How a Psychological Injury Claim is Decided
We’re here to support you and your worker
A psychological injury can feel overwhelming. It’s normal for workers to feel anxious while they wait for a decision. From the first call to the decision, our team checks in, explains each step—and, when needed, connects your worker to support. WCB has a team trained to provide the specialized support needed for psychological injury claims.
Are you a first responder opening a claim for PTSD?
Learn about the claim process for PTSD in first responders, which follows a different process than other psychological injury claims.
Here about a physical injury?
Return to work—why it’s talked about early
Staying connected to work—when it’s safe—is an important part of recovery. That’s why we start the conversation early. Working while a worker recovers does not affect whether their claim is approved.
For psychological injuries, a client care navigator will usually reach out while the claim is being reviewed. They’ll talk with you and your worker about safe duties, accommodations, or transitional work that could help them stay connected. A return-to-work specialist may also contact you to explore options.
What to expect after a claim is opened
Once the claim is opened, we’ll speak with you and your worker. We’ll gather the information needed to decide if the claim is approved for benefits. Most often, a decision is made within 3 weeks of opening the claim.
You and the worker will receive an explanation by phone, along with a detailed written decision for your records.
Who’s involved and how they help
Client Care Navigator
- Checks in, explains next steps, and answers questions
- Connects the worker with community resources and supports as needed
- Helps you and the worker discuss safe ways to stay connected to work
Eligibility Specialist
- Contacts the worker to gather information and decide if the injury is eligible under the Workers’ Compensation Act
- May also speak with you and others who have relevant information
- May ask for:
- A detailed description of the events that led to the injury
- A timeline of events
- Any internal safety or HR reports or processes related to the injury
- Information about the job description and job demands
- Any documented complaints or investigation reports from the employer, police, or OH&S
- The job description or employment agreement
We understand that sharing details can be challenging. Your worker can pause, ask for clarification, and take breaks. We’ll explain why we’re asking for each piece of information. They can also have a support person present, if they choose.
Additional information gathering
Sometimes, depending on the situation, specialized service providers assist the WCB in collecting more information. If a third-party WCB claim investigator is needed, the decision can take longer. We’ll keep you informed about what’s happening and why.
Psychological assessment (if needed)
If needed, a psychological assessment may be requested as part of the review. WCB will arrange and cover the cost of the assessment.
How will the claim impact my rates?
Assessment rates for psychological injury claims are set the same way as any other kind of injury. Learn about how your rates and premiums are set.
The best way to keep rates low is to actively participate in return-to-work planning and support the process so your worker can get back on the job in an early and safe way.
What if I want to appeal a decision?
If you disagree with a claim decision, you can file an appeal within 30 days of receiving the written decision.