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.
- Team Leaders will approve cost relief equal to or greater than $100,000.
- 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) POL and PRO 11/2017, Second Injury and Re-Employment Reserve (effective October 1, 2017 to March 31, 2021).
(2) POL and PRO 21/2010, Second Injury and Re-Employment Reserve (effective February 3, 2012 to October 1, 2017).
(3) 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 03/2017 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 15/2016 Suspension of Benefits
POL 01/2008 Suspension of Benefits – Pregnancy