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WCB Procedures

  • Initial entitlement decision
    • Detailed business procedure
    • Injury-specific IED
    • Supporting references
  • Medical testing and exam referrals
    • Detailed business procedure
    • Types of medical testing and exams
    • Supporting references
  • Opioid management
    • Scenarios
    • Supporting references
  • Rate setting
    • Section 56 rate
    • Concurrent rate
    • Additional rates
    • Communication
    • Supporting references
  • Re-employment services
    • Refer the worker
    • Supporting references
    • Additional RE services

Injury-specific initial entitlement decision

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Dental injury


A dental injury can occur on its own, as a result of another physical work-related injury or as damage directly caused by the treatment of a work-related injury.

Review available documents to confirm the dental injury. This can include:

  • A report of the dental damage
  • A detailed dental history
  • A report outlining the proposed treatment
  • X-rays or photos

If there are work-related TMJ concerns, obtain related medication history and assist the worker in determining their oral hygiene requirements, such as a special appliance or aid.

A request for an opinion from a dental consultant may be required to determine the relationship between the dental damage and the work-related accident, or if there is anticipated severe or long-term damage as a result of the injury.

Administrative tasks

Send the initial dental assessment request (SP001A) to the dental treatment provider.

Send the appropriate decision letter:
Dental treatment approved (SP001B)
Dental treatment not approved (SP001C)

Update the Dental treatment line in eCO with the appropriate benefit and approval codes. And to request a referral, if applicable.

Fractures


Review the worker’s medical and x-ray reports on file to help confirm the details of the fracture.

Administrative tasks

Add the initial treating physician, clinic, hospital or as a participant on the claim if available.

Enter the correct fracture ICD code on the injury details screen in eCO and click "Calculate Best Practice" button in the injury duration best practice section to calculate and display best practice and assist with determining an initial estimated return to work date on the return to work screen.

Enter the worker’s treatment information into the “Treatment details” screen in eCO.

Hearing loss (occupational noise-induced)


Workers can be compensated for noise-induced hearing loss that occurs within Alberta and Saskatchewan, or if they were employed with the Government of Canada in Nunavut, Yukon or Northwest Territories.

Review the available documentation and communicate with the worker and employer to gather:

  • A history of the worker’s hearing loss and a medical history. Discuss symptoms and concerns with the worker.
  • Records of the worker’s employment history and exposure to noise.
  • An audiogram completed within the last year by a registered hearing aid practitioner (RHAP) or audiologist.
  • Any additional audiogram readings or ENT (ear, nose and throat) reports.

If appropriate, send the hearing loss factsheet to the worker for more information


Review the reports to determine whether the pattern of hearing loss shown on the audiogram(s) is consistent with occupational noise-induced hearing loss.

If required, obtain a medical opinion from a medical consultant to establish:

  • The level of hearing loss
  • The relationship between the hearing loss and occupational noise exposure
  • The level of entitlement for tinnitus
  • An indication of a permanent clinical impairment and recommendation for compensation.

In some cases, the medical consultant may request further testing such as an auditory brain stem response test or an MRI.

In order for a claim for occupational noise induced hearing loss to be accepted, the following criteria must be met:

  • The worker’s audiogram(s) demonstrate the pattern shown in the noise-induced hearing loss chart below:
  • The worker has been exposed to at least two years of noise levels equal to or greater than 85 decibels averaged over an eight-hour workday (the Alberta occupational exposure limit).

Administrative tasks

Send the hearing loss package

  • Hearing information form (C042)
  • Worker's employment record form (C131)
  • Employer’s information questionnaire (C139)
  • Hearing loss medical release form (C583)

If the worker has been employed through a union, a letter from the union can provide a history of employment.

Send a dizziness/balance questionnaire to the worker if dizziness/balance problems are reported (traumatic injury) in consultation with the worker.

Occupational injury or disease


Occupational disease may progress over time, and may involve multiple employers. A worker may experience symptoms immediately following exposure to a workplace hazard or many years later.

Occupational injury or disease claims may require further information gathering to determine when the illness began and if it was a result of the worker’s workplace conditions.

Obtain the worker’s health and employment history. Gather their previous health and/or dental records and any related diagnostic reports such as x-rays.

The following information can also help guide the entitlement decision for an occupational injury or disease:

  • The timeframe between the exposure and the onset of symptoms.
  • Details on how the worker was exposed.
  • The job description and if required, the brand name of the safety equipment used.
  • Biochemical testing reports.
  • Information detailed on workplace Materials Safety Data Sheets (MSDS).
  • Air quality reports/industrial hygiene reports, Occupational Health and Safety reports and any other reports documenting substances within the work environment.

If required, request a medical opinion to gain additional information or guidance on the relationship between the symptoms and work exposure, diagnosis, work restrictions, and whether a permanent impairment is anticipated.

Psychological injury


Psychological or psychiatric injuries at work can happen suddenly, due to a traumatic situation, or can develop over time. They can also develop in response to being injured at work or undergoing treatment for a work-related injury. To accept a claim for a psychiatric or psychological injury, there must be a confirmed psychological or psychiatric diagnosis as defined in the most current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

WCB will presume that a confirmed psychological or psychiatric injury arose out of and occurred in the course of employment in the following circumstances, unless there is evidence to the contrary:

  • A first responder (as defined in section 24.2 of the Workers' Compensation Act) has been diagnosed with post-traumatic stress disorder (PTSD) or a worsening of an existing case of PTSD (for accidents/incidents that occur on or after December 10, 2012). First responders include firefighters, police officers, peace officers (sheriffs only), and paramedics (including emergency medical responders (EMRs), primary care paramedics and advanced care paramedics).

    For accidents/incidents that occur on or after April 1, 2018, correctional officers and emergency dispatchers are also covered.

    Effective April 1, 2018, this presumptive coverage also includes other psychological/psychiatric conditions that develop after a confirmed exposure to a traumatic event at work.
  • A worker has been diagnosed with a psychological/psychiatric condition and had a confirmed exposure to a traumatic event at work (for accidents/incidents that occurred between April 1, 2018 and December 31, 2020).

For any circumstances and time frames not specified above, WCB will accept a confirmed psychological/psychiatric injury when there is a link between the psychological/psychiatric diagnosis and the work accident/incident(s) or the injury/subsequent treatment. This includes:

  • A traumatic event at work; it must be confirmed that the psychological/psychiatric injury was caused, at least in part, by the traumatic event/situation at work.
  • An accumulation of work stressors over time or a stressor that exists over time; it must be confirmed that the stressor(s) is the predominant cause of the psychiatric/psychological injury.
  • A psychological response to being injured and/or undergoing treatment for that injury; it must be confirmed that the psychological/psychiatric injury was caused, at least in part, by the injury or treatment.

An event/incident(s) at work is considered to be traumatic when it involves direct personal experience of an event or directly witnessing an event that is sudden, frightening, shocking, specific and involves actual or threatened death or serious injury to oneself or others or threat to one’s physical integrity.

For the period of April 1, 2018 to December 31, 2020, a traumatic event can also include workload or work-related interpersonal incidents that are excessive and unusual in comparison to the pressures and tensions experienced in normal employment.

Effective January 1, 2021, interpersonal relations between a worker and coworkers, management, or customers may be traumatic when they result in behaviours that are aggressive, threatening or abusive. Excessive workload alone would not be considered traumatic but may be considered as a chronic stressor.

Review the information on file to determine if there is evidence that the worker experienced a traumatic incident at work or an accumulation of stressors over time.

Also review whether there is a confirmed psychiatric or psychological diagnosis made by a physician (including psychiatrists) or psychologist using the criteria in the most current edition of the DSM.

Contact the worker and the employer to obtain information about the traumatic incident or workplace stressors. Ask questions to get an understanding of the worker’s injuries, how they’re coping and progressing and any initial or ongoing medical treatment they’ve received.

If a decision to accept the claim or injury cannot be made immediately and the worker advises they are not yet receiving any treatment, offer up to five sessions of psychological counselling so they can receive support until the review is complete.

If the information is unclear or there is no confirmed DSM diagnosis, contact the worker’s physician or psychologist using the appropriate letter to obtain additional information or clarification.

If appropriate, send the related psychological injury fact sheets to the worker and/or employer for more information:

  • Bullying and harassment in the workplace worker fact sheet
  • Presumptive coverage for traumatic psychological injuries worker fact sheet
  • Psychological injuries as a result of stressors that occurred over time at work (chronic onset) worker fact sheet
  • Psychological injuries as a result of traumatic event(s) at work worker fact sheet
  • Psychological injuries—frequently asked questions worker fact sheet
  • Bullying and harassment in the workplace employer fact sheet
  • Presumptive coverage for traumatic psychological injuries employer fact sheet
  • Psychological injuries as a result of stressors that occurred over time at work (chronic onset) employer fact sheet
  • Psychological injuries from traumatic event(s) at work employer fact sheet
  • Support your employee as they recover from a psychological injury employer fact sheet

When additional information is required to make a decision on acceptance or the injury, obtain an opinion from a medical consultant or psychological consultant or consider referrals for additional investigation(s) such as a Traumatic Psychological Injury (TPI) assessment, a Comprehensive Psychological Assessment (CPA) or an Independent Medical Examination (IME – psychiatric). A CPA may be helpful in establishing if the work stressors are the predominant cause of the psychological injury diagnosed. See the medical testing and exam referrals procedure for more information on making a referral.

Additional information may be needed to make the entitlement decision, such as interviews with other stakeholders, witness statements or investigation by the Special Investigations Unit.

Administrative tasks

Request medical - physician (SP006A)

Psychological report request (SP021D)

Request med-psychiatrist (SP006H)

Chronic psych intro (CL026B)

General information questionnaire for emotional injuries (C844)

DSM confirmation physician (SP026J)

DSM confirmation psychologist (SP026K)

The claim can be accepted under presumptive coverage when there is a confirmed traumatic incident and a confirmed psychological/psychiatric diagnosis of:

  • Acute stress disorder
  • Post-traumatic stress disorder (PTSD)
  • Adjustment disorder with depressed mood
  • Adjustment disorder with anxiety
  • Adjustment disorder with mixed anxiety and depressed mood
  • Adjustment disorder with disturbance of conduct
  • Adjustment disorder with disturbance of emotions and conduct
  • Specific phobias related to the traumatic event (for example, a fear of heights after a fall from a significant height or a fear of driving after being involved in a major motor vehicle accident).

Psych IED accept (CL041H)

Psych IED deny (CL026G)

Repetitive strain injury


Contact the worker and employer and discuss whether there was a specific task that lead to the injury. Ask additional questions related to the worker’s job duties:

  • Describe the typical tasks you perform each day.
  • How long does it take to complete each task? How many times per day do you perform them?
  • What are the typical movements required to complete those tasks (such as twisting, lifting or reaching)?
  • How long has this been your typical work day?
  • Have there been any recent changes to your job?
  • Do you rest between tasks?
  • When are your scheduled breaks? Do you take them?
  • When did you first notice symptom(s) and have they become worse? What were you doing at the time?
  • Are there any other factors that may have contributed to your injury?

Also consider:

  • Whether the worker has previous injuries or pre-existing conditions.
  • Knowledge of the worker’s job and industry.
  • The medical provider’s opinion.

Administrative tasks

Ensure physical demands analysis (C545) and job description forms are on file.

    If additional information is still required after contacting the worker/employer, send:
  • Worker's progressive injury questionnaire (C504)
  • Employer's progressive injury questionnaire (C606)
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Contact WCB-Alberta

Edmonton: 780-498-3999
Calgary: 403-517-6000

Toll free

Alberta: 1-866-922-9221
Canada wide: 1-800-661-9608

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