Management of work-related accidents outside Quebec

Is the management of workers’ compensation or occupational disease files in the various Canadian provinces the same thing?

It is a source of pride to see an organization whose activities extend across the country! However, the aspect involving the management of work accident or occupational disease files can be a source of headaches. Indeed, insiders will tell you that the mechanisms in effect concerning the management of these files are not all uniform, especially when Quebec is compared with the provinces in the rest of Canada.

While in Quebec, the employer will often have the impression that the treating physician is king and in control of the outcome of the case, policies and philosophies differ in other provinces.

Today, we offer you an overview of the notable distinctions between Quebec and the rest of Canada, where the management method is more uniform.

In Quebec, the A.I.A.O.D requires that the “Notice of Employer and Claim for Reimbursement” form be submitted no later than 2 days following the end of the mandatory period. It is not the practice of the CNESST to impose sanctions if this notice is filed late.

This is not the case in other provinces where the time frame for reporting accidents is much shorter. In most provinces, the time limit is 3 days from the date of the accident. Importantly, some provinces even apply financial penalties for incidents that are not reported within the prescribed time frame.

Here again, Quebec is the exception, where the authorization or refusal of a return to work, particularly through temporary assignment, is the sole prerogative of the attending physician. The result is that, apart from using perseverance and creativity, the employer is at the mercy of the attending physician’s opinion and the proactivity of the CNESST compensation officer.

In contrast, in the rest of Canada, return to work is the priority in claims management. The Act sets out returning to work obligations for both the employer and the injured worker. The various Boards have mechanisms and return to work specialists in place to assist the parties in meeting their obligations.

In fact, greater emphasis is placed on the “functional abilities” factor in other provinces. The opinion of therapists (physiotherapist, occupational therapist, etc.) will be taken into account to a great extent in the development of a return-to-work plan, often even more so than that of the treating physician.

The question to ask in these provinces is not “Does the treating physician authorize the proposed work?” but rather “Is the proposed work suitable given the worker’s condition and current functional abilities?”

If the answer to this question is yes, it is up to the employer to submit a formal proposal for light/modified/adapted work to the employee, which the employee can accept or refuse.

The Boards also sometimes go further, going so far as to suspend the payment of benefits to a worker who refuses, without a valid reason, the proposed work, if it is suitable and without risk of aggravation of the medical condition.

No other province provides for a medical arbitration mechanism such as that found in the A.I.A.O.D. Consequently, the so-called medico-legal management of the file is almost non-existent, except through the litigation process.

Since the right to resort to medical expertise is not provided for in the Act, serious circumstances are necessary to resort to it in the other provinces. Therefore, it is important to have a well-established return-to-work plan to reduce the length of the work stoppage and limit the cost of benefits.

Finally, a similarity! Each province has policies to ease the financial burden of a case in certain circumstances. The presence of a pre-existing personal condition that has had an impact on the consequences of the injury is one of the circumstances found in most provinces.

In short, the particularities of the various provincial systems and the philosophy of managing work accident or occupational disease files illustrate the importance of a concerted and wise approach.

Our consultants are available to assist you in the management of your workers’ compensation and occupational disease files in all Canadian provinces.

>> Contact our team!