCB-funded representation at an appeal, similar to what workers have in
the Office of the Appeals Advisor.
Employer advisors are available in five provinces: British Columbia, New
Brunswick, Newfoundland and Labrador, Ontario and Prince Edward
Island. Employer advisors in those five provinces are available to: provide
advice on rights and obligations, assist with cost relief and issues related
to workplace injuries and deaths, and assist or represent employers’
interests at appeals. These services are generally funded by the workers’
compensation system and offered at no cost.
27
Workers’ Compensation Act , section 10(1)
28
Alberta Public Agencies Governance Act , section 14(2)
http://www.qp.alberta.ca/1266.cfm?page=A31P5.cfm&leg_type=Acts&isbncln=9780779761333&display=html
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 24
DID YOU KNOW?
In 2015, there were
2,115 new client requests
for the services of an
appeals advisor. 1,998
issues were resolved,
192 issues were
withdrawn and
members of the Office
of the Appeal Advisor
represent claimants
at 621 hearings.
Source: WCB – Alberta
2015 Highlights
OFFICE OF THE APPEALS ADVISOR
The Office of the Appeals Advisor is operated as a department of the
WCB, but under a separate mandate established by policy. 29 It makes
advisors available to inform and represent workers through the review
and appeal processes.
Generally, the advisors are experienced former case managers. Through
their training and certification in Tribunal Administrative Justice from the
Foundation of Administrative Justice, appeals advisors have expertise in
administrative law and its role in the review and appeals process. They
also have the ability to interpret and apply the Workers’ Compensation Act
and WCB policies.
An advisor can help a person determine whether they have grounds for
review of a decision. An advisor may also suggest alternatives to filing an
appeal. Advisors can accompany workers and represent them at Appeals
Commission hearings. 30
Some people question whether the Office of the Appeals Advisor is able to
provide impartial and effective advice to workers, since it is not independent
from the WCB. Others feel the services being provided are effective.
PRIVACY AND CONFIDENTIALITY
When a worker appeals a decision of the WCB, the WCB is required
to provide the Appeals Commission with its records and information,
including personal information (e.g., medical), relating to the claim or
matter that is under appeal. The WCB is also required to provide the
Appeals Commission with the written decision being appealed. 31
On request, the worker (or the worker’s representative), the employer
(or the employer’s representative), and any other person with a direct
interest in the claim may also receive redacted copies of this information
from the WCB.
Recognizing that privacy rights are important to everyone, it makes sense
to consider how information sharing takes place in the appeals process.
Questions have arisen regarding what and how information about a
worker’s claim is presently shared with parties, and what safeguards
the WCB uses to determine what information is to be shared.
29
WCB Policy 01-07-01, Part III, Application 1
https://www.wcb.ab.ca/pdfs/public/policy/manual/printable_pdfs/0107_1.pdf
30
Office of the Appeals Advisor brochure
http://www.workeradvocates.ca/pdfs/WCB_OAA_brochure.pdf
31
Workers’ Compensation Act , section 13.2(5)
25 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
WCB GOVERNANCE
BOARD OF DIRECTORS OF THE WCB
The WCB is governed by a Board of Directors, which is appointed by the
Lieutenant Governor in Council. The Board consists of a Chair, and up to
three members considered to be representative of the interests of each of:
employers, workers and the general public. 32
The Board of Directors:
• guides the WCB’s strategic direction;
• appoints and evaluates the performance of the WCB’s
President and CEO;
• determines the salary and benefits of the WCB’s President
and CEO which are paid out of the Accident Fund;
DID YOU KNOW?
The Alberta WCB
operates according
to Principles of
Alberta Workers’
Compensation approved
by the board. These
principles are available
at https://www.wcb.
ab.ca/pdfs/public/policy/
manual/printable_pdfs/
table_contents.pdf
• approves and monitors the WCB’s administrative budget
and financial results;
• provides oversight of the WCB’s management of its business
and affairs; and
• is responsible for establishing the operating policies of the WCB.
The Corporate Governance Policy Manual provides the guidelines from
the WCB under which the Board of Directors operates.
The President and CEO serves as the communication link between
the Board of Directors, which focuses on the WCB’s strategic direction,
and the WCB administration, which carries out the WCB’s day-to-day
operations. The President and CEO is accountable for the performance
and employees of the WCB.
Varying opinions have been expressed about the relationship between
these board members and the stakeholders they are considered to be
representative of. Interest has also been expressed in the nomination
and recruitment process for new board members.
As a public agency the WCB is subject to the Alberta Public
Agencies Governance Act , which includes requirements that
support effective governance.
32
Alberta Workers’ Compensation Act , section 5.
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 26
DID YOU KNOW?
Past policy development
reviews of the WCB
have covered topics
such as causation and
psychological injuries.
Sometimes the subject
of a policy review or
policy consultation
can be controversial.
On May 18, 2016, the Government of Alberta introduced the Reform of
Agencies, Boards and Commissions Compensation Act , which includes
the WCB. If you would like to provide your feedback to government about
this legislation and the compensation philosophy and approach you can
do so at www.alberta.ca/abc-compensation.aspx. The WCB review panel
will have access to the input collected that relates to the WCB as it
continues its review.
WCB CORPORATE OBJECTIVES
AND KEY DELIVERABLES
On an annual basis, the WCB Board of Directors establishes corporate
objectives and key deliverables. Some of the measures and their results
(from the 2015 WCB Alberta Annual Report) include the following:
• Returning injured workers to a state of fitness needed to return to
work. With WCB support, 92.5% of injured workers achieved the fitness
needed to return to work. This result exceeded the target of 90%.
• Delivering fair decision. Decisions are reviewed and audited to ensure
they are fair. WCB’s average audit score of all decision audited was 94%.
Performance targets can drive the culture of an organization. Some have
expressed concerns about how the achievement of corporate performance
targets such as early return to work for injured workers are being rewarded.
Others say that an injured worker’s chances of successfully returning to
work increase significantly if they return to work within 3 months. Based
on this, they suggest that the WCB’s performance measures are valid.
POLICIES OF THE WCB
The Board of Directors determines the need for and nature of consultation
when a policy is changed or developed. 33
On an annual basis, the WCB creates a Policy Development Plan that
identifies the issues it plans to address during that year. In addition,
if a stakeholder believes a policy should be changed, they can send
in a written request to the Chair for a policy review.
The WCB has established a policy and consultation process which includes:
• Issue Identification;
• Research and Analysis;
• Policy Development/Amendment;
• Stakeholder Consultation;
• Approval and Implementation.
33
The Workers’ Compensation Board Mandate and Roles
alberta.ca/albertacode/images/ags-Workers-Compensation-Board-MRD.pdf, page 7-8
27 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
Consultation can include public and/or expert consultation. For the
most part, consultation is conducted through the WCB website (posted
for 60 days). Depending on the nature of the issue, the WCB may convene
an in-person meeting.
Stakeholders can subscribe to receive an email notice when the WCB’s
Policies and Information Manual is updated online or when a new policy
is posted for consultation.
In British Columbia, there is a Policy and Practice Consultative Committee
made up of representatives from WorkSafeBC (the WCB equivalent in BC)
and the employer and worker communities. The committee provides input
and advice to WorkSafeBC’s senior executive on stakeholder consultation
processes, stakeholder perspectives on priority issues (e.g., policy,
legislation) and the identification of stakeholder issues. In addition,
on behalf of their communities, the committee is a forum to receive
updates on key operational initiatives and share relevant information.
In Alberta, the WCB covers over two million workers and thousands of
employers. Its policies therefore have wide-reaching consequences in the
province. It is important to consider whether the WCB’s policy development
process is adequate and effective. Some have questions about the process
used by the WCB to evaluate whether its policies are achieving their
intended goals.
REVIEW OF THE WORKERS’
COMPENSATION SYSTEM
The last comprehensive review of the workers’ compensation system
in Alberta was conducted more than 15 years ago.
The Alberta Public Agencies Governance Act contains a general
requirement for the Minister to review each agency’s mandate and
operations every seven years. However, there is no requirement in the
Workers’ Compensation Act to conduct a review of the entire workers’
compensation system within a specific time period.
Other Canadian jurisdictions have requirements in their legislation to
review their workers’ compensation statutes and regulations on a regular
basis. For example, Saskatchewan has a requirement to conduct a review
every four years; Newfoundland and Labrador every five years; and
Manitoba every ten years. Some have suggested Alberta should adopt
a similar requirement.
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 28
PREVENTION OF WORKPLACE
INJURY AND ILLNESS
ROLE OF WCB IN PREVENTION
The Occupational Health & Safety (OHS) program in Alberta is
responsible for improving workplace compliance with OHS legislation
through evidence-based prevention initiatives, education and
enforcement activities. OHS is located in the Ministry of Labour.
Among its functions, OHS:
• is responsible for prevention activities that include: Work Safe Alberta;
proactive strategic programs; the Certificate of Recognition (COR)
Program; and the Work Right Campaign;
• educates workers, employers and the public through the use of bulletins,
publications, e-learning programs and other educational materials;
• approves training programs across Alberta, such as Workplace
Hazardous Materials Information System (WHMIS) training, First Aid
training, and Spirometry and Lung Function training; and
• approves worker permits, such as the Blasters Permit Program
and the Asbestos Permit Program.
Since OHS falls under different legislation, the WCB Review is not intended
to conduct a detailed examination of OHS. However, since the workers’
compensation system impacts OHS, the WCB Review will examine
interactions between the system and OHS.
The funding for OHS in Alberta is provided through the WCB. This
approach is consistent with other jurisdictions in Canada. In some
jurisdictions, however, OHS and workers’ compensation are housed
in one organization. (See Appendix D for details.)
CERTIFICATE OF RECOGNITION
A Certificate of Recognition (COR) is awarded to employers who
develop health and safety programs that meet provincial standards
established by OHS.
29 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
A COR indicates that an employer’s health and safety management
system has been evaluated by a certified auditor (called a “Certifying
Partner”). Certifying Partners are organizations that work in partnership
with the Government of Alberta to:
• develop health and safety systems;
• provide health and safety training and services;
• coordinate the audit process; and
DID YOU KNOW?
There are approximately
70 partners committed
to promoting and
improving health
and safety in Alberta.
• provide quality assurance.
Employers must obtain and maintain a valid COR to qualify for a financial
incentive through the WCB.
The COR also has reputational benefits from a health and safety
perspective. For example, some companies in Alberta require that
their subcontractors hold a valid COR.
SAFETY ASSOCIATIONS
The WCB also administers grants of annual operating funding to seven
Alberta safety associations, for the purpose of promoting education in
accident prevention to employers. These grants are funded through a
levy that is added to the WCB premiums of employers in the represented
industries. In some industries, safety associations are funded directly by
member contributions.
Industry and safety associations can:
• assist industry members with the development and implementation
of health and safety programs;
• produce publications for industry including catalogues, posters
and videos;
• coordinate audit services (including auditor training) to help employers
assess their programs; and
• develop and deliver health and safety training for industry members.
The decision to fund a safety association is made by employers in the
applicable industry. The majority of the employers (as measured by
insurable earnings) must vote in favour of a funded association. The funds
are collected by the WCB and distributed to the association in quarterly
installments. The release of installments is contingent on a safety
association submitting financial statements to the WCB.
Right now, it is unclear who safety associations are accountable to.
It is also unclear whether there are regular evaluations of the outcomes
being achieved by safety programs and associations. Some suggest there
may be an enhanced role for WCB or OHS to play in the monitoring of the
performance of safety associations and employer prevention programs,
and the provision of rewards or incentives for performance.
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 30
HEALTH AND SAFETY INFORMATION
Information gathered by the WCB represents the only available source
of health and safety information that can be compared across employers
and industries. This information is useful in setting health and safety policy
and program direction. It is also often used by the public to evaluate the
health and safety performance of Alberta’s employers. While the value
of WCB information is evident, it has been identified by some that there
are challenges and gaps in the data collected and reported such as
unreported claims, lack of information on root cause of injuries and
leading indicators, and accessibility of information.
The users of WCB information are diverse, including: the Government of
Alberta; industry and safety associations; employers; researchers; health
practitioners and service providers; workers; unions; other jurisdictions;
and the public. The types of information available are also diverse,
including: industry level claims; employer level claims; injured workers
demographics; injury and illness claims; and financial aspects of
employers and claims.
While the value of WCB information is evident, it has some challenges
and gaps, such as unreported claims, lack of information on root cause
of injuries and leading indicators, and accessibility and quality of the
information. Also, workers’ claims data collection is not harmonized across
different provinces and territories. These factors limit the usefulness of the
information in the prediction of injury and illness risk. The WCB’s mandate
does not explicitly require it to collect data for prevention purposes.
It makes sense to examine existing data gathering, and how this might be
changed or enhanced to better inform prevention programs and foster
continuous improvement in workplace health and safety performance.
31 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
FUNDING AND FINANCIAL
SUSTAINABILITY
EMPLOYER PREMIUMS
DID YOU KNOW?
The WCB is funded through premiums assessed to employers. There are
no tax dollars involved in the workers’ compensation system, and there
are no deductions made from workers’ paycheques to fund the system.
Employer premiums are established each year. Employers are charged
a certain dollar amount per $100 of payroll. This is known as the
“assessment rate”. In 2016, Alberta has an estimated average assessment
rate of $1.01 per $100 payroll. This average rate is the lowest in Canada,
with other jurisdictions ranging from $1.11 to $2.65 per $100 payroll. 34
There are a variety of reasons for the difference in average assessment
rates between the provinces and territories (for example, different funding
policies, historical fund balances, industries covered.) This makes it
difficult to make fair comparisons.
Approximately 70% of
the costs of a currentyear injury are paid well
into the future. Many
injuries have costs that
continue to be paid for
decades beyond the
date of accident.
Source: 2014 WCB Alberta
Annual Report
An employer’s assessment rate is determined in the following way:
• The WCB assesses the overall financial picture of the workers’
compensation system. Using actuarial reports and financial forecasts,
the WCB determines what it will need to pay out. A significant piece of
this puzzle is the projected present and future costs of claims that are
expected to be made to the WCB in the upcoming year. Historical data
helps the WCB project these figures.
• On the basis of the overall financial picture, and with a view to its
Funding Policy, the WCB determines what overall amount of money
it needs to collect from all employers covered by the WCB in Alberta.
This amount of money is determined so that the premiums collected
in the current year will pay for all estimated present and future costs
of claims that are made during that year.
• Based on the overall amount of premiums that need to be collected,
the WCB determines premium rates for each rate group. There are
118 rate groups covering 364 industries. Some rate groups have only
one industry in them. (For example, residential construction is one rate
group.) Other rate groups include up to 20 industries. The premium
rates of each rate group are set based on their historical pattern of
claims costs. (This is sometimes called the “industry rate”.)
34
Association of Workers’ Compensation Boards of Canada
– Key Assessment/Premium Rate Information for 2016 http://awcbc.org/?page_id=566
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 32
• Each employer within a rate group is then assigned their premium rate
based on their record of claims costs. This is called the “experience
rating”. Based on how the employer stacks up to the average of
their rate group (or “industry average”), their premium rate for large
employers can be set up to 40% higher or lower than the industry rate.
Small employer rates can be set up to 5% higher or lower than the
industry rate.
This process of determining employer premiums is intended to achieve
three things. First, it ensures that every employer pays something,
thereby maintaining the collectivist nature of the workers’ compensation
system. Second, it provides for fairness by distributing the premiums
based on which employers and industries are more likely to be the
source of WCB claims and costs. Third, by reflecting the different
claims histories of different employers and industries, it builds
accountability into the system.
Some employers pursue cost relief to mitigate claims experience costs.
This is where costs are partly or fully removed from the employer’s
experience record, and the costs are then shared by all employers in
the rate group. Cost relief does not affect the overall costs of a claim,
nor does it change the benefits received by a worker.
The WCB’s use of an “experience rating” component means that an
employer’s WCB claims influence the WCB premiums they pay. Some
have suggested the experience rating gives employers an incentive to
suppress WCB claims. Others say the experience rating gives employers
an incentive to undertake safety programs and measures that prevent
injuries and illnesses in their workplaces.
INDUSTRY CUSTOM PRICING
The WCB offers Industry Custom Pricing (ICP) as an option for the
calculation of employer premiums. Participation in ICP is industrybased. The WCB works with representatives of an industry to customize
a pricing model for that industry. Various options exist. For example,
an industry can choose to change the experience rating component,
so that individual employers’ claims records are weighted more heavily
in the calculation of WCB premiums.
An industry must choose to move to ICP. Employers in the industry
are polled on the proposed ICP program. If a majority of the industry
votes in favour, the ICP program is then implemented for all employers
in the industry.
An industry can later choose to opt out of the ICP program and revert back
to the WCB’s standard pricing model, by way of a similar majority vote.
In an industry-wide vote about ICP, a “majority” is defined as at least
50% of the industry as measured by insurable earnings. This means
that, in some industries, a handful of very large employers can decide
the vote, even if they constitute a minority of the total number of
employers in the industry.
33 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
As a result, some have raised concerns that the WCB’s approach
to establishing an ICP program creates inequities between smaller
and larger employers. Others say the approach is not inequitable,
because it is based on the number of workers in the industry,
not the number of employers.
PARTNERSHIPS IN INJURY REDUCTION
DID YOU KNOW?
In 2015, $966.7 million
in benefit costs
were incurred by
WCB (excluding
administration costs.)
The WCB contributes to the prevention of workplace injuries by
participating in the Partnerships in Injury Reduction (PIR) program.
The PIR program is a voluntary program in which employer and worker
representatives work collaboratively with the government to build
health and safety management systems.
A Partner is an association, corporation or organization that commits
to taking a leadership role in health and safety by entering into a formal
agreement with the Alberta government. The Government and each
Partner sign a Memorandum of Understanding outlining the specific
commitments made by each organization.
The WCB offers an incentive (in the form of a premium reduction)
to employers who participate in PIR. Some have questioned whether
this incentive makes sense, since it is not connected to the employer’s
experience rating (i.e., their claims record). Others have suggested that
the incentive makes sense, as it encourages employers to build safety
management systems.
THE WCB ACCIDENT FUND
The Workers’ Compensation Act requires the WCB to maintain sufficient
funds in the WCB’s Accident Fund for the payment of present and future
compensation to injured workers.
The concept of future compensation is important. In many instances,
the WCB will be required to pay benefits to a worker for a long time period.
Benefits will also be subject to inflation over time. There needs to be
sufficient money in the Accident Fund to cover these long-term costs.
The Accident Fund is considered fully funded when the total of all assets
equals or exceeds 100 percent of total liabilities.
The Accident Fund is managed so that it can generate investment
returns. These investment returns can sometimes be better or worse
than expected. Management of the Accident Fund involves a lot of
actuarial science and the knowledge of investment professionals.
In managing the Accident Fund and establishing employer premiums,
the WCB follows its Funding Policy, for which the Board is responsible.
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 34
DID YOU KNOW?
Over the past 10 years
the WCB’s funded ratio
has ranged considerably,
from a low of 104% to a
high of 140%. This reflects
the volatility that can
occur in the marketplace,
and hence, in the
Accident Fund.
Source: 2014 WCB Alberta
Annual Report
The Funding Policy has several goals:
• Minimize the risk of being unfunded – To ensure injured workers
benefits are secure, and that there is sufficient money in the Accident
Fund for the payment of current and future benefits.
• Current employers pay for today’s accidents – Stability is maintained
in the Accident Fund by having today’s employers pay for the current
and future costs of today’s accidents. This reduces the risk of passing
the costs on to the next generation of employers.
• Minimize cost volatility to employers – To ensure that volatility of the
Accident Fund does not create volatility in employer premiums. The
objective is that premium rates reflect the current and future costs
of today’s accidents.
• Minimize the total cost charged to employers – The Accident Fund
is managed to earn a rate of return that covers the annual growth
in the liabilities associated with current and prior year accidents.
To achieve the goals of the Funding Policy, the WCB has established
a target funding range for the Accident Fund of between 114% and 128%.
This range was developed in consultation with experts independent of
the WCB and the use of asset-liability modelling tools. The WCB indicates
that the funding range, and the modelling that supports the range, are
reviewed each year to ensure they remain appropriate.
If the funded ratio of the Accident Fund falls below the target funding
range (i.e., lower than 114%), the WCB can decide to collect additional
money from employers in order to bring the Accident Fund to required
levels. This will be done in the form of a levy.
Conversely, if the funded ratio of the Accident Fund rises above the target
funding range (i.e., greater than 128%), the WCB can decide to distribute
a portion of surplus to employers. When the WCB does this, any money
distributed is from better-than-expected investment returns, not the
premiums that were collected.
This is akin to using a portion of interest from an investment, without
touching the principal of the investment. Employer premiums are like the
principal, and they stay in the Accident Fund so that they can fully fund
the present and future costs of claims. Interest amounts that are realized
from better-than-expected investment returns can be taken out of the
Accident Fund and distributed to employers.
Questions have arisen about the WCB’s target funding range and its
implications for premiums, levies and distributions. Some people say that
the WCB should freeze or cut premiums so that it does not have a surplus
in its Accident Fund. Other people say that freezing or cutting premiums
would go against the principle that today’s premiums pay for today’s
accidents and would raise the risk that there would be insufficient money
available to pay the current and future costs of benefits for workers. Still
others say that the Accident Fund should retain a comfortable surplus,
in case markets are volatile and the Fund’s investments fall in value.
35 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
APPENDIX A:
WORKERS’ COMPENSATION VS PRIVATE INSURANCE
Some of the differences between workers’ compensation and the private insurance
industry are summarized in the table below:
WORKERS’ COMPENSATION
PRIVATE INSURANCE
Self-regulating, exclusive jurisdiction subject
to statutory review and appeal and judicial
review and appeal.
Regulation by the Superintendent of Insurance.
Compulsory for all industries under the
Workers’ Compensation Act, voluntary for
exempt industries.
Voluntary except for compulsory auto insurance.
Statutory monopoly given to the Workers’
Compensation Board (WCB).
Competitive marketplace for both brokers
and providers.
Mandatory coverage cannot be cancelled,
and claims must be honoured even if
premiums are not paid.
Policy can be cancelled for non-payment
of premiums.
The WCB has no choice of risk and cannot
refuse coverage to any employer that is
subject to mandatory coverage.
Insurers have choice of risk and the right
to reject customers,
Mandatory coverage or the right to claim
cannot be forfeited for breach of the statute
by the employer or the worker.
Breach of conditions may result in forfeiture
of the policy or rejection of a claim.
Claims can always be reopened.
Claims can be finally settled.
Disputes are resolved by the statutory review
and appeal process or administrative law
proceedings.
Disputes resolved by legal action in the courts.
The WCB is not-for-profit. Excess premiums
can be rebated.
Private insurers are for-profit.
The WCB has a public law duty to workers
and employers.
Private insurers have a contractual duty
and must act in utmost good faith.
The WCB can only pursue third party action
against non-participants.
Private insurers subrogate against one another.
Originally published in Douglas R. Mah’s book, Workers’ Compensation Practice in Alberta ,
2 nd ed., Carswell. Reprinted with permission of the author and publisher.
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 36
APPENDIX B:
WCB CLAIM STATISTICS
The information below outlines the volume of claims administered by the WCB in 2015.
Active claims
as of
January 1, 2015
28,586
Total new
claims reported
133,437
Including
Lost-time
26,029
Medical-aid-only
107,408
Total Claims
Administered
in 2015
180,922
Recurrent
claims*
18,899
* Recurrent claims are previously inactive claims that required further adjudication or case management. Claims
may reopen for a number of reasons, such as payment for medical aid or requests for further compensation benefits.
(Source: WCB Annual Report.)
CLAIMS VOLUME IN 2015
Active claims as of January 1
28,586
New lost-time claims
26,029
New medical-aid-only claims
107,408
Total new claims reported
133,437
18,899
Recurrent claims
(previously inactive claims that required further adjudication or case management. Claims
may reopen for a number of reasons, such as payment for medical aid or requests for further
compensation benefits)
Total Claims Administered
180,922
The information below outlines the number of claims that the WCB determined
were ineligible for payment of benefits, based on the reasons identified:
INELIGIBLE CLAIMS IN 2015
Lost-time
Claim
Medical-aidonly claims
Total Ineligible
Claims
133
3,827
3,960
246
2,756
3,002
Injury or illness not arising
out of/in course of employment
2,009
4,948
6,957
Total
2,388
11,531
13,919
Insufficient information available
to process claim
Not covered under Workers’
Compensation Act
37 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
APPENDIX C:
APPEALS COMMISSION STATISTICS
Of the appeals heard by the Appeals Commission in 2014-15, 57% were confirmed,
19% were varied and 24% were reversed.
The top five issues of appeal were:
• acceptability of claim 16%,
• additional entitlement 14%,
• temporary total disability 12%,
• Economic Loss Payment (ELP) Calculation 10%, and
• rehabilitation services 7%.
In 2014-15, the Appeals Commission received 1,068 requests for appeal (including 959 initial
requests, 76 reconsiderations and 33 time extension requests). In that same time period,
1,128 appeals were concluded (including 991 initial requests, 111 reconsiderations and 26 time
extension requests). Workers submitted 83% of the appeals and employers submitted 17%.
The average number of days from the date the appeal is filed to the first hearing date
offered was 157 days. 35
35
Appeals Commission 2014-2015 Annual Report
https://www.appealscommission.ab.ca/Reports/Annual%20Reports/2014-2015%20Annual%20Report.pdf
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 38
APPENDIX D:
ORGANIZATIONS RESPONSIBLE
FOR OCCUPATIONAL HEALTH & SAFETY
Overview of the Organizations Responsible for Occupational Health & Safety. 36
Enforcement
Regulations
Training/
Education
Prevention
Funding
Government
Government
Government
Government
WCB
WorkSafe BC*
WorkSafe BC
WorkSafe BC
WorkSafe BC
WorkSafe BC
Saskatchewan
Government
Government
Government
Government
WCB
Manitoba
Government
Government
Government
SAFE Work
Manitoba
(independent
arm of the WCB
governed by
a prevention
committee of
the WCB board
of Directors
WCB
Ontario
Government
Government
Government
Government
Workplace
Safety and
Insurance
Board
Quebec
Commission
des normes,
de l’équité,
de la santé et
de la sécurité
du travail
(CNESST)*
CNESST
CNESST
CNESST
CNESST
Government
Government
WorkplaceNL
WorkplaceNL
WorkplaceNL
WorksafeNB*
WorksafeNB
WorksafeNB
WorksafeNB
WorksafeNB
Government
Government
WCB
WCB
WCB
WCB
WCB
WCB
WCB
WCB
Alberta
British
Columbia
Newfoundland
and Labrador
New
Brunswick
Nova Scotia
Prince
Edward Island
Yukon
Northwest
Territories
and Nunavut
WCB
WCB
WCB
WCB
WCB
Workers’
Safety and
Compensation
Commission
Workers’
Safety and
Compensation
Commission
Workers’
Safety and
Compensation
Commission
Workers’
Safety and
Compensation
Commission
Workers’
Protection
Fund
* These entities deliver workers’ compensation.
36
Association of Workers’ compensation Boards of Canada – 2015 – Occupational Health & Safety:
Who is Responsible? http://awcbc.org/?page_id=77
39 | WORKING TOGETHER ALBERTA WORKERS’ COMPENSATION BOARD (WCB) REVIEW
A GUIDE TO THE REVIEW OF THE WORKERS’ COMPENSATION SYSTEM | 40