Employers should know this about WCB decisions

How to Deal with an Adverse WCB Decision — For Employers

Jan 8, 2019

  • A lot can be involved in a WCB decision and employers need to be confident it’s been made appropriately
  • Workplace injuries are costly incidents, from the temporary loss of the employee to the threat of increased WCB premiums
  • When a WCB decision doesn’t align with an employer’s expected outcome, there are options available

When an employee’s injured, the employer’s interest should be in ensuring a healthy, safe return to work on an appropriate timeline. This process will involve the Worker’s Compensation Board.

You’ll need to report the injury to the WCB, but you’ll also be a part of the entire claims process through to the return to work. Ideally, after the injury is reported, the claim will receive the appropriate decision, the employee will receive any compensation they’re entitled to during their recovery, and they’ll return to their original duties — or modified, alternative duties — in line with expectations.

But What Can Go Wrong in a WCB Claim?

Of course, circumstances aren’t always so simple. As an employer, you may encounter various sources of frustration and difficulty throughout the process:

  • Even though you’re not on the hook for compensation payments and may be able to hire temporary help, it’s no trivial task to cover for the absence of an experienced, skilled worker
  • Proposed modified duties may be unworkable — the original role may intrinsically involve significant heavy lifting that a disability now prevents, but maybe there’s also not enough alternate work available
  • More workplace accidents mean higher premiums: you have to therefore ensure that every claim relating to your workers stems from a legitimate workplace incident
  • You may disagree with the claim decision — the injury or illness may be less severe than presented, or it may not be related to your workplace at all

Many people can be involved in a WCB claim — the employee, the employer, the employee’s family doctor, a WCB-selected doctor, the WCB decision-maker, and lawyers.

This presents opportunities for different interpretations and motivations to muddy the facts. When a WCB claim would unfairly punish a business, an employer will want to know what their options are.

Appeal a WCB Decision with Independent Medical Advice

When a WCB decision would adversely affect your business — and you think there’s something more going on — it’s time to seek independent medical advice.

With an Independent Medical Examination, you can cut down on the potential for bias to have an informed decision. Enlisting a relevant specialist on a speedy timeline can help better understand the severity of an issue, as well as the expected length of recovery.

Key issues that may lead to a successful WCB challenge include:

  • What caused the injury?
  • Was the mechanism of injury plausible?
  • The role of any pre-existing condition
  • Was there only a temporary exacerbation of a pre-existing condition vs. a permanent aggravation?
  • Was the recovery time consistent with published WCB norms?

You may find this new opinion allows for a faster — while still safe — return to work. It may inform you about what would be appropriate duties, modified, part-time or otherwise.

These benefits can drastically cut down on the expense of a medical leave of absence and the repercussions of an unsupported WCB ruling. All this while still respecting the health of the employee and working toward a healthy, productive return to work.

Getting an employee back to work in the right circumstances at the right time is in everyone’s interest. Contact Western Medical Assessments today to find out how an Independent Medical Examination can work for you.

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