Workers-Compensation-U教学讲解课件

WorkersCompensationAwarenessSessionDenisSt-JeanWorkersCompensationAwareness1INTRODUCTION–WorkersCompensationAwarenessSessionYourNameFunctionExperience,Knowledge-CompensationChallenges/Expectation?FacilitatorINTRODUCTION–WorkersCompens2Workers-Compensation---U教学讲解课件3SESSIONOUTLINEIntroductionGECACollectiveAgreementsTBSPoliciesHowtogetaclaimapprovedbytheBoard?RolesofPartiesOtherCompensationOptionsConclusion/FeedbackSESSIONOUTLINEIntroduction4INTRODUCTIONLifecyleofaclaimBeforetheInjuryTheInjuryCompensationShorttermPermanentReturntoWorkAccommodationShorttermPermanentINTRODUCTIONLifecyleofaclai5GECA(1918;1952)GECA(1918;1952)6GECAGovernmentEmployeeCompensationAct–1918reviewedin1952CoversFederalGovernmentWorkers–300000Coverageapersonalinjurybyanaccidentand/ordeseasearisingoutofandinthecourseofemploymentReferencestoProvincialWorkersCompensationActsGECAGovernmentEmployeeCompen7GECANoFaultSystemEmployerassumesfinancialcostwhileworkersgaveuptheirrighttosueProvincial/TerritorialBoardsadjudicateclaimsSamebasicprinciplesbetweenBoards,buttherearedifferencesinbenefitsGECANoFaultSystem8GECACoverageincludes:LossofearningsNon-economiclossMedical,medicationRehabilitationLMRsReturntoworkprovisionsGECACoverageincludes:9GECASummaryProvincial/TerritoriesCompensationLegislationBenefitsAdjudication&AppealProcessHRSDC–LabourProgramAdministrativeAgreementFunding3rdpartiesGECASummary10GECAChallengesDeterminingextenttowhichGECAincorporatesprovinciallaws–lackofclarityPresumptionclausesapplication?Rate/conditionsvaryfromProvincetoprovinceLastreview1952–butprovincesupdateregularlytheiractGECAChallenges11GECAChallengesPhilosophyofCompensationhasevolvedsinceGECAwasreviewed,manyconceptsareabsent,butpresentinProvincialacts:PresumptionclausesReturntoworkWorkerrehabilitationTimelimitsFinesandpenaltiesHowtotrainPSACmembersGECAChallenges12COLLECTIVEAGREEMENTCOLLECTIVEAGREEMENT13COLLECTIVEAGREEMENTInjury-On-DutyLeave37.01Anemployeeshallbegrantedinjury-on-dutyleavewithpay

forsuchperiodasmaybereasonablydeterminedbytheEmployerwhenaclaimhasbeenmadepursuanttotheGovernmentEmployeesCompensationActandaWorkers'CompensationauthorityhasnotifiedtheEmployerthatithascertifiedthattheemployeeisunabletoworkbecauseof:(a)personalinjuryaccidentallyreceivedintheperformanceofhisorherdutiesandnotcausedbytheemployee'swillfulmisconduct,or(b)anindustrialillnessoradiseasearisingoutofandinthecourseoftheemployee'semployment,iftheemployeeagreestoremittotheReceiverGeneralforCanadaanyamountreceivedbyhimorherincompensationforlossofpayresultingfromorinrespectofsuchinjury,illnessordisease,provided,however,thatsuchamountdoesnotstemfromapersonaldisabilitypolicyforwhichtheemployeeortheemployee'sagenthaspaidthepremium.COLLECTIVEAGREEMENTInjury-On-14COLLECTIVEAGREEMENTAccumulationofVacationLeaveCredits34.02Foreachcalendarmonthinwhichanemployeehasearnedatleastten(10)days’paytheemployeeshallearnvacationleavecreditsattherateof:COLLECTIVEAGREEMENTAccumulati15COLLECTIVEAGREEMENTSickLeaveWithPayCredits35.01(a)Anemployeeshallearnsickleavecreditsattherateofninedecimalthreesevenfive(9.375)hoursforeachcalendarmonthforwhichtheemployeereceivespayforatleastten(10)days.COLLECTIVEAGREEMENTSickLeave16COLLECTIVEAGREEMENT35.05Whenanemployeehasinsufficientornocreditstocoverthegrantingofsickleavewithpayundertheprovisionsofclause35.03,sickleavewithpaymay,atthediscretionoftheEmployer,begrantedtoanemployeeforaperiodofuptoonehundredandeighty-sevendecimalfive(187.5)hours,subjecttothedeductionofsuchadvancedleavefromanysickleavecreditssubsequentlyearned.35.06Whenanemployeeisgrantedsickleavewithpayandinjury-on-dutyleaveissubsequentlyapprovedforthesameperiod,itshallbeconsidered,forthepurposeoftherecordofsickleavecredits,thattheemployeewasnotgrantedsickleavewithpay.COLLECTIVEAGREEMENT35.05Whe17COLLECTIVEAGREEMENTArticle54LeaveWithorWithoutPayforOtherReasons54.01Atitsdiscretion,theEmployermaygrant:(a)leavewithpaywhencircumstancesnotdirectlyattributabletotheemployeepreventhisorherreportingforduty;suchleaveshallnotbeunreasonablywithheld;(b)leavewithorwithoutpayforpurposesotherthanthosespecifiedinthisAgreement.COLLECTIVEAGREEMENTArticle5418COLLECTIVEAGREEMENTOtherimpacts:Sick/VacationLeaveCreditsEmploymentInsuranceEligibilityCPP/QPPBenefitsPensionPlanDisabilityInsuranceLifeInsuranceMedical/DentalInsuranceOtherbenefitsCOLLECTIVEAGREEMENTOtherimpa19CRAPOLICIES–

Workers’CompensationCRAPOLICIES–

Workers’Compe20CRAPOLICIESInjuryandIllnessPolicyWork-RelatedInjuryOrIllness(AppendixC1)Workers'Compensation

Anemployeeinjuredinanaccidentattheworkplaceordisabledbyreasonofanillnessduetothenatureofhisorheremployment,isentitledtoreceivecompensationforlossofearnings,medicalcareandotherbenefits.Thesebenefitsaresimilartothosereceivedbyprivateindustryemployeesthroughworkers’compensationintheprovinceinwhichtheywork.ThegovernmentprovidesthesebenefitstoemployeesundertheGovernmentEmployees'CompensationAct(GECA)administeredbyTheDepartmentofHumanResourcesandSkillsDevelopment(HRSDC).Insteadofestablishingitsownsystemforcompensationandtreatment,thegovernmentusestheservicesalreadyavailablethroughprovincialworkers’compensationboards.TheregionalofficesofLabourCanadaareresponsibleforreceivingandprocessingclaimsthroughtotheappropriateprovincialauthority.Theyprovideageneraladvisoryservicetoemployeesandunions,aswellastoemployers,ontheinterpretationandapplicationofthelegislation.CRAPOLICIESInjuryandIllness21CRAPOLICIESBenefits

Include:compensationforlossofearnings(ifaninjuredemployeesisnotentitledtoinjury-on-dutyleave);medical,hospital,andrelatedservices;rehabilitationservices;apension,ifaninjuryresultsinapermanentdisability;andpensionstodependantsofemployeeswhoarefatallyinjuredinthecourseoftheiremployment.CRAPOLICIESBenefits22CRAPOLICIESInjury-on-dutyleaveToavoidduplicatepayment,itisextremelyimportantthatpersonnelofficersindicateontheoriginalinjuryreportwhethertheinjuredemployeeisentitledtoinjury-on-dutyleave,whichisprovidedforinthecollectiveagreement.CRAPOLICIESInjury-on-dutylea23CRAPOLICIESInformationbookletsTherearetwoinformationbookletsavailablefromLabourCanada.Ahandbookentitled"IfYouHaveanAccident"shouldbeprovidedtoallemployees,andabookletentitled"Employer'sGuide"shouldbeinthehandsofallpersonsresponsibleforthereportingofinjuries.CRAPOLICIESInformationbookle24CRAPOLICIESEmployers'Guide

DisallowanceofclaimsThemostcommonreasonsfordisallowingaclaimarethefollowing:Itisnotshownclearlythatthedisabilityistheresultofanaccident,oroccupationaldisease.Theinjuryoroccupationaldiseasereporteddidnotariseoutofandinthecourseofemployment.Adescriptionofanaccidentisgiven,butthedisabilityisnottheresultofit.Theinjuryreportedisnotsubstantiatedbymedicalevidence.CRAPOLICIESEmployers'Guide25CRAPOLICIESInjury-on-DutyLeaveEmployeesoftheCRAareeligibleforbenefitsprovidedbytheGovernmentEmployees’CompensationActforpersonalinjuryresultingfromanaccidentinthecourseofandarisingoutoftheiremploymentoranillnessthatwasaconsequenceoftheiremployment.CRAPOLICIESInjury-on-DutyLea26CRAPOLICIESInjury-on-DutyLeaveRighttoChooseDoctorAninjuredorillemployeehastherighttochooseadoctorfortherequiredtreatment,butoncethechoiceismadeitmustbeadheredto.Permissiontochangedoctorsmustbeobtainedinwritingfromtheprovincialworkers’compensationauthorityexceptinQuebecwherethereisnosuchrestriction.CRAPOLICIESInjury-on-DutyLea27CRAPOLICIESVerificationofdisabilityperiodWhileCRAisawaitingthereceiptofcertificationrequiredforthegrantingofinjury-on-dutyleave,thedisabledemployeemaybegrantedsickleavetotheextentofhisorhersickleavecredits.Iftheemployeehasinsufficientsickleavecredits,heorshemaybeadvancedadditionalsickleaveinaccordancewiththetermsofthecollectiveagreement.Whensickleaveisgrantedandinjury-on-dutyleaveissubsequentlyapprovedforthesameperiod,theemployeeistobecreditedwiththenumberofdaysofsickleaveinvolved.CRAPOLICIESVerificationofdi28CRAPOLICIESTerminationofinjury-on-dutyleaveInjury-on-dutyleaveshouldnotbegrantedbeyondthedatecertifiedthroughLabourCanadathattheemployeeisfitforwork,including"lightduty"work,whereitisavailable.CRAPOLICIESTerminationofinj29CRAPOLICIESTerminationofinjury-on-dutyleaveNormally,after130(working)days,allemployeeswillbepaiddirectlybytheprovincialworkers’compensationboard.Thelevelofpaymentwillbebasedontheprovincialregulations.CRAPOLICIESTerminationofinj30CRAPOLICIESTerminationofinjury-on-dutyleaveProvincialwagecompensationbenefitsfortotallydisabledemployeesaregenerally

75%ofearnings,basedonamaximumannualearningsceiling.CRAPOLICIESTerminationofinj31CRAPOLICIESDutytoAccommodatePersonswithDisabilities

Arequestforaccommodationneednotbeinwriting,butshouldbecommunicatedasclearlyandspecificallyaspossible.Thepersontowhomtherequesthasbeendirectedshoulddothefollowing:Determinethetypeofaccommodationrequired,basedoninformationprovidedbytheemployee.Ifthecandidateoremployeedoesnotknowwhattypeofaccommodationisrequired,consultexpertsinthefieldtodeterminetheappropriateaccommodation.Thiscouldincludetheperson'sownphysician,psychologistorcentresofexpertisewithinthePublicServiceCommissionortheaccommodatingdepartment.Providetheaccommodationbasedontherequestofthepersonbeingaccommodated,or,ifnecessary,ontheadviceofexperts.CRAPOLICIESDutytoAccommodat32CRAPOLICIESDutytoAccommodatePersonsrequestingaccommodationmaybeaskedtoprovidedocumentationfromaqualifiedhealthcareprofessionaltoclarifythelimitationscausedbythedisabilityand/orthetypeofaccommodationthatwouldbemosteffective.Anymedicalrecordsprovidedshouldbekeptstrictlyconfidentialandseparatefrompersonnelfiles.Requestsforthistypeofinformationshouldcomefrompersonneldesignatedtodealwithaccommodationrequestsandtrainedtohandlepotentiallysensitivemedicalinformation.CRAPOLICIESDutytoAccommodat33CRAPOLICIESDutytoAccommodateCRAshoulddeveloptheirowninternalproceduresfordealingwithaccommodationrequests,includingmechanismsforresolvingsituationswhereaccommodationisdenied.Allcandidatesandemployeesshouldbeadvisedofsuchprocedures.PersonswhoaredeniedaccommodationmayalsowishtousetherecoursemechanismssetoutintheCanadianHumanRightsCommission.CRAPOLICIESDutytoAccommodat34HowtogetaclaimapprovedbytheBoard?Howtogetaclaimapprovedby35HowtogetaclaimapprovedbytheBoard?ClaimingWorkersCompensationWhen?How?WhatshouldIsay/notsay?WhatifIneedaccommodation?WherecanIgethelp?Howtogetaclaimapprovedby36HowtogetaclaimapprovedbytheBoard?DefinitionofAcccidentincludes:Achanceeventoccasionedbyaphysicalornaturalcause;orThebiggestreasonforthedenialoftheseclaimsisalackofproofthataninjuryhappenedAdisablementarisingoutofandinthecourseofemploymentThemajorreasonforthedenialoftheseclaimsislackofprrofthattheworkcausedtheinjuryHowtogetaclaimapprovedby37HowtogetaclaimapprovedbytheBoard?

Personalinjurybyanaccidentand/ordeseasearisingoutofandinthecourseofemployment:Exemple:Donotsay:Ifellandhurtmyself.Say:Iwaswalkingthroughtheofficeinthescanningdivision.Isteppedonamarkerthatwasonthefloor.MyrightlegwentforwardandIlostmybalance.Ifellbackwards.Ihitmyshoulderonthefaxmachine.Ihurtmyrightshoulderonthemachine.WhenIlandedonthefloor,Ihurtmyrightwrist,myneck,andmyrighthip.Howtogetaclaimapprovedby38HowtogetaclaimapprovedbytheBoard?

ReconsiderationsandAppealsOntario:AnoticeofObjectionmustbeinwriting6monthtimelimittoappealExceptforRTW/LMR:30daysTwo(2)levelsofappealsARO/TribunalQuébecAwrittenlettertotheCSST30daystoappealintialdecisionAformmustbecompletedtotheCLP45daystoappealHowtogetaclaimapprovedby39ROLESOFPARTIESROLESOFPARTIES40ROLESOFPARTIESMakingaCasePlan:OpenafileforeachworkerKeepcopiesofallinformationRecordallactivitiesPhonecallsInterviewsLettersConfirmwiththeworkerwhatissueswillbeaddressedPriorizeissuesandactionNotethedateandlevelofdecisionbytheBoardrelatingtoeachissueNoteanyissuesthatariseinqualifyingforbenefitsDeterminewhatinformationisrequiredWitnessesMedicalinformationPhysicaldemandsExposuresAnalyzeeachproblemandoutlineactionplanROLESOFPARTIESMakingaCase41ROLESOFPARTIESWorkerItisbettertotalkinpersonratherthanoverthephoneAdvisetheworkertobringcopiesofallcorrespondence&informationreceivedEncouragetheworkertoexplaintheproblemReviewanydocumenttheworkerhasreceivedfromtheBoardordoctorsforahistoryoftheclaimPre-accidentjobhistoryDescriptionofjobatthetimeofaccidentDescriptionoftheaccidentEventssincetheaccidentsReviewtherelevantfactstomakesureyouunderstandcorrectlyROLESOFPARTIESWorker42ROLESOFPARTIESBoardCompleteandsendAuthorizationformtotheBoardIncludeworker’snameandclaimnumberExplainreasonswhyyouarewritingandtheactionsyouwishtheBoardtoTakecareExplainanynewinformation,indicatewhytheyareimportantExplainyourargumentsMakesurethedecisionmakerunderstandstheissueKeeparecordofallcallsROLESOFPARTIESBoard43ROLESOFPARTIESDoctorIntroductionofyourselfandyourrelationshiptotheworkerReasonswhyyouarewritingBriefstatementofissueRelevantbriefbackgroundandhistoryRequestthedoctor’smedicalopinionregardingtheissueunderappealRequestthattheopinionbeevidence-basedROLESOFPARTIESDoctor44ROLESOFPARTIESLocal/ComponentIdentifylocalrepresentative,involvethispersonintherepresentationprocessIdentifyServiceOfficerandcommunicatewithhim/hertoassistanceandfollow-uponaccidentinvestigationandcorrective/preventionmeasuresaswellasleaveadvanceifrequired,andeventuallyreturntoworkstrategy.participationbyaworkerrepresentativeontheaccidentinvestigationteam,willpermittoobtainkeyinformationonaccidentcausationwhichwilloftenhelptheinjuredworkerinmakingademonstrationthattheworker’sinjurywascaused–byanaccidentarisingoutofandinthecourseofhisemploymentorisdisabledbyreasonofanindustrialdiseaseduetothenatureoftheemployment-.AssistmemberwhenagrievancemayberequiredfollowingbeingadvisedbytheemployerthattheemployeewillbeterminatediftheychoosetoresignortoapplyformedicalretirementROLESOFPARTIESLocal/Compon45ROLESOFPARTIESLocal/ComponentTOOLOpenfileAttachsummaryNameofworkerMembernumberComponentLocalEmployerdataWSIBFileNumberInjury/diseasetypeDateofaccidentNameoftreatingdoctorDecisionunderappeal–datetimelinesforappealDocumentalltelephoneconversation,interviewsandlettersProtectappealdeadlinewithsampleletter(templatetobeprovided)stipulatingthatyouareprotectingtheappealdeadline,youwantacompletecopyofthefile,youwillanalyzethefileandfurtheradvisetheBoardwhetheryouwillpursuetherepresentationEnsurethattheworkeranditsLocal/ComponentrepresentativesunderstandthattheyarecustodiansoftheirclaimsROLESOFPARTIESLocal/Compon46ROLESOFPARTIESLocal/ComponentItisrecommendthateachlocalhasatleastonepersonthathasbasicunderstandingoftheWCBprocesswhocanassisttheworkerinwritingtheinitialclaimtoensurekeyelementsofthedescriptionofeventareincludedandtoworkwiththeworkertoobtainsickleavecreditadvancesfromtheemployerand/orapplyforotherbenefitswhiletheBoardanalyzestheeligibilityoftheclaim.Alocalrepresentativeshouldalsoworkwiththeworkerandtheemployertoensurethataccommodationsareputinplacewhenaworkerhasfunctionallimitationsrequiringit.ROLESOFPARTIESLocal/Compon47ROLESOFPA