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Determining eligibility

Once we receive reports from an injured worker, his or her employer, and health care provider(s), we can determine whether the worker is eligible for benefits. Our process is driven by the Workers Compensation Act and is designed to be fair and transparent. At any point, our Claims team is available to provide clear explanations and advice on the claim.

When we receive a report of a work-related injury or illness, we start a claim for the worker. Then we have to answer two questions:

  1. Is the worker eligible for benefits?
  2. If so, what benefits and services will the worker receive?

Eligibility

We start by asking a couple of fundamental questions to determine whether a worker is eligible for benefits:

  • Was the worker working for a person or company that carries WorkSafeBC insurance or is legally required to do so?
  • Was the injury or illness work-related?

We consider many factors in determining whether an injury or illness was caused by work or the work environment. We collect and review all available information, including reports from the worker, employer, and health care provider(s).

On complex claims, we often have to review a great deal of information to make a decision. We strive to do this and communicate our decision as quickly as possible.

Workers and employers with questions about our decision should contact us right away. You may ask us to review the claim decision and we'll be happy to discuss the reasons for the decision. If you have information that will help change the decision, you may submit it to us at any time. You can also request a formal review through our Review Division within 90 days of the decision.

Benefits

If a claim is accepted, we'll send a letter explaining:

  • Health care benefits and services the worker will receive
  • Wage-loss benefits the worker will receive to compensate for any lost wages, if appropriate
  • The process for reimbursement for any medical treatments the worker may have received before the claim was approved
  • The next steps in the process

Checking the status of a claim

Workers, employers, and health care providers can easily find out whether a claim has been accepted. If you have the worker's claim number, you can go online to check the status.

Check claim status

Or, you can call our Claims Call Centre.