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Page 1: Workers Compensation Awareness Session Denis St-Jean
Page 2: Workers Compensation Awareness Session Denis St-Jean

Workers CompensationWorkers Compensation

Awareness SessionAwareness Session

Denis St-JeanDenis St-Jean

Page 3: Workers Compensation Awareness Session Denis St-Jean

INTRODUCTION – Workers INTRODUCTION – Workers Compensation Awareness Compensation Awareness SessionSession Your NameYour Name FunctionFunction Experience, Knowledge - Experience, Knowledge -

CompensationCompensation Challenges / Expectation?Challenges / Expectation? FacilitatorFacilitator

Page 4: Workers Compensation Awareness Session Denis St-Jean
Page 5: Workers Compensation Awareness Session Denis St-Jean

SESSION OUTLINESESSION OUTLINE IntroductionIntroduction GECA GECA Collective AgreementsCollective Agreements TBS PoliciesTBS Policies How to get a claim How to get a claim

approved by the Boardapproved by the Board? ? Roles of PartiesRoles of Parties Other Compensation Other Compensation

OptionsOptions Conclusion / FeedbackConclusion / Feedback

Page 6: Workers Compensation Awareness Session Denis St-Jean

INTRODUCTIONINTRODUCTION

Lifecyle of a claimLifecyle of a claim Before the InjuryBefore the Injury The InjuryThe Injury CompensationCompensation

Short termShort term PermanentPermanent

Return to WorkReturn to Work AccommodationAccommodation

Short termShort termPermanentPermanent

Page 7: Workers Compensation Awareness Session Denis St-Jean

GECA GECA (1918 ; 1952)(1918 ; 1952)

Page 8: Workers Compensation Awareness Session Denis St-Jean

GECAGECA Government Employee

Compensation Act – – 1918 reviewed 1918 reviewed in 1952in 1952 Covers Federal Government Covers Federal Government

Workers – Workers – 300 000300 000

Coverage a personal injury by an Coverage a personal injury by an accident and/or desease arising out accident and/or desease arising out of and in the course of employmentof and in the course of employment

References to Provincial Workers References to Provincial Workers Compensation ActsCompensation Acts

Page 9: Workers Compensation Awareness Session Denis St-Jean

GECAGECA

No Fault System Employer assumes financial

cost while workers gave up their right to sue

Provincial / Territorial Boards adjudicate claims

Same basic principles between Boards, but there are differences in benefits

Page 10: Workers Compensation Awareness Session Denis St-Jean

GECAGECA

Coverage includes:Coverage includes: Loss of earningsLoss of earnings Non-economic lossNon-economic loss Medical, medicationMedical, medication RehabilitationRehabilitation LMRsLMRs Return to work provisionsReturn to work provisions

Page 11: Workers Compensation Awareness Session Denis St-Jean

GECAGECA

SummarySummary Provincial / Territories Provincial / Territories

Compensation LegislationCompensation Legislation BenefitsBenefits Adjudication & Appeal ProcessAdjudication & Appeal Process

HRSDC – Labour ProgramHRSDC – Labour Program Administrative AgreementAdministrative Agreement FundingFunding 3rd parties3rd parties

Page 12: Workers Compensation Awareness Session Denis St-Jean

GECAGECA

ChallengesChallenges Determining extent to which Determining extent to which

GECA incorporates provincial GECA incorporates provincial laws – lack of claritylaws – lack of clarity

Presumption clauses application?Presumption clauses application? Rate / conditions vary from Rate / conditions vary from

Province to provinceProvince to province Last review 1952 – but provinces Last review 1952 – but provinces

update regularly their actupdate regularly their act

Page 13: Workers Compensation Awareness Session Denis St-Jean

GECAGECA

ChallengesChallenges Philosophy of Compensation has Philosophy of Compensation has

evolved since GECA was reviewed, evolved since GECA was reviewed, many concepts are absent, but many concepts are absent, but present in Provincial acts:present in Provincial acts: Presumption clausesPresumption clauses Return to workReturn to work Worker rehabilitationWorker rehabilitation Time limitsTime limits Fines and penaltiesFines and penalties

How to train PSAC membersHow to train PSAC members

Page 14: Workers Compensation Awareness Session Denis St-Jean

COLLECTIVE AGREEMENTCOLLECTIVE AGREEMENT

Page 15: Workers Compensation Awareness Session Denis St-Jean

COLLECTIVE AGREEMENTCOLLECTIVE AGREEMENTInjury-On-Duty LeaveInjury-On-Duty Leave 37.0137.01 An employee shall be granted An employee shall be granted injury-on-duty leave injury-on-duty leave

with paywith pay for such period as may be reasonably determined for such period as may be reasonably determined by the Employerby the Employer when a claim has been made pursuant to when a claim has been made pursuant to the the Government Employees Compensation ActGovernment Employees Compensation Act and a and a Workers' Compensation Workers' Compensation authority has notified the Employer authority has notified the Employer that it has certified that the employee is unable to work that it has certified that the employee is unable to work because ofbecause of::

(a) personal injury accidentally received in the performance of (a) personal injury accidentally received in the performance of his or her duties and not caused by the employee's willful his or her duties and not caused by the employee's willful misconduct,misconduct,

oror(b) an industrial illness or a disease arising out of and in the (b) an industrial illness or a disease arising out of and in the

course of the employee's employment,course of the employee's employment,

if the employee agrees to remit to the Receiver General for if the employee agrees to remit to the Receiver General for Canada any amount received by him or her in Canada any amount received by him or her in compensation for loss of pay resulting from or in respect of compensation for loss of pay resulting from or in respect of such injury, illness or disease, provided, however, that such such injury, illness or disease, provided, however, that such amount does not stem from a personal disability policy for amount does not stem from a personal disability policy for which the employee or the employee's agent has paid the which the employee or the employee's agent has paid the premium.premium.

Page 16: Workers Compensation Awareness Session Denis St-Jean

COLLECTIVE AGREEMENTCOLLECTIVE AGREEMENT

Accumulation of Vacation Accumulation of Vacation Leave CreditsLeave Credits

34.0234.02 For each calendar month For each calendar month in which an employee has in which an employee has earned at least ten (10) days’ earned at least ten (10) days’ paypay the employee the employee shall earn shall earn vacation leave creditsvacation leave credits at the rate at the rate of:of:

Page 17: Workers Compensation Awareness Session Denis St-Jean

COLLECTIVE AGREEMENTCOLLECTIVE AGREEMENT

Sick Leave With Pay CreditsSick Leave With Pay Credits 35.01

(a) An employee shall earn sick earn sick leave creditsleave credits at the rate of nine decimal three seven five (9.375) hours for each calendar month for each calendar month for which the employee receives for which the employee receives pay for at least ten (10) days.pay for at least ten (10) days.

Page 18: Workers Compensation Awareness Session Denis St-Jean

COLLECTIVE AGREEMENTCOLLECTIVE AGREEMENT 35.05 When an employee has insufficient or no

credits to cover the granting of sick leave with pay under the provisions of clause 35.03, sick sick leave with pay may, at the discretion of the leave with pay may, at the discretion of the Employer, be granted to an employee for a Employer, be granted to an employee for a period of up to one hundred and eighty-seven period of up to one hundred and eighty-seven decimal five (187.5) hoursdecimal five (187.5) hours, subject to the deduction of such advanced leave from any sick leave credits subsequently earned.

35.06 When an employee is granted sick leave with pay and injury-on-duty leave is subsequently approved for the same period, it shall be considered, for the purpose of the record of sick leave credits, that the employee was not granted sick leave with pay.

Page 19: Workers Compensation Awareness Session Denis St-Jean

COLLECTIVE AGREEMENTCOLLECTIVE AGREEMENTArticle 54Article 54Leave With or Without Pay for Other Leave With or Without Pay for Other

ReasonsReasons54.0154.01 At its discretion, the Employer may At its discretion, the Employer may

grant:grant: (a) leave with pay when circumstances (a) leave with pay when circumstances

not directly attributable to the employee not directly attributable to the employee prevent his or her reporting for duty; prevent his or her reporting for duty; such leave shall not be unreasonably such leave shall not be unreasonably withheld;withheld;

(b) leave with or without pay for (b) leave with or without pay for purposes other than those specified in purposes other than those specified in this Agreement.this Agreement.

Page 20: Workers Compensation Awareness Session Denis St-Jean

COLLECTIVE AGREEMENTCOLLECTIVE AGREEMENT

Other impacts:Other impacts: Sick / Vacation Leave CreditsSick / Vacation Leave Credits Employment Insurance EligibilityEmployment Insurance Eligibility CPP / QPP BenefitsCPP / QPP Benefits Pension PlanPension Plan Disability InsuranceDisability Insurance Life InsuranceLife Insurance Medical / Dental InsuranceMedical / Dental Insurance Other benefitsOther benefits

Page 21: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIES – CRA POLICIES – Workers’ CompensationWorkers’ Compensation

Page 22: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIESInjury and Illness PolicyInjury and Illness PolicyWork-Related Injury Or Illness (Appendix C1)Work-Related Injury Or Illness (Appendix C1)Workers' CompensationWorkers' Compensation An employee injured in an accident at the workplace or An employee injured in an accident at the workplace or

disabled by reason of an illness due to the nature of his disabled by reason of an illness due to the nature of his or her employment, is entitled to receive compensation or her employment, is entitled to receive compensation for loss of earnings, medical care and other benefits. for loss of earnings, medical care and other benefits. These benefits are similar to those received by private These benefits are similar to those received by private industry employees through workers’ compensation in industry employees through workers’ compensation in the province in which they work.the province in which they work.

The government provides these benefits to employees The government provides these benefits to employees under the under the Government Employees' Compensation Act (GECA) administered by The Department of Human (GECA) administered by The Department of Human Resources and Skills Development (HRSDC). Instead of Resources and Skills Development (HRSDC). Instead of establishing its own system for compensation and establishing its own system for compensation and treatment, the government uses the services already treatment, the government uses the services already available through provincial workers’ compensation available through provincial workers’ compensation boards.boards.

The regional offices of Labour Canada are responsible for The regional offices of Labour Canada are responsible for receiving and processing claims through to the appropriate receiving and processing claims through to the appropriate provincial authority.provincial authority. They provide a general advisory service to They provide a general advisory service to employees and unions, as well as to employers, on the employees and unions, as well as to employers, on the interpretation and application of the legislation.interpretation and application of the legislation.

Page 23: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIESBenefitsBenefits Include:Include: compensation for loss of earnings (if compensation for loss of earnings (if

an injured employees is not entitled an injured employees is not entitled to injury-on-duty leave); to injury-on-duty leave);

medical, hospital, and related medical, hospital, and related services; services;

rehabilitation services; rehabilitation services; a pension, if an injury results in a a pension, if an injury results in a

permanent disability; and permanent disability; and pensions to dependants of pensions to dependants of

employees who are fatally injured in employees who are fatally injured in the course of their employment. the course of their employment.

Page 24: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIES

Injury-on-duty leaveInjury-on-duty leave

To avoid duplicate payment, it is To avoid duplicate payment, it is extremely important that extremely important that personnel officers indicate on personnel officers indicate on the the original injury reportoriginal injury report whether whether the injured employee is entitled the injured employee is entitled to injury-on-duty leave, which is to injury-on-duty leave, which is provided for in the collective provided for in the collective agreementagreement..

Page 25: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIES

Information booklets Information booklets There are two information booklets There are two information booklets

available from Labour Canada. A available from Labour Canada. A handbook entitled "If You Have an handbook entitled "If You Have an Accident" should be provided to all Accident" should be provided to all employees, and a booklet entitled employees, and a booklet entitled "Employer's Guide" should be in the "Employer's Guide" should be in the hands of all persons responsible for hands of all persons responsible for the reporting of injuries.the reporting of injuries.

Page 26: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIESEmployers' GuideEmployers' Guide

Disallowance of claimsDisallowance of claims

The most common reasons for disallowing a The most common reasons for disallowing a claim are the following:claim are the following:

It is not shown clearly that the disability is It is not shown clearly that the disability is the result of an accident, or occupational the result of an accident, or occupational disease. disease.

The injury or occupational disease reported The injury or occupational disease reported did not arise out of and in the course of did not arise out of and in the course of employment. employment.

A description of an accident is given, but A description of an accident is given, but the disability is not the result of it. the disability is not the result of it.

The injury reported is not substantiated by The injury reported is not substantiated by medical evidence.medical evidence.

Page 27: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIESInjury-on-Duty LeaveInjury-on-Duty Leave

Employees of the CRA are Employees of the CRA are eligible for benefits provided by eligible for benefits provided by the the Government Employees’ Compensation Act for personal injury resulting from for personal injury resulting from an accident in the course of and an accident in the course of and arising out of their employment or arising out of their employment or an illness that was a an illness that was a consequence of their consequence of their employment.employment.

Page 28: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIESInjury-on-Duty LeaveInjury-on-Duty Leave

Right to Choose DoctorRight to Choose Doctor An injured or ill employee has the An injured or ill employee has the

right to choose a doctor for the right to choose a doctor for the required treatment, but once the required treatment, but once the choice is made it must be choice is made it must be adhered to. Permission to adhered to. Permission to change doctors must be obtained change doctors must be obtained in writing from the provincial in writing from the provincial workers’ compensation authority workers’ compensation authority except in Quebec where there is except in Quebec where there is no such restriction.no such restriction.

Page 29: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIES

Verification of disability periodVerification of disability period While CRA is awaiting the receipt of While CRA is awaiting the receipt of

certification required for the granting of injury-certification required for the granting of injury-on-duty leave, the disabled employee may be on-duty leave, the disabled employee may be granted sick leave to the extent of his or her granted sick leave to the extent of his or her sick leave credits.sick leave credits.

If the employee has insufficient sick leave If the employee has insufficient sick leave credits, he or she may be advanced additional credits, he or she may be advanced additional sick leave in accordance with the terms of the sick leave in accordance with the terms of the collective agreementcollective agreement. When sick leave is . When sick leave is granted and injury-on-duty leave is granted and injury-on-duty leave is subsequently approved for the same period, subsequently approved for the same period, the employee is to be credited with the number the employee is to be credited with the number of days of sick leave involved.of days of sick leave involved.

Page 30: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIES

Termination of injury-on-duty Termination of injury-on-duty leave leave

Injury-on-duty leave should not Injury-on-duty leave should not be granted beyond the date be granted beyond the date certified through Labour Canada certified through Labour Canada that the employee is fit for work, that the employee is fit for work, including "light duty" work, including "light duty" work, where it is available. where it is available.

Page 31: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIES

Termination of injury-on-duty leave Termination of injury-on-duty leave Normally, Normally, after 130 (working) daysafter 130 (working) days, ,

all employees all employees will be paid directly by will be paid directly by the provincial workers’ compensation the provincial workers’ compensation boardboard..

The level of payment will be based The level of payment will be based on the provincial regulations. on the provincial regulations.

Page 32: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIES

Termination of injury-on-Termination of injury-on-duty leaveduty leave

Provincial wage Provincial wage compensation benefits for compensation benefits for totally disabled employees totally disabled employees are generally 75% of are generally 75% of earnings, based on a earnings, based on a maximum annual earnings maximum annual earnings ceilingceiling..

Page 33: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIESDuty to Accommodate Persons with Duty to Accommodate Persons with

DisabilitiesDisabilities A request for accommodation need not be in writing, A request for accommodation need not be in writing, but should be communicated as clearly and but should be communicated as clearly and specifically as possible. The person to whom the specifically as possible. The person to whom the request has been directed should do the following:request has been directed should do the following:

Determine the type of accommodation required, based Determine the type of accommodation required, based on information provided by the employee.on information provided by the employee.

If the candidate or employee does not know what type If the candidate or employee does not know what type of accommodation is required, consult experts in the of accommodation is required, consult experts in the field to determine the appropriate accommodation. field to determine the appropriate accommodation. This could include the person's own physician, This could include the person's own physician, psychologist or centres of expertise within the Public psychologist or centres of expertise within the Public Service Commission or the accommodating Service Commission or the accommodating department.department.

Provide the accommodation based on the request of Provide the accommodation based on the request of the person being accommodated, or, if necessary, on the person being accommodated, or, if necessary, on the advice of experts.the advice of experts.

Page 34: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIESDuty to AccommodateDuty to Accommodate

Persons requesting accommodation may be Persons requesting accommodation may be asked to provide documentation from a asked to provide documentation from a qualified health care professional to clarify qualified health care professional to clarify the limitations caused by the disability the limitations caused by the disability and/or the type of accommodation that and/or the type of accommodation that would be most effective.would be most effective.

Any medical records provided should be Any medical records provided should be kept strictly confidential and separate from kept strictly confidential and separate from personnel files. Requests for this type of personnel files. Requests for this type of information should come from personnel information should come from personnel designated to deal with accommodation designated to deal with accommodation requests and trained to handle potentially requests and trained to handle potentially sensitive medical information. sensitive medical information.

Page 35: Workers Compensation Awareness Session Denis St-Jean

CRA POLICIESCRA POLICIESDuty to AccommodateDuty to Accommodate

CRA should develop their own internal CRA should develop their own internal procedures for dealing with procedures for dealing with accommodation requests, including accommodation requests, including mechanisms for resolving situations mechanisms for resolving situations where accommodation is denied. All where accommodation is denied. All candidates and employees should be candidates and employees should be advised of such procedures.advised of such procedures.

Persons who are denied Persons who are denied accommodation may also wish to use accommodation may also wish to use the recourse mechanisms set out in the recourse mechanisms set out in the Canadian Human Rights the Canadian Human Rights Commission.Commission.

Page 36: Workers Compensation Awareness Session Denis St-Jean

How to get a claim approved How to get a claim approved by the Boardby the Board??

Page 37: Workers Compensation Awareness Session Denis St-Jean

How to get a claim approved How to get a claim approved by the Boardby the Board??

Claiming Workers Claiming Workers CompensationCompensation When?When? How?How? What should I say / not say?What should I say / not say? What if I need accommodation?What if I need accommodation? Where can I get help?Where can I get help?

Page 38: Workers Compensation Awareness Session Denis St-Jean

How to get a claim approved by How to get a claim approved by the Boardthe Board??

Definition of Acccident Definition of Acccident includes:includes: A chance event A chance event

occasioned by a physical occasioned by a physical or natural causeor natural cause; or; or

The biggest reason for The biggest reason for the denial of these the denial of these claims is a lack of proof claims is a lack of proof that an injury happenedthat an injury happened

A disablement arising out A disablement arising out of and in the course of of and in the course of employmentemployment

The major reason for the The major reason for the denial of these claims is denial of these claims is lack of prrof that the lack of prrof that the work caused the injurywork caused the injury

Page 39: Workers Compensation Awareness Session Denis St-Jean

How to get a claim approved How to get a claim approved by the Boardby the Board??

Personal injury by an accident Personal injury by an accident and/or desease arising out of and in and/or desease arising out of and in the course of employment:the course of employment:

Exemple:Exemple:

Do not say: I fell and hurt myself.Do not say: I fell and hurt myself.

Say:Say: I was walking through the office in I was walking through the office in the scanning division. I stepped on a the scanning division. I stepped on a marker that was on the floor. My right marker that was on the floor. My right leg went forward and I lost my leg went forward and I lost my balance. I fell backwards. I hit my balance. I fell backwards. I hit my shoulder on the fax machine. I hurt my shoulder on the fax machine. I hurt my right shoulder on the machine. When I right shoulder on the machine. When I landed on the floor, I hurt my right landed on the floor, I hurt my right wrist, my neck, and my right hip.wrist, my neck, and my right hip.

Page 40: Workers Compensation Awareness Session Denis St-Jean

How to get a claim approved by How to get a claim approved by the Boardthe Board??Reconsiderations and AppealsReconsiderations and Appeals

Ontario:Ontario: A notice of A notice of

Objection must Objection must be in writingbe in writing

6 month time 6 month time limit to appeal limit to appeal Except for RTW Except for RTW / LMR: 30 days/ LMR: 30 days

Two (2) levels Two (2) levels of appealsof appeals

ARO / TribunalARO / Tribunal

QuQuébecébec A written letter to A written letter to

the CSSTthe CSST 30 days to 30 days to

appeal intial appeal intial decisiondecision

A form must be A form must be completed to the completed to the CLPCLP 45 days to 45 days to

appealappeal

Page 41: Workers Compensation Awareness Session Denis St-Jean

ROLES OF PARTIESROLES OF PARTIES

Page 42: Workers Compensation Awareness Session Denis St-Jean

ROLES OF PARTIESROLES OF PARTIESMaking a Case Plan:Making a Case Plan: Open a file for each workerOpen a file for each worker Keep copies of all informationKeep copies of all information Record all activitiesRecord all activities

Phone callsPhone calls InterviewsInterviews LettersLetters

Confirm with the worker what issues will be Confirm with the worker what issues will be addressedaddressed

Priorize issues and actionPriorize issues and action Note the date and level of decision by the Board Note the date and level of decision by the Board

relating to each issuerelating to each issue Note any issues that arise in qualifying for benefitsNote any issues that arise in qualifying for benefits Determine what information is requiredDetermine what information is required

WitnessesWitnesses Medical informationMedical information Physical demandsPhysical demands ExposuresExposures

Analyze each problem and outline action planAnalyze each problem and outline action plan

Page 43: Workers Compensation Awareness Session Denis St-Jean

ROLES OF PARTIESROLES OF PARTIESWorkerWorker

It is better to talk in person rather than over It is better to talk in person rather than over the phonethe phone

Advise the worker to bring copies of all Advise the worker to bring copies of all correspondence & information receivedcorrespondence & information received

Encourage the worker to explain the problemEncourage the worker to explain the problem Review any document the worker has Review any document the worker has

received from the Board or doctors for a received from the Board or doctors for a history of the claimhistory of the claim

Pre-accident job historyPre-accident job history Description of job at the time of accidentDescription of job at the time of accident Description of the accidentDescription of the accident Events since the accidentsEvents since the accidents

Review the relevant facts to make sure you Review the relevant facts to make sure you understand correctly understand correctly

Page 44: Workers Compensation Awareness Session Denis St-Jean

ROLES OF PARTIESROLES OF PARTIESBoardBoard

Complete and send Authorization form Complete and send Authorization form to the Boardto the Board

Include worker’s name and claim Include worker’s name and claim numbernumber

Explain reasons why you are writing Explain reasons why you are writing and the actions you wish the Board to and the actions you wish the Board to Take careTake care

Explain any new information, indicate Explain any new information, indicate why they are importantwhy they are important

Explain your argumentsExplain your arguments Make sure the decision maker Make sure the decision maker

understands the issueunderstands the issue Keep a record of all callsKeep a record of all calls

Page 45: Workers Compensation Awareness Session Denis St-Jean

ROLES OF PARTIESROLES OF PARTIESDoctorDoctor Introduction of yourself and your Introduction of yourself and your

relationship to the workerrelationship to the worker Reasons why you are writingReasons why you are writing Brief statement of issueBrief statement of issue Relevant brief background and Relevant brief background and

historyhistory Request the doctor’s medical Request the doctor’s medical

opinion regarding the issue under opinion regarding the issue under appealappeal

Request that the opinion be Request that the opinion be evidence-basedevidence-based

Page 46: Workers Compensation Awareness Session Denis St-Jean

ROLES OF PARTIESROLES OF PARTIESLocal / ComponentLocal / Component

Identify local representative, involve this person Identify local representative, involve this person in the representation processin the representation process

Identify Service Officer and communicate with Identify Service Officer and communicate with him/her to assistance and follow-up on him/her to assistance and follow-up on accident accident investigationinvestigation and and corrective/prevention corrective/prevention measuresmeasures as well as as well as leave advanceleave advance if required, if required, and eventually and eventually return to work strategyreturn to work strategy..

participation by a worker representative on the participation by a worker representative on the accident investigation team, will permit to accident investigation team, will permit to obtain obtain key information on accident causationkey information on accident causation which will which will often help the injured worker in often help the injured worker in making a making a demonstration that the worker’s injury was caused demonstration that the worker’s injury was caused –by an accident arising out of and in the course of –by an accident arising out of and in the course of his employment or is disabled by reason of an his employment or is disabled by reason of an industrial disease due to the nature of the industrial disease due to the nature of the employment -.employment -.

Assist member when a grievance may be Assist member when a grievance may be required following being advised by the required following being advised by the employer that the employee will be employer that the employee will be terminated if they choose to resign or to terminated if they choose to resign or to apply for medical retirementapply for medical retirement

Page 47: Workers Compensation Awareness Session Denis St-Jean

ROLES OF PARTIESROLES OF PARTIES Local / Component Local / Component

TOOLTOOLOpen fileOpen file Attach summaryAttach summary

Name of workerName of worker Member numberMember number ComponentComponent LocalLocal Employer dataEmployer data WSIB File NumberWSIB File Number Injury/disease typeInjury/disease type Date of accidentDate of accident Name of treating doctorName of treating doctor Decision under appeal – dateDecision under appeal – date timelines for appealtimelines for appeal

Document all telephone conversation, interviews and lettersDocument all telephone conversation, interviews and letters Protect appeal deadline with sample letter (template to be Protect appeal deadline with sample letter (template to be

provided) stipulating that you are protecting the appeal deadline, provided) stipulating that you are protecting the appeal deadline, you want a complete copy of the file, you will analyze the file and you want a complete copy of the file, you will analyze the file and further advise the Board whether you will pursue the further advise the Board whether you will pursue the representationrepresentation

Ensure that the worker and its Local/Component representatives Ensure that the worker and its Local/Component representatives understand that they are custodians of their claimsunderstand that they are custodians of their claims

Page 48: Workers Compensation Awareness Session Denis St-Jean

ROLES OF PARTIESROLES OF PARTIESLocal / ComponentLocal / Component

It is recommend that each local has at least It is recommend that each local has at least one person that has one person that has basic understanding of basic understanding of the WCB process who can assist the worker the WCB process who can assist the worker in writing the initial claimin writing the initial claim to ensure key to ensure key elements of the description of event are elements of the description of event are included and to work with the worker to included and to work with the worker to obtain sick leave credit advances from the obtain sick leave credit advances from the employer and/or apply for other benefits employer and/or apply for other benefits while the Board analyzes the eligibility of the while the Board analyzes the eligibility of the claimclaim. A local representative should also . A local representative should also work with the worker and the employer to work with the worker and the employer to ensure that ensure that accommodationsaccommodations are put in are put in place when a worker has place when a worker has functional functional limitationslimitations requiring it. requiring it.

Page 49: Workers Compensation Awareness Session Denis St-Jean

ROLES OF PARTIESROLES OF PARTIESRegional OfficeRegional Office Work with member in need of Representation Work with member in need of Representation

for Workers Compensation appealfor Workers Compensation appeal Work with Component and Locals for:Work with Component and Locals for:

Initial claimInitial claim Process explanationProcess explanation Appeal preparationAppeal preparation Explain Workers Compensation decisions and Explain Workers Compensation decisions and

impacts for member and workplaceimpacts for member and workplace Provide training for interested Local officers in Provide training for interested Local officers in

Rights and Obligations under Workers Rights and Obligations under Workers Compensation applicable LegislationCompensation applicable Legislation

Lobbies Provincial Federations of Labour for Lobbies Provincial Federations of Labour for legislation amendmentslegislation amendments

Work with Office of the Workers Advisors in Work with Office of the Workers Advisors in those Provinces and Territories where they those Provinces and Territories where they represent unionized workersrepresent unionized workers

Page 50: Workers Compensation Awareness Session Denis St-Jean

ROLES OF PARTIESROLES OF PARTIES

National – Program SectionNational – Program Section Represent Labour to Regulatory Represent Labour to Regulatory

Review Working GroupsReview Working Groups Lobbies Government for GECA Lobbies Government for GECA

legislative amendmentslegislative amendments

Page 51: Workers Compensation Awareness Session Denis St-Jean

OTHER COMPENSATION OTHER COMPENSATION OPTIONSOPTIONS

Page 52: Workers Compensation Awareness Session Denis St-Jean

OTHER COMPENSATION OTHER COMPENSATION OPTIONSOPTIONS

What if the Board takes a long time to decide on my claim What if the Board takes a long time to decide on my claim or if the Board rejects my claim?or if the Board rejects my claim? Sick leave creditsSick leave credits Sick leave advancesSick leave advances Employment Insurance sick leave benefits (first 15 weeks) – Employment Insurance sick leave benefits (first 15 weeks) –

max. 42 300$ / 55% (23 265$ annual)max. 42 300$ / 55% (23 265$ annual) Disability Insurance (after 13 weeks) 70% / 66% / top upDisability Insurance (after 13 weeks) 70% / 66% / top up Canada Pension Plan Total Disability BenefitsCanada Pension Plan Total Disability Benefits Public Service Superannuation ActPublic Service Superannuation Act

(2% X # years)(2% X # years) WelfareWelfare

WSIB: max. 75 100$ annual / 85%WSIB: max. 75 100$ annual / 85% CSST: max. 62 000$ annual / 90%CSST: max. 62 000$ annual / 90%

I you apply for these benefits you must let them know that I you apply for these benefits you must let them know that you are also applying for WCB benefits. They will ask you you are also applying for WCB benefits. They will ask you to sign a form which is a promise to pay back the money to sign a form which is a promise to pay back the money you may receive from WCB.you may receive from WCB.

Page 53: Workers Compensation Awareness Session Denis St-Jean

CONCLUSIONCONCLUSION Lifecyle of a claimLifecyle of a claim

Before the InjuryBefore the Injury The InjuryThe Injury CompensationCompensation

Short termShort term PermanentPermanent

Return to WorkReturn to Work AccommodationAccommodation

Short termShort termPermanentPermanent

Page 54: Workers Compensation Awareness Session Denis St-Jean

Denis St-JeanDenis St-JeanNational Health and Safety OfficerNational Health and Safety OfficerPublic Service Alliance of CanadaPublic Service Alliance of Canada