Document name

COVID-19 Response – Employer Relief Measures – Claim Cost Relief

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ADM POL 04/2020

June 30, 2022

COVID-19 injury claim is a communicable disease, as defined in POL 02/2010, Injuries – Communicable Diseases, and for the purposes of this policy, includes:

• Any injury claim that has been accepted under the Injuries – Communicable Disease Policy (POL 02/2010) as a result of a worker contracting COVID-19, or
• Any injury claim that has been accepted under the Injuries – Psychological Policy (POL 02/2017) as a result of a worker having contracted COVID-19 or having to provide care for COVID-19 positive patients for extended periods of time that is excessive and unusual compared to normal employment.

1. Section 145 of The Workers’ Compensation Act, 2013 authorizes the Workers’ Compensation Board (WCB) to establish reserves to meet losses from any disaster or other circumstances where the liability would, in the opinion of the Board, unfairly burden employers.
   1. POL 05/2014, Occupational Disease Reserve, establishes guidelines to provide cost relief for occupational diseases that have a cause and effect link to employment activities.
   2. POL 12/2014, Disaster Reserve, establishes guidelines to provide cost relief in situations where claims costs resulting from disasters unfairly burden employers.
   3. POL 03/2021, Second Injury and Re-Employment Reserve, establish guidelines to provide employers with full or partial cost relief on claims:
      1. Attributed to an earlier work-related injury.
      2. That involve a worker’s pre-existing conditions.
      3. Where the worker has a good reason for not participating in health care or an individualized vocational plan, and
      4. Other situations determined by the Board.
2. Under Section 19(1) of the Act, the WCB has a duty to:
   1. Arrange provision of any health care or treatment that may be needed because of a work injury.
   2. Arrange to provide rehabilitation to injured workers.
   3. Consult and cooperate with injured workers in the development of rehabilitation plans intended to return them to positions of independence in suitable productive employment.
3. Workers have a legislated responsibility to take all reasonable action to lessen earnings loss resulting from an injury and to co-operate with the WCB in a rehabilitation plan to return the worker to a position of independence in suitable productive employment (Section 51).

COVID-19 Injury Claims

1. Where a COVID-19 claim (as defined above) is determined by the WCB to have arisen out of and in the course of employment between March 2, 2020 and June 30, 2022 inclusive, the employer will be provided with total cost relief. All claims costs will be charged to WCB’s Occupational Disease Reserve (i.e., earnings loss benefits, medical costs, etc.).
2. If the employer qualifies for cost relief for a COVID-19 claim, Operations staff will notify the employer in writing.

Delays in Treatment or Vocational Rehabilitation

3. The WCB will charge partial claims costs to the Second Injury and Re-Employment Reserve if recovery from an accepted work injury is prolonged due to delays in treatment or vocational rehabilitation caused by limited health care services available during the COVID-19 situation.
4. Operations staff will identify:
   1. Claims that qualify for cost relief, and
   2. The portion of claims costs that will be charged to the Second Injury and Re-Employment Reserve.
      For example:
      1. Claims costs (e.g., earnings loss benefits) paid after the worker’s last medical treatment until they are able to resume treatment.
      2. Claims costs paid while the worker’s vocational rehabilitation was paused until they are able to resume their program.
5. Operations will review and document the cost relief review decision (i.e., on the CRR memo). If the employer qualifies for cost relief, Operations staff will notify the employer in writing. The letter will note:
   1. The reason why the employer is receiving cost relief, and
   2. How much cost relief the employer will receive.

Employers’ Experience

6. If an employer receives cost relief, a credit is applied to the employer’s experience (POL 27/2016, Experience Rating Program – Discounts or Surcharges will apply).
7. If an employer is found guilty of violating a public health order, any cost relief applied may be reversed, at the discretion of the WCB, and the costs will affect the employer’s cost experience.