When a claim is accepted, the WCB will begin paying benefits on that claim. For more information on how and when benefits are paid, check out the Claim Payment Processing Schedule. There are several different types of benefits and services, designed to help you recover from your injury or illness as you return to work or to help keep you and your family secure from the impact of a workplace injury.
Health Care Benefits
Health care costs related to a workplace injury or illness may be covered.
In general, the WCB covers costs for the following pre-approved services and personal equipment. Please talk to your case worker to determine if specific services are available to you
- Prescriptions **Important information regarding your prescription medication coverage**
- Dental expenses
- Other health care items (crutches, braces, artificial limbs, wheelchairs, etc., including maintenance and repair
- Repair or replacement of eyeglasses and dentures damaged when the injury occurred (conditions apply)
Note that your employer is responsible for paying for ambulance transportation to an appropriate health care facility at the time of the injury, if required.
Temporary Earnings Replacement Benefits
Depending on your injury, you may not be able to return to your regular job right away. This can create a financial impact for you. The WCB is here to provide support during this time through financial compensation.
Most injuries don’t entirely prohibit you from working. But, you may be working at a different job or for fewer hours per week during your transition back to your regular job. Work is an important factor in recovery.
Earnings replacement benefits are based on your earnings loss — the difference in your income before your injury, and after your injury.
In more than 90 per cent of cases, when you have an injury at work, you will return to work at your pre-injury earnings. As you recover, you will receive Temporary Earnings Replacement Benefits (TERB). These benefits are usually paid every two weeks at the following rates for as long as you are unable to return to your regular job.
The calculation works like this:
- 75% of your net earnings loss for up to 26 weeks after your injury occurs
- After 26 weeks the TERB increases to 85% of your net earnings loss
There is a waiting period before you can begin to receive earning-loss benefits from the WCB. This period is two- fifths (2/5) of your normal work week. The amount you would have earned during this period is taken off the first compensation cheque.
For example, if you usually work five days a week you would have two days’ worth of your net weekly benefit deducted from your first cheque (2/5 x 5 days).
If your loss of earnings is greater than 5 weeks, the deducted amount is reimbursed.
In the vast majority of workplace injuries, there is either no time loss at all, or the worker returns to work within a few weeks at most. In some cases, the situation is more serious, and the impact of injury is more severe.
There are two types of long-term benefits if the impact of your workplace injury is permanent.
- Permanent Impairment Benefit (PIB)
- Extended Earnings Replacement Benefit (EERB)
Permanent Impairment Benefit (PIB)
A permanent impairment benefit (PIB) compensates for permanent impairment due to a workplace injury.
Eligibility for a PIB is determined by a review of your medical information and a medical assessment performed by an accredited WCB Medical Advisor.
The assessment allows your case worker to set a Permanent Impairment (PI) rate. The PI is used to calculate the amount of your benefit.
Your Permanent Impairment Benefit is calculated as follows:
PIB = (PI x 30%) x (85% x net average weekly earnings)
After 16 months, if you have medical information that shows a change in your condition, another medical assessment may be conducted. If this assessment results in a change in your PI, then your benefit amount would also change.
Extended Earnings Replacement Benefit (EERB)
If your injury is so severe that you are unable to return to work at your pre-injury earnings, and there is medical evidence supporting a permanent impairment, you may be eligible to receive Extended Earnings Replacement Benefits (EERB).
Extended Earnings Replacement Benefits (EERB) are paid monthly, in most cases, to replace a permanent loss of earnings — but only if your lost earnings are greater than the amount of your Permanent Impairment Benefit.
In the very tragic event a worker dies from a workplace injury, survivor benefits to the spouse and/or dependants are provided. The deceased’s spouse and dependants may be entitled to various benefits.
- A one-time lump-sum benefit of $15,000
- Funeral expenses up to $5,000
- Survivor benefits for spouses and dependent children
- Benefits for other dependents, depending on the situation
- Survivor benefits are also only payable until age 65 — then an annuity is payable.
To learn more about survivor benefits, please contact us.
In most industries, when you are ready to safely return to work, and your employer has 20 or more workers, and you have been employed for 12 consecutive months, your employer is obliged to re-employ you. Some employers, such as those in the construction industry, may be exempt.
This obligation lasts up to two years after your injury but will end if you refuse an acceptable offer of re-employment.
If you can do the essential duties of your pre-injury job, you are entitled to be offered:
- the same job upon returning to work.
- a comparable position, if your position is not available.
- suitable work, if there is no comparable position available.
- positions more like your pre-injury job as they become available.
If you cannot do the essential duties of your pre-injury job, but you are able to do other work safely, you are entitled to be offered the first suitable position available, and positions more suited to your abilities as your recovery progresses.
The WCB can help with workplace modifications that allow you to return to work. Some funding may be provided for these modifications. In addition to health and financial benefits, some other programs are designed to help you return to work in a safe and timely manner, and you can read more about these programs later in this booklet.
Additional Return-to-Work Services
Employment incentive program
Depending on the nature of your injury, you may not be able to return to your original job.
To create opportunities for you, the WCB offers employers incentives to hire injured workers through our Employment Incentive Program. Employers benefit from hiring a skilled worker, and workers benefit by getting back on the job — proven as an important factor in recovery.
Vocational rehabilitation services
Workers receiving Permanent Impairment Benefits who are unable to return to their pre-injury position due to their injury may be considered for Vocational Rehabilitation Services.
Vocational rehabilitation involves assessing your skills and abilities and matching them to a modified set of job tasks at work, or to a new job with another employer. It may also involve skills development and job search assistance. We will work with you to find the right solution that fits your situation.
If you are unable to return to the job you held prior to your injury, the WCB can help you obtain job experience. Our goal is to help you get back to work at a job with the equivalent salary as your pre-injury job.
The On-the-Job Training Program provides you with experience at a new job, which will help you find employment. Your wages are subsidized during your work term.
For more information on any of these programs, please contact your case worker.
Third Party Claims
WCB coverage is no-fault insurance, and employers and co-workers are protected from legal action in the event of a workplace injury.
In some cases, a third party may be involved in a workplace injury. In these cases, you may choose to take legal action against that third party. Alternatively, you may accept benefits, and in most cases, the WCB will take legal action to recover damages. Please contact us for more details about third-party claims.
Special Adjudication/Specialized Claims
Some claims are of a more complex nature, such as “over a period time” occupational disease claims, environmental exposure and claims involving hearing loss. These claims are handled by the Specialized Adjudication team at WCB. The process for reviewing these claims can be lengthy due to the amount of information the WCB will need to collect and review.
Occupational Disease claims
An Occupational Disease is a disease or condition which is caused by factors unique to a particular job or trade. For example, coal mining is known to be linked to several lung diseases. A history of work with, or around, asbestos can also result in disease. For more information about eligibility for Occupational disease, check out our policy, Policy 1.2.14 - General Entitlement - Occupational Disease Recognition.
The process for reviewing these claims can be lengthy due to the amount of information the WCB will need to collect and review. This can take several months. If you wish to submit a claim:
- Fully complete an Occupational Disease application form. Incomplete forms create delays in processing your claim. The form aims to collect as much details as possible about your employment such as:
- What condition is being claimed? Has a diagnosis been made by a physician?
- What materials may you have been exposed to in the workplace? What was the state or form of the material (gas, vapor, dust, etc.)?
- At what points in your employment history do you feel you were exposed?
- In your workplace, was protective safety equipment available for your use?
- Your employer(s) will be contacted to confirm your employment and provide details of your possible exposure(s).
- All medical reports concerning your diagnosis are needed. A Board Medical Advisor will be asked to provide a medical review and opinion,
- Your caseworker will make a decision to allow or disallow the claim based on the evidence on file. You will be provided a written reasoned decision. If your claim is accepted you may be entitled to:s
Earnings loss benefits
Permanent Impairment Benefits (PIB)
Medical Aid benefits
Environmental Exposure Claims
Environmental exposure claims should not be confused with occupational disease claims. An environmental exposure claim can be a short term (acute) or over period of time exposure to a noxious (harmful or unpleasant) substance.
An environmental exposure claim is registered when a medical report or WCB Injury report is filed with WCB. Additional information about the nature of the exposure and medical information will be collected from the worker. The employer will also be asked to provide additional information about the nature of the exposure and any relevant work site information.
Environmental exposure claim reviews can take significant time to complete, depending on the nature of the exposure(s) and the type of information required for review.
If you experienced a hearing loss due to a singular traumatic event, such as an explosion, you should complete an Injury Report form with your employer, as you would for any other workplace injury. Make sure you have a hearing test as soon as possible to establish a baseline of your hearing and seek medical treatment right away as this type of hearing loss can sometimes be medically treated.
Most work-related hearing loss is Noise-Induced, and is gradually caused by exposure to hazardous noise over a period of time.
- Steps for completing an occupational hearing loss claim
Complete an Occupational Noise Induced Hearing Loss form as soon as you become aware that your hearing loss could be work related – the filing deadline is generally 1 year.
Obtain a hearing test. Be sure you tell the clinic that you are filing a WCB claim. Be sure your test is completed by a Certified Audiologist and is a complete diagnostic test.
It is important to answer each question fully so we gather all information that could impact your claim. Provide as much detail about your workplace duties as possible and be sure to list the names of every medical person you saw about your hearing problems. An incomplete form will delay processing.
If you worked outside Nova Scotia in noisy jobs before moving here, you should apply in the province of employment first. People with military service should discuss their loss with the Department of Veteran’s Affairs prior to coming to the WCB.
- Claims Process
The Occupational Hearing Loss Administrator gathers all information and supporting documentation from you, your employer(s), and your health care providers. The WCB uses that information to decide about your claims acceptance and benefits level.
A contact letter will be sent to you acknowledging we have received and initiated your claim. This process may require seeking input from medical professionals and gathering additional information. Depending on the volume of claims and the complexity of the file, the process for review can be lengthy.
Claims must meet the criteria under our policy for Occupational Noise Induced Hearing Loss
- Benefits and Services.
Benefits associated with noise induced hearing loss claims is the provision of a hearing aid for one or more ears. WCB covers costs for pre-approved hearing aids ($1450 per ear), and a yearly battery allowance ($100 per year, per ear)
A permanent impairment benefit (PIB) issued for permanent impairment due to the development of a workplace injury. Eligibility for a PIB is determined by a medical assessment of your file.
Tinnitus is a ringing, rushing, buzzing or roaring sound experienced in one or both ears. Tinnitus can be caused by workplace exposure, and there may be additional PIB benefits payable and other assistive devices covered if recommend by a medical professional.