Document name
Second Injury and Re-employment Reserve
Document number
PRO 03/2021
Effective date: April 1, 2021
Application: All injuries on or after the effective date.
Policy subject: Employer accounts – Claims costs adjustments and cost relief
Purpose:
To establish guidelines for charging claim costs to the Second Injury and Re-Employment Reserve.
BACKGROUND
POL 03/2021, Second Injury and Re-Employment Reserve establishes guidelines for providing employers with cost relief under the Second Injury and Re-Employment Reserve (the “reserve”).
PROCEDURE
- When do Operations staff determine if cost relief should be provided to an employer?
- Operations staff will review claims for cost relief throughout the life of a claim.
- This includes reviewing claims for cost relief as decisions are made (e.g., referral from Claims Entitlement Services to Case Management, when a claimant is placed on long-term earnings loss benefits and at claim closure).
- What type of costs can be charged to the reserve?
- Compensation.
- Medical.
- Pension/long-term earnings loss benefits.
- Rehabilitation, or
- All of the above.
- What amount of partial claim costs can be charged to the reserve?
- A percentage of costs charged to expense codes (e.g., wage loss, medical, etc.),
- Costs before and/or after specific dates, or
- A combination of (a) and (b) above.
- Are employers notified if they qualify for cost relief?
- Operations staff will notify employers in writing if a claim qualifies for cost relief. The letter will note:
- The reason why they are receiving cost relief, and
- How much cost relief they will receive.
- If an employer requests a review for cost relief, Operations staff will provide the employer the results of the review in writing.
- Operations staff will notify employers in writing if a claim qualifies for cost relief. The letter will note:
- What happens when an employer disagrees with a decision regarding cost relief?
- An employer may submit a request of appeal regarding the cost relief decision (POL 21/2013, Appeals – Claims).
- Upon request, the WCB may provide copies of claim documents relevant to the cost relief decision to the employer or their representative (POL 05/2017, Privacy of Information).
- In situations where cost relief has been granted, employers may request to have their previous years’ discount/surcharge calculation reviewed (POL 27/2016, Experience Rating Program – Discounts or Surcharges).
Policy references
Section heading
Legislative Authority
Legislative Authority
The Workers’ Compensation Act, 2013
Sections 112 & 145.
Section heading
Document History
Document History
(1) March 1, 2022. Housekeeping changes to the procedure for minor updates including removal of references to secondary approval amounts.
(2) POL and PRO 11/2017, Second Injury and Re-Employment Reserve (effective October 1, 2017 to March 31, 2021).
(3) POL and PRO 21/2010, Second Injury and Re-Employment Reserve (effective February 3, 2012 to October 1, 2017).
(4) POL and PRO 14/1999, Second Injury and Re-Employment Reserve (effective February 1, 2000 to February 3, 2012).
Section heading
Complements
Complements
POL 03/2021 Second Injury and Re-Employment Reserve
POL 07/2021 Arising Out of and In the Course of Employment
POL 27/2016 Experience Rating Program – Discounts or Surcharges
POL 14/2017 Funding
POL 04/2017 Injuries – Occupational Disease
POL 04/2011 Injuries – Traveling for or Attending Medical Aid or Return-to-Work Programming
POL 05/2014 Occupational Disease Reserve
PRO 17/2016 Overpayment Recovery – Compensation
POL 12/2017 Pre-Existing Conditions - Aggravation or Acceleration
POL 05/2017 Privacy of Information
POL 13/2017 Rate Setting Model
POL 08/1996 Return-to-Work Plans
POL 08/2017 Serious and Willful Misconduct
POL 10/2016 Suspension – While Incarcerated
POL 10/2021 Suspension of Benefits
ADM PRO 01/2022 Secondary Approval Levels (WCB Staff)