Document name

Medical Appointment Allowance

Document number

POL 17/2025

Medical appointment, for the purpose of this policy, means any occasional health care appointment or consultation required for the work-related injury. This does not include regularly scheduled visits as part of an ongoing or intensive treatment program.

No time loss claim means a claim where the worker has continued to work full-time and has not missed any time from work due to the work injury other than for of the occasional medical appointments related to the injury.

Occasional, for the purpose of this policy, means infrequent, irregularly scheduled or sporadic.

Medical appointment allowance means a benefit provided to a worker or employer to cover missed time from work due to occasional medical appointments, related to a work-related injury. Its purpose is to support the worker in maintaining their current level of function. The medical appointment allowance is not considered an earnings loss benefit.

1. The Workers’ Compensation Act, 2013 (the Act), directs that if a worker is not disabled beyond the day on which they are injured, no compensation, other than medical aid, is to be paid (Section 31(1)). If a worker is disabled beyond the date of injury, compensation benefits are payable (Section 31(2)).
2. The Act directs the Workers’ Compensation Board (WCB) to arrange, provide or cover, without charge, any medical aid that may be required as a result of a work injury and that the WCB considers necessary (Section 19(1)(b), 103(1) and 115(c)).
3. Employers have an obligation to report work injuries to the WCB when they become aware of an injury that prevents a worker from earning full wages or that requires medical attention (Section 52).
4. When a worker’s injury results in a loss of earnings beyond the day of the injury, the WCB shall determine the loss of earnings resulting from the injury and shall ensure compensation to the worker (Section 68(1)).
5. The Act authorizes the WCB to take any necessary measures to assist in lessening or removing any barriers resulting from a worker’s injury (Section 111(b)).
6. No employer shall directly or indirectly deduct wages when a worker is entitled to benefits under the Act (Section 164(1)). This includes deducting any type of leave benefit (e.g., sick, vacation, pressing necessity, etc.) when a worker is absent for medical appointments due to a work-related injury.

1. POL 35/2024, Establishing Initial Wage Base outlines when earnings loss benefits are payable when a worker misses time from work for regularly scheduled medical appointments.
2. The WCB is committed to achieving the most appropriate, timely and safe return to work (POL 03/2024, Continuum of Care). This includes ensuring workers attend medical treatment required as a result of a work-related injury.
3. A medical appointment allowance is payable when the following apply:
   1. A worker is able to return to normal or modified employment duties,
   2. A worker is performing full hours of employment, and
   3. A worker misses time from work solely due to occasional medical appointments to maintain the current level of function.
4. A medical appointment allowance is only provided for medical appointments approved by the WCB. This allowance will not be granted for appointments that the WCB does not consider necessary.
5. When a worker misses time from work only for an occasional medical appointment and the employer compensates the worker for the missed time, the WCB will reimburse the employer directly, upon request.
6. Earnings loss benefits are payable when the following apply:
   1. A worker is unable to return to normal or modified employment duties,
   2. A worker is unable to perform full hours of employment, and 
   3. A worker misses time from work for regularly scheduled medical appointments as part of an ongoing or intensive treatment program.
7. Claims that have received payments for a medical appointment allowance only, will be adjusted to exclude them from the discount or surcharge calculation for employers who are in the Standard Experience Rating Program (POL 27/2016, Experience Rating Program – Discounts or Surcharges).