Policy Manual - Workers Compensation Board of Nova Scotia

WCB Nova Scotia Policy Manual :: Table of Contents

Policy Sections

1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11

1. Entitlement

Overview

1.1 Injuries

Back Injuries 1.1.1R
Coverage Police/Fire Fighters Employed in Off-Duty Hours 1.1.2
Claims Adjudication - Processing Continuing Claims 1.1.3

1.2 Occupational Diseases

Guidelines for Automatic Assumption - Injuries prior to January 1, 2000 1.2.1R
Guidelines for Automatic Assumption - Injuries on or after January 1, 2000 1.2.1A
Fee Schedule Assessment: Automatic Assumption Claims 1.2.2
Voluntary Autopsy Reports - Deceased Pneumonoconiosis Pensioners 1.2.3
Carpal Tunnel Syndrome 1.2.4R
Occupational Hearing Loss - Injuries prior to January 1, 2000 1.2.5R1
Occupational Hearing Loss - Injuries on or after January 1, 2000 1.2.5AR
Workplace Noise Levels 1.2.6R
Lead Poisoning 1.2.7R
Lung Cancer - Foundry Workers 1.2.8
Lung Cancer - Coke Oven Workers 1.2.9
Medical Conditions from Coke Oven Workers other than Lung Cancer 1.2.10
Lung Cancer in Asbestos Workers 1.2.11
Mesothelioma in Asbestos Workers 1.2.12
Laryngeal Cancer - Asbestos and Nickel Workers 1.2.13

1.3 General

Loss of Wages While Undergoing Active Medical Treatment 1.3.1
Interruption of Medical Treatment - Circumstances Beyond Worker's Control 1.3.2R
Rescinded 1.3.3R
Volunteer Fire Fighters 1.3.4
Criteria for psychiatric conditions: occupational stress 1.3.5
Compensability of Stress as an Injury Arising out of and in the Course of Employment 1.3.6

1.4 Decision Making

(rescinded) 1.4.1
(rescinded) 1.4.2
Weighing Conflicting Medical Evidence 1.4.3

2. Health Care

Overview

2.1 Workers' Expenses

Workers' Travel Expenses for Health Care 2.1.1R7
(rescinded) 2.1.1R6
(rescinded) 2.1.1R5
(rescinded) 2.1.1R4
(rescinded) 2.1.2R
(rescinded) 2.1.3R
(rescinded) 2.1.4R
Clothing Allowance 2.1.5R2
Attendant Allowance 2.1.6
Eyeglasses 2.1.7R
Loss of Personal Items 2.1.8

2.2 Services/Treatments

Spinal Fusion - Second Opinion 2.2.1R
Fee Schedule - Second Opinion Spinal Surgery 2.2.2
Home Breathing Machines 2.2.3
Chemonucleolysis 2.2.4
Treatment: Pain Clinic 2.2.5
Home Oxygen Therapy 2.2.6
Portable Home Oxygen Therapy 2.2.7
Epidural Analgesia and Paravertebral Blocks 2.2.8R

2.3 General

Provision of Health Care Services 2.3.1R
Hospital Admissions: Semi-Private 2.3.2
Double Doctoring - Prescriptions 2.3.3
Prescription Drugs 2.3.4R

2.4 Functional Restoration Program

Normal Recovery Times 2.4.7R1

3. Short-Term and Long-Term Benefits

Overview

3.1 Earnings Profiles

Calculation of Gross Earnings 3.1.1R2
Calculation of Net Earnings 3.1.2R

3.2 Temporary Earnings-Replacement Benefit (TERB)

Calculation of Temporary Earnings-Replacement Benefit 3.2.1R
Waiting Period Without Compensation (Deductible) 3.2.2R1
TERB - Hearings, Examinations, Treatments, etc. 3.2.3R

3.3 Permanent-Impairment Benefit (PIB)

Calculation of Permanent-Impairment Benefit 3.3.1R
Permanent-Impairment Rating Schedule 3.3.2R2
Review of Permanent-Impairment Benefit 3.3.3R
Determining Permanent Impairment Ratings using the Guides to the
Evaluation of Permanent Impairment (AMA Guidelines) 3.3.4R
Eligibility Criteria and Compensation Related to Chronic Pain 3.3.5R

3.4 Extended Earnings-Replacement Benefit (EERB)

Calculation of Extended Earnings-Replacement Benefit 3.4.1R1
Review of Extended Earnings-Replacement Benefit 3.4.2R1

3.5 Estimation of Earning Ability

Definition of Suitable Employment 3.5.1
Definition of Reasonably Available Employment 3.5.2
Wage Rate to be Used in Estimating Earning Ability 3.5.3

3.6 Annuities

Amounts to be Reserved to Provide Annuity 3.6.1
Annual Reporting of Amount in Annuity Accounts 3.6.2
Payment at Age 65 3.6.3
Payment When EERB Commuted 3.6.4
Payment Where Intended Recipient Dies Before Becoming Eligible to Receive Payments 3.6.5
Payment Where Intended Recipient Dies After Becoming Eligible for Payments 3.6.6
Apportionment Where More Than One Spouse Qualifies 3.6.7
Interest to be Applied to an Annuity Account 3.6.8
Periodic Payment of Annuities 3.6.9

3.7 Permanent Disability Pensions: Injuries Before March 23,1990

Pension Benefits 3.7.1
Commutation of Pensions 3.7.2R

3.8 Supplementary Benefits

Eligibility Criteria 3.8.1R4

3.9 General

Maximum Insurable/Assessable Earnings 3.9.1R1
Duration of ERB and PIB Benefits 3.9.2
Combining of Workers' Compensation Benefits 3.9.3
(rescinded) 3.9.4
Commutation of PIBs and EERBs 3.9.5
Implementation of Appeal Board Decisions on Permanent
Compensation in the Absence of Measurable Impairment 3.9.6
(rescinded) 3.9.7
(rescinded) 3.9.8
(rescinded) 3.9.9
Payment of Interest on Transitional Benefits 3.9.10
Apportionment of Benefits 3.9.11R1
Inflation-Indexing of Benefits 3.9.12

4. Vocational Rehablitation

Overview

4.1 Entitlement to VR Services

Eligibility for Vocational Rehabilitation 4.1.1R
Extent of Vocational Rehabilitation Services 4.1.2
Goals and Objectives of Individual VR Plans 4.1.3
Non-Cooperation by Worker 4.1.4
Attendance in Training Programs 4.1.5
VR - Non-Participation - Circumstances Beyond Worker's Control 4.1.6

4.2 VR Program Expenses

Workplace Modifications 4.2.1
Tools and Equipment 4.2.2
Relocation Assistance 4.2.3
Workers’ Travel Expenses for Vocational Rehabilitation 4.2.4R5
(rescinded) 4.2.4R4

4.3 General

Eligibility of Clients While on Training and Job Search Programs 4.3.1

5. Re-employment

Overview

5.1 Eligibility and Coverage

Employer Coverage 5.1.1R
Worker Eligibility 5.1.2
Case Appropriate for Re-Employment 5.1.3

5.2 Nature of Re-Employment Obligations

Determination of Date of Injury for Purposes of Re-Employment 5.2.1
Employer's Obligations Within the Re-Employment Period 5.2.2
Termination Within the Re-Employment Period 5.2.3
Worker Able to Perform Essential Duties of Pre-Injury Employment 5.2.4
Worker Able to Perform Suitable Work 5.2.5
Accommodation 5.2.6

5.3 Defences and Exceptions

Employer Defences 5.3.1
Collective Agreements 5.3.2
Established Hiring Practices in Worker's Trade or Occupation 5.3.3
Section 71 of Labour Standards Code 5.3.4

5.4 Enforcement of Obligation

Order to Re-Employ 5.4.1
Penalties Under Section 99 for Breach of Re-Employment Obligations 5.4.2

5.5 Appeals

Re-Employment Appeals 5.5.1

6. Survivor Benefits

Overview

6.1 One-Time Benefits

Death Benefit 6.1.1
Burial Expenses 6.1.2
Expenses for Transportation of Body 6.1.3
Death of a Worker While in Receipt of Compensation 6.1.4

6.2 Periodic Benefits

Survivor Pension 6.2.1R
Survivor Pension - More Than One Spouse Qualifies 6.2.2
Dependent-Child Benefit 6.2.3
Discretionary Benefits to Surviving Dependants 6.2.4
Benefits to Person Standing in Place of Parent 6.2.5
Recalculation of Benefits When One Dependant Ceases to Qualify 6.2.6
Duration of Payments to Dependants 6.2.7R
Annuity 6.2.8R

6.3 General

Death Prior to February 1, 1996 6.3.1R

7. Specialized Adjudication

Overview

7.1 Transitional Claims - Temporary Disability

Benefits On or After February 1, 1996 for Injuries Before February 1, 1996 7.1.1

7.2 Transitional Claims - Permanent Disability

Recalculation of Awards Where Injury Occurred On or After March 23, 1990 7.2.1

7.3 Amended Interim Earnings Loss

Statement of Principles 7.3.1
Eligibility for Award 7.3.2
(rescinded) 7.3.3
Effective Date of Awards 7.3.4
Calculation of Award 7.3.5
Pre-Accident Earnings 7.3.6
Indexing of Pre-Accident Earnings 7.3.7
Post-Accident Earnings - Documentation 7.3.8
Post-Accident Earnings - Canada Pension Plan (CPP) Disability Benefits 7.3.9
Post-Accident Earnings - Permanent Partial Disability Awards 7.3.10
Duration of Benefits 7.3.11
Workers Reaching Normal Retirement Age 7.3.12
Commutation of Awards 7.3.13
Reinstated AIEL Benefit for pre-March 23, 1990 injuries 7.3.14

7.4 Recalculation of Long-Term Benefits Pursuant to Section 228

(rescinded) 7.4.0
(rescinded) 7.4.1
(rescinded) 7.4.2
(rescinded) 7.4.3
(rescinded) 7.4.4
(rescinded) 7.4.5
(rescinded) 7.4.6
(rescinded) 7.4.7

7.5 Compensation for chronic pain for injuries on or after March 23, 1990 and up to January 31, 1996

(rescinded) 7.5.1
(rescinded) 7.5.2
(rescinded) 7.5.3R
(rescinded) 7.5.4R
(rescinded) 7.5.5
Criteria for compensation for chronic pain 7.5.6

8. Internal Appeals

Overview

8.1 Reconsideration and Internal Appeals

(rescinded) 8.1.1
(rescinded) 8.1.2R
Appeals and Referral to a Hearing Officer 8.1.3R1
Participants in an Appeal 8.1.4R
(rescinded) 8.1.5
Referrals to Medical Review Commission 8.1.6
Reconsiderations Pursuant to s.185(2) Where a Final Decision of the Board Addressing an Issue Has Been Rendered 8.1.7R1
Requests for reconsideration pursuant to former s.196 of Chapter 10 of the Acts of 1994-1995 8.1.8

8.2 Referrals to the Chair

Adjournment and Referral of Appeal by Hearing Officer to Chair of Board of Directors 8.2.1
Interim Awards During Adjournment 8.2.2

9. Assessments and Collections

Overview

9.1 Scope of Coverage

Continuous Coverage - Less Than Three Workers 9.1.1R
Special Protection Coverage 9.1.2
Coverage for contractors and subcontractors which employ less than three workers 9.1.3

9.2 Classification of Firms

Multiple Classification - Eligibility 9.2.1
Classification of Firms not Eligible for Multiple Classification 9.2.2

9.3 Rate Setting

Classification, Rate Setting and Experience Rating Process 9.3.1R
Temporary Transition 9.3.2RA
Transition 9.3.2R1
Data Used in Rate Setting at Rate Group Level 9.3.3R
Costs Used for Fatal Claims for Rate Setting 9.3.4R
Claims Costs Which are Excluded from Rate Setting 9.3.5R

9.4 Experience Rating

Experience Rating Participation 9.4.1R1
Maximum Merit or Demerit 9.4.2R3
Data Used in Experience Rating 9.4.3R
Claims Costs Which are Excluded from Experience Rating 9.4.4R
Costs Used for Fatal Claims for Experience Rating 9.4.5R

9.5 Penalties

Penalty for Late Submission of Payroll Statements 9.5.1R1
Penalty for Unpaid/Overdue Assessments 9.5.2R
Penalty for Failure to register With the Board 9.5.3R1
Late Reporting of Year-end Subcontractor Report 9.5.4R

9.6 Apportionment of Claims Costs

Effective Date for Apportionment 9.6.1
Apportionment of Claims Costs Under Concurrent Employment 9.6.2
Apportionment of Claims Costs Under a Rehabilitation Program 9.6.3
Apportionment of Claims Costs for Learners 9.6.4
Apportionment of Claims Costs for Workers Under 30 9.6.5
Employer Cost Relief for Overpayment 9.6.6

9.7 Collections

Write-Off of Uncollectable Accounts 9.7.1

9.8 General

Backdating Coverage 9.8.1R
Interest Charged for Underestimating Payroll 9.8.2R1
(rescinded) 9.8.3
Holdback of Assessment Premium From Contractors and Subcontractors 9.8.4
Definition of Assessable Earnings 9.8.5

10. General Policies

Overview

10.1 Reporting of Accidents

Accident Reporting: Duties of Employers 10.1.1R
Accident Reporting - Penalties 10.1.2

10.2 Benefit Overpayments

Recovery of an Overpayment 10.2.1R
Appealing an Overpayment 10.2.2R

10.3 Administration

Quality of Service Delivery 10.3.1R
Retroactivity of Policy Changes 10.3.2R
(rescinded) 10.3.3
Photocopying of Clients' Files 10.3.4
Access by Employers to Information Contained in Clients' Claim Files 10.3.5
Provision of Information to Canada Pension Plan 10.3.6
Fraud and Misrepresentation 10.3.7R
Investment Policy 10.3.8
Procurement Policy 10.3.9
Corporate Information Protection Policy 10.3.10
Consultation With Stakeholders 10.3.11

11. Prevention

11.1 Priority Employer Program

Selection Criteria for Priority Employer Program 11.1.1
Termination of Priority Employer Program Coaching Services 11.1.2