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Document name

Occupational Disease – Cost Relief

Document number

PRO 17/2023

Effective date: December 1, 2014

Application: All new injury claims on or after the effective date.

Policy subject: Employer accounts – Claims costs adjustments and cost relief

Purpose:

To establish guidelines for providing cost relief for occupational diseases.

BACKGROUND

The Workers’ Compensation Board (WCB) has approved POL 17/2023, Occupational Disease – Cost Relief. This procedure provides guidelines on how to apply POL 17/2023.
The Occupational Disease Reserve was created to cover costs that may have arisen from latent occupational diseases where exposure today may result in the establishment of a future claim. In 2014, the benefits liabilities included a provision for latent occupational diseases; therefore, while cost relief is still available, the Occupational Disease Reserve was eliminated.
There will be no changes to the processes followed by Operations’ staff as a result of elimination of the Occupational Disease Reserve and provision for latent occupational diseases in the benefits liabilities.

PROCEDURE

An employer may face high claim costs from an occupational disease. The WCB can remove all or a portion of the claim costs from an employer’s cost experience.
The costs for an occupational disease injury claim will be relieved from the employer’s experience based on the net costs of a claim. In determining the net costs, Operations staff will consider all relevant:
1. Recoveries (for example, third party recoveries), or
2. Relief under the Second Injury and Re-employment Reserve.
Operations staff will decide if a disease is:
1. Occupational, and
2. The cause of a work injury (POL 04/2017, Injuries – Occupational Disease).
Operations staff will determine whether a claim meets the conditions for cost relief (POL 17/2023).
If the claim meets the conditions for cost relief, Operations staff will determine:
1. The percentage of costs to be transferred to the benefit liabilities, and
2. The effective date.
All or a portion of the claim costs will be removed from the employer’s experience when a latent occupational disease has a cause and effect link to work known at exposure. Operations staff will determine the portion of costs by comparing the exposure covered by The Workers’ Compensation Act, 2013 (the “Act”) against the factors identified in Point 2 of POL 17/2023.
Operations staff will remove all costs from an employer’s cost experience for a latent occupational disease when there would have been no known cause and effect link at the time of exposure. In these cases, medical research confirmed a cause and effect link between the exposure and the latent occupational disease long after exposure occurred (i.e., asbestos exposure).
Operations staff will advise the employer, in writing, of all decisions regarding cost relief.
When the WCB provides cost relief, an employer may request to have their previous years’ experience rating reviewed by Employer Services (POL 27/2016, Experience Rating Program – Discounts or Surcharges).

Policy references

Section heading

Legislative Authority

The Workers’ Compensation Act, 2013

2(1)(r)(iii), 2(1)(aa), 20, 145

Section heading

Document History

(1) January 19, 2024. Update to clarify that the elimination of the Occupational Disease Reserve and provision for latent occupational diseases in the benefit liabilities does not result in any change in process for the Operations Department.
(2) December 31, 2023. Update to clarify that the Occupational Disease Reserve was eliminated in 2014 and provision for latent occupational diseases was captured in the benefit liabilities.
(3) POL and PRO 05/2014, Occupational Disease Reserve (effective December 1, 2014 to December 30, 2023).
(4) January 1, 2023. Housekeeping change to add cost relief definition.
(5) December 31, 2014. Actuarial standards require expected cost of future latent occupational diseases in the benefits liability.
(6) POL and PRO 10/1999, Disaster and Occupational Disease Reserve (effective February 1, 1999 to November 30, 2014).