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Difference between revisions of "Workers' Compensation Claim Benefits (7:XI)"
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Workers' Compensation Claim Benefits (7:XI) (view source)
Revision as of 22:21, 2 December 2021
, 22:21, 2 December 2021→E. Health Care Benefits
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A temporary disability ceases when the worker’s medical condition either resolves entirely or is not expected to change significantly in the next 12 months. At this point, the medical condition is said to have “plateaued” and is considered permanent (see RSCM II, Policy #34.54). In either case, the Board ceases to pay further temporary wage loss benefits under ss. 191 or 192 of the Act [Former Act, s. 29 or 30] at this point. | A temporary disability ceases when the worker’s medical condition either resolves entirely or is not expected to change significantly in the next 12 months. At this point, the medical condition is said to have “plateaued” and is considered permanent (see RSCM II, Policy #34.54). In either case, the Board ceases to pay further temporary wage loss benefits under ss. 191 or 192 of the Act [Former Act, s. 29 or 30] at this point. | ||
== | == D. Health Care Benefits == | ||
Health care benefits are payable under ss. 156-161 of the Act [Former Act, s. 21] for the period of the worker’s disability, and thereafter to “cure and relieve from the effects of the injury or alleviate those effects”. Chapter 10 of the RSCM II greatly expands the Board’s regulation and control of particular health care benefits including all forms of treatment, medical investigation with specialists, medical aids and medications. As noted above, if a worker has an impairment but can perform their full pre-injury job, the claim is accepted for health care benefits only (as long as there is a short episode of disability: see RSCM II, Policy #33.00). | Health care benefits are payable under ss. 156-161 of the Act [Former Act, s. 21] for the period of the worker’s disability, and thereafter to “cure and relieve from the effects of the injury or alleviate those effects”. Chapter 10 of the RSCM II greatly expands the Board’s regulation and control of particular health care benefits including all forms of treatment, medical investigation with specialists, medical aids and medications. As noted above, if a worker has an impairment but can perform their full pre-injury job, the claim is accepted for health care benefits only (as long as there is a short episode of disability: see RSCM II, Policy #33.00). | ||
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The Board has the right to supervise a worker’s treatment (Act, ss. 156-161 [Former Act, s. 21]) and to authorize any surgery. If a worker decides to undergo surgery or other treatment that is not authorized by the Board, the costs may not be paid, and if the injury is worsened by the treatment, benefits may be cut off or reduced. The Board usually agrees to pay for surgery recommended by the worker’s own doctor, but the doctor should ask for the Board Advisor’s approval. The Board often refuses to pay for drugs or physiotherapy considered unnecessary by its advisors. Medical Aid decisions can be appealed. | The Board has the right to supervise a worker’s treatment (Act, ss. 156-161 [Former Act, s. 21]) and to authorize any surgery. If a worker decides to undergo surgery or other treatment that is not authorized by the Board, the costs may not be paid, and if the injury is worsened by the treatment, benefits may be cut off or reduced. The Board usually agrees to pay for surgery recommended by the worker’s own doctor, but the doctor should ask for the Board Advisor’s approval. The Board often refuses to pay for drugs or physiotherapy considered unnecessary by its advisors. Medical Aid decisions can be appealed. | ||
== F. Income Continuity Benefits == | == F. Income Continuity Benefits == | ||