Difference between revisions of "I've Been Cut off Workers' Compensation Benefits"

From Clicklaw Wikibooks
 
(31 intermediate revisions by 7 users not shown)
Line 1: Line 1:
−
{{Template:Legal Help Guide TOC}}The Workers' Compensation Board (the WCB, also known as WorkSafeBC) pays benefits to people who have an injury or disease caused by their work. The WCB also pays benefits to dependents of a worker who has been killed on the job or died due to an occupational disease.   
+
{{Template:Legal Help Guide TOC}}The Workers' Compensation Board (the WCB, also known as WorkSafeBC) pays benefits to people who have an injury or disease caused by their work. The WCB also pays benefits to dependents of a worker who has been killed on the job or died due to an occupational disease.   
  
−
Workers' compensation is a no fault social insurance scheme that replaces the personal injury laws that are enforced by the courts. If you have been injured at work, you will not be allowed to sue your employer or any other worker who may have caused the injury. Your only recourse is to make a workers' compensation claim. That makes it very important that you report your injury to your employer and the WCB as soon as possible after it occurs, and that you and your doctor give the WCB the information it needs about your condition and prospects for recovery.   
+
Workers' compensation is a no fault insurance scheme. If you have been injured at work, you <span class="noglossary">will</span> not be allowed to sue your employer or any other worker or employer who may have caused the injury. Your only recourse is to make a workers' compensation claim. That makes it very important that you report your injury to your employer and the WCB as soon as possible after it occurs, and that you and your doctor give the WCB the information it needs about your condition and prospects for recovery.   
  
−
You can make your WCB claim by telephone or online, or by completing a claim form and sending it to the Board. Be sure that you don't overlook matters that may not seem serious at the time. For example, if you tell the WCB that you fell and hurt your back, and later realize that you also twisted your knee, it may be harder to persuade them to accept the knee condition. If that happens, you should appeal.
+
Initially, the WCB pays benefits equal to 90% of the net (take home) wages you were earning at the time of injury. After ten weeks the benefits <span class="noglossary">will</span> be based on your long term average earnings. If your benefits drop significantly at this point, you should consider an appeal.
  
−
Initially, the WCB pays benefits equal to 90% of the net (take home) wages you were earning at the time of injury. After ten weeks the benefits will be based on your long term average earnings. If your benefits drop significantly at this point, you should consider an appeal.   
+
When the WCB decides that you have recovered, your benefits <span class="noglossary">will</span> cease. If you and/or your doctor do not agree that you are ready to go back to work, you should appeal. The WCB <span class="noglossary">will</span> also terminate your benefits if they feel that your condition has stabilized and become permanent. If you or your doctor disagree, you should appeal.   
  
−
When the WCB decides that you have recovered, your benefits will cease. If you and/or your doctor do not agree that you are ready to go back to work, you should appeal.  The WCB will also terminate your benefits if they feel that your condition has stabilized and become permanent.  If you or your doctor disagree, you should appeal.
+
Workers who have a permanent <span class="noglossary">disability</span> are entitled to a total or partial pension, payable until age 65. Permanently disabled workers (and sometimes others) may also be entitled to vocational rehabilitation assistance. As well, WCB plays all medical and related <span class="noglossary">costs</span> of an injury or disease.  
  
−
Workers who have a permanent disability are entitled to a total or partial pension, payable until age 65.  The amount of the pension will almost always be based on a comparison of your disability to a totally disabled worker.  Under this approach, a worker with a back injury might be considered only 10% disabled, which means the pension benefits would be only 10% as much as the WCB was paying before the condition became permanent.  If you feel that your disability is more serious than the WCB acknowledges, you should appeal. 
+
If a <span class="noglossary">decision</span> of the WCB limits your benefits or cuts you off benefits, the first stage of the appeal process is to request a ''review of the <span class="noglossary">decision</span>'' by the WCB Review Division.  
−
 
 
−
If you have a permanent disability and have not been able to return to work, you may be entitled to a loss of earnings pension, which will be based on the actual difference between what you were earning before the injury, and what you are earning or could earn afterward.  If the WCB refuses to pay you on that basis, or decides that you could be earning more than you are, you should appeal. 
 
−
 
 
−
Permanently disabled workers (and sometimes others) may be entitled to vocational rehabilitation assistance, which supports them while they search for a new job or learn a new occupation if their injury prevents them from safely returning to their old one.  If you feel that you need such assistance, and the Board refuses to provide it, you should appeal. 
 
−
 
 
−
The WCB also pays all medical and related costs of an injury or disease.  The Board must therefore pay your hospital and doctor's bills, and also any expenses for medication, physiotherapy, nursing services, etc.  Other possible forms of help include artificial limbs, a wheelchair or scooter, modifications to a home or vehicle, assistance with daily living, and home maintenance.  If the WCB refuses to pay for any such expenses that are needed because of the injury, you should appeal.
 
  
 +
== First steps ==
 +
 +
#To request a review of a <span class="noglossary">decision</span> by the WCB's Review Division, get the [http://www.worksafebc.com/forms/assets/PDF/63m1.pdf Request for Review] form online or by phone at 1-888-855-2477.
 +
#Complete the Request for Review form and submit it to the Review Division ''within ninety (90) days'' of the date that the WCB <span class="noglossary">decision</span> or <span class="noglossary">order</span> was made. The address is on the form.
  
 
{{Tipsbox
 
{{Tipsbox
−
| width = 70%
+
| width = 90%
−
| tips = If you are off work for a significant period of time, you will receive many letters from WorkSafeBC. Read these carefully, because each one could be a decision denying or limiting benefits. If in doubt, get legal advice, and if there is something in the letter that you don't agree with, challenge it. If you fail to request a review of a decision within the 90 day time limit, you may lose any chance of changing it, no matter how unfair it is.
+
| tips = If you are off work for a significant period of time, you <span class="noglossary">will</span> receive many letters from WorkSafeBC. Read these carefully, because each one could be a <span class="noglossary">decision</span> denying or limiting benefits. If in doubt, get legal advice, and if there is something in the letter that you don't agree with, challenge it. If you fail to request a review of a <span class="noglossary">decision</span> within the ninety (90) day time limit, you may lose any chance of changing it, no matter how unfair it is.
 
}}
 
}}
  
 +
== What happens next ==
  
−
== First steps ==
+
=== WCB Review Division ===   
−
   
+
You <span class="noglossary">will</span> receive a complete copy of your WCB file, including all documents the Board has about your claim. Review it carefully to better understand why the Board made the <span class="noglossary">decision</span> you are appealing, so that you can explain to the Review Division why it is wrong.
−
# You can request a review of any decision that affects your benefits or rights.  Such reviews are conducted by the WCB's Review Division.  Your request must be filed within 90 days of the date when you receive the decision. You can get the "Request for Review" and "Request for Disclosure" forms by phone at 1-888-967-5377 or online at the WorkSafe BC website, [http://www.worksafebc.com www.worksafebc.com]. Click on the "Forms" link, then the "Workers" link under the heading "WorkSafeBC Forms", and scroll down to Form 63M1, "Request for Review" and Form 25M13, "Request for Disclosure".)
 
−
# Complete the Request for Disclosure and Request for Review forms and send them to the Review Division.
 
  
−
== What happens next ==
+
If your review involves a medical issue, such as whether you are able to return to work, ask your doctor to write to the Board. Most successful reviews are based on new medical evidence.
−
 
 
−
You will receive a complete copy of your WCB file, including all documents the Board has about your claim.  Review it carefully to better understand why the Board made the decision you are appealing, so that you can explain to the Review Division why it is wrong.
 
  
−
If your review involves a medical issue, such as whether you are able to return to work, ask your doctor to write to the Board.  Most successful reviews are based on new medical evidence.
+
Your review may also involve a policy issue. The WCB's policy manual, which is nearly 800 pages long, has the force of law, and there are detailed policies about almost every aspect of the claims process. You can read or download the [http://www.worksafebc.com/publications/policy_manuals/Rehabilitation_Services_and_Claims_Manual/default.asp ''Rehabilitation Services and Claims Manual''] from the WCB's website.   
  
−
Your review may also involve a policy issue. The WCB's policy manual, which is nearly 800 pages long, has the force of law, and there are detailed policies about almost every aspect of the claims process. Many policies are complicated, and some of them are very unfair.  You can read or download the policy manual from the WCB's website.  Click the "policy" tab at the top of the page and go to volume 2 of the Rehabilitation and Claims Manual.
+
The Review Officer <span class="noglossary">will</span> give you a deadline for sending in any new information or arguments. If you need more time, ask for it. Make sure that you tell the Review Officer about any wrong information in the file, whether it's from a WCB doctor, your employer, or anyone else, and that you explain why the Board's <span class="noglossary">decision</span> was wrong.
  
−
You can also seek legal help.  The Workers' Advisers Office (WAO) provides free, expert advice and occasionally  representation to any worker who requests it.  Contact them immediately, as you may have to wait for an appointment.  Most unions also provide free, expert help to their injured members.  If you belong to a union, tell them about the injury immediately.  There are also community organizations that do WCB cases, and there are private lawyers and non-lawyer advocates who are experts in WCB matters.  If you can't return to your former job, a work injury may cost you hundreds of thousands of dollars over the rest of your life.  in such cases, the benefit of having expert representation may be well worth the cost of hiring a lawyer.
+
The Review Division usually decides the review within six months.
 +
 
  
−
The Review Officer will give you a deadline for sending in any new information or arguments. If you need more time, ask for it.  Make sure that you tell the Review Officer about any wrong information in the file, whether it's from a WCB doctor, your employer, or anyone else, and explain why the Board's decision was wrong.
+
{{Tipsbox
 +
| width = 90%
 +
| tips = There are several options for seeking legal help on a WCB claim review. The Workers' Advisers Office provides free, expert advice and occasionally  <span class="noglossary">representation</span> to any worker who requests it. Contact them immediately, as you may have to wait for an appointment. Most unions also provide free, expert help to their injured members. If you belong to a union, tell them about the injury immediately. There are also community organizations that do WCB cases, and there are private lawyers and non-lawyer advocates who are experts in WCB matters.  
 +
}}
  
−
The Review Division usually decides the review within six months.  You can appeal its decisions on most issues to the Workers' Compensation Appeal Tribunal (WCAT). Unlike the Review Division, the WCAT is independent of the Board.  You must appeal '''within 30 days''' after the date of the Review Board decision.  Some decisions, such as vocational rehabilitation matters and relatively minor pension disputes, cannot be appealed to the WCAT, however.
+
=== Workers' Compensation Appeal Tribunal (WCAT) ===
 +
If you disagree with the Review Division's <span class="noglossary">decision</span>, you can appeal it to the Workers' Compensation Appeal Tribunal (WCAT). You must appeal ''within thirty (30) days'' after the date of the Review Division <span class="noglossary">decision</span>.  
  
−
The WCAT conducts appeals by rehearing them, which means that it considers all the evidence and makes its own findings of fact and law. You should ask for an oral hearing, so that you can explain your case in person.  
+
The WCAT conducts appeals by rehearing them, which means that it considers all the evidence in the file and any new evidence presented by the parties, and then makes its own findings of fact and law. You should ask for an oral hearing, so that you can explain your case to the WCAT vice-chair in person.  
  
−
The WCAT is the final level of appeal, but it can reconsider its own decisions, either because of new evidence that couldn't be presented at the first appeal, or because of a serious legal error in the first decision.  There is no time limit for seeking reconsideration.  Ask for legal advice before doing so, however, as you can only make such a request once.  
+
The WCAT is the final level of appeal, and its decisions can only be challenged in a judicial review proceeding in the Supreme Court of BC. The WCAT can, however, reconsider its own decisions on the basis of new evidence that couldn't have been presented at the first appeal, or because the first <span class="noglossary">decision</span> was based on a serious legal error.
  
 
== Where to get help ==
 
== Where to get help ==
 
   
 
   
−
See the [[Resource Guide]] in Part 2 for a list of helpful resources. Your best bets are:   
+
See the [[Resource List for Legal Help for British Columbians|Resource List]] in this Guide for a list of helpful resources. Your best bets are:   
 
* [[Workers' Advisers]].  
 
* [[Workers' Advisers]].  
 
* [[PovNet]].  
 
* [[PovNet]].  
−
* [[Access Pro Bono]], [[Lawyer Referral Service]], [[Salvation Army Pro Bono Lawyer Consultation Program]], [[Private Bar Lawyers]].  
+
* [[Access Pro Bono]], [[Lawyer Referral Service]], and [[Private Bar Lawyers|private bar lawyers]].  
 
* [[Community Legal Assistance Society]].  
 
* [[Community Legal Assistance Society]].  
−
* [[Law Students Legal Advice Program]] (see Chapter 7, "Workers' Compensation" for useful information on workers' compensation issues).
+
* The ''Law Students' Legal Advice Program Manual'' chapter on "[http://www.clicklaw.bc.ca/resource/1723 Workers' Compensation]."  
−
* The WCB's website, [http://www.worksafebc.com www.worksafebc.com], has a lot of information about workers' compensation, including its policy manuals, practice directives, the manual and past decisions of the Review Division and all the forms needed to pursue a claim.   
+
* The WCB's website at [http://www.worksafebc.com www.worksafebc.com] has a lot of information about workers' compensation, including its policy manuals, practice directives, past decisions of the Review Division, and all the forms needed to pursue a claim.   
−
* The WCAT website, [http://www.wcat.bc.ca] also has a great deal of useful information, including its procedure manual, and a searchable collection of its past decisions.   
+
* The WCAT website at [http://www.wcat.bc.ca www.wcat.bc.ca] also has a great deal of useful information, including its procedure manual and a searchable collection of its past decisions.   
 +
* The Clicklaw common question "[http://www.clicklaw.bc.ca/question/commonquestion/1077 I’ve been cut off workers' compensation benefits]."
 +
 
 +
Before meeting with a lawyer or advocate, complete the form [[Preparing for Your Interview]] included in this Guide. Make sure you bring copies of all documents relating to your case. 
 +
 
 +
{{REVIEWED | reviewer = [[Trevor Thomas]], March 2017}}
  
−
Before meeting with a lawyer or advocate, complete the form [[Preparing for Your Interview]] in Part 3 of this guide. Make sure you bring copies of all documents relating to your case. 
 
 
{{Template:Legal Help Guide Navbox|type=problems}}
 
{{Template:Legal Help Guide Navbox|type=problems}}
 +
 +
{{Creative Commons for Legal Help Guide}}

Latest revision as of 04:29, 2 May 2017

Legal Help Guide
Legalhelpguidecover.png
This page is
from the wikibook
Legal Help for
British Columbians.
See the full contents
and contributors.
v • d • e

The Workers' Compensation Board (the WCB, also known as WorkSafeBC) pays benefits to people who have an injury or disease caused by their work. The WCB also pays benefits to dependents of a worker who has been killed on the job or died due to an occupational disease.

Workers' compensation is a no fault insurance scheme. If you have been injured at work, you will not be allowed to sue your employer or any other worker or employer who may have caused the injury. Your only recourse is to make a workers' compensation claim. That makes it very important that you report your injury to your employer and the WCB as soon as possible after it occurs, and that you and your doctor give the WCB the information it needs about your condition and prospects for recovery.

Initially, the WCB pays benefits equal to 90% of the net (take home) wages you were earning at the time of injury. After ten weeks the benefits will be based on your long term average earnings. If your benefits drop significantly at this point, you should consider an appeal.

When the WCB decides that you have recovered, your benefits will cease. If you and/or your doctor do not agree that you are ready to go back to work, you should appeal. The WCB will also terminate your benefits if they feel that your condition has stabilized and become permanent. If you or your doctor disagree, you should appeal.

Workers who have a permanent disability are entitled to a total or partial pension, payable until age 65. Permanently disabled workers (and sometimes others) may also be entitled to vocational rehabilitation assistance. As well, WCB plays all medical and related costs of an injury or disease.

If a decision of the WCB limits your benefits or cuts you off benefits, the first stage of the appeal process is to request a review of the decision by the WCB Review Division.

First steps[edit]

  1. To request a review of a decision by the WCB's Review Division, get the Request for Review form online or by phone at 1-888-855-2477.
  2. Complete the Request for Review form and submit it to the Review Division within ninety (90) days of the date that the WCB decision or order was made. The address is on the form.
Tipsandnotes.png
 If you are off work for a significant period of time, you will receive many letters from WorkSafeBC. Read these carefully, because each one could be a decision denying or limiting benefits. If in doubt, get legal advice, and if there is something in the letter that you don't agree with, challenge it. If you fail to request a review of a decision within the ninety (90) day time limit, you may lose any chance of changing it, no matter how unfair it is.

What happens next[edit]

WCB Review Division[edit]

You will receive a complete copy of your WCB file, including all documents the Board has about your claim. Review it carefully to better understand why the Board made the decision you are appealing, so that you can explain to the Review Division why it is wrong.

If your review involves a medical issue, such as whether you are able to return to work, ask your doctor to write to the Board. Most successful reviews are based on new medical evidence.

Your review may also involve a policy issue. The WCB's policy manual, which is nearly 800 pages long, has the force of law, and there are detailed policies about almost every aspect of the claims process. You can read or download the Rehabilitation Services and Claims Manual from the WCB's website.

The Review Officer will give you a deadline for sending in any new information or arguments. If you need more time, ask for it. Make sure that you tell the Review Officer about any wrong information in the file, whether it's from a WCB doctor, your employer, or anyone else, and that you explain why the Board's decision was wrong.

The Review Division usually decides the review within six months.


Tipsandnotes.png
 There are several options for seeking legal help on a WCB claim review. The Workers' Advisers Office provides free, expert advice and occasionally representation to any worker who requests it. Contact them immediately, as you may have to wait for an appointment. Most unions also provide free, expert help to their injured members. If you belong to a union, tell them about the injury immediately. There are also community organizations that do WCB cases, and there are private lawyers and non-lawyer advocates who are experts in WCB matters.

Workers' Compensation Appeal Tribunal (WCAT)[edit]

If you disagree with the Review Division's decision, you can appeal it to the Workers' Compensation Appeal Tribunal (WCAT). You must appeal within thirty (30) days after the date of the Review Division decision.

The WCAT conducts appeals by rehearing them, which means that it considers all the evidence in the file and any new evidence presented by the parties, and then makes its own findings of fact and law. You should ask for an oral hearing, so that you can explain your case to the WCAT vice-chair in person.

The WCAT is the final level of appeal, and its decisions can only be challenged in a judicial review proceeding in the Supreme Court of BC. The WCAT can, however, reconsider its own decisions on the basis of new evidence that couldn't have been presented at the first appeal, or because the first decision was based on a serious legal error.

Where to get help[edit]

See the Resource List in this Guide for a list of helpful resources. Your best bets are:

Before meeting with a lawyer or advocate, complete the form Preparing for Your Interview included in this Guide. Make sure you bring copies of all documents relating to your case.

This information applies to British Columbia, Canada. Last reviewed for legal accuracy by Trevor Thomas, March 2017.


v • d • e
 
Common Legal Problems
Creative Commons Attribution-NonCommercial-ShareAlike 2.5 Canada Licence Legal Help for British Columbians © Cliff Thorstenson and Courthouse Libraries BC is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 2.5 Canada Licence.

(1) The assertion of a legal right to an order or to a thing; (2) the remedy or relief sought by a party to a court proceeding.

An application to a higher court for a review of the correctness of a decision of a lower court. A decision of a judge of the Provincial Court of British Columbia can be appealed to the Supreme Court of British Columbia. A decision of a judge of the Supreme Court can be appealed to the Court of Appeal for British Columbia. See "appellant" and "respondent."

In law, the re-examination of a term of an order or agreement, usually to determine whether the term remains fair and appropriate in light of the circumstances prevailing at the time of the review. In family law, particularly the review of an order or agreement provided for the payment of spousal support. See "de novo," "family law agreements," "order" and "spousal support."

Facts, or proof tending to support the existence of facts, presented to a judge at a hearing or trial. Evidence can be given through the oral testimony of witnesses, in writing as business records and other documents, or in the form of physical objects. Evidence must be admissible according to the rules of court and the rules of evidence. See "circumstantial evidence," "hearsay" and "testimony."

A person licensed to practice law in a particular jurisdiction by that jurisdiction's law society. See "barrister and solicitor."

A reconsideration or retrial of a court proceeding or an application, sometimes based on the evidence which was presented at the first hearing or trial, sometimes based on new evidence. See "action," "application," "de novo" and "hearing."

In law, any proceeding before a judicial official to determine questions of law and questions of fact, including the hearing of an application and the hearing of a trial. See "decision."

In law, (1) the whole of the conduct of a court proceeding, from beginning to end, and the steps in between, may also be used to refer to (2) a specific hearing or trial. See "action."

(1) A lawyer or a person other than a lawyer who helps clients with legal issues, or (2) to argue a position on behalf of someone.

(1) In law, a court proceeding; a lawsuit; an action; a cause of action; a claim. (2) A historic decision of the court; case law. See "action," "case law, " "court proceeding," and "precedent."

Retrieved from "https://stagewiki.clicklaw.bc.ca/index.php?title=I%27ve_Been_Cut_off_Workers%27_Compensation_Benefits&oldid=35479"
Personal tools
Namespaces

Variants
Actions
Site
Tools
Contributors
Print/export