General Adjudication Guidelines
- To determine entitlement for communicable disease injury claims, Claims Entitlement staff will review each claim on its own merits, assessing whether an injury occurred and if it arose out of and in the course of employment. Claims Entitlement staff will first determine if the communicable disease arose out of employment (if exposure to the communicable disease occurred), and then whether the worker was in the course of employment when exposure occurred (reviewing the circumstances of exposure).
- When determining if the communicable disease arose out of and in the course of employment, Claims Entitlement staff may use the following as a general guideline when gathering evidence to confirm exposure:
- Confirm with the employer the existence of a communicable disease in the workplace.
- Confirm that the worker had the opportunity to be exposed to the communicable disease in the workplace.
- Confirm that the incubation period of the communicable disease is clinically compatible with the worker’s symptoms and the timing of the workplace exposure.
- Determine if any other workers in the same workplace have contracted the disease.
- Establish whether or not the exposure could have occurred outside of the workplace (i.e. was there a documented community outbreak of the disease, of pandemic proportions, and did the outbreak affect the workers immediate family), and
- Determine if the nature of employment increases the exposure risk of contracting the disease as compared to the general population. The WCB considers occupations that have increased exposure risk to include, but are not limited to:
- Health care workers, and
- Long-term care facility workers.
- Where it is determined that a communicable disease arose out of and in the course of employment, in general the determination of compensability will be made on the basis of a known medical diagnosis provided in a medical report.
Preventative Measures Against Communicable Disease
- Where the worker suffers an adverse reaction (e.g., allergic) to a compulsory immunization that medically requires the worker to be absent from employment, Claims Entitlement will consider the reaction and its consequences to be compensable.
- Where the worker suffers an injury that results from an adverse reaction to voluntary immunization, Claims Entitlement will consider the reaction and its consequences as non-compensable because voluntary immunization is not a condition of employment.