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How a claim is processed
After WorkSafeBC has received forms from the injured worker, the employer, and the attending doctor, or has received a call through Teleclaim, WorkSafeBC processes the claim to determine if the injury or disease was work-related.
- If more information is needed to make a decision, a WorkSafeBC representative will call the injured worker to explain what is happening.
- If there is enough information for a WorkSafeBC representative to accept a claim, WorkSafeBC will send the first compensation payment by mail.
- If there is enough information for a WorkSafeBC representative to determine that a claim cannot be accepted by WorkSafeBC, he or she will call the injured worker and also send a letter explaining the reasons why.
WorkSafeBC's goal is to mail the first compensation cheque within 17 days from when the worker was first disabled so their pay cycle won't be interrupted. The more straightforward the injury, the easier it is to pay compensation quickly.
Claim types
There are three types of claims:
No time lost – health care claim only
- Worker has returned to work without losing time from work beyond the day of injury.
- WorkSafeBC covers medical costs; employer pays worker for the day the accident occurred.
Time-loss claim
- Claim initially handled in WorkSafeBC call centre by client service representatives (up to three weeks).
- Claims more than three weeks are transferred to theentitlement unit, where entitlement officers adjudicate claims and facilitate return to work.
Time-loss – case management
- Claims involving workers with non-traumatic activity-related soft tissue injury, catastrophic injury, severe brain injury, or a psychological injury are transferred directly to a case manager.
- For claims more than four to six weeks, or where it is expected there may be difficulties returning to work, the claim will be transferred to a case manager for ongoing management.
Claim number
When a claim is made with WorkSafeBC, the injured worker, the employer, and the treating physician will receive a claim number. With this number, you can check the status of a claim online to find out if the claim has been accepted. You can also phone the WorkSafeBC Claims Call Centre to check claim status. No personal information on the worker can be accessed by the employer or physician.
If you're an injured worker and your claim has been accepted, you'll also receive a personal access number and instructions on how to use WorkSafeBC's online claim status and automated phone system for information on:
- Whether a payment has been made to you
- How much that payment is
- When the cheque was mailed to you
For security and privacy reasons, do not give your personal access number to anyone.
Employers and health care providers do not have access to wage-loss payment information.
The WorkSafeBC team
Client service representatives answer questions and make entitlement decisions on claims; manage straightforward claims with up to three weeks of time loss.
Entitlement officers make decisions on straightforward and complex cases; manage straightforward claims involving up to four weeks of time loss.
Service expediters support the entitlement officer and arrange work conditioning referrals.
Case managers provide ongoing management of complex claims that are in receipt of wage loss for periods of greater than four weeks.
Team assistants provide support to the case manager.