Coverage / Benefits. Discussion Paper

Transcription

1 Coverage / Benefits Discussion Paper September 2007

2 TABLE OF CONTENTS SUBJECT... 1 INTRODUCTION... 1 BACKGROUND... 2 COVERAGE... 2 Exclusion from Coverage...4 BENEFITS IN NEW-BRUNSWICK... 5 Satisfaction with Benefits...6 BENEFIT COMPARISONS TO OTHER CANADIAN JURISDICTIONS... 7 A - Types of Benefits...7 i - Wage Loss Benefits...7 ii - Permanent Disability Benefits...11 iii - Health Care and Rehabilitation...13 iv - Personal Care and Independent Living...13 v - Claim Related Travel...13 vi Dependency Benefits...14 B - Satisfaction with Benefits...14 C - Cost of Benefits...15 D - Rehabilitation...17 E - Annuities...17 F - Occupational Diseases...19 CONCLUSION... 19

3 Subject This document discusses the coverage and benefits of New Brunswick s Workplace Health, Safety and Compensation Commission. It is the first question to be answered in Phase II of the s Terms of Reference - How well does the Workplace Health Safety and Compensation Commission's legislated scope of coverage compare to other Canadian jurisdictions, including: number of workers covered; benefits offered to injured workers; treatment of workers while on benefits, and back-to-work activity reports? Introduction The first Workmen s Compensation Act in New Brunswick received royal assent in 1918, although the concept of modern workers' compensation had its origins in Germany, Great Britain and the United States between the late 1800's and early 1900's. In Canada, workers' compensation had its beginnings in the province of Ontario when Mr. Justice William Meredith was appointed to a Royal Commission to study workers' compensation in His final report, known as the Meredith Report was produced in There were five basic cornerstones to the original workers' compensation laws known as the Meredith Principles ; cornerstones which have survived, to a greater or lesser extent, as follows: 1. No-fault compensation: Workplace injuries are compensated regardless of fault. The worker and employer waive the right to sue. There is no argument over responsibility or liability for an injury. Fault becomes irrelevant, and providing compensation becomes the focus. 2. Collective liability: The total cost of the compensation system is shared by all employers. All employers contribute to a common fund. Financial liability becomes their collective responsibility. 3. Security of payment: A fund is established to guarantee that compensation monies will be available. Injured workers are assured of prompt compensation and future benefits. 4. Exclusive jurisdiction: All compensation claims are directed solely to the compensation board. The board is the decision-maker and final authority for all claims. The board is not bound by legal precedent; it has the power and authority to judge each case on its individual merits. 5. Independent board: The governing board is both autonomous and non-political. The board is financially independent of government or any special interest group. The administration of the system is focused on the needs of its employer and worker clients, providing service with efficiency and impartiality. 1 The 1980 Boudreau report helped establish the current system based on wage loss security with the objective of maintaining the individual s income in the same ratio to the Industrial Composite after the injury as he/she was receiving before the injury and/or subsequent re-occurrence. 2 It must also be integrated with other benefits payable such as the Canada Pension Plan, Old Age Security Plan and income tax system Boudreau Report Report of the Workers Compensation Study Committee, February 1980, p Page 1

4 Background The New Brunswick Workplace Health, Safety and Compensation Commission (WHSCC) is responsible for administering the Workplace Health, Safety and Compensation Commission Act, the Workers Compensation Act and the Occupational Health and Safety Act. The WHSCC administers no-fault workplace accident and disability insurance. The system is funded primarily through assessments on employers. During the 1970 s and 1980 s, the Canadian systems moved from awarding benefits according to loss of body part or function to a wage-loss system. Most jurisdictions underestimated the cost of benefits, including New Brunswick. In 1985, New Brunswick had an unfunded liability of $50 million. To address this problem, the system underwent reforms in These reforms included: Reducing wage recovery from 90% of average net earnings to 80%, Disallowing employers to top-up compensation benefits, and Introducing a three-day waiting period (reimbursable after 30 days on claim). There were further reforms to the New Brunswick system in 1998: Increasing wage recovery from 80% of average net earnings to 85%, Removing the three day waiting period when injured worker is hospitalized and where the injury is recurrent, and Reimbursing the three-day wait after 20 days on claim. The new WHSCC Strategic Plan and Risk Assessment document emphasizes the importance of benefits for injured workers. There are a number of initiatives relating to benefits including: Continuously evaluating the competitiveness of employee wages and benefits; Managing a return to work and disability management program for employees; providing clients who have a work restriction with the opportunity to learn new skills and preparing them to re-enter the workforce; Partnering with the Government of New Brunswick to educate workers, employers, and the public on the duty to accommodate requirements; and Centrally adjudicating claims to reduce the number of days it takes for an injured worker to receive their first benefit payment. Coverage In 2005, 94.51% of the New Brunswick workforce was covered by workers compensation with coverage estimated at 93.9% in This included all workers covered under legislation - assessed employers and self-insured employers (i.e., government of New Brunswick) under the WC Act and under the Government Employees Compensation Act (i.e., military, RCMP). It was estimated that about 6% of workers had no coverage in New Brunswick in According to Statistics Canada there were 355,400 employed in the labour force in New Brunswick in 2006 which means 333,720 workers were covered by legislation. Therefore, approximately 21, 324 workers had no coverage. Page 2

5 In New Brunswick Coverage under legislation 94.51% 93.9% Employed in labour force 350, ,400 Number workers covered 331, ,720 Number of workers without coverage 19,242 21,680 The percentage of workforce covered in other jurisdictions in 2005 ranged from 67.19% in Manitoba to 100% in Nunavut / Northwest Territories. Percentage of Workforce Covered (AWCBC 2005 Key Statistical Measures) Percent (%) National Average NT NL PE NB QC BC AB SK NS ON MB There are two types of coverage: (1) universal coverage which covers all workers and (2) coverage with certain exclusions, either by industry / occupation or by number of employees. New Brunswick falls within the latter category. Across Canada, legislation generally requires compulsory coverage for most employment. Employers who register for compensation coverage for their workers are either required to do so by the WC Act (compulsory coverage) or may register voluntarily. Jurisdictions define compulsory coverage through legislation or regulation by either: Listing all occupations or industries that must register for coverage, thereby excluding those not listed; or Listing all occupations or industries not required to register for coverage, thereby including all others in compulsory coverage. In New Brunswick, employers with three or more workers, or in the fishing industry employers with 25 or more workers, are subject to the Act and must register for coverage. Employers who are not subject to the Act may register voluntarily with the Commission when they have at least one worker and a minimum of $3,000 in assessable earnings. New Brunswick workers who are employed outside of New Brunswick may also be covered under the WC Act. Page 3

6 In all jurisdictions except Ontario, the Board or Commission can declare volunteers workers under the Act. In New Brunswick 3, employers not subject to the Act may register voluntarily with the Commission when they have at least one worker and a minimum of $3,000 in assessable earnings. Volunteers considered workers under the Workers Compensation Act in New Brunswick include firefighters, emergency services workers, persons assisting a peace officer, ambulance attendants/drivers and volunteer/auxiliary police officers. However, volunteers working at fundraising events or crowd control are not covered. The Commission pays benefits to volunteers based on loss of earnings from their primary employment. Persons that assist a peace officer are entitled to loss of earnings benefits even if there is no lost income. The loss of earnings would be based on the average earnings of a police officer. Once mandatory or voluntary coverage is established, personal coverage may be requested for (1) a non-salaried officer of a limited or incorporated company and (2) a proprietor, partners and spouses of a proprietor or partner. The coverage requested may not be less than $12,000 nor greater than the maximum annual assessable earnings ($53,200 in 2007). Exclusion from Coverage Manitoba, Nova Scotia and Ontario exclude industries/occupations that are not included in the Acts. Examples of common exclusions for compulsory employer coverage are: Alberta: farming Manitoba: farming, teaching Nova Scotia: farming, educational institutions, financial services Ontario: financial institutions Prince Edward Island: fishing Saskatchewan: farming, teaching New Brunswick and Nova Scotia are the only jurisdictions that exclude employers based on employer size, although Nova Scotia also excludes industries by Regulation. In New Brunswick, employers with less than three workers, or in the fishing industry employers with less than 25 workers, are not required to register for coverage. This 25 employee rule excludes a large percentage of fishing vessels in this province. Benefits in New-Brunswick Monies paid to injured workers by the Workers' Compensation Boards/Commissions (WCBs) are generally known as workers' compensation benefits. In New Brunswick, under the Workers Compensation Act compensation benefits include 4 : Payment For Time Lost From Work (Loss of Earnings benefits) Generally speaking, Loss of Earnings benefits will amount to 85% of the injured worker s average net earnings after income tax, Canada Pension Plan contributions and employment insurance premiums have been deducted and will not exceed the maximum compensation allowable for the year of the injury. 3 Information Document; WHSCC Discussion Paper Workers Compensation Coverage for Volunteers, October understanding your compensation benefits. Page 4

7 Medical Treatment and Health Care Expenses The WHSCC pays all reasonable expenses for required medical treatment arising from a work-related injury, for the rest of the injured worker s life. The Commission may also reimburse for the cost of prescription medication, assistive devices, and other items. Transportation Allowances The WHSCC makes payments to help cover claim-related travel expenses, including travel to and from medical appointments, Appeals Tribunal hearings, and training sessions. These payments can include, but are not limited to, transportation, accommodation, meals and associated child / dependent care expenses. Personal Care Allowances The WHSCC provides monthly Personal Care Allowances if required and as a result of a work-related injury or occupational disease, ongoing assistance with personal care and the activities of daily living. Long-Term Disability benefits Workers who suffer a permanent loss of earnings due to a work restriction resulting from a workrelated injury or occupational disease may be entitled to Long-Term Disability benefits. These benefits are designed to compensate for any discrepancy between the earnings the injured worker was capable of receiving pre-accident, and the earnings capable of receiving post-accident. Permanent Physical Impairment award As of January 1, 1982, if an injured worker suffers a permanent physical impairment as a result of a compensable accident, he/she is entitled to a Permanent Physical Impairment Award a lump sum award in recognition of the injured worker s loss of opportunity. Benefits to Dependents of Fatally Injured Workers Surviving spouses will receive monthly benefits equal to 80% of the deceased worker s average net earnings for the first 12 months following the worker s death. After that period, the spouse will select one of two benefit plans designed by the WHSCC that will provide monthly benefits that include pension and dependent child amounts. Assistance Toward Funeral Expenses For burial expenses, the WHSCC will pay an amount equal to 20% of the New Brunswick Industrial Aggregate Earnings (NBIAE) amount, which is set on an annual basis. Recent improvements to benefits in New Brunswick are summarized in the chart below 5 including new policies on return to work incentives and conditions for entitlement relating to hearing loss. 5 WHSCC Information Document May 2007, p WHSCC Costing Reports 2004 to 2006 Page 5

8 Year of Change Policy Conditions for Entitlement - Tests of Time, Place and Activity Calculation of Benefits RTW Incentives New policy Home Care and Independence Care Allowances Conditions for Entitlement - Hearing Loss Hearing Aids and Batteries Prostheses, Orthoses and Assistive Devices Home Modifications Transportation Expenses Meal Expenses Satisfaction with Benefits Summary of Benefit Improvements Summary of Changes Entitlement expanded: When business requires travel from home to different job sites. When required to travel overnight on business. When required to use remote parking lots. Pre-1982 benefits are not considered as LOE benefit when calculating benefits. 7 levels instead of 5. Amounts for longer periods of care significantly increased. New policy. Removed caps paid at cost. Increase of New Accident Costs $25,000 - $50,000 Increase on Benefit Liabilities N/A N/A $235,000 $120,000 - $240,000 $150,000 - $475,000 $225,000 - $695,000 $438,000 - $756,000 $3,725,000 - $7,630,000 $2,825,000 New policy. $150,000 $3,115,770 Provides the option for additional home modification if an injured worker s condition deteriorates unexpectedly after initial home modifications are complete. $50,000 - $120,000 N/A Rate increased from $0.30 to $0.35. $390,000 $2,750,000 Rate increased from $30.00 to $33.25 for in-province travel. $33,000 $230,000 For the past eight years, an independent WHSCC Client Satisfaction Survey has been conducted by Omnifacts Bristol Research. The following, taken from WHSCC Client Satisfaction Survey, Omnifacts Bristol Research December 2006, portrays the results of satisfaction as it relates to benefits. Time to Receive First Benefit Payment In general, injured workers were satisfied with the amount of time it took to receive their first benefits, an increase of 10% from 2000 to Satisfaction with Time Required to Receive First Benefits (completely or mostly satisfied) Injured workers 70% 71% 71% 78% 78% 83% 80% Page 6

9 Amount of Benefits Provided Satisfaction with the amount of benefits provided to workers was fairly high for both injured workers and registered employers, but declined slightly in On the other hand, the stakeholders perception of the satisfaction of injured workers and registered employers with the amount of benefits has significantly increased in 2006, but was still lower than the actual levels of satisfaction. Satisfaction with amount of benefits (Those completely or mostly satisfied) Injured workers 70% 66% Registered employers 77% 73% Stakeholders perception of injured workers satisfaction 33% 48% Stakeholders perception of registered employers satisfaction 56% 70% Benefit Comparisons to Other Canadian Jurisdictions A - Types of Benefits i - Wage Loss Benefits During the 1970 s and 1980 s, the Canadian systems moved from awarding benefits according to loss of body part or function to a wage-loss system whereas the injured worker receives monetary compensation based on earnings. Section 38.1(3) of the WC Act provides the legal authority for maximum compensable earnings. They are set at one-and-a-half times the New Brunswick Industrial Aggregate Earnings (NBIAE). The NBIAE is set under section 38.1(1) at $27,323 for 1993 and increases annually by the percentage increase in the Consumer Price Index for Canada for all items for the twelve month period ending the thirtieth day of June in each year. The increase is set on January 1 of each year under section The percentage of earnings benefits are based on loss of earnings in all jurisdictions. This is the amount the worker was earning before the injury and the amount the worker is capable of earning after the injury. In New Brunswick benefits for wage loss is 85% of net loss of earnings. Loss of earnings benefits range from 75% in Nova Scotia and Yukon to 90% in most other jurisdictions. Jurisdiction Max. Comp. Earnings 2007 Key Benefits Information 6 % of earnings benefits are based on Waiting Period Employer required to pay worker for Day of Injury AB $64,600 90% net No Yes No BC $64,400 90% net No No No MB No Max 90% net No Yes No NB $53,200 85% net 3 days No No NL $48,425 80% net No Yes No NT/NU $69,200 90% net No No No Employer required to pay worker for Period after Injury 6 Page 7

10 Jurisdiction Max. Comp. Earnings 2007 Key Benefits Information 6 % of earnings benefits are based on Waiting Period Employer required to pay worker for Day of Injury NS $46,700 75% net 1 st 26 wks then 85% net 2 days No No ON $71,800 85% net No Yes No PE $44,700 80% net 1 st 38 wks then 85% net 60% weekly compensation QC $59,000 90% net No Yes 14 days SK $55,000 $55,000 90% net No No No YT $72,300 75% gross No No No No Employer required to pay worker for Period after Injury In New Brunswick, the maximum compensable earnings for 2007 are $53,200 based on one-and-ahalf times the NBIAE. Across Canada this ranges from $44,700 in Prince Edward Island to $72,300 in the Yukon. Manitoba has no limit on insurable earnings. Top-up/claw back In New Brunswick injured workers cannot receive a top-up to their compensation benefit unless the pre-accident net earnings are above the maximum compensable earnings. In this case, an injured worker s combined loss of earnings benefits and remuneration from employment cannot exceed 85% of the injured workers pre-accident net earnings. Seven jurisdictions do allow a top-up to their compensation as shown in the following table. No Can injured workers receive a top-up to their compensation benefits? (I.e., remuneration in excess of the maximum benefit) AB Yes BC Yes MB Yes, allow for top-ups but cannot exceed 100% of actual loss of earnings capacity. NB No NL No NS Yes NT/NU Yes ON Yes PE QC SK YT No, the WCB reduces the wage loss benefits dollar for dollar by the amount that exceeds the injured workers maximum legislative percentage (considered a claw back). Yes No, considered remuneration. No, considered remuneration. Source: AWCBC Supplemental Benefits Employment-Related Remuneration, Collateral (Top-Up) Benefits Page 8

11 Supplements to Compensation (Income sources considered when calculating wage-loss benefits) In New Brunswick, injured workers are allowed to earn, through a combination of compensation benefits and financial remuneration, a maximum of 85% of their pre-accident earnings. The Commission, through Policy No : Supplements to Compensation, has identified guidelines for financial remuneration and they continually look at the issue of supplements to compensation. Currently these include: Wage or salary; Vacation pay; Bonuses and tips; Overtime; Shift differentials or premiums; Retroactive pay increases; Sick leave benefits; Unemployment insurance benefits; Employer-sponsored disability coverage; and Any payment by the employer made to or on behalf of the injured worker. Also included when estimating net capable earnings are: income tax, EI premiums, Canada Pension Plan Disability (CPPD), and contributions under Canada Pension Plan (CPP). Many jurisdictions have similar policies in place. However, Manitoba excludes retirement pension benefits, vacation pay cash-out or any severance pay. Newfoundland excludes among other income sources, severance pay and CPPD when determining wage loss benefits. Prince Edward Island workers are expected to apply for disability benefits under the Canada Pension Plan or the Québec Pension Plan. Workers who do not apply and, in the opinion of the Workers Compensation Board are eligible for such disability benefits, will be determined to be in receipt of such benefits and will have their wage loss benefits adjusted accordingly. Workers under 21 / Students 7 A worker under the age of 21 is defined as a young worker, whereas a student/learner is a person who is formally training for an occupation, trade or vocation. In November 2006, the Board of Directors approved Policy No : Workers Under 21 to interpret the definition of average earnings under the WC Act which currently provides the Commission with the discretion to estimate the future earnings of workers under the age of 21 when calculating benefits. However, for workers and students 21 years of age and over, their earnings are based on actual loss of earnings at the time of injury whether or not they are students with no provisions for estimating future earnings. Future earnings of young workers are not estimated in Ontario, Saskatchewan and the Yukon. New Brunswick, Nova Scotia, Manitoba and Alberta use age specific criteria to determine when young workers are eligible to have future earnings estimated. Newfoundland, British Columbia and the Northwest Territories use age criteria to estimate future earnings. The specific age used is based on specific claim. Jurisdictions that do not estimate future earnings of students include the Yukon, Prince Edward Island and New Brunswick. 7 WHSCC Discussion Paper Workers Compensation Coverage for Workers under 21 Page 9

12 With the exception of British Columbia, accidents have been decreasing for workers between the ages 15 to 19 years. In workers between the ages of 20 to 24 years, several jurisdictions have seen an increase in time-loss injuries between 2003 and They are Manitoba, British Columbia, Yukon, and Nunavut / Northwest Territories. Waiting Period In New Brunswick, the WC Act provides the authority for a three-day wait for compensation benefits (wage-loss benefits). An injured worker does not receive compensation until three days has passed without wages or supplements to compensation, i.e., vacation pay, although all reasonable medical expenses are paid by WHSCC. This amendment was introduced as part of 1993 legislative package to deal with unfunded liability. Any injured worker can be reimbursed for the three-day wait if: (1) original injury results in hospitalization, (2) compensation lasts for 20 days or more, (3) a recurrence of original workplace injury happens within 20 days of original injury, or (4) recurrence of injury results in hospitalization. New Brunswick, Nova Scotia and Prince Edward Island are the only provinces with a waiting period of 2-3 days. In Alberta, Manitoba, Newfoundland, Ontario and Québec, the employer is required to pay the worker for the day of injury. Québec is the only jurisdiction that requires the employer to pay the worker for 14 days after the injury. The Commission would then reimburse the employer. The table below details the wait periods for all jurisdictions. Jurisdiction Employer required to pay worker for: Day of injury Period after injury Employer reimbursed for: Day of injury Period after injury WCB pays compensation for day of injury WCB pays compensation following day of injury Source: Waiting Period AB Yes No No Yes No Yes No BC No No No Yes No Yes No MB Yes No No Yes No Yes No NB No No No No No Yes, following 3 working days three-day waiting period NL Yes No No Yes No Yes No NT/NU No No No Yes No Yes No NS No No No Yes No After 2 days 2 days ON Yes No No Yes No Yes No PE No No No No No Yes 60% wkly compensation QC Yes 14 days No Yes No Yes No SK No No No No No Yes No YT No No No Yes No Yes No Page 10

13 An example of waiting period benefit comparisons in Atlantic Canada 8 Benefit Amounts Starting from the date of the Accident NB NS NL PE Coverage 85% 75% 80% 80% net 51,900 net 45,100 net 47,245 net 43,300 Waiting period 3 day wait 2 day wait No wait 60% of benefits 1 st week benefit amount, after waiting period is $ $ If employer pays employee his wages for the two $ $ applied. days WCB will pay employer $ Subsequent weekly benefit amount $ $ $ $ Cumulative benefit amount Week 3 $1, $1, $1, $1, Week 4 $2, $1, $2, $1, Week 52 (Total annual benefit) $33, $28, $27, $25, ii - Permanent Disability Benefits Permanent Partial Impairment Awards 9 (PPI) Most jurisdictions operate a duel award system consisting of loss of earnings benefits and PPI awards. PPI awards consist of a lump sum payment intended to compensate for a permanent loss of function caused by a work-related injury. Most jurisdictions including New Brunswick, base the impairment amount on the functional limitations caused by the injury although Saskatchewan offers specific awards related to disfigurement. In 2006, the minimum lump sum PPI awards ranged from $500 in New Brunswick, Prince Edward Island and Saskatchewan to over $29,000 in Ontario. Nova Scotia does not set a minimum amount. The maximum lump sum PPI awards ranged from $30,900+ in Manitoba to $75,713 in Ontario. In some jurisdictions such as Nova Scotia and Ontario, there is no set maximum. In New Brunswick, the maximum PPI award is set at $53,200 (2007). Permanent Physical Impairment Awards (Information as of March 2007) Minimum Maximum AB $1, $74, BC N/A N/A MB $1, Maximum $30,900 plus $1,240 for each full percentage over 30% 8 9 WHSCC Information Document May 2007, p. 18. WHSCC Information Document May 2007; AWCBC and Jurisdictional Scan; Workplace Health, Safety and Compensation Commission: (Understanding Compensation Benefits) Page 11

14 Permanent Physical Impairment Awards (Information as of March 2007) Minimum Maximum NB $ $51, NL $1, $47, NS No set minimum No set maximum NT/NU N/A N/A ON $29, $75, PE $ Maximum earnings ceiling in effect on date of accident. QC $ N/A SK $500 $45,200 YT Varies depending on % impairment, age of worker and average wage in year of impairment Varies depending on % impairment, age of worker and average wage in year of impairment Long-Term Disability Workers who suffer a permanent loss of earnings resulting from a work-related injury, recurrence of injury or occupational disease may be entitled to long-term disability benefits that are designed to compensate the injured worker for any discrepancy between pre-accident earnings and his / her earnings capability post-accident. Policy No : Entitlement to Long-Term Disability Benefits, provides the guidelines for determining the injured worker s entitlement to long-term disability benefits. The injured worker must be eligible for loss of earnings benefits and have completed rehabilitation but continue to suffer a work restriction due to the compensable injury; and are unable to return to their pre-accident earning capacity as a result of the work restriction. Estimated Capable Earnings (Deeming) New Brunswick s legislation, as does all jurisdictions legislation, provides the basis for loss of earnings benefits for an injured worker - the difference between what the injured worker was earning before the accident (average net earnings) and what the injured worker is capable of earning after the accident (net estimated capable earnings) or deemed to earn. Section 38.1(1) of the WC Act defines loss of earnings as (a) average net earnings, less (b) the earnings the worker is estimated to be capable of earning at a suitable occupation after sustaining the injury, less any income tax and premiums under the Employment Insurance Act and contributions under the Canada Pension Plan that would be payable by the worker based on those earnings. The Commission s Policy No : Determination of Loss of Earnings, provides guidelines to staff on determining the injured workers loss of earnings. The Commission reviews the initial determination of loss of earnings within 12 weeks of when entitlement to benefits began. This allows the Commission to determine what best represents the injured worker s long-term earning pattern. If there is a reason to re-determine the loss of earnings, the Commission uses either a 12-month period to obtain earning information or a 36-month period if this better represents the injured worker s loss of earnings. The Commission reviews and adjusts benefits annually according to Policy No : Annual Review of Compensation Benefits. The policy stated goal of rehabilitation (Policy No : Rehabilitation) is to help injured workers achieve pre-accident functional capacity and return to pre-accident employment, if possible; or medical recovery sufficient to enable them to return to safe, productive employment as soon as is Page 12

15 medically possible. In returning to safe and suitable employment, the Commission also has a policy (Policy No : Identifying Suitable Employment) that identifies suitable employment. It involves: A reasonable commute that is defined by the Commission as: - Seventy-five kilometres one-way from the worker s place of residence or the worker s pre-accident commute (whichever is greater); and - One that the worker has the functional ability to travel. The injured worker may reasonably become qualified to perform; Does not endanger the health, safety or well-being of other workers in the workplace; Allows an injured worker to achieve optimal earning potential; and Reasonably exists in the current labour market. To determine this, the Commission uses resources such as: - New Brunswick s Labour Market Information Analysis Division; and - Locally advertised job opportunities. iii - Health Care and Rehabilitation In most jurisdictions the Board or Commission is the authority that determines the necessity, character and sufficiency of the medical aid provided or to be provided. In New Brunswick it is the Worker s Compensation Act that provides that authority. All reasonable costs associated with the workplace injury including cost of initial medical reports are born by the Commission. All jurisdictions provide comprehensive medical aid coverage, rehabilitation and return to work assistance for injured workers. For further information, see the discussion paper on Healthcare Delivery. iv - Personal Care and Independent Living All jurisdictions pay for personal care when needed. It is provided to seriously injured workers who require assistance with their daily living activities in their home or with other activities such as banking and shopping. Personal care in New Brunswick includes nursing, physical care assistance, home support and home maintenance and can include respite care (period of rest for caregiver). Personal care benefits in New Brunswick range from $67.27 to $1, per month or actual costs if professional services are used. The Quality of Life grant in New Brunswick for independent living helps seriously injured workers participate in recreational and social activities. The initial grant can be up to $2,000 and up to $1,000 every five years following the initial grant. Personal care benefits in the other Atlantic Provinces: Newfoundland and Labrador: provincial rates for professional and personal care fees. Nova Scotia: maximum of $2,000 per month. Prince Edward Island: no fixed amount. v - Claim Related Travel Travel expenses in relation to a claim are covered in all jurisdictions. Allowance for transportation in New Brunswick is $0.35/km. and ranges from $0.145/km in Québec (public transportation permitting) to $0.52/km in the Yukon. Page 13

16 Allowance for accommodations in New Brunswick is $65/night and ranges from $59/night in Saskatchewan to a maximum of $105/night in Québec. British Columbia, Northwest Territories and Nunavut, Nova Scotia, Ontario and Yukon have no set rates. Allowance for meals (per diem) ranges from $25.00 in Newfoundland to $80.35 in the Yukon. In New Brunswick it is $ vi Dependency Benefits 10 Each jurisdiction provides benefits to surviving spouses and dependents based on a legislated percentage of the deceased worker s earnings. In New Brunswick, benefits for the first year following the death are 80% of the deceased s average net earnings. After one year, the spouse elects one of two options: 1. 85% of the deceased worker s average net earnings to age 65 and an additional amount equal to 5% set aside for annuity at age 65. a. When the spouse remarries, the benefits are subject to a family means test. b. When benefits combined with net earnings of the new spouse exceed 85% of the deceased worker s average net earnings plus the net earnings of the new spouse, benefits are reduced. 2. Lump sum payment of 60% net annual income of the deceased worker, benefits of 60% of the deceased worker s average net earnings to age 65, with an amount equal to 8% set aside for annuity at age 65. a. Monthly payments also paid for dependent children (percentage of NB Industrial Aggregate Earnings). b. Children from previous relationship are eligible. c. No income test i. Survivor benefits are not terminated upon remarriage. ii. Either option cannot be more than 85% of earnings. All jurisdictions provide burial expenses ranging from $2,500 in Ontario to $10,600 in Saskatchewan. New Brunswick provides up to $7,000 for burial expenses based on an amount equal to 20% of NBIAE (New Brunswick Industrial Aggregate Earnings). B - Satisfaction with Benefits In 2005, in New Brunswick the average calendar days from injury to first payment issued for all new lost-time claims was 37 days. A satisfaction survey by Omnifacts Bristol Research indicated that in general, injured workers were satisfied with the amount of time it took to receive their first benefits This ranged from days in Saskatchewan to days in Yukon. The percentage change in the average calendar days from injury to first payment issued for all new lost-time claims ranges from a decrease of percent in Saskatchewan to an increase of percent in Prince Edward Island. New Brunswick has shown an increase of percent although this has been declining since Information Document (AWCBC March 2006) ; WHSCC Workers Compensation: A guide for New Brunswick Workers, Revised June 2006 Page 14

17 Average calendar days from injury to first payment issued for all new lost-time claims Percent Change from 2000 to 2005 AB % BC % MB % NB % NL % NS % NT % ON % PE % QC U/A U/A U/A U/A U/A U/A U/A SK % YT % CA U/A U/A U/A U/A U/A U/A U/A Source: AWCBC Key Statistical Measures In 2005, in New Brunswick the time period from date of registration to date of first payment issued for all new lost-time claims was 26 days. This ranged from days in Saskatchewan to days in Yukon. The percentage change in the time period from date of registration to date of first payment issued for all new lost-time claims ranges from a decrease of percent in Nova Scotia to an increase of percent in Yukon. New Brunswick has shown a decrease of percent. Time period from date of registration to date of first payment issued for all new lost-time claims Percent Change from 2000 to 2005 AB % BC % MB % NB % NL % NS % NT % ON % PE % QC U/A U/A U/A U/A U/A U/A U/A SK % YT % CA U/A U/A U/A U/A U/A U/A U/A Source: AWCBC Key Statistical Measures C - Cost of Benefits With the exception of two jurisdictions, Alberta and Prince Edward Island, benefit payments for assessable employers have increased. These are the total benefit payments made, for current and prior accident years, for all benefits types (i.e., short-term disability, long-term disability, survivors Page 15

18 benefits, healthcare, and rehabilitation services). The increase in costs ranges from 0.2 percent in British Columbia to 68.9 percent in Nova Scotia. New Brunswick s benefit costs for assessable employers have increased by 4.5 percent over the past five years, whereas the average for Canada is 11.7 percent. Benefit Payments for All Years Paid During the Year for Assessable employers. Excludes admin. costs ($000's) % change AB $ 570,839 $ 755,647 $ 567,696 $ 543,031 $ 529, BC $ 890,594 $ 848,083 $ 842,345 $ 865,501 $ 891, MB $ 124,739 $ 120,763 $ 126,829 $ 130,322 $ 133, NB $ 97,987 $ 92,443 $ 97,254 $ 96,238 $ 102, NL $ 104,935 $ 101,403 $ 110,169 $ 104,972 $ 108, NS $ 112,645 $ 116,075 $ 126,108 $ 138,805 $ 190, NT $ 17,767 $ 20,328 $ 20,621 $ 18,745 $ 18, ON $ 2,279,000 $ 2,382,000 $ 2,447,000 $2,577,769 $ 2,666, PE $ 15,474 $ 13,431 $ 13,532 $ 13,194 $ 13, QC $ 1,347,298 $ 1,427,091 $ 1,519,830 $1,557,783 $ 1,571, SK $ 161,302 $ 172,992 $ 166,883 $ 167,091 $ 162, YT $ 10,829 $ 12,617 $ 12,716 $ 12,423 $ 12, CA $ 5,733,409 $ 6,062,873 $ 6,080,983 $6,225,874 $ 6,401, Source: AWCBC Key Statistical Measures The trend for increasing benefits costs can also be seen by self-insured employers. Again, Alberta and Prince Edward Island have shown a decrease in costs, as well as British Columbia. In many cases, the increase in benefit costs is greater for self-insured employers than for the assessed employers. Benefit Payments for All Years Paid During the Year for Self-Insured employers. Excludes admin. Costs ($000's) % change AB $ 7,646 $ 10,159 $ 6,498 $ 7,305 $ 7, BC $ 41,760 $ 42,525 $ 40,348 $ 42,187 $ 40, MB $ 16,943 $ 16,313 $ 16,546 $ 17,671 $ 19, NB $ 17,816 $ 18,654 $ 17,999 $ 19,068 $ 19, NL $ 5,725 $ 5,993 $ 6,883 $ 6,708 $ 6, NS $ 27,873 $ 25,998 $ 27,027 $ 27,827 $ 33, NT $ 629 $ 708 $ 268 $ 570 $ ON $ 229,000 $ 217,000 $ 228,000 $ 235,781 $ 242, PE $ 2,533 $ 2,118 $ 2,147 $ 2,291 $ 2, QC unavailable unavailable unavailable unavailable unavailable unavailable SK $ 2,096 $ 2,183 $ 2,751 $ 2,533 $ 2, YT not applicable unavailable unavailable unavailable unavailable unavailable CA unavailable unavailable unavailable $ 361,941 $ 375,249 unavailable Source: AWCBC Key Statistical Measures Page 16

19 D - Rehabilitation Return to Work Obligations The requirements to re-hire injured workers vary across Canada. In Alberta there is no requirement under legislation to rehire although under the human rights legislation, employers have a duty to accommodate workers with disabilities. The requirement may also be based on number of workers per employer a range of 10 to 25 plus workers. New Brunswick exempts employers of less than 10 workers and has a range of workers employed by an employer for one year and 20 or more for two years. New Brunswick requires the worker to have been employed by the accident employer for at least one year before the employer is required to re-hire. In June 2005, the Board of Directors approved Policy No : Return to Work (RTW) Incentive Policy. The Board was concerned that without the development of such incentives, injured workers would be discouraged in their attempts to return to work as benefits are reduced dollar for dollar by earnings received. They wanted to build incentives for injured workers that would help facilitate their transition back to work by allowing them to continue to receive some benefits or money from the Commission in addition to their earnings for a defined period of time. E - Annuities 11 In New Brunswick an annuity is defined in Policy No : Funding Annuities Benefits, as a sum of money administered under a contractual agreement with an external carrier to provide a pension for an injured worker or surviving spouse at age 65 in the form of equal monthly payments for a specified period of time. An injured worker or surviving spouse becomes eligible after receiving benefits for 24 months. An additional amount equal to five percent of benefits plus interest is set aside to offset lost CPP. From the amount set aside for an annuity was eight percent. The policy states Injured workers who previously qualified to have eight percent set aside under section 38.3(1)(a) of the WC Act (repealed); and who received, or were entitled to receive this amount in a lump sum payment, also qualify to have five percent set aside for all benefits they were entitled to be paid after January 1, Some jurisdictions such as Saskatchewan and the Yukon set aside 10 percent. Alberta does not pay an annuity. Instead, the Economic Loss Payment is adjusted upon reaching retirement age (usually age 65 but may be later) to reflect the loss of retirement income, rather than employment income, and continues for the life of the worker. In Manitoba the worker has the option of contributing up to the same percentage of future wage loss the WCB is contributing towards the annuity. This percentage the WBC sets aside depends on the amount contributed by the employer to the worker s company pension plan before and after the accident. F - Occupational Diseases 12 Occupational diseases continue to be a significant issue for all compensation boards in Canada. 13 In New Brunswick it represents one to three percent of claims accepted by the Commission. An accident as defined by the Workers Compensation Act (WC Act) takes place suddenly and harm is generally perceived immediately. For an occupational disease, the effect of exposure is typically perceived over a period of time. 11 Association of Workers Compensation Boards of Canada (AWCBC) Spring WHSCC Information Document; WHSCC Report on Occupational Disease Association of Workers Compensation Boards of Canada, Strategic Issues -Top Three Issues in Workers Compensation Jurisdictions; Association of Workers Compensation Boards of Canada (2005). Emerging Issues for Workers Compensation, Page 17

20 It is estimated that occupational diseases represented approximately one half of the total of workplace-related fatalities that occurred in Canada in A report released in October 2005 by the Canadian Centre for Occupational Health and Safety (CCOHS) noted "deaths due to work-related disease increased steadily over the past two decades". Despite this increase, recognizing and preventing work-related diseases continues to be a challenge because of: The complexities involved in linking work and health issues; A limited understanding of exposure-effect relationships; Long latency periods; and Limited disease reporting and data collection. 15 In New Brunswick, occupational diseases represent $1 to $4 million of annual claim costs of $98 to $114 million. Claims accepted by other jurisdictions show that there are 768 occupational diseases not yet found in WHSCC s list of previously accepted claims. Occupational Cancers and Firefighters Firefighters in New Brunswick including volunteer firefighters are covered under the Workers Compensation Act although not through a presumption clause. On June 8, 2007 government announced the formation of a working group to review the issue of cancer coverage for firefighters, for the purpose of introducing legislation this fall. As of mid 2006, some jurisdictions have adopted presumption legislation for firefighters including British Columbia, Alberta, Manitoba, Saskatchewan, and Nova Scotia. There may be other conditions that must be met, i.e., Manitoba firefighters must work a minimum of 15 years with regular exposure to qualify for certain identified cancers. Québec, by contrast, has determined that insufficient evidence exists. Scientific literature relating some cancers to the occupation of firefighting is suggestive but not conclusive. An amendment to Ontario s Workplace Safety and Insurance Act, 1997 (WSIA), received Royal Assent on May 4, 2007 allowing the government to make regulations affecting Ontario's full-time, parttime and volunteer firefighters and fire investigators. 16 The Ontario government has now introduced a regulation for full-time firefighters that identifies and sets out the conditions and restrictions in order for each of eight types of cancer (see chart below), as well as heart injuries suffered within 24 hours of fighting a fire or participating in a training exercise involving a simulated fire emergency, to be presumed to be work-related, unless shown otherwise. Cancer / Illness (Ontario) Brain Cancer Bladder Cancer Kidney Cancer Colorectal cancer Non-Hodgkin's lymphoma Leukemia (certain types) Ureter cancer Criteria Years of Service 10 years 15 years 20 years 10 years (diagnosed prior to 61 st birthday) 20 years 15 years 15 years 14 Centre for the Study of Living Standards, Five Deaths a Day: Workplace Fatalities in Canada, , Canadian Centre for Occupational Health and Safety, Recognizing and Preventing Occupational Disease: Strategies and Recommendations from Canadians, Page 18

21 Cancer / Illness (Ontario) Esophageal cancer Heart injury Criteria Years of Service 25 years Within 24 hours of fighting a fire or participating in a training exercise involving a simulated fire emergency Conclusion This discussion paper is one component resulting from the research undertaken by the Independent Review Panel as it strives to meet its mandate in determining whether the WHSCC is functioning appropriately and to its fullest potential. The panel held an initial meeting in June with employer and worker stakeholder organizations. The Panel also met with various members of the Board of Directors, staff of the WHSCC, staff of the Appeals Tribunal, the actuary of the WHSCC and various individuals within the Department of Post- Secondary Education, Training and Labour. The has met a number of times to discuss strategy, research required, the consultation process, etc. Extensive research has been undertaken through the Internet, contact with various Workers Compensation Boards across Canada, and unconditional support by the Board of Directors, Appeals Tribunal and staff of New Brunswick s Workplace Health, Safety and Compensation Commission. This discussion paper is one of the consultation tools being used by the to complete Phase III of its mandate: The Review Panel will develop and execute a targeted consultation to engage key stakeholders and obtain feedback on the findings from Phases I and II. Stakeholder perspectives and recommendations will be sought. To this end, the would like to invite your comments / briefs in writing on how well the Workplace Health, Safety and Compensation Commission s legislated scope of coverage compare to other Canadian jurisdictions, including: Number of workers covered; Benefits offered to injured workers; Treatment of workers while on benefits, and Back-to-work activity reports; and Other topic areas addressed in the document. Please submit your comments / briefs by Wednesday, October 31, 2007 to: Mail: New Brunswick Workplace Health, Safety and Compensation System 535 Beaverbrook Court Suite 105 Fredericton, NB E3B 1X6 Fax: [email protected] Page 19