I've Been Cut off Workers' Compensation Benefits

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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 ensure 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 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. 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 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.


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 90 day time limit, you may lose any chance of changing it, no matter how unfair it is.


First steps[edit]

  1. You can request a review of any decision that affects your benefits or rights. Such review 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, 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".)
  2. Complete the Request for Disclosure and Request for Review forms and send them to the Review Division.

What happens next[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 you feel that it was wrong.

If your review involves a medical issue, such as whether you are able to return to work, ask your doctor whether he or she agrees. If not, ask the the 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 claims 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 of those 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 and go to volume 2 of the Rehabilitation and Claims Manual, and read the policies and practices that apply to the decision you are reviewing.

You can also seek legal help. The Workers' Advisers Office (WAO) provides free, expert advice and sometimes 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. If you have a serious injury and can't return to your former job, you may lose hundreds of thousands of dollars over the rest of your life. in such cases, the benefit of having a lawyer or other expert advocate may be well worth the cost.

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.

The Review Division usually decides the review within six months. For most issues, if you don't agree with the decision you can appeal it 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 certain pension decisions, cannot be appealed to the WCAT, however.

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 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. Ask for legal advice before requesting a reconsideration, though, as you can only do so once.

Where to get help[edit]

See the Resource Guide in Part 2 for a list of helpful resources. Your best bets are:

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.

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Common Legal Problems

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In family law, an antiquated term referring to child support and spousal support. See "child support" and "spousal support."

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

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