Employers have a number of questions regarding workers' compensation claims reporting and management coming out of the COVID-19 pandemic, including whether claims for COVID-19 should be reported to the compensation board and whether workers would be entitled to workers' compensation benefits for COVID-19 and lost time for workers who are required to self-isolate when suspected of having it. Each provincial compensation board has published information surrounding these issues.
Can a Worker get Entitlement to WCB Benefits for COVID-19?
While most compensation boards have taken the position that most cases of COVID-19 will not be work-related, workers may be entitled to benefits under certain circumstances. Generally, workers can have entitlement under the provincial workers' compensation regime for COVID-19 if they contracted it as a direct result of their employment. The compensation boards in the majority of provinces have set out criteria for entitlement including:
- A confirmed medical diagnosis of COVID-19 or non-medical factual evidences supporting a diagnosis of COVID-19; and
- Evidence that the nature of the worker's employment created a risk of them contracting the disease that was greater than the ordinary exposure risk for the general public.
The compensation boards have generally held that entitlement to benefits will depend on the specific circumstances of each claim. This is in keeping with the practices of the various compensation boards in determining entitlement for any occupational disease or illness.
Employers should be sure to conduct a thorough investigation into any instance of COVID-19 in order to try to determine the source of the infection to the extent possible. Employers should also be sure to have a thorough description of a worker's function and duties within the organization in order to be able to support or refute whether the worker's job created a greater risk of them contracting the disease that was greater than that of the general public.
When reporting a claim for COVID-19 with the WCB, as with any claim, employers should provide the WCB with as much information as possible so that the WCB can make an informed decision on entitlement. Employers who disagree with WCB decisions to allow entitlement to benefits will have the opportunity to appeal those decisions through the regular appeal and review channels through the various compensation boards.
Are Workers Entitled to Wage Loss Benefits from the Compensation Board for COVID-19?
Workers may be entitled to wage loss benefits, if the WCB allows their claim for COVID-19 and they suffered a wage loss because of the disease. However, most compensation boards have stated that coverage is not provided for people who, on a precautionary basis, are quarantined, self-isolating or sent home. In those cases, unless there is a confirmed diagnosis of COVID-19 that arose out of and in the course of the worker's employment, there is no occupational illness and, therefore, no entitlement to workers' compensation benefits.
Workers who have been asked to self-isolate and who develop symptoms may subsequently be entitled to benefits, if the benefit entitlement criteria are met.
If a worker has contracted COVID-19 as a result of their employment, employers may be able to mitigate their worker's compensation costs by offering suitable work, if such work is available. As those workers would likely be prevented from returning to the workplace for a period of time due to the virus, appropriate work from work home may be considered, if possible,
Should Claims for COVID-19 be Reported to the Compensation Board?
Some of the compensation boards have provided guidance on whether a claim for COVID-19 should be reported. British Columbia, Alberta and Saskatchewan have stated that cases of COVID-19 should be reported to the Board if the criteria for entitlement are met (i.e. if the worker who contracted the disease is at greater risk than the general public for contracting the disease), or if they lose time from work because of the disease. Manitoba did not stipulate the requirement that the person who contracted the disease be at greater risk than the general public, but set out its ordinary reporting criteria where a person sought medical attention and lost time from work.
While not all of the compensation boards have provided specific guidance on when an employer should report a claim for COVID-19, it is recommended that employers report if a worker has lost time from work due to COVID-19, if the worker who has the disease is at a greater risk than the general public for exposure to the disease due to the nature of their employment, and certainly, if the compensation board requests that a report be filed.
As stated above, each claim will be adjudicated based on its specific facts and circumstances. As with all claims, employers may dispute entitlement to benefits when reporting the claim, or should benefits be allowed by the compensation board through the usual appeal and review measures.
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