Work Safe

 

 

Frequently Asked Questions (FAQs)

Many clinicians are unfamiliar with how WorksafeNB creates, adjudicates and manages claims. This information is provided for general use only. Provisions of
the Act and Policies of WorksafeNB supercede and information provided herein.

We hope that this section will help to demystify how the Commission works. 
Information is provided in a question & answer format.

This page provides general information about compensation, who is covered under the legislation and what is considered an accident under the legislation.  From the FAQ index table below, you can go to FAQs relating to Adjudication and Benefit Services, Case Management and Clinical Services. Click either the page heading or a specific question.

Index for Frequently Asked Questions

General Information

What is compensation?
Who is covered?
Who is not covered?
What is an 'accident'?
What types of compensation is my patient entitled to?
What is a Permanent Physical Impairment
(PPI) award?
How can I send reports to WorksafeNB?

How can I contact WorksafeNB about a patient?

 

Adjudication and Benefit Services (ABS) Page

What is Adjudication and Benefit Services (ABS)?
How is a claim created?
What is adjudication?
How is adjudication done?
When is medical assistance sought in adjudication?
What is a 'claim adjudicator'?
What is the physician's obligation to file initial and ongoing reports?
What if my patient does not file a claim?
What types of injuries require case management?
How can I contact WHSCC about a patient?

How can I send reports to WHSCC?

 

Case Management Page

What types of injuries require case management?

What is the physician's obligation to file initial and ongoing reports?

What is a case manager?
What is a case management team?
What is the medical advisor's role in case management?
How can I get help expediting the referral, test and/or procedure?
How can I contact WorksafeNB about a patient?

How can I send reports to WorksafeNB?

 

Clinical Page

What is impairment?

What is (work-related) disability?

What drugs does WorksafeNB cover?

What is a claimant’s “default formulary”?

What is the difference between special authorization and a formulary?

Does WorksafeNB cover OTC drugs?

What is opioid management?

Does WorksafeNB cover antidepressants?

Does WorksafeNB cover GI cytoprotective agents?

Does WorksafeNB cover anxiolytics and sedatives?

What is neuropathic pain drug management?

Does WorksafeNB cover new drugs?

Does WorksafeNB cover 1st aid supplies?

Does WorksafeNB cover urinary catheter supplies?

What investigations, treatments and procedures does WorksafeNB cover?

When do I have to get pre-authorization for payment of referrals, investigations, treatments and procedures?

What services does the Workers' Rehab Centre offer?

Does WorksafeNB cover alternative or complementary medicine services?

What is the P&A Questionnaire?

How does WorksafeNB evaluate treatment effectiveness?

How do I get a clinician’s information binder?

 

 
Q: What is compensation?  [Top]
Compensation is a no fault insurance program solely funded by employers of New Brunswick. It provides medical and financial assistance to both employers and workers to limit as much as possible the impact of work injuries. It compensates the injured worker for lost income, pays health care requirements and vocational rehabilitation as necessitated by the workplace injury.
Q: Who is covered?  [Top]
In general, workers injured on the job are covered. There are some conditions that apply:
  • Employers must be an employer under the Workers' Compensation Act
  • Employers with three or more employees, full or part-time are required to register
  • Employers with less than 3 employees need not apply for coverage
  • Workers in the fishing industry with more than 25 employees must be registered
  • Persons assisting a Peace Officer with an arrest or preserving the peace are considered employees of the Crown
Q: Who is not covered?  [Top]
  • Persons who play sports as their main source of income
  • Outworkers (premises not under the control of the employer)
  • Employer's family members under 16 years of age residing with the employer
  • Persons employed as domestic servants
  • Armed forces Personnel
  • Members of the RCMP
Q: What is an 'accident'?  [Top]
  • Chance event occasioned by a physical or natural cause
  • Disablement caused by an occupational disease
  • Any other disablement arising "out of and in the course of employment"
  • Includes a willful and intentional act, provided that it is not the act of a worker and did not result in the death or serious and permanent disability of the worker
Q: What types of compensation is my patient entitled to?  [Top]
  • Wage replacement (Regular Loss of Earnings) if the worker has been off work without pay for at least 3 days
  • Medical aid costs - clinical assessment, investigations, surgery and costs related to obtaining these services
  • Vocational rehab costs, if a permanent work restriction is identified through objective assessment(s). These costs relate to vocational retraining and job search assistance.
  • Long-term disability (LTD), if a permanent work restriction resulting in loss of earnings is identified through objective assessment(s).
  • Permanent Physical Impairment (PPI) award
Q: What is a Permanent Physical Impairment (PPI) award? [Top]
This is an award to an injured worker to recognize loss of opportunity from a permanent loss of an anatomical body part or physical body function arising out of the injury. The award is based on the percentage that the impairment represents relative to the whole body.

Loss of functional ability to perform work and other tasks is addressed through wage replacement (RLOE) and LTD.