The claim process
All claims filed with the WCB begin with adjudication. Adjudication is the decision-making process to consider whether or not a claim can be accepted.
To adjudicate your claim, the WCB requires:
- A Worker's Report from you.
- An Employer's Report from your employer.
- Medical information from a health care provider.
When a Worker's Report is filed, the WCB registers your claim and assigns it to a case manager.
All injury reports filed with the WCB are unique and are reviewed carefully by case managers, who make decisions in accordance with the Workers Compensation Act and Regulations. The processing time for most WCB claims is one to two weeks. However, more complex claims could take longer than two weeks. If more information is required to make a decision about your claim, the case manager will contact you, your health care provider, or your employer.
Once all required information has been received, the case manager will make a decision on your claim. If it is accepted, you may be eligible for benefits and services. While benefits are provided after a claim is accepted, some treatments – such as physiotherapy or chiropractic care – may be approved before a decision is made.
If your injury causes you to lose time from work, the WCB is here to support your recovery and return to work. Your case manager will work with you throughout the process.
If your claim is not accepted
If your claim is not accepted, you will be informed by a letter from the WCB. If you have any questions or concerns, you may discuss the decision with your case manager. You also have the right to appeal. If you think the decision was wrong, you can request a reconsideration within 90 days from the date the decision was made.
Helping you get back to work is part of the claim process
Returning to work is an important part of a healthy recovery. The longer an injured worker is away from the workplace, the more complex their recovery can become. Workers who stay at work doing modified, transitional, or accommodated work following a workplace injury recover more quickly. Getting back is part of getting better.
That is why, along with treatment and recovery, the WCB focuses on helping you return to work in a safe and timely manner.
If your injury or illness results in time away from work, you as a worker are responsible for taking reasonable steps to help yourself recover and return to work. This includes:
- Contacting your employer as soon as possible after the injury occurs and maintaining weekly contact throughout your recovery.
- Cooperating with your employer and the WCB in the timely and safe return to work process.
- Taking an active role in your recovery by:
- Following the prescribed treatment.
- Attending scheduled appointments.
- Asking questions if there is something you don't understand.
- Participating in your treatment plan. If you miss treatments or appointments, you may delay your recovery and risk suspension of your benefits.
- Keeping your WCB case manager informed of any changes in your medical condition or income, including confirmation of a return to work date. If you are not sure whether a change should be reported, ask your case manager.
- Maintaining weekly contact with a WCB Occupational Therapist, if one is involved in your recovery.
From the WCB, you can expect:
- To be treated with fairness, care, and respect.
- Open and honest communication.
- Professionalism and integrity.
- Your case manager to support your successful recovery and return to work by:
- Assisting you with your claim.
- Answering questions about your treatments and conditions.
- Acting as a contact with your health care providers and your employer.
- Coordinating resources to support you and your family during your recovery and return to work.
If you can't find what you are looking for, or have any questions about your claim, please contact us.
If possible, please have the following on hand when contacting the WCB about your claim:
-Your date of injury or the date you first noticed symptoms.
-Your case manager's name and phone number.
-Your 6-digit claim number.