Difference between revisions of "Workers' Compensation"

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Getting hurt or ill on the job not only impacts your health, but can leave you without a source of income. That’s where British Columbia’s workers’ compensation program comes in.


==What is Workers’ Compensation?==
==What you should know==
Workers’ Compensation is a government program run by the Workers’ Compensation Board of BC and paid for by employers. The Workers’ Compensation Board now uses the name “WorkSafeBC.” The program is designed to:
*pay workers for some of their lost income and certain expenses if they suffer a workplace injury or disease – regardless of who was at fault – or to pay a worker’s family if the worker dies from the injury or disease.
*help injured workers get back to work.
*make and enforce health and safety rules and promote safety in the workplace. As of November 2013, WorkSafeBC policies deal with workplace bullying and harassment. They explain what these terms mean and set out the duties of employers, employees and supervisors to prevent and respond to workplace bullying and harassment. Details are on the WorkSafeBC website at [http://www.worksafebc.com www.worksafebc.com].


The ''Workers Compensation Act'' is available at [http://www.bclaws.ca www.bclaws.ca].
===Workers’ compensation pays injured workers and promotes workplace safety===
'''Workers’ compensation''' is a BC government program [https://www.canlii.org/en/bc/laws/stat/rsbc-1996-c-492/latest/rsbc-1996-c-492.html under the ''Workers Compensation Act'']. [https://www.worksafebc.com/en It is run by Work Safe BC] and is paid for by employers. The program pays workers for some of their lost income and certain expenses if they suffer a workplace injury or disease — regardless of who was at fault. The program pays a worker’s family if the worker dies from the injury or disease.


==Who can get Workers’ Compensation?==
The program also helps injured workers get back to work. As well, it promotes health and safety in the workplace, including preventing and responding to workplace bullying and harassment (including sexual harassment).
The program covers almost all workers, both full- and part-time, including office workers, farm workers, performers, and domestic workers. Unregistered labour contractors may also be entitled to benefits. Independent contractors can register with the program for personal optional protection. If they don’t do this, they are not entitled to compensation for work injuries or diseases.


If you suffer a workplace injury or disease, you may be able to get one or more of the following benefits.
===Who can get workers’ compensation===
The workers’ compensation program covers almost all workers in British Columbia, both full- and part-time, including office workers, farm workers, performers, and domestic workers.


==Types of benefits==
Unregistered labour contractors may also be entitled to benefits. Independent contractors can register with the program for personal optional protection. If they don’t do this, they are not entitled to compensation for workplace injuries or diseases.
===1. Short-term disability or wage loss benefits for temporary disability===
These benefits pay you, at least partly, for income you lose because of your workplace injury or disease. If you are injured and unable to work, the benefits are usually 90% of your net wages. These benefits pay you for lost income, but only up to a maximum wage (adjusted each year). If you remain temporarily disabled after 10 weeks, WorkSafeBC may recalculate your benefits based on your income in the 12 months before your injury or disease. Wage loss benefits continue until you are no longer temporarily disabled or your condition becomes stable and will not get any better or worse.


===2. Long-term or permanent disability and death benefits===
If you suffer a workplace injury or disease, you may be able to get a range of disability benefits, health care benefits, and vocational rehabilitation benefits. We explain the various types of benefits shortly.
If you are permanently disabled, totally or partly, you are entitled to permanent disability benefits. These are paid in one of two ways: a “permanent functional impairment (PFI) award” or a “loss of earnings (LOE) award.” Usually, WorkSafeBC pays a PFI award. But if WorkSafeBC finds that a PFI award does not properly compensate you – because your disability reduces your ability to continue working in your occupation to an exceptional extent – it may pay an LOE award. Although a permanent disability award covers permanent chronic pain, it does not cover loss of enjoyment of life, or damage to your clothes or vehicle.


Normally, if benefits are more than $200 a month, they are paid monthly. If benefits are less than $200 a month, you will probably get a lump-sum payout. Even if WorkSafeBC plans to pay you benefits monthly, you can apply for a “commutation” (a lump-sum payout) of all or part of your award. Generally, you won’t get a commutation if the benefits are more than $200 a month. You may get a commutation only if it improves your income. And you must have another stable income source, apart from the benefits.
A workplace injury or disease can include a mental disorder. For example, a worker who is sexually harassed at work and suffers a mental disorder from it, may be able to get compensation (even if the harassment did not involve a physical injury).


Families of workers who are killed on the job or die from a workplace injury or disease, may qualify for an award and vocational training help.
===Benefits if you suffer a temporary disability===
If you suffer a temporary disability, you can qualify for '''short-term disability benefits''' and '''wage loss benefits'''.


===3. Health care benefits===
These benefits pay you, at least partly, for income you lose because of a workplace injury or disease. If you are injured and unable to work, the benefits are usually 90% of your net wages at the time of your injury or disease. These benefits pay you for lost income, up to a maximum wage (adjusted each year). If you remain disabled after 10 weeks, Work Safe BC may recalculate your benefits based on your net income in the 12 months before your injury or disease.
Health care benefits pay for doctors, hospitals, nursing care, home care, prescription drugs, and other health care professionals like physiotherapists, dentists, and chiropractors. They also cover other expenses, including medical supplies, appliances like crutches, hearing aids, dentures, and eyeglasses, and modifications to home, vehicles, and workplace.


===4. Vocational rehabilitation benefits===
Wage loss benefits continue until you are no longer temporarily disabled or your condition becomes stable.
If WorkSafeBC decides that you cannot return to your pre-injury job because of your injury and your employer cannot offer a modified job, you may be entitled to vocational rehabilitation services. These benefits are for vocational retraining, workplace redesign or job modification, training on the job, and job search activity. If your injury or disease eventually forces you to change your occupation, you should think about your future educational and vocational needs. You should ask WorkSafeBC for rehabilitation guidance to help you plan your future. You have to take charge of your own rehabilitation. If you have a good idea of what you want, you explain it, and it is appropriate, the more likely you are to get it.


==How to apply==
===Benefits if you are permanently disabled===  
If you suffer a workplace injury or illness, report it immediately to your employer, your doctor and WorkSafeBC. You can get application forms from your employer, your union, or the WorkSafeBC website at [http://www.worksafebc.com www.worksafebc.com]. Call 604.231.8888 in the lower mainland and 1.888.967.5377 elsewhere in BC (free of charge). Your employer and your doctor must report your injury or disease to WorkSafeBC within 3 days of when you tell them about it.
If you are permanently disabled, totally or partly, you may be able to get '''permanent disability benefits''' and '''retirement benefits'''.


You have only one year from your accident or disease to apply for compensation. After that, you may lose your right to benefits unless special circumstances stopped you from applying on time.
Work Safe BC won’t decide about any permanent disability until your condition becomes stable. “Stable” means your condition stays the same and the medical evidence indicates it will probably not get any better or worse over the next 12 months.


A WorkSafeBC officer will examine your claim and decide if you get benefits, and if so, the type and amount. WorkSafeBC won’t decide about any permanent disability until your condition becomes stable, meaning that it stays the same and does not get any better or worse.
The focus is on whether and how your condition impairs your future earning capacity. If Work Safe BC finds it does, they look at providing a permanent disability award.


Deciding whether you get benefits can be complicated. You should discuss your case with your union, a lawyer, or the Workers’ Advisers Office. Workers’ Advisers work for the Ministry of Labour and Citizens’ Services to help workers with their claims. They are separate from WorkSafeBC and there’s no charge for their service. Their website is [http://www.labour.gov.bc.ca/wab www.labour.gov.bc.ca/wab] and their phone numbers are 604.713.0360 in Vancouver and 1.800.663.4261 elsewhere in BC.
====How the benefits are calculated====
Permanent disability benefits are paid in one of two ways: a “permanent functional impairment” award (called a PFI award) or a “loss of earnings” award (called an LOE award). Usually, Work Safe BC pays a PFI award, to compensate you based on the kind of injury you have. But if Work Safe BC finds that a PFI award does not properly compensate you — because your disability reduces your ability to continue working in your occupation to an exceptional extent — it may pay an LOE award.


==Reviews and Appeals – if you disagree with the WorkSafeBC decision==
====How the benefits are paid====
If WorkSafeBC decides that you are not eligible for benefits, or if you don’t understand its decision, ask the WorkSafeBC officer handling your claim for an explanation. Ask for a decision letter if you didn’t already get one. If you’re still not satisfied, you can ask the Review Division of WorkSafeBC to review the decision. But you must ask for a review within 90 days of the date of WorkSafeBC’s decision letter or, in some cases, within 90 days of the date when WorkSafeBC told you its decision orally. WorkSafeBC should automatically give you a copy of your claim file and you can use the information in it for your review. After you request a review, you will receive a letter setting a time to make written submissions. The Review Division does not normally hold oral hearings.
Normally, if long-term benefits are more than $200 a month, they are paid monthly. If benefits are less than $200 a month, you will probably get a lump-sum payout. Even if Work Safe BC plans to pay your benefits monthly, you can apply for a lump-sum payout of all or part of your award.


The Review Division considers the written submissions and WorkSafeBC’s file and gives its decision, usually within 150 days. The WorkSafeBC website, at [http://www.worksafebc.com www.worksafebc.com], has more information on reviews. The phone numbers for the Review Division are 604.214.5411 in the lower mainland and 1.888.922.8804 elsewhere in BC. At the same time, if you feel that WorkSafeBC has treated you unfairly, you can also complain to its Fair Practices Office and the Ombudsperson of BC ([http://www.ombudsman.bc.ca www.ombudsman.bc.ca] and 1.800.567.3247).
===Health care and vocational rehabilitation benefits===
'''Health care benefits''' pay for doctors, hospitals, nursing care, home care, prescription drugs, and other health care professionals like physiotherapists, dentists, and chiropractors. They also cover other expenses, including medical supplies, appliances like crutches, hearing aids, dentures, and eyeglasses, as well as modifications to your home, vehicles, and workplace.


If you’re not satisfied with the decision of the Review Division, in most cases you have the right to appeal to the Workers’ Compensation Appeal Tribunal ([http://www.wcat.bc.ca www.wcat.bc.ca]). You must appeal within 30 days of the date of the decision of the Review Division.
If Work Safe BC decides you cannot return to your pre-injury job because of your injury and your employer cannot offer a modified job, you may be entitled to '''vocational rehabilitation services'''. These benefits are for vocational retraining, workplace redesign or job modification, training on the job, and job search activity.


==For more information==
{| class="wikitable"
Check the WorkSafeBC website at www.worksafebc.com for more information on workers’ compensation and reviews.
|align="left"|'''Tip'''
If you suffer a workplace injury or disease that eventually forces you to change your occupation, you should think about your future educational and vocational needs. You should ask Work Safe BC for rehabilitation guidance to help you plan your future. You have to take charge of your own rehabilitation. If you have a good idea of what you want, you explain it, and it is appropriate, the more likely you are to get it.
|}


Check script [[Appealing a Workers' Compensation Decision (Script 286)|286]], called “Appealing a Workers’ Compensation Decision”, and the Tribunal’s website at [http://www.wcat.bc.ca www.wcat.bc.ca] for more information on appeals. Also, check the Workers’ Advisers website at [http://www.labour.gov.bc.ca/wab www.labour.gov.bc.ca/wab] for detailed information on reviews and appeals. Employers should check the Employers’ Advisers website at [http://www.labour.gov.bc.ca/eao www.labour.gov.bc.ca/eao].
===Benefits for families of workers===
Families of workers who are killed on the job or die from a workplace injury or disease, may qualify for benefits.


The possible benefits include:


[updated February 2014]
* A monthly pension benefit for the surviving spouse, based on the worker’s earnings. This benefit continues for the spouse’s lifetime.
* A monthly benefit for a dependent child up to the age of 19. Benefits may continue to age 25 if the child regularly attends post-secondary school.
* Grief and vocational counselling for the surviving spouse, and grief counselling for any dependent children.
* Funeral benefits.


==How to apply for benefits==


----
===Step 1. Report the injury or illness immediately===
----
If you suffer a workplace injury or illness, report it immediately to your employer, your doctor and Work Safe BC. You can report the injury to Work Safe BC:


* By phone by calling Teleclaim at 1-888-967-5377.
* [https://www.worksafebc.com/en/claims/report-workplace-injury-illness/how-workers-report-workplace-injury-illness Online at the Work Safe BC website].
* By completing the print '''application for compensation and report of injury form''', and mailing or faxing it to Work Safe BC. You can get the print form from your employer, from your union, or [https://www.worksafebc.com/en/resources/claims/forms/application-for-compensation-and-report-of-injury-or-occupational-disease-form-6?lang=en from Work Safe BC].


Your employer and your doctor must report your injury or disease to Work Safe BC within three days of when you tell them about it.
===Step 2. Apply for benefits===
You must apply to Work Safe BC if you want benefits. Just reporting an injury to your employer and doctor is not enough. [https://www.worksafebc.com/en/claims/report-workplace-injury-illness/how-workers-report-workplace-injury-illness You can apply for benefits on the Work Safe BC website], or by completing the '''application for compensation and report of injury''' form, and mailing or faxing it to Work Safe BC.
You have '''one year''' from your accident or disease to apply for compensation. After that, you may lose your right to benefits unless special circumstances stopped you from applying on time.
====What happens when you apply====
A Work Safe BC officer will examine your claim and decide if you get benefits, and if so, the type and amount.
A decision on whether you get benefits can be complicated. You can discuss your case with your union, a lawyer, or the '''Workers’ Advisers Office'''. Workers’ advisers work for the Ministry of Labour to help workers with their claims. They are separate from Work Safe BC and there’s no charge for their services. To reach the Workers’ Advisers Office, visit [https://www2.gov.bc.ca/gov/content/employment-business/employment-standards-advice/personal-injury-and-workplace-safety the BC government website] or call 604-713-0360 in Vancouver or 1-800-663-4261 elsewhere in BC.
===Step 3. Ask for a review===
If Work Safe BC decides you are not eligible for benefits, or if you don’t understand its decision, ask the Work Safe BC officer handling your claim for an explanation. Ask for a decision letter if you didn’t already get one. If you’re still not satisfied, you can ask Work Safe BC for a '''review of the decision'''.
In a few scenarios, you can’t ask for a review but need to appeal directly to the Workers’ Compensation Appeal Tribunal. For example, if you are challenging a decision to reopen (or not reopen) a matter, or challenging a decision on a discriminatory action complaint (where an employer punished you for raising safety concerns at work). Appeals are explained shortly.
====Time limit to ask for review====
You must ask for a review within '''90 days''' of the date of Work Safe BC’s decision letter or, in some cases, within 90 days of the date when Work Safe BC told you its decision orally or stopped paying you.
====The review process====
When you ask for a review, Work Safe BC should automatically give you a copy of your claim file and you can use the information in it for your review. After you request a review, you will receive a letter setting a time to make written submissions. The review division does not normally hold oral hearings.
The review division considers the written submissions and Work Safe BC’s file and gives its decision, usually within 150 days. [https://www.worksafebc.com/en/review-appeal The Work Safe BC website has more information on reviews]. The phone numbers for the review division are 604-214-5411 in the Lower Mainland and 1-888-922-8804 elsewhere in BC.
{| class="wikitable"
|align="left"|'''Tip'''
While your review is being considered, if you feel that Work Safe BC has treated you unfairly, you can also complain to Work Safe BC’s Fair Practices Office and [https://bcombudsperson.ca/ complain to the Ombudsperson of BC] (who can be reached at 1-800-567-3247).
|}
===Step 4. Appeal the review decision===
If you disagree with the decision on the review, [http://www.wcat.bc.ca/ you can usually '''appeal''']. You bring the appeal to the Workers’ Compensation Appeal Tribunal. You cannot appeal review decisions on some issues, such as vocational rehabilitation benefits, certain types of disability awards, and whether benefits are paid as a lump sum.
If you decide to appeal, you must do so within '''30 days''' of the decision of the review division. For details on the process, see [[Workers' Compensation|appealing a workers’ compensation decision]].
==Who can help==
===With a claim===
The '''Work Safe BC''' website includes extensive information on workers’ compensation benefits, how to apply for benefits, and the process to review or appeal a decision.
* Call 604-231-8888
* Call 1-888-967-5377
* [https://www.worksafebc.com/ Visit website]
The '''Workers’ Advisers Office''' is a government office that helps workers with claims for workers’ compensation benefits. They are separate from Work Safe BC and there’s no charge for their services.
* Call 1-800-663-4261
* [https://www2.gov.bc.ca/gov/content/employment-business/employment-standards-advice/personal-injury-and-workplace-safety Visit website]
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Revision as of 05:15, 7 November 2020

This information applies to British Columbia, Canada. Last reviewed for legal accuracy by Tim Martiniuk, Workers’ Compensation Appeal Tribunal (WCAT) in January 2018.

Getting hurt or ill on the job not only impacts your health, but can leave you without a source of income. That’s where British Columbia’s workers’ compensation program comes in.

What you should know

Workers’ compensation pays injured workers and promotes workplace safety

Workers’ compensation is a BC government program under the Workers Compensation Act. It is run by Work Safe BC and is paid for by employers. The program pays workers for some of their lost income and certain expenses if they suffer a workplace injury or disease — regardless of who was at fault. The program pays a worker’s family if the worker dies from the injury or disease.

The program also helps injured workers get back to work. As well, it promotes health and safety in the workplace, including preventing and responding to workplace bullying and harassment (including sexual harassment).

Who can get workers’ compensation

The workers’ compensation program covers almost all workers in British Columbia, both full- and part-time, including office workers, farm workers, performers, and domestic workers.

Unregistered labour contractors may also be entitled to benefits. Independent contractors can register with the program for personal optional protection. If they don’t do this, they are not entitled to compensation for workplace injuries or diseases.

If you suffer a workplace injury or disease, you may be able to get a range of disability benefits, health care benefits, and vocational rehabilitation benefits. We explain the various types of benefits shortly.

A workplace injury or disease can include a mental disorder. For example, a worker who is sexually harassed at work and suffers a mental disorder from it, may be able to get compensation (even if the harassment did not involve a physical injury).

Benefits if you suffer a temporary disability

If you suffer a temporary disability, you can qualify for short-term disability benefits and wage loss benefits.

These benefits pay you, at least partly, for income you lose because of a workplace injury or disease. If you are injured and unable to work, the benefits are usually 90% of your net wages at the time of your injury or disease. These benefits pay you for lost income, up to a maximum wage (adjusted each year). If you remain disabled after 10 weeks, Work Safe BC may recalculate your benefits based on your net income in the 12 months before your injury or disease.

Wage loss benefits continue until you are no longer temporarily disabled or your condition becomes stable.

Benefits if you are permanently disabled

If you are permanently disabled, totally or partly, you may be able to get permanent disability benefits and retirement benefits.

Work Safe BC won’t decide about any permanent disability until your condition becomes stable. “Stable” means your condition stays the same and the medical evidence indicates it will probably not get any better or worse over the next 12 months.

The focus is on whether and how your condition impairs your future earning capacity. If Work Safe BC finds it does, they look at providing a permanent disability award.

How the benefits are calculated

Permanent disability benefits are paid in one of two ways: a “permanent functional impairment” award (called a PFI award) or a “loss of earnings” award (called an LOE award). Usually, Work Safe BC pays a PFI award, to compensate you based on the kind of injury you have. But if Work Safe BC finds that a PFI award does not properly compensate you — because your disability reduces your ability to continue working in your occupation to an exceptional extent — it may pay an LOE award.

How the benefits are paid

Normally, if long-term benefits are more than $200 a month, they are paid monthly. If benefits are less than $200 a month, you will probably get a lump-sum payout. Even if Work Safe BC plans to pay your benefits monthly, you can apply for a lump-sum payout of all or part of your award.

Health care and vocational rehabilitation benefits

Health care benefits pay for doctors, hospitals, nursing care, home care, prescription drugs, and other health care professionals like physiotherapists, dentists, and chiropractors. They also cover other expenses, including medical supplies, appliances like crutches, hearing aids, dentures, and eyeglasses, as well as modifications to your home, vehicles, and workplace.

If Work Safe BC decides you cannot return to your pre-injury job because of your injury and your employer cannot offer a modified job, you may be entitled to vocational rehabilitation services. These benefits are for vocational retraining, workplace redesign or job modification, training on the job, and job search activity.

Tip

If you suffer a workplace injury or disease that eventually forces you to change your occupation, you should think about your future educational and vocational needs. You should ask Work Safe BC for rehabilitation guidance to help you plan your future. You have to take charge of your own rehabilitation. If you have a good idea of what you want, you explain it, and it is appropriate, the more likely you are to get it.

Benefits for families of workers

Families of workers who are killed on the job or die from a workplace injury or disease, may qualify for benefits.

The possible benefits include:

  • A monthly pension benefit for the surviving spouse, based on the worker’s earnings. This benefit continues for the spouse’s lifetime.
  • A monthly benefit for a dependent child up to the age of 19. Benefits may continue to age 25 if the child regularly attends post-secondary school.
  • Grief and vocational counselling for the surviving spouse, and grief counselling for any dependent children.
  • Funeral benefits.

How to apply for benefits

Step 1. Report the injury or illness immediately

If you suffer a workplace injury or illness, report it immediately to your employer, your doctor and Work Safe BC. You can report the injury to Work Safe BC:

  • By phone by calling Teleclaim at 1-888-967-5377.
  • Online at the Work Safe BC website.
  • By completing the print application for compensation and report of injury form, and mailing or faxing it to Work Safe BC. You can get the print form from your employer, from your union, or from Work Safe BC.

Your employer and your doctor must report your injury or disease to Work Safe BC within three days of when you tell them about it.

Step 2. Apply for benefits

You must apply to Work Safe BC if you want benefits. Just reporting an injury to your employer and doctor is not enough. You can apply for benefits on the Work Safe BC website, or by completing the application for compensation and report of injury form, and mailing or faxing it to Work Safe BC.

You have one year from your accident or disease to apply for compensation. After that, you may lose your right to benefits unless special circumstances stopped you from applying on time.

What happens when you apply

A Work Safe BC officer will examine your claim and decide if you get benefits, and if so, the type and amount.

A decision on whether you get benefits can be complicated. You can discuss your case with your union, a lawyer, or the Workers’ Advisers Office. Workers’ advisers work for the Ministry of Labour to help workers with their claims. They are separate from Work Safe BC and there’s no charge for their services. To reach the Workers’ Advisers Office, visit the BC government website or call 604-713-0360 in Vancouver or 1-800-663-4261 elsewhere in BC.

Step 3. Ask for a review

If Work Safe BC decides you are not eligible for benefits, or if you don’t understand its decision, ask the Work Safe BC officer handling your claim for an explanation. Ask for a decision letter if you didn’t already get one. If you’re still not satisfied, you can ask Work Safe BC for a review of the decision.

In a few scenarios, you can’t ask for a review but need to appeal directly to the Workers’ Compensation Appeal Tribunal. For example, if you are challenging a decision to reopen (or not reopen) a matter, or challenging a decision on a discriminatory action complaint (where an employer punished you for raising safety concerns at work). Appeals are explained shortly.

Time limit to ask for review

You must ask for a review within 90 days of the date of Work Safe BC’s decision letter or, in some cases, within 90 days of the date when Work Safe BC told you its decision orally or stopped paying you.

The review process

When you ask for a review, Work Safe BC should automatically give you a copy of your claim file and you can use the information in it for your review. After you request a review, you will receive a letter setting a time to make written submissions. The review division does not normally hold oral hearings.

The review division considers the written submissions and Work Safe BC’s file and gives its decision, usually within 150 days. The Work Safe BC website has more information on reviews. The phone numbers for the review division are 604-214-5411 in the Lower Mainland and 1-888-922-8804 elsewhere in BC.

Tip

While your review is being considered, if you feel that Work Safe BC has treated you unfairly, you can also complain to Work Safe BC’s Fair Practices Office and complain to the Ombudsperson of BC (who can be reached at 1-800-567-3247).

Step 4. Appeal the review decision

If you disagree with the decision on the review, you can usually appeal. You bring the appeal to the Workers’ Compensation Appeal Tribunal. You cannot appeal review decisions on some issues, such as vocational rehabilitation benefits, certain types of disability awards, and whether benefits are paid as a lump sum.

If you decide to appeal, you must do so within 30 days of the decision of the review division. For details on the process, see appealing a workers’ compensation decision.

Who can help

With a claim

The Work Safe BC website includes extensive information on workers’ compensation benefits, how to apply for benefits, and the process to review or appeal a decision.

The Workers’ Advisers Office is a government office that helps workers with claims for workers’ compensation benefits. They are separate from Work Safe BC and there’s no charge for their services.

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