Ch 7 *Janine* Done

Question 1

What is the workers compensation legislation in BC called?

Answer 1

Workers Compensation Act (WCA)

Question 2

What is WCA?

Answer 2

An insurance system financed by employers that guarantees compensation to workers for work-related injuries/diseases, regardless of fault.

Question 3

Do workers give up their right to sue if they use WCA?

Answer 3

Yes. They give up their right in exchange for guaranteed benefits.

Question 4

Is WCA a fault or no-fault insurance?

Answer 4

No-fault

Question 5

What is the trade off of WCA?

Answer 5

Employers pay the whole cost of the insurance, giving employees guaranteed compensation for work place injuries. The trade off is that employers are protected from being sued by the employee (and employees don’t feel compelled to sue).

Question 6

Are all industries covered under WCA?

Answer 6

No. Some like financial institutions, recreational and social clubs, broadcast systems, and law firms are optional AND some like independent contractors, sole proprietors, and executive officers are not covered.

Question 7

What factors generate controversy around eligibility criteria for claims?

Answer 7

Stress, chronic pain, and environmental sensitivity.

Question 8

What is the most significant change to the act?

Answer 8

The Occupational Health and Safety Regulations.

Question 9

What does the Occupational Health and Safety Regulations focuses on ?

Answer 9

Prevention and reducing effects of injuries

Question 10

What does the Workers Compensation Board do?

Answer 10

They mediate between employers and employees for return to work, rehabilitation stepping in only when parties are unable/unwilling to resolve the issues.

Question 11

When is an injury eligible for compensation under WCB?

Answer 11

when it is an injury or disability arising out of and in the course of employment.

Question 12

What is willful misconduct?

Answer 12

When an injury can be attributed solely to the serious and wilful misconduct of the worker. The injury will not be covered by WCA UNLESS the injury results in death or permanent disablement.

Question 13

What does arising out of and in the course of employment mean?

Answer 13

That the injury need not result from performance of the job so long as it is reasonably incidental to it.

Question 14

What are the key features of Workers’ Compensation?

Answer 14

1. No-fault system
2. Benefits are funded solely from employers
3. It’s against the law for employees to contribute to the fund
4. Workers may not waive their rights
5. coverage is mandatory for most employees
6. Requires cooperation from both employees and employers in the effort to early and safe return to work
7. Labour market reentry plan if worker can’t return to his original employer
8. Workers Comp system is administrated by WorkSafe BC

Question 15

Why would an non-compulsory industry employer contribute to WCB benefits?

Answer 15

To protect from lawsuits for work-related injuries at a relative low-cost.

Question 16

Can any worker regardless of their industry opt-in to WCB benefits?

Answer 16

Yes

Question 17

Who is the onus on to prove a causal relationship between work and a slow-onset disability?

Answer 17

The employee.

Question 18

Who is the onus on to prove that an accident sustained during employment did not arise out of and in the course of employment?

Answer 18

The employer.

Question 19

What is rebuttable presumption?

Answer 19

The presumption that the injury is related to the employment.

Question 20

When are occupational diseases compensable?

Answer 20

If causal relationship exists.

Question 21

Is a secondary injury/accident that is causally linked to a work-related injury compensable?

Answer 21

Yes.

Question 22

What do Schedules B & D of the WCA list?

Answer 22

Diseases that arise from specific industrial processes.

If the worker contracts a listed disease, there is a rebuttable presumption that the disease resulted from employment.

Question 23

If a pre-existing condition is found to be a contributing factor to a work-place injury/disease, will the claim be upheld?

Answer 23

Yes, the worker may receive either all or partial benefits, although the employer may be relieved of part of the costs of the claim.

Question 24

Does presumption of work-relatedness apply to disability cases?

Answer 24

No. The onus is on the employee to prove the relationship.

Question 25

What are the three criteria to prove mental stress?

Answer 25

1. The stress is an acute reaction to sudden and unexpected events related to the employment;
2. It is diagnosed by a physician or psychologist as a mental or physical condition; and
3. It does not arise in the proceedings involved in making a compensation claim.

Question 26

What does WorkSafe BC do?

Answer 26

They administer the WCA.

They hear all workers claims and make determinations as to whether compensation is payable for claims.

Question 27

Under s.96, what does the WCB have jurisdiction to do?

Answer 27

Determine how much assessments (insurance fees) should be for employers in specific industries.
Make additional assessments for specific employers who have not complied with safety standards and are found to have unsafe work condition.

Question 28

What benefits are injured workers entitled to?

Answer 28

Employer pays loss of full wages and benefits starting the day of injury.
WCB pays health care costs related to the injury.
WCB pays 90% of lost of earnings from first working day after the date of injury.

Question 29

What benefits are injured workers entitled to upon returning to work?

Answer 29

If employee is on modified duties, the WCB will make up 90% of the loss.

Question 30

What other benefits does WCB provide to injured workers?

Answer 30

Non-economic loss (NEL) benefit: pain and suffering, loss of enjoyment.
Loss of retirement income: after 12 consecutive months of lost earnings 5% of LOE benefits are set aside.
Other benefits: Survivor, death

Question 31

What are the types of disabilities?

Answer 31

Permanent Total Disability
Temporary Total Disability
Permanent Partial Disability or disfigurement

Question 32

What is vocational rehabilitation?

Answer 32

Following injury or illness workers rejoin the workforce in some other capacity. WCB finances this retraining from it’s accident fund.

Question 33

Who has the duty to cooperate?

Answer 33

Employees and employers

Question 34

Why is the duty to cooperate an important part of WCB?

Answer 34

Because the goal of WCB is to return the worker to the pre-accident employer where possible.

Question 35

Under duty to cooperate, what must the employer and employee do?

Answer 35

Keep in touch
Disclose medical information that is pertinent
Make accommodations to facilitate early return to work

Question 36

What is the penalty to employees for failing to cooperate?

Answer 36

Suspension of benefits.

Question 37

What are the steps in effective claims management for employers?

Answer 37

1. Establish effective procedures for investigating injuries.
2. Document all claims no matter how minor.
3. Compensate justifiable claims promptly; protest doubtful claims from the outset.
4. Keep notes of all contacts with WCB.
5. Don’t contact the employee’s physician.
6. Ensure confidentiality.

Question 38

What is the process and limitation on appeals?

Answer 38

Disagreement on decision = file review by review officer within 90 days.
Disagreement with review officer’s decision = file written notice of appeal with Workers Compensation Appeals Tribunal within 30 days.

Question 39

What type of tribunal is the WCA’s tribunal?

Answer 39

Administrative

Question 40

Who funds the WCA system?

Answer 40

Employers based on industry level assessments as well as individual employer’s assessments. It is illegal for employers to recover any of these costs from employees.