Benefits

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Wage Replacement

Wage replacement benefits are equal to 90% of your net earnings. The maximum insurable earnings are set by the Board of Directors. For 2017 this is at $98,700.00. Very few people need to worry about this. These benefits need to be reported as income to Revenue Canada but are not taxable. You can receive these benefits by a check in the mail or sign up for the direct deposit. Wage replacement benefits fall under 2 different categories. These are temporary total disability or temporary partial disability. These will become important when you are at different stages in your claim process, as well as for appeals. Pay attention to how your benefits are listed and learn what this means. The policy explaining this can be found here, https://www.wcb.ab.ca/assets/pdfs/public/policy/manual/printable_pdfs/0402_1.pdf  This policy also includes info stating: “WCB may pay allowances for travel or subsistence expenses or both when workers are required to travel and/or stay away from home to attend WCB-directed appointments. As well, WCB may pay a wage loss allowance if workers lose wages as a result of attending WCB directed appointments.” I really loathe how they use the word “May” so loosely. Policy is law and they are required to follow it!

Medical

Medical benefits are the costs paid out for all medical pertaining to your injuries. These also include expenses for things such as prescriptions and physiotherapy. The list can be found on their site from the following link:  https://www.wcb.ab.ca/claims/benefits-during-your-claim/medical-benefits.html Their site info claims “If you have suffered a severe injury you may be entitled to more specialized medical benefits such as: personal care allowance, vehicle modification, home modification, psychological counselling and wheelchair costs”.  Their section on these medical benefits also states “there may be additional services available to you and your case manager will give you additional information”. THIS IS NOT TRUE! I had a severe injury and did not know I was entitled to things like home care and the ones listed above. This is why it is so important to learn these things!

Fatality & Survivor

Fatality/Survivor benefits are also covered. This is policy not a generous act on WCB’s part! Many families are unaware of this and I have heard the WCB does not afford this information willingly. WCB covers partial expenses for burial, cremation and memorial services. If your spouse or partner died as a result of their work injuries, the spouse is entitled to receive other benefits.  A survivor is the dependent spouse, common-law partner or child of a worker who has passed away. Dependent children living with you may also be eligible for benefits. WCB’s site has a fact sheet explaining this and can be found at: https://www.wcb.ab.ca/assets/pdfs/workers/WFS_workrelated_fatalities.pdf Never rely on the case managers to provide information to you or your family. They are instructed to keep costs down! The website for WCB has information pertaining to every situation so it’s important to familiarize yourself with what is available with all stages of your claim.

Expense Reimbursement

Lastly there are expense reimbursement benefits. They will not tell you what is considered as expenses to be reimbursed and there is no list to be found other than under medical. Their site claims that, “If you have to pay up front for an expense related to your work/illness (e.g. travel expense, prescriptions, etc.) we will reimburse you. To receive reimbursement for expenses you have been approved for; simply submit the original receipts to your adjudicator or case manager. Make sure your name and claim number is clearly marked on each receipt.”  They also claim they will let you know in advance which ones are approved. This is also not true! I have heard this from many different workers including my experience with this.

Overpayments

There is many times that WCB has discovered a worker was overpaid some form of benefits. If this is an error on the case manager’s end, they only have 2 weeks to find the error in order to recover the overpayment. This is stated in the policy surrounding this issue and can be seen from the link below: https://www.wcb.ab.ca/assets/pdfs/public/policy/manual/printable_pdfs/0501_2_app1.pdf  

This only applies to workers whose claim is still active and they are still receiving benefits. The information regarding other reasons they recover overpayments can be found in the link provided above.

PCI'S,ELP'S & NELP'S

A Permanent Clinical Impairment award is a onetime payment issued to a worker based on the percentage of their body affected. When you were diagnosed with permanent compensable work restrictions, the earning capacity with suitable employment became affected. Remember what is defined as suitable employment under the applicable claim stage.  Policy states WCB will send you to one of their doctors to “assess the permanent impairment of earning capacity by assessing the impact the permanent restrictions have on your ability to earn with any suitable employment”. This information is then used to determine any Economic Loss Payment (ELP) you would be entitled to. But again they need to establish suitable employment to determine your earning capabilities. This is also based on you reaching a medical and vocational plateau. This basically means your injury will not get any better and further medical won’t be required, and you will not need any more training to secure suitable employment. For example, if you were only able to work part time at an office job until you retire, they would take your actual taxable earnings and subtract it from your 90% compensation benefit. You would then be paid the difference in a monthly payment.

The Non-economic Loss Payment (NELP) is issued when the permanent clinical impairment is found to affect the lifestyle you have outside the workplace. Policy also states this is a “lump sum payment and is based on the degree of permanent clinical impairment resulting from the injury”. An example of this would be if your lifestyle was active prior to your workplace accident, the NELP is to compensate you for losing this.  The information for these payments can be found at the following links: 

PCI https://www.wcb.ab.ca/assets/pdfs/public/policy/manual/printable_pdfs/0404_2_app1.pdf 

ELP https://www.wcb.ab.ca/assets/pdfs/public/policy/manual/printable_pdfs/0404_2_app3.pdf 

NELP https://www.wcb.ab.ca/assets/pdfs/public/policy/manual/printable_pdfs/0404_2_app2.pdf