Injury-specific initial entitlement decision
Send the initial dental assessment request (SP001A) to the dental treatment provider.
Send the appropriate decision letter:
Update the Dental treatment line in eCO with the appropriate benefit and approval codes. And to request a referral, if applicable.
Add the initial treating physician, clinic, hospital or as a participant on the claim if available.
Enter the correct fracture ICD code on the injury details screen in eCO and click "Calculate Best Practice" button in the injury duration best practice section to calculate and display best practice and assist with determining an initial estimated return to work date on the return to work screen.
Enter the worker’s treatment information into the “Treatment details” screen in eCO.
|Hearing loss (occupational noise-induced)||
Send the hearing loss package
If the worker has been employed through a union, a letter from the union can provide a history of employment.
Send a dizziness/balance questionnaire to the worker if dizziness/balance problems are reported (traumatic injury) in consultation with the worker.
|Occupational injury or disease|
Request medical - physician (SP006A)
The claim can be accepted under presumptive coverage when there is a confirmed traumatic incident and a confirmed psychological/psychiatric diagnosis of:
Psych IED accept (CL041H)
Psych IED deny (CL026G)
|Repetitive strain injury||
Ensure physical demands analysis (C545) and job description forms are on file.