Starting A Claim

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WCB - STARTING A CLAIM

By Teresa Roper, TRH Claims Management

It is important when sending a claim in to WCB to be specific and thorough.  If for example you were hit with something when it fell, and your foot was injured, but you were knocked backwards onto the ground and hit your back, it is imperative that you identify both your foot and your back as the places hurt during the incident.

Many people and doctors focus on the worst injury and overlook the secondary ones.

Currently I have a client fighting for the WCB to take responsibility for an injury to his back.  His foot was crushed in the injury and although it does say “back contusion” on his first doctor’s report, he never reports the relatively minor injury to his back on the Worker’s report.  A surgery (on his foot) later, his back was still sore, and when a MRI was performed five months post injury a herniated disc at L1 and a compression fracture at L2 are now not being accepted by WCB because although they were aware of the back contusion, in the shadow of his crushed foot and possible amputation, his back injuries were not mentioned again for four months.  The result, WCB has denied that portion of his injury.  It’s been almost 2 years and his foot is fine, his back however is not.

In his case we are lucky, we have witnesses to the injury, but unfortunately, the wait to get into the Appeals Commission, because lets face it your chances of winning at the DRB level (while you are still in the WCB) is at least 6 months and in some cases closer to a year.  And then you must wait for the decision ..It is not made the same day.

So if you report an injury that is minor and you never require medical assistance and never miss a second of work, who cares if the WCB knows it (and don’t have to do anything) – It is much better than them not knowing about it (or claiming not to) and denying it later down the line.

In short on the workers’ report of injury

1)     On the diagram of the body– circle all injured parts.

2)     In the section marked “What part of your body was injured” – List everything that was injured, bruised, scrapped, or doesn’t quite feel right since the accident.

3)     In the section marked “ What type of injury is this” – If you know; write it, if you think it is a bruise or maybe a break, write “Bruise? Break? “  Remember – If you are not a doctor – you cannot make a diagnosis.

When dealing with the WCB make your own paper trail - submit every thing in writing– It may save you in the end.  Remember the WCB is “just” an Insurance Company.