Marco Conceptual

dealing with bureaucracy both a time-consuming and frustrating experience. This frustration is compounded by medical issues, dealing with physicians and possible financial stress and may be taken out on the case manager. The Panel believes that case managers need on- going training to help them better deal with difficult communications with injured workers. Furthermore, mediation should be offered when the client/case manager relation becomes dysfunctional.

The stress of dealing with the claims process can be lessened if the case manager and the injured worker establish an effective relationship from the outset. The Panel considers it important that the case manager ensures that an injured worker who submits a major lost-time claim has been provided with and understands the Worker’s

Compensation: A Guide for New Brunswick Workers.

As previously noted, the principal method used by the WHSCC to process a claim resulting from a workplace accident is the receipt of Form 67. The Panel heard from injured workers that it was complicated to fill out this form. In 2006, the WHSCC developed in

Case

managers…primary

interface with the

injured workers…

consultation with several employers across the province, a new Form 67 for reporting workplace accidents and occupational diseases. This shorter and more simplified form still ensures that the WHSCC effectively captures the necessary information to adjudicate claims more quickly. Employers asked to further improve the service by offering it electronically.

As an employer, the WHSCC was the first to pilot the electronic Form 67. The Panel understands the commission has completed its pilot of the new electronic form and will continue to use the electronic reporting method. The Commission is now in the process of introducing the service to other New Brunswick employers for their input into the pilot phase. The City of Saint John and McCain Foods Limited are the first external employers to begin using the application. At present, the electronic Form 67 is designed and setup for employer access only. However, it is a combined reporting form for both the employer and injured worker and allows the employer to file the

application on the injured worker’s behalf with their consent. Some of the benefits of the electronic version of Form 67 are:

• It is designed so that all essential information required has been placed in mandatory fields. This will eliminate the WHSCC receiving incomplete forms and having to gather the missing information; which in turn will allow for quicker adjudication of claims.

• The electronic form is faster and will simplify the claims process for employers. Depending on how a question is answered, the user will not have to fill out unnecessary information, as they will be prompted to the next appropriate field.

• The electronic form will relieve some of the pressure relating to the mandatory three-day reporting deadline for employers. The Independent Review Panel believes the electronic version of Form 67 should be available on the WHSCC website for all employers and workers to access.

From injury to first payment issued for all new lost-time claims was 39 days in 2006, up two days from 2005. The Independent Review Panel considers this is unacceptably high and steps must be taken to decrease this to a more reasonable level.

The Commission provides compensation to injured workers for injuries where there is objective medical evidence. Often there are different medical views especially with complex cases, i.e., pre-existing conditions. The Commission's policy is to weigh all evidence and make a decision based upon the weight of the evidence. Conflict can be minimized by improved lines of communication between the case manager and family physician or specialist.

Recommendation #32

The Independent Review Panel recommends the WHSCC direct a thorough study of the current legislative definition provisions for benefits entitlement to determine the impact of the “in the absence of any evidence to the contrary” standard.

Recommendation #33

The Independent Review Panel recommends a comprehensive review of case management policies, processes, and a restructuring of resources to ensure reasonable caseloads to permit WHSCC staff to provide timely and effective transition services to workers and their families.

Recommendation #34

The Independent Review Panel recommends the Commission provide ongoing client service training including specific training in the handling of difficult communications with injured workers.

Recommendation #35

The Independent Review Panel recommends the Commission offer mediation when the client/case manager relation becomes dysfunctional.

Recommendation #36

The Independent Review Panel recommends the WHSCC establish an ongoing awareness and educational campaign for both workers and employers directed to ensure both parties know and understand their claims reporting responsibilities and rights.

Recommendation #37

The Independent Review Panel recommends that once the Form 67 pilot project with pilot employers has been completed and assessed, the electronic version should be available on the WHSCC website for all employers and workers to access. Furthermore, technical assistance should be available to those who are not fully conversant with the use of computers to assist with completing the form.

Recommendation #38

The Independent Review Panel recommends the WHSCC undertake a process to maximize efforts to ensure the time to first payment for new lost-time claims is at a minimum.