Disclosure of claim information
Procedure summary
Published On
| Purpose | To disclose claim information to injured workers, employers, their authorized representatives and other parties directly concerned, in accordance with the Workers' Compensation Act (WCA) and privacy legislation. |
| Description | Decision makers may receive requests to disclose claim or worker (non-claim) information from workers, employers, authorized representatives or other concerned parties. Requests may be received verbally or in writing, including through Claims Contact Centre (CCC) or Claims Review Services (CRS). When a request is received, the decision maker completes a preliminary review to confirm the requester has authorization or consent, the request is clear and there are no known restrictions on disclosure. If the decision maker's preliminary review confirms the request can proceed, they refer it to the appropriate team for processing:
After a request is referred, CCC or CRS is responsible for processing the disclosure request. This includes reviewing the requested records, determining what information can be disclosed, applying any required severing or restrictions, preparing the disclosure package and releasing the information to the requester in accordance with the Workers' Compensation Act and privacy legislation. If a request cannot proceed, the requester is informed of the reason and any available review or appeal options. The worker and/or their authorized representative is informed of requests for information related to their claim, as required. |
| Key information | Access and privacyWCB protects personal information while supporting transparent decision-making. Individuals have a right to access information that affects them. WCB collects, uses and discloses only the information necessary to administer the Workers’ Compensation Act (WCA), in accordance with the Protection of Privacy Act (POPA), Access to Information Act (ATIA), Health Information Act and Records Management Regulation. Additional guidance is provided in Policy 01-02, Part I: Access and Privacy and Policy 01-02 Access and Privacy, Application 1: General. Under POPA and ATIA, individuals have the right to request access to their own personal information, subject to limited exceptions as outlined in the Acts. For additional guidance, refer to Policy 01-02, Part I: Access and Privacy and Policy 01-02 Access and Privacy, Application 1: General. Personal informationPersonal information is recorded information about an identifiable individual, such as name, address, date of birth, age, sex, martial status, identifying number (e.g., claim number), health information, employment history. For the complete definition, refer to s1(q) of the Protection of Privacy Act (POPA). Personal information types
Disclosure of claim informationWCB may disclose information under the WCA or other applicable legislation (e.g., POPA, ATIA or Health information Act), or with the individual's consent. Information is disclosed on a need-to-know basis and only to the extent necessary to carry out the purposes of the Act. Before information is disclosed, the records are reviewed to ensure disclosure is appropriate and will not result in unauthorized release of information. Workers are notified when a party other than themselves or their authorized representative requests information about them or their claim, as required. For information on unauthorized disclosure of personal information, refer to the 9-3 Breach of privacy procedure. Most requests are fulfilled at no cost; however, processing fees may apply in certain circumstances as outlined in Policy 01-02, Part II, Application 1, Question 6. For additional guidance on WCB's access and disclosure practices, refer to Policy 01-02, Part II, Application 2: Disclosure of Information and the WCB-Alberta website - Access to Information. The WCB can share information under the WCA when it is needed to carry out the purposes of the Act. This includes sharing with:
WCB can also release information:
Workers are entitled to request that any information held by the WCB be released to them, their authorized representatives and/or third parties at their discretion, except for information about active investigations concerning the worker or their claim(s). The purpose of these requests may be to prepare for a request for review of a customer service decision or an appeal of a DRDRB decision or for personal reasons such as record-keeping, etc. Employers may request a copy of the claim file to appeal a claim decision or apply for cost relief. They may also access select documents to support return-to-work planning. Additionally, the employer's access may be restricted if costs are transferred to another employer's account. Other concerned parties, such as insurance companies, law enforcement, etc. may request information for a number of reasons. Refer to the Inquiry sources (Other parties directly concerned) and required actions section for common inquiries and how what information may or may not be released. In short, information is disclosed on a need-to-know basis to support the management of the claim. Sometimes, the worker, employer or their authorized representative may request claim file documents from the claim owner during a phone call or by email or letter. In these cases the requester or the request will be referred to the CCC or the claim owner will refer the request to the CRS team. Criteria for Claim Owners to release information directlyDecision makers typically do not release information however; they can use their discretion and release information when all of the following are true:
If the claim owner is releasing information, it must be sent through a secure method with a note placed on to the file with what was released and who received it. If there are any questions or the above criteria are not met, then the request should always be sent through CCC or CRS. |
