POLICY: 05-02 PART II
Alberta WCB
Policies &
Information
Chapter:
COST AND ENTITLEMENT ADJUSTMENTS
Subject :
COST RELIEF
Authorization:
Date:
BoD Resolution 96/10/53
November 26, 1996
APPLICATION 1 : GENERAL
Does cost relief apply when
there is an enhancement
factor?
Costs resulting from the application of an enhancement
factor are relieved from the employer's experience account,
unless the costs result from a single accident causing
multiple injuries (see Policy 04-04, Permanent Disability) .
6.
Does the WCB apply cost
reliefwhen a worker is
injured during an epileptic
seizure?
Epilepsy itself is not compensable unless it resulted from a
compensable head injury. Costs for epilepsy or epileptic
seizures resulting from a compensable head injury will be
charged to the accident employer's experience account .
Full cost relief only applies when there is no compensable
head injury but a seizure occurs during the course of
employment, causing other injuries (see Policy 02-01,
Arises Out of and Occurs in the Course of Employment) .
7.
How is cost relief applied to
second injury claims?
Costs resulting from the acceptance of a second injury
claim (see Policy 03-01, Injuries) will be relieved from the
employer's experience account and charged to the industry
of the primary accident employer .
The same applies when a worker suffers a new injury or
aggravates a pre-existing condition while participating in a
WCB sponsored training program. The resulting costs are
removed from the accident employer who provided the
training or assessment services.
8.
Does cost relief apply to any
supplements or allowances?
The WCB will relieve costs resulting from a supplement
granted under s.65 ofthe Act (see Policy ADJ-30,
rescinded effective January 1, 1995). Costs resulting from
a Rehabilitation Surgery Allowance or a Level One Home
Maintenance Allowance are charged to the accident
employer's industry (see Policy 03-02, Aggravation of a
Pre-Existing Condition and Policy 04-07, Services for
Workers with Severe Injuries).
Issue Date: January 1, 2002
Supersedes January 1, 2000
Copyright 2001 All rights reserved
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5.
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POLICY: 05-42 PART II
Alberta WCB
Policies &
Information
Chapter :
COST AND ENTITLEMENT ADJUSTMENTS
Subject :
COST RELIEF
Authorization:
Date:
BoD Resolution 96/10/53
November 26, 1996
APPLICATION 1 : GENERAL
9.
Under what conditions does
an employer receive cost
relieffor compensation
overpayments?
If the employer did not contribute to the overpayment by
providing incorrect information, the WCB may remove the
amount ofthe overpayment from the employer's account
(see Policy 05-01, New Evidence).
10. Does the WCB relieve costs
when the worker has
concurrent earnings?
Concurrent earnings are earnings at the date of accident
from employment sources other than the accident employer
(see Policy 04-01, Establishing Net Earnings) .
When concurrent earnings are used to establish the
worker's compensation rates, the costs resulting from the
concurrent earnings are relieved from the accident
employer's experience account .
11.
What happens in the case of
third parry recoveries?
The WCB may provide cost relief when a settlement or
judgement is received from a third party concerning a
worker's claim. The WCB may consider early cost relief in
third party motor vehicle accidents (see Policy 07-02,
Experience Records).
Issue Date: January 1, 2002
Alberta
Supersedes: January 1, 2000
Copyright 2001 All rights reserved
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When changes to benefit amounts are effective the date of
the amended decision, there is no overpayment for benefits
paid to that date. The WCB may still remove the benefit
costs provided the employer did not contribute to the
overturned decision by supplying incorrect information.
The WCB will calculate the difference in benefits as though
the decision has been retroactive and may remove that
amount from the employer's account.
POLICY: 05-02 PART II
Alberta WCB
Policies &
Information
Chapter:
COST AND ENTITLEMENT ADJUSTMENTS
Subject :
COST RELIEF
Authorization :
Date:
BoD Resolution 96/10/53
November 26, 1996
APPLICATION 2: OCCUPATIONAL DISEASE
5.
What is the provision for
cost relief on cardiac
claims?
Cost relief applies only if the claim for cardiac condition is
accepted:
as an aggravation ofa pre-existing cardio respiratory
condition, or
"
on the basis of a presumptive causal relationship (see
Policy 03-01, Injuries) .
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"
The WCB will relieve claim costs exceeding the dollar
value of eight times the weekly maximum compensation
rate [based on maximum insurable earnings under s.56(4)
ofthe Act] in effect at the date of accident. The dollar
value is the same for all workers, regardless ofthe worker's
individual earnings (see Addendum A at the end of the
policy for the dollar value) .
6.
How is cost reliefapplied to
other occupational disease
claims?
Depending on the nature of the disease, each case is judged
on its own merits . Cost relief may be considered using the
principles described in Questions 1 and 3 above.
Issue Date. January 1, 2002
supersedes: June 1, 1999
Copyright 2001 All rights reserved
Part II
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Alberta WCB
Policies &
Information
POLICY : 05-02 PART II
Chapter:
COST AND ENTITLEMENT ADJUSTMENTS
Subject :
COST RELIEF
Authorization :
Date :
BoD Resolution 96/10/53
November 26, 1996
APPLICATION 3 : BACK INJURIES
1.
What cost relief does an
employer receive on a claim
for a single back injury?
The WCB does not provide cost reliefto claims resulting
from a direct injury to an otherwise healthy spine.
Claim costs exceeding the dollar value of eight times the
weekly maximum compensation rate [based on maximum
insurable earnings under s.56(4) of the Act ] in effect at the
date ofaccident are relieved. The dollar value is the same
for all workers, regardless ofthe worker's individual
earnings (See Addendum A for the dollar value) .
Date of accident prior
to August 1, 1994
Alberta
For back injuries (other than a direct injury to the spine)
occurring prior to August 1, 1994 with over eight weeks
of disablement, the WCB will presume that a pre-existing
condition is likely a contributing factor. Claim costs in
excess of the amount specified in Addendum A are relieved
from the accident employer's account.
Issue Date. January 1, 2002
Supersedes: January 1, 2000
Copyright 2001 All rights reserved
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Date ofaccident on or For back injuries occurring on or after August 1, 1994,
after August], 1994
cost relief will be considered if medical evidence indicates
that the compensable accident has aggravated a preexisting condition and causes a prolonged period of
disability.
POLICY: 05-02 PART II
Alberta WCB
Policies &
Information
Chapter
_COST AND ENTITLEMENT ADJUSTMENTS
Subject :
COST RELIEF
Authorization :
BoD Resolution 96/10/53
Date:
November 26, 1996
APPLICATION 3 : BACK INJURIES
5.
How does the WCB
To determine if a compensable injury has aggravated a pre-
e.g., twisting, lifting heavy objects)
"
the extent or severity of the underlying condition
"
the degree to which the injury may have affected the
condition.
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determine ifthe
existing condition, the WCB will obtain a medical opinion,
compensable back injury has taking into consideration:
aggravated the underlying
condition?
" the mechanism of injury (how the injury occurred:
In all cases where a pre-existing condition is present, the
WCB must also determine if the compensable injury has
aggravated the condition and prolonged the period of
disability. Even significant pre-existing conditions
identified by imaging may not have been aggravated by a
trivial injury and, in such cases, cost relief is not applicable .
When the pre-existing condition is not aggravated, but the
period of disability is longer than normally expected for the
compensable injury, the WCB will review the claim to
determine if the ongoing disability is related to the
compensable injury .
Alberta
Issue Date January 1, 2002
Supersedes: December 15, 2000
Copyright 2001 All rights reserved
Part II page
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POLICY: 05-02 PART II
Alberta WCB
Policies &
Information
Chapter:
COST AND ENTITLEMENT ADJUSTMENTS
Subject :
COST RELIEF
Authorization:
Date :
BoD Resolution 96/10/53
November 26, 1996
ADDENDUM A
Eight Times the Weekly Maximum Compensation Rate
Date of Accident
Maximum Claim Costs
February 1, 1975 ** to June 25, 1975
June 26, 1975 to June 30, 1976
July 1, 1976 to June 30, 1977
July 1, 1977 to June 30, 1978
July 1, 1978 to June 30, 1979
July 1, 1979 to December 31, 1980
January 1, 1981 to December 31, 1981
January 1, 1982 to December 31, 1982
January 1, 1983 to December 31, 1983
January 1, 1984 to December 31, 1984
January 1, 1985 to December 31, 1985
January 1, 1986 to December 31, 1986
January 1, 1987 to December 31, 1987
January 1, 1988 to December 31, 1988
January 1, 1989 to December 31, 1989
January 1, 1990 to December 31, 1990
January 1, 1991 to December 31, 1991
January 1, 1992 to December 31, 1992
January 1, 1993 to December 31, 1993
January 1, 1994 to December 31, 1994
January 1, 1995 to December 31, 1995
January 1, 1996 to December 31, 1996
January 1, 1997 to December 31, 1997
January 1, 1998 to December 31, 1998
January 1, 1999 to December 31, 1999
January 1, 2000 to December 31, 2000
January 1, 2001 to December 31, 2001
January 1, 2002
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$1,150 .72
$1,495 .92
$1,668 .48
$1,795 .04
$1,904.40
$2,100 .00
$2,531 .52
$3,969 .60
$4,082 .48
$4,116 .88
$4,072 .08
$4,075 .28
$4,053 .04
$3,972 .40
$4,055 .20
$4,058 .96
$4,045 .76
$4,206 .64
$4,211 .44
$4,217 .36
$4,287 .36
$4,364 .08
$4,431 .04
$4,500 .88
$4,528 .40
$4,811 .36
$5,000 .40
$5,881 .92
'"'" Prior to February 1, 1975, all costs exceeding $1,000 .00 were relieved from the employer's experience account.
Issue Date: January l, 2002
Supersedes: December 15, 2000
Copyright 2001 All rights reserved
Part II
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