Claims Management

Home Health & Safety Claims Management

When a worker is injured at the workplace, employers are responsible for several tasks that can be categorized in one of two ways: Claims Management and Injury Management.

Claims Management includes:

  • internal incident reporting
  • external reporting to WorkSafeBC by both the employer and injured worker
  • conducting incident investigations and submitting copies to WorkSafeBC

Looking for Injury Management Information?

Go to Injury Management

Who is Involved?

Once a claim has been initiated, the responsibility for managing the claim is shared by the employer, injured worker, healthcare professionals, and WorkSafeBC. By working together, negative impacts on both the injured worker and the workplace can be successfully reduced.

What are Their Responsibilities?

Employers are responsible for:

  • ensuring that injured workers receive prompt treatment from an onsite first aid attendant
  • transported injured workers to medical aid, when necessary
  • conducting a timely incident investigation to determine root cause(s) and prevent similar injuries
  • reporting serious incidents immediately to WorkSafeBC’s Prevention Division
  • filing a claim with WorkSafeBC’s Claims Division to initiate a claim and coverage for the injured worker by submitting a Form 7
  • fulfilling the duty to cooperate with the injured worker and WorkSafeBC to ensure the worker’s timely and safe return to, or continuation of, work

The injured worker(s) is responsible for:

  • immediately reporting all work-related incidents, injuries, illnesses, and diseases to their direct supervisor/manager. If necessary, the injured worker shall seek medical aid
  • reporting any injury to WorkSafeBC’s Claims Division if external medical attention is sought or they miss time from their job due to the work-related injury or illness by submitting a Form 6
  • keeping in regular contact with the employer throughout the claim process

When a physician assesses or treats a workplace injury, they are required to submit a report to WorkSafeBC’s Claims Division. These reports include findings, diagnoses, and treatment recommendations. WorkSafeBC relies on the medical evidence physicians provide when making decisions about the claim. Physiotherapists may also be involved in the treatment of worker injuries and can provide useful insight regarding injury rehabilitation.

Healthcare professionals can help by:

  • talking to the injured worker about what they can do, rather than what they can’t do
  • encouraging them to keep in regular contact with their employer
  • reviewing the alternate and/or modified work list provided by the employer, or asking the worker to make a list of the work duties that they can perform
  • discussing with the worker how remaining involved at work can support their recovery and what they can expect during the recovery process

The WorkSafeBC Claims Division is responsible for:

  • gathering information and evidence from the injured worker, employer, and healthcare professionals regarding what happened and the injuries sustained
  • registering and adjudicating injury claims arising from the workplace incident
  • determining coverage allowance for injured workers as well as potential cost relief for employers if/when eligible (i.e. pre-existing conditions contributing to the injury)

Incident Reporting Requirements

Initially, workers are responsible for reporting the incident and any associated injuries to the employer. For reportable injuries (injuries that require medical aid, or medical aid and time off), workers are required to report their injuries to WorkSafeBC’s Claims Division. Beyond that, there are certain requirements for external reporting that fall within the employer’s responsibilities.

Note: Union reporting, and additional regulatory body reporting such as Technical Safety BC, RCMP, etc. are not included on this page, but should also be considered.

Disclaimer

When a “serious incident” occurs at a workplace, the employer must immediately report the incident to WorkSafeBC’s Prevention Division by calling the Prevention Line. This reporting requirement is in addition to reporting the injury for claim purposes.

Prevention Line:
604-276-3100 (Lower Mainland)
1-888-621-7233 (Nationwide)

A “serious incident” is any of the following:

  • Serious injury* to or death of a worker
  • Major structural failure or collapse of a building, bridge, tower, crane, hoist, temporary construction support system, or excavation
  • Major release of a hazardous substance
  • Fire or explosion that had the potential to cause serious injury to a worker
  • Blasting incident causing personal injury
  • Dangerous incident involving explosives, whether or not there is personal injury

* “Serious Injury” is defined in the WorkSafeBC Guideline G-P2-68-1. Use the link below to read the guideline.

Read the Guideline

Employers

Employers must submit an Employer’s Report of Injury or Disease (Form 7) to WorkSafeBC within 72 hours of being advised of an injury or accident. This is most efficiently done through the online submission available in the Online Services Portal.

Injured Workers

Injured Workers must submit a Worker’s Application for Compensation (Form 6) to WorkSafeBC only when they have sought medical attention or if they are missing work due to their injury. The worker can contact Teleclaim to provide their details, fill out the form, and submit it either over the phone, through mail, or the online portal.

Physicians

Physicians are required to submit a Physician Report (Form 8) to WorkSafeBC once it is established that the worker is relating their injury to their work activities. This report is submitted by the physician directly to WorkSafeBC electronically.