Document name
Arising Out of and In the Course of Employment
Document number
PRO 03/2017

Effective date: September 1, 2017

Approved date: June 20, 2017

Application: All injury claims.

Policy subject: Decision making - Principals

Purpose:

To clarify when an injury arises out of or in the course of employment.

BACKGROUND

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POL 03/2017, Arising Out of and In the Course of Employment outlines when the Workers’ Compensation Board (WCB) considers an injury to have arisen out of and in the course of employment. The following procedure provides guidelines Operations staff follow when determining if an injury claim is acceptable.

PROCEDURE

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General Guidelines

  1. Operations staff review claims on a case-by-case basis when determining if an injury arose out of and in the course of employment.
  2. Operations staff must determine if the injury occurred within a time and place and from an activity related to employment. This includes considering what happened and how it relates to the worker’s employment (i.e., if employment was necessary for the injury to happen).
  3. Operations staff will consider:
    1. What activity the worker was engaged in when they were injured.
    2. Where the worker was performing the employment activity. The place the injury occurred is one element in determining if there is an employment link.
    3. When the worker was in engaged in the employment activity. This may also be an important factor in determining if the activity was “in the course of employment”.
  4. Operations staff may accept injuries that result from an activity reasonably related to employment. To determine if an injury is reasonably related to employment, Operations staff will consider:
    1. The type of work being performed.
    2. The type of work environment.
    3. The customs and practices of the particular workplace (i.e., activities the employer explicitly or implicitly allows).
  5. Operations staff will follow the specific guidelines outlined in POL 03/2017 (i.e., travelling to and from work, temporary lodging, entering and exiting employers premises, rest breaks on the employers premises) to determine if an injury arose out of and in the course of employment, when applicable.
  6. Operations staff will also follow guidelines for certain injuries, as outlined in Section 3, Injuries – Type of Injury of the WCB Policy Manual (e.g., Occupational Diseases, Heart Attacks, etc.).
  7. If Operations staff confirm that an injury either arose out of employment or in the course of employment but cannot confirm both, they will presume the injury was a result of employment and accept the claim. However, if there is information that shows the injury is not the result of employment, the claim will not be accepted.

Claim Decisions

  1. If evidence in support of both sides of an issue is approximately equal, the WCB will resolve the issue in favour of the worker (POL 02/2019, Decision Making).
  2. At their discretion, Operations staff may accept a claim if the following has been confirmed:
    1. The worker was injured during working hours and while performing work for the purpose of employment.
    2. The injury was the result of the worker completing tasks for the purpose of their employment duties with immediate or near immediate symptoms.
    3. The employer confirms that the injury was employment related.
    4. Details of the injury are consistent between the employer, worker and health care provider.
  3. If Operations staff cannot confirm the injury with the employer (i.e., after they have made repeated requests to the employer) they will make a decision using any relevant information received.
  4. In most cases, medical confirmation of the injury is required prior to Operations staff accepting a claim and issuing wage loss benefits.
  5. If medical confirmation has not been received or the worker did not seek medical treatment, at their discretion Operations staff may accept and issue initial wage loss benefits when:
    1. The injury has a clear employment connection.
    2. The employer confirms the work injury and the worker’s time loss.

Medical confirmation of the work injury must be obtained before any additional wage loss benefits are issued.

  1. To determine that an injury is the result of employment, Operations staff may request additional information from the employer, worker or health care professional or obtain an opinion from a WCB Medical Officer (MO).
  2. Ongoing disablement and treatment is evaluated on a continuous basis throughout the duration of a claim. Benefits are only issued where ongoing impairment and treatment is a result of the original compensable injury.
  3. All decisions are subject to review when any additional relevant information is received.

Appeals

  1. If a worker or employer disagrees with a claim decision, they may request that it be reviewed or re-considered (POL 21/2013, Appeals – Claims).

Attachments

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Legislative Authority

Page/document title
The Workers’ Compensation Act, 2013 Sections 2(1)(r), 20, 23, 26, 27, 29, 30, 48

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Document History

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(1)    POL 12/2013, Arising Out Of and In the Course of Employment (effective January 1, 2014 to August 31, 2017).
(2)    POL 13/2001, Arising Out of and In the Course of Employment (effective November 30, 2001 to December 31, 2013).
(3)    POL 12/98, Injuries, Travelling to and from or for Work (effective September 16, 1998 to December 31, 2013).
(4)    POL 27/95, Injuries, Rest Breaks (effective January 1, 1996 to December 31, 2013).
(5)    POL 17/91, Injuries, Entering or Exiting Employer Premises (effective June 28, 1991 to December 31, 2013).

Section heading

Complements

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