WCB premiums is not optional for many employers, knowing how premiums are established can help manage premium rates. WCB issues an Employer Premium Rate Statement annually to every employer that pays WCB premiums and to establish premium rates. The key to managing your premium rate is understanding how the calculations work and what the employer options are. The WCB premium rate, for employers, is the cost of coverage per $100 of insurable earnings for all employees of their company. All employers categorized into Industry Classifications depending on the business they are in. Industry Classifications are put into different rate groups determined by employers with similar business activities and claims experience. Each Rate Group has a rate established from statistical information, collected from the industries in that Rate Group, which is used as the foundation for calculating an employer’s premium rate. This is known as the Industry Rate. Claims Management is a proactive approach to controlling claims costs. Effective claims management is reporting of all incidents to employer immediately so proactive measures can be managed such as modified duties. Current legislation states that claims must be appealed within one year of the date the decision was made. Therefore, it is imperative to identify potential issues and address all decisions made on a claim within the required timeframe. This is why early intervention including treatment is key to getting the employee back to pre-incident duties. Our Current Claims Management team ensures claims are reviewed properly. When an incident, injury or illness occurs, and a claim is pending, our team ensures all employers rights are upheld, including:
To be compensable, an injury must be the result of an accident as defined under Policy 02-01, Arises Out of and Occurs in the Course of Employment. Therefore, when adjudicating the eligibility of a claim, WCB looks at the nature of the injury and its relationship to the compensable accident. Often there is an obvious relationship between the nature of the injury and the compensable accident (e.g., a firefighter is burned when fighting a fire). However, the relationship is not always obvious. In these cases, there is a need for additional information, especially medical information, to establish the relationship to the compensable accident. For example, many occupational diseases have a long latency period. WCB's inquiries must establish whether the work-related exposure was sufficient to cause the condition (see Application 3, Occupational Disease). In general, every claim is subject to a similar adjudicative process. The relationship between the injury and the compensable accident is examined to determine entitlement. Additional medical advice is sought on an as needed basis. Complex claims may require additional investigation to determine work-relatedness.
Internal claims management can be very time consuming and complex. Understanding WCB legislation, policies and procedures and how they are applied to a claim, support in reducing costs and getting employees back to work. Over a combined 40 years of managing claims and the WCB, allows us to quickly access pertinent information and historical data that can be directly applied to your company’s needs.
By having the SDI Group manage your claims allows you to focus on other important aspects of your business, which in turn, allows our clients to be even more efficient with claims costs. Cost Recovery Review provides an in-depth analysis of your WCB claims history. The claims costs that appear on your annual experience rate statements, are used to establish your WCB premium rate. As such, any reduction in claims costs can have a positive impact on your WCB premium rate.
The SDI Group reviews your claims and ensures that no unnecessary costs are being assessed against your account, and that any opportunities for cost recovery are not overlooked. Even if no recoveries are realized, our review will ensure that the claim’s costs are justified.