COVID-19 Response – Employer Relief Measures – Claim Cost Relief (ADM POL 04/2020)

(PDF)

Application applies to:

• All COVID-19 injury claims (full cost relief).
• Existing claims where the worker’s recovery is delayed beyond expected return to work timelines, due to postponed treatment or vocational rehabilitation during the COVID-19 pandemic (partial cost relief).

Purpose      To provide cost relief to employers during the COVID-19 crisis for specific situations.

Definition
COVID-19 injury claim is a communicable disease, as defined in POL 02/2010, Injuries – Communicable Diseases, and for the purposes of this policy, includes:

Any injury claim that has been accepted under the Injuries – Communicable Disease Policy (POL 02/2010) as a result of a worker contracting COVID-19, or
Any injury claim that has been accepted under the Injuries – Psychological Policy (POL 02/2017) as a result of a worker having contracted COVID-19 or having to provide care for COVID-19 positive patients for extended periods of time that is excessive and unusual compared to normal employment.

Background

Section 145 of The Workers’ Compensation Act, 2013 authorizes the Workers’ Compensation Board (WCB) to establish reserves to meet losses from any disaster or other circumstances where the liability would, in the opinion of the Board, unfairly burden employers.

a. POL 12/2014, Disaster Reserve, establishes guidelines to provide cost relief in situations where claims costs resulting from disasters unfairly burden employers.
b. POL 11/2017, Second Injury and Re-Employment Reserve, establish guidelines to provide employers with full or partial cost relief on claims:

i. Attributed to an earlier work-related injury.
ii. That involve a worker’s pre-existing conditions.
iii. Where the worker has a good reason for not participating in health care or an individualized vocational plan, and
iv. Other situations determined by the Board.

2. Under Section 19(1) of the Act, the WCB has a duty to:

a. Arrange provision of any health care or treatment that may be needed because of a work injury.
b. Arrange to provide rehabilitation to injured workers.
c. Consult and cooperate with injured workers in the development of rehabilitation plans intended to return them to positions of independence in suitable productive employment.

3. Workers have a legislated responsibility to take all reasonable action to lessen earnings loss resulting from an injury and to co-operate with the WCB in a rehabilitation plan to return the worker to a position of independence in suitable productive employment (Section 51).

Policy
COVID-19 Injury Claims

1. Where a COVID-19 claim (as defined above) is determined by the WCB to have arisen out of and in the course of employment, the employer will be provided with total cost relief. All claims costs will be charged to WCB’s Disaster Reserve (i.e., earnings loss benefits, medical costs, etc.).
2. If the employer qualifies for cost relief for a COVID-19 claim, Operations staff will notify the employer in writing.

Delays in treatment or vocational rehabilitation

3. The WCB will charge partial claims costs to the Second Injury and Re-Employment Reserve if recovery from an accepted work injury is prolonged due to delays in treatment or vocational rehabilitation caused by limited health care services available during the COVID-19 situation.

4. Operations staff will identify:

a. Claims that qualify for cost relief, and
b. The portion of claims costs that will be charged to the Second Injury and Re-Employment Reserve.

For example:

i. Claims costs (e.g., earnings loss benefits) paid after the worker’s last medical treatment until they are able to resume treatment.
ii. Claims costs paid while the worker’s vocational rehabilitation was paused until they are able to resume their program.

5. Operations will review and document the cost relief review decision (i.e., on the CRR memo). If the employer qualifies for cost relief, Operations staff will notify the employer in writing. The letter will note:

a. The reason why the employer is receiving cost relief, and
b. How much cost relief the employer will receive.

Employers’ experience

6. If an employer receives cost relief, a credit is applied to the employer’s experience (POL 27/2016, Experience Rating Program – Discounts or Surcharges will apply).

7. If an employer is found guilty of violating a public health order, any cost relief applied may be reversed, at the discretion of the WCB, and the costs will affect the employer’s cost experience.

Effective date      March 1, 2020
Expiration           For COVID-19 claims as defined above, full cost relief guidelines are effective until such time the situation is no longer considered a global pandemic.

For existing claims where the worker’s recovery is delayed beyond expected return to work timelines due to postponed treatment or vocational rehabilitation during the COVID-19 state of emergency, partial cost relief will be effective until the worker is able to resume treatment or their individualized vocational plan.

Approved date                April 28, 2020

Legislative authority    The Workers’ Compensation Act, 2013 Sections 19, 20, 51, 145

Document history

(1) New ADM policy to respond to the COVID-19 pandemic and Saskatchewan’s state of emergency declared on March 18, 2020 which included Public Health Orders that limited public and business services allowed to continue operating (including various health care services).

Complements

POL 12/2014 Disaster Reserve
POL 11/2017 Second Injury and Re-Employment Reserve
PRO 11/2017 Second Injury and Re-Employment Reserve
POL 02/2010 Communicable Diseases
PRO 02/2010 Communicable Diseases
POL 02/2017 Psychological Injuries