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Triage assessment referral - Archived Nov 22, 2023

Procedure summary

Published On

Feb 1, 2023
Purpose

To refer injured workers for services to assist them in exploring new job options when they can no longer return to their date-of-accident job or employer.

To determine entitlement and amount of wage loss benefits.

Description

The decision maker anticipates the need for re-employment services for their worker and, in most cases, refers the worker for a triage assessment. During the triage assessment, a re-employment specialist collaborates with the worker to assess their needs and then makes recommendations for the right re-employment services that would best suit the worker’s unique needs and circumstances.

The recommended services can range from basic “skilling up” services that focus on short term training options to enhance the worker's employability, to longer-term services such as job training and supported job search.

Throughout the re-employment process, the decision maker keeps in regular contact with the worker and re-employment specialist to monitor the worker’s progress and to offer additional assistance and support to the worker.

The decision maker makes every effort to support the worker in finding a job that maximizes their earning potential or matches what the worker earned at their date of accident job.

If the worker’s return-to-work options lead to lower earnings, the decision maker determines whether they may be entitled to an additional wage loss benefit. The wage loss benefit provides a top up between the worker’s estimated or actual earnings and their earnings at the time of their injury.

Key information

Decision makers can make a referral for a triage assessment while the worker is still in treatment.

The re-employment services triage assessment supports workers by focusing on the services they need and allows them to access training earlier so they stay focused and engaged in returning to work.

The assessment also supports decision makers by making recommendations for the services that will best support their workers' return to work. Changing jobs or careers can be a challenging time for an injured worker. The decision maker ensures the worker is engaged and plays an active role in each decision and step throughout their return-to-work journey.

While the decision maker assists the worker in finding a job, it is the re-employment specialist who assesses the worker and makes the recommendation for services based on the triage assessment results.

As of April 1, 2021, workers have a duty to cooperate in their return to work and vocational rehabilitation (re-employment). Cooperation means full participation and disclosure, as required, in those activities and services at each stage of a claim that are focused on supporting a worker’s recovery and return to work. The goal is to act in good faith to maximize recovery and achieve return to work, or independence for workers who are medically unable to return to work. There may be an impact to the worker’s benefits if they are not cooperating.

Detailed Business Procedure

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1. Determine whether the worker would benefit from re-employment services

Indicators that a worker may be ready for re-employment services could include:

  • The worker is physically fit for some level of work and is not expected to have a significant change to their functional abilities.
  • The worker is ready to focus on their re-entry to the workforce.
  • The worker has work restrictions that are anticipated and confirmed by their healthcare providers, and their restrictions indicate a job change is needed.
  • There is a possibility of the worker being able to return to their date of accident job with the appropriate workplace modificationsIdentified and recommended as part of the triage assessment..
  • All attempts to accommodate the worker at their date of accident place of employment have been unsuccessful or are not applicable.

Refer the worker for a re-employment triage assessment when:

  • They are fit to work at a consistent level of fitness, have work restrictions and are not job attached.
  • The worker is participating in a return-to-work program, permanent work restrictions are anticipated and modified work is not available.
  • Modified work is available, but the worker requires additional “skilling up” to assist in the sustainability of the modified duties.

The worker may benefit from “skilling up” services to increase their overall employability. These services may be recommended as part of their re-employment services or separately. Examples of these additional skill training programs include trade certificates, computer skills upgrading and resume services.

Workers should be considered for skilling up services when:

  • They are confirmed as no longer being job attached.
  • They are at significant risk of losing their job (confirmed through a discussion with their employer).
  • Their employer confirms they need WCB’s help to increase their worker’s skillset.

If the worker is not eligible for re-employment services, alternative services may be available to them, including:

  • Referral to WCB-Alberta’s Community Support program.
  • Programs outside of WCB-Alberta such as government and community supports and services.

Administrative tasks

There are no administrative tasks for this step.

2. Contact the worker to discuss the referral for re-employment services

In this initial conversation with the worker,

  • Discuss the referral, the purpose of the initial triage assessment and the re-employment process.
  • Answer any questions they may have.
  • Confirm specific work restrictions based on the medical reporting on the worker’s file, and the worker’s location to be used for job search.

Wherever possible, address and remove obstacles such as:

  • Travel requirements
  • Training/skills gaps
  • Lack of computer/keyboarding skills
  • Language difficulties

If the worker decides not to cooperate in re-employment services, have a discussion with them to understand the reasons, and, where possible, offer solutions to remove barriers. Otherwise, ensure the worker understands that their benefits will be impacted. Refer for Alternate Dispute Resolution services if required. Benefit entitlement will be dependent on that outcome.

Administrative tasks

There are no administrative tasks for this step.

3. Contact the employer to discuss the referral for re-employment services

If the worker is not job attached, contact their employer to advise the worker will begin re-employment services and discuss the anticipated outcome.

Ask the employer questions such as:

  • Will you be hiring your injured worker back? Will it be within the next three months?
  • If so, what date do you intend to hire them back?
  • Would your worker benefit from any skilling up services that we offer?

If the employer does not anticipate hiring the worker back for more than three months, explain the “skilling up” services that are available and whether they might be appropriate for the worker.

Administrative tasks

If proceeding with skilling up, send the appropriate letter - based on the worker's situation - to the worker with a copy to the employer:

  • Fit for Work - Restrictions & WLS Pending (CL041Z)
  • Retraining Over 30 Days Approved (CL017Q)
  • Reopen to Re-employment Services (CL016I)
  • RE Update (CLO41G)
4. Make the referral

Call the date-of-accident employer to advise that the worker will begin re-employment services and outline the anticipated outcome.

Administrative tasks

Select a service provider, update eCO, launch the return-to-work referral script.

Complete the return-to-work referral script (FM733). Select “Yes” to the question “Are you requesting vocational services from the RTW provider?” In the “Other Services/Additional Information” field, enter “RE Triage Assessment.”

Send the CL041F (Care plan update) or CL041G (RE update).

5. Participate in a case conference with the worker and RE provider to discuss the recommendations

Together, discuss the outcome of the triage assessment and the re-employment services available to the worker.

The worker may go straight into supported job search (SJS), they may do part-time skilling up while continuing with SJS, or they may require full time retraining.

When the triage assessment report is received, the Payment Unit reviews the compensation rate (section 56 or 61) to determine that it was set accurately.

Administrative tasks

Review the triage assessment report (C1406) for recommendations.

The triage assessment report triggers a task to the Team Desk/Payment/Re-Employment Rate Review for rate review purposes.

6. Determine which benefits the worker should receive

The type of payment depends on the whether the worker:

  • Is “job ready"A worker is job ready when they are non job-attached, are fit for some level of work and are not expected to have a significant increase in their functional abilities over the next eight weeks.
  • Has begun any type of training
  • Is waiting for training
  • Is in supported job search

Administrative tasks

There are no administrative tasks for this step.

Supporting references

Policies

  • 04-01 Part I - Establishing Net Earnings
  • 04-02 Part I - Temporary Benefits
  • 04-01 Part II – Application 3 - Establishing Net Earnings
  • 04-02 Part II – Application 1 - General
  • 04-04 Part I - Permanent Disability
  • 04-04 Part II – Application 1 - Determining Impairment of Earning Capacity
  • 04-04 Part II – Application 3 - Economic Loss Payment - Dates of Accident on or after January 1, 2018
  • 04-04 Part II – Application 4- Economic Loss Payment - Dates of Accident from January 1, 1995, to December 31, 2017, Inclusive
  • 04-04 Part II – Application 6 - Earnings Loss Supplements
  • 04-05 Part I - Return-to-Work Services
  • 04-05 Part II – Application 1 - General
  • 04-05 Part II – Application 5 – Job Search
  • 04-05 Part II – Application 6 - Training-on-the-Job Programs
  • 04-05 Part II – Application 7 – Training
  • 04-05 Part II – Application 8 - Relocation
  • 04-05 Part II – Application 9 – Self-Employment
  • 04-11 Part I – Duty To Cooperate
  • 04-11 Part II – Application 1 - Duty To Cooperate

Procedures

  • 7-2 Supported job search

Workers’ Compensation Act

Applicable Sections

  • Section 36 – Board entitlement to information
  • Sections 43 (1) (2) – Evaluation of a disability
  • Sections 56 – Compensation for disability
  • Sections 59 (1-3) – Cost of living adjustments
  • Section 63 – Determining impairment of earning capacity
  • Section 67 – Compensation to learner and apprentice
  • Section 70 (6) – Compensation for death
  • Section 89 (1-3) - Board to provide vocational and rehabilitation services
  • Section 151.1 (1) - Prohibition

Workers' Compensation Regulation

Applicable Sections

Related Legislation


Procedure history

November 15, 2022 - January 31, 2023
August 10, 2021 - November 14, 2022
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