1. Determine the information to be requested and discuss with the worker, if necessary
Determine what information is needed and confirm it is required to assess entitlement to benefits or services, or to manage the claim. Refer to the Key Information section for a guidance on how this information supports claim decision‑making. If the information being requested is from outside of Alberta, confirm the worker has signed and accepted the declaration and consent section on the last page of the completed Worker's Report of Injury or Occupational Disease (C060). This can be used for authorization to collect the information. If the request is for an Alberta Health Statement of Benefits Paid, follow the 11-1 Requesting medical reports procedure. If needed, call the worker to explain the information being requested and why it is relevant to their claim, the information is sensitive or the worker may have questions about it. Ensure they understand that information related to their claim may be shared to third parties, including the employer. Note: Medical information gathered for litigation should not be requested. Instead, arrange medical assessments through WCB, if needed. Refer to the 11-1B Medical report for litigation purposes internal library resource for details.
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Administrative tasks
Document the discussion in a file note using the appropriate category and standard text.
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2. Request the information verbally or in writing
Request the specific information needed and explain why it is required for the claim. Use clear language and include a timeline. The information can be requested in writing (letter and email) or by phone. When requesting information, ensure: - The reason for collection is clearly identified.
The information must be required to determine entitlement to benefits or services. If the purpose is not obvious, document the rationale explaining why the information is necessary. When appropriate, obtain an expert opinion to support the request. Example: If cardiac test results are requested on a shoulder claim, document that the information is required to assess whether there is a relationship between the two conditions. - The information is relevant to claim management.
Relevance is determined by the decision maker and must directly support claim decisions or management. - The request is specific.
Only request the information that is needed (e.g., a specific medical report or information related to a particular condition or injury). Example: Request a specific motor vehicle accident report rather than all information related to the accident. - The information is professional and relates only to WCB business.
The document is dated and signed. For external documents, the document must be signed in full signature (initials not acceptable). In cases of a typed report the staff member's full name and credentials may be typed in, but the individual staff member is still required to sign the document in full signature. - The information is placed on the claim as soon as possible, except for transitory documents.Refer to the Key Information section for details about transitory documents.
Note: Collect proof of earnings (e.g., T1 General, T4s, pay stubs, EI records) only when all other reasonable options for obtaining accurate earnings information have been exhausted. These records may contain information that is not relevant and should not be collected unnecessarily. All verbal and written requests for earnings information must clearly state that only the required information should be submitted.
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Administrative tasks
Send the appropriate letter based on the type of information being requested. If the request is made verbally, document the discussion in a file note (Contact and appropriate standard text). Indicate that the worker, employer or other individual was advised to submit only relevant information.
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3. Confirm the received information meets WCB standards
Review the claim information (i.e., documents, email and mixed media) received to ensure the information meets the following WCB standards: - Relates to that worker. Documents with other claim numbers are acceptable if they pertain to the same worker and employer. In some cases, another worker's name and claim number may be relevant (e.g., in a motor vehicle accident involving multiple claims).
- Compare the information on the mail with the worker's information:
- Are there differences in the worker's information (e.g., name, Social Insurance Number, date of birth)
- Date of accident
- Injury and part of body. If the injury is different from what was previously reported, could it still be related to that claim?
- Necessary for determining entitlement. This includes information needed for gathering evidence, making decisions, implementing actions or communicating outcomes/decisions.
- Accurate, complete and legible. Ensure the information is clear and complete.
- Relevant. For example, some records collected to confirm earnings may contain both relevant and irrelevant information.
- Properly filed. Place the information on the claim file upon receipt. Claim information must not be stored elsewhere. Transitory documents (e.g., duplicate or draft documents) are the exception and can be destroyed when no longer needed.
- If voice or audio recordings are received, process them in the same way as any other correspondence received from a worker, employer or representative. When possible, obtain the information from the source.
If the mail meets the standards above, action it accordingly. If the mail does not meet the standards above (e.g., contains irrelevant information), proceed to step 4 to action.
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Administrative tasks
Refer to the 9-1A Storage, access and assessment of mixed media internal library resource.
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4. Action claim information not in compliance with WCB standard
If the information is not relevant, take appropriate action to address it. Possible actions include the following: - Return irrelevant information to the source.
- Request the document be modified by correcting or severing information.
- Forward the document requiring modification to the Claims Records Services team through a file note.
- Request the document be moved to a different claim file due to being misfiled.
- Request the document be reindexed to the correct code.
- Request the document be deleted from the claim file.
Decision makers require supervisor approval to have claim documents (mail) or file notes deleted.- Note: Duplicate documents should only be placed on the claim file if they contain unique notes or other markings not present on the original. If a duplicate is confirmed, request it be deleted.
If there is a confirmed duplicate, have it or the worst copy from the claim and send it for shredding (paper files). Ensure Section 95(1)(e) of the Access to Information Act and Section 60(1) of the Protection of Privacy Act are followed:- ATIA:
95(1) “a person must not knowingly (e) destroy any records subject to this Act, or direct another person to do so, with the intent to evade a request for access to the records - POPA:
60(1) A person not must knowingly (a) Collect, use or disclose personal information in contravention of Part 1.
- Request a new claim to be created.
- Document the decision in a file note (Entitlement decision) and request a new file be created. The Registry & Accounts Services Team will register a new claim based on the information documented in the file note.
- If the mail is reviewed by an administrative assistant, they will obtain approval from the decision maker (either verbally or via email) before sending the request to create a new claim.
- Request consolidation of duplicate worker ID numbers or claim numbers. Refer to the Consolidate worker ID numbers or duplicate claims section.
The modify desk clerk will move or reindex documents when the request is received via phone call. However, all requests from a decision maker to delete documents requires a file note and approval, if needed, as indicated above. Note: If there is a need to obtain a copy of the original document, refer to the 9-1C Request original paper-based mail to return to the sender document in the internal Resource Library.
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Administrative tasks
Return irrelevant information to the source: - If received via email, return the information to the sender via email and delete the emails.
- If the document is scanned on claim file, follow the process below to have the document deleted. Also, if the original document should be returned to the source, refer to the 9-1C Request for original paper-based mail to be returned to sender document in the internal Resource Library.
To request the document be corrected or content severed, send a file note (Other) to the Claims Records Services, Team Desk. Indicate the: - specific document to be modified (name and ID)
- date and time the document was scanned to file
- information required for the request (e.g., what needs to be severed and why)
To request the document be moved or reindexed, send a file note (Other) to the Document Modification, Team Desk. Indicate the: - document name and ID
- date and time the document was scanned to file
- information required for the request (e.g., new location or index code and why)
If the document belongs to a different worker, do not include that worker's personal information in the file note (e.g., name, date of birth or other identifying details). For urgent requests, set the file note priority field to High. To request the document be deleted, send a file note (Other) to the supervisor requesting deletion of the document. The file note must include the: - document name and ID
- date and time the document was scanned to file
- reason for deletion (e.g., not relevant or does not relate to the worker, employer or claim)
If approved, the supervisor will send a file note (Other) to the Document Modification, Team Desk. Otherwise, they will send a file note to the requestor explaining why the document cannot be deleted. To have a file note deleted, refer to the 11-15D Delete an eCO file note, alert or script internal library resource. To request a new claim be created, send a file note (Registration & Accounts, Register a New Claim) to the Registry Priority Desk, Team Desk. Document all necessary information (i.e., new date of accident - including claims for progressive injuries, nature of injury, part of body, name of accident employer and whether there is time loss).
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