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Document name

Occupational Disease Reserve

Document number

PRO 05/2014

Effective date: December 1, 2014

Application: All new injury claims on or after the effective date.

Policy subject: Employer accounts – Claims costs adjustments and cost relief

Purpose:

To establish guidelines for the Occupational Disease Reserve.

BACKGROUND

The Workers’ Compensation Board (WCB) has approved POL 05/2014, Occupational Disease Reserve.
This procedure provides rules on how to apply POL 05/2014.

PROCEDURE

An employer may face high claim costs from an occupational disease. The WCB can charge all or a portion of the claim costs to the Occupational Disease Reserve.
The Occupational Disease Reserve will be charged costs based on the net costs of a claim. In determining the net costs, Operations staff will consider all relevant:
1. Recoveries (for example, third party recoveries), or
2. Relief under the Second Injury and Re-employment Reserve.
Operations staff will decide if a disease is:
1. Occupational, and
2. The cause of a work injury (POL 04/2017, Injuries – Occupational Disease).
Operations staff will determine whether a claim meets the conditions for cost relief (POL 05/2014).
If the claim meets the conditions for cost relief, Operations staff will determine:
1. The percentage of costs to be transferred, and
2. The effective date.
All or a portion of the claim costs will be charged to the Occupational Disease Reserve when the claim has a cause and effect link to work known at exposure. Operations staff will determine the portion of costs by comparing the exposure covered by The Workers’ Compensation Act, 2013 (the “Act”) against the factors identified in Point 2 of POL 05/2014.
Operations staff will charge all costs to the Occupational Disease Reserve when the claim does not have a cause and effect link to work known at exposure. Rather, the link establishes from future scientific evidence.
Operations staff will advise the employer, in writing, of all decisions regarding cost relief.
When the WCB provides cost relief, an employer may request to have their previous years’ experience rating reviewed by a Quantitative Research Analyst (POL 27/2016, Experience Rating Program – Discounts or Surcharges).