The practice area of a Workers’ Compensation lawyer is generally understood to include advising with respect to rate classifications and calculations, cost containment, claims management and providing representation at hearings and appeals.
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When an employee or a worker becomes injured, disabled, or becomes ill, and is unable to work for a period, workers’ compensation comes in to provide the said worker some benefits or indemnity to him/her in this unprecedented circumstance.
Workers’ compensation generally provides cash benefits, healthcare benefits, back-to-work assistance, or other benefits to workers who, during the performance of their jobs or because of an accident in the workplace, would suffer an injury, illness, or becomes temporarily disabled.
It would usually fall under the benefits to be provided by the employers; hence, the monthly premiums are paid by them. However, the manner of payment, the amount of premiums paid by employers, the benefits to be received by the employee, and any other matter, would depend on the laws and regulations of the country.
To guide parties herein – either the private or public insurance-provider, the employer, or the worker – lawyers in this field may be sought out, specifically, a workers’ compensation lawyer.
In Canada, the regulation of workers’ compensation is mostly exercised by the provincial government as to private sector, and by the federal government for the public sector and those which are specifically federally regulated businesses or corporations.
As a result, each province has enacted its own set of regulations with regards to the registration, calculation of premiums, management of funds, disbursement of benefits, and among others, relating to workers’ compensation. That is why it’s important to consult with a workers’ compensation lawyer since these provincial laws may have specific differences, although the principles may be common to most.
Each province in Canada has its own Workers’ Compensation Boards (WCBs, the link takes you to a list of each province), which are independent with each other with regards to its management or operations, since these WCBs are empowered by different respective provincial legislations. At its inception, a business is then required to register with appropriate WCB, subject to investigations and penalties when not complied with.
Private employers across the provinces are required to pay premiums which are consolidated into a common fund. These fund the WCBs itself and the workers’ compensation benefits granted to employees. This makes contributions or premiums to be mandatory, and employers may be sanctioned for its non-compliance. The specific amounts to be paid by the employers are updated regularly, which places the responsibility upon the employers to proactively coordinate with their WCB, and a workers’ compensation lawyer may help employers with these transactions.
Making a claim or an application for workers’ compensation are also done before the WCBs. Each claim or application may depend on the injury, illness, disease, or disability that a worker suffers from. However, these claims or applications may be denied by the WCBs because of fraud, improper applications or claims, criminal activity or offense, among others, and these grounds may differ from each province. In making such claim or application, both the employer and the worker may be assisted by a workers’ compensation lawyer to ensure that these are compliant with rules and regulations by the WCB and reduce the chances of its denial.
The WCB may also exercise quasi-judicial functions when it hears and adjudicates appeals taken from the denials of workers’ compensation applications or claims. These appeals are subject to the procedures of the specific WCB, which may include investigations to be conducted by the WCB’s sub-offices, conduct of a trial-like proceeding, or submission of arguments, etc. A workers’ compensation lawyer can help workers and employers with this regard, such as in preparation of necessary submissions for appeals, and in representations before these tribunals.
Aside from complying with these regulations, it is also the responsibility of the employer to prevent any workplace injury or disease from occurring by ensuring a healthy and safe workplace, assist employees in reporting injuries and illnesses before the WCB, and help employees who has already recovered to return to their work.
Government employees working in federally regulated institutions are governed by the Government Employees Compensation Act (GECA), except for those working for the Canadian Forces or the Royal Canadian Mounted Police. Processing of compensation claims and applications, appeals, payment of benefits, and other kinds of support may be coursed through the Federal Workers’ Compensation Service (FWCS), which may partner with the respective WCB in the province.
In addition, under the FWCS regulations and other federal statutes, it is not only government employees who may use workers’ compensation, but also:
Generally, most employees are covered by workers’ compensation benefits. This is because most employers are required to register under the Workers’ Compensation Boards (WCBs) and are mandated to pay premiums for their employees. Some WCB may also require employers to register its “non-employees”, such as contractors or third-party employees.
However, there are employees exempted from this rule, such as those who are self-employed and are independent contractors. For them, they may opt to purchase private insurance which may be an equivalent to a workers’ compensation benefit.
For employees who are covered or not covered by federal or provincial laws on workers’ compensation, this may be referred to a workers’ compensation lawyer to ensure the business’ compliance on these laws.
Although operations and procedures of WCBs differ from each province, they all generally follow principles with regards to the workers’ compensations. These principles are based on the report made by Sir William Meredith in a study regarding workers’ compensation – hence, these principles being named as the “Meredith Principles”. This is essentially a compromise on the part of the workers in relinquishing their right to sue their employers in lieu of these benefits.
Do you have inquiries on workers’ compensation and its related matters? Head down to see the Lexpert Ranked list of the best workers’ compensation lawyers in Canada.
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