POLICY NUMBER: 1. 3. 2R

Effective Date: January 9, 2003
Date Issued: January 27, 2003
Date Approved by Board of Directors: January 9, 2003
Topic: Interruption of Medical Treatment – Circumstances Beyond Worker’s Control
Section: Entitlement
Subsection: General

Policy Statement

1. Where a worker is unable to commence, or continue, medical treatment required with respect to the compensable injury for reasons which, in the opinion of the Board, are genuinely beyond the worker's control, compensation benefits will:

1.1 continue to be paid for that period which the worker, in the opinion of the Board, would have been eligible to receive compensation benefits while undergoing treatment, had the treatment not been delayed or interrupted; or,

1.2 be temporarily suspended and reinstated when the worker is once again able to commence or resume medical treatment,

whichever appears to be in the best interests of the worker.

2. Where benefits are suspended, the worker will be provided a minimum two weeks written notice prior to suspension.

3. Policy statement 1 and 2 do not apply where the circumstance preventing the worker from commencing or continuing medical treatment is pregnancy. The Board shall continue to pay compensation benefits in circumstances where the effects of the compensable injury prevent the worker from returning to her employment but the worker’s pregnancy, or health conditions related to pregnancy, present a valid medical reason for refusing or discontinuing medical treatment required with respect to the compensable injury.

3.1. Notwithstanding the above, compensation benefits will not be paid to a worker in respect of those periods of time where her pregnancy or conditions related to the pregnancy, are themselves of a nature which prevent the worker from returning to her employment.

3.2. The Board will normally require a medical opinion or certificate to confirm a pregnant worker’s medical condition.

Guidelines

A minimum of two weeks notice is provided to the worker in order to allow an opportunity to secure coverage through an alternative illness coverage plan (if any) normally available to the worker.

Application

This Policy applies to all decisions made on or after January 9th, 2003.

References

Workers' Compensation Act (Chapter 10, Acts of 1994 - 95), Section 37(1)