Fitness-for-work decision
Procedure summary
Published On
| Purpose | To determine if a worker is ready to return to work in their date-of-accident job or other suitable work and develop an appropriate return-to-work plan. |
| Description | WCB Alberta is committed to helping injured workers achieve a successful recovery and a safe return to work at the earliest opportunity, including using appropriate modified work alternatives. The decision maker monitors the worker's care plan including their progress in treatment and determines when a worker is ready to return to work based on medical reports. When medical reporting supports a fitness level, the decision maker collaborates with the worker, employer and treatment provider to develop a return-to-work plan. Depending on the claim circumstance, a return-to-work plan could involve:
The decision maker communicates the fitness-for-work decision verbally and in writing, explaining the medical information used to determine the worker's fitness level, work restrictions and the plan to support their return to work. |
| Key information | Medical reports that assess a worker's capabilities are crucial for understanding the impact of an injury or illness on their ability to perform specific tasks. These reports typically evaluate the worker's functional ability to engage in activities such as sitting, standing, walking, lifting, bending, twisting, kneeling, squatting, climbing, overhead reaching, pushing/pulling, driving, etc. The findings help to determine suitable work accommodations or the necessity for rehabilitation services to support the worker's return to work safely and effectively. The decision maker reviews the medical reports to determine the worker's work capabilities and work restrictions and compares the worker's fitness level with the physical requirements of their date-of-accident job including the frequency a task is performed. For psychological injuries, the decision maker considers other requirements for the date-of-accident job (e.g., social and cognitive requirements). Before a fitness-for-work decision can be made, the physical requirements of the worker's date-of-accident job must be confirmed. When they are unclear, the decision maker obtains clarification by requesting a job description and physical demands analysis, or when appropriate, arranging a return-to-work planning meeting. It is best practice to obtain information about job requirements and modified work options early on in the claim. In some circumstances, the worker may not be capable of returning to their date-of-accident duties, but they may be fit for work with restrictions (i.e., modified duties). For example, if a worker's regular job duties require them to lift 11 kg (medium level) from their waist to an overhead position on a frequent basisA frequent basis is 34-66% or 2 hours 41 minutes to 5 hours 17 minutes of the workday., but they are only able to lift 11 kg on an occasional basisAn occasional basis is 6-33% or 25 minutes to 2 hours 40 minutes of the workday., this is considered a work restriction. Modified work is one of the most effective ways to support the recovery of an injured worker and provides many benefits to both the worker and employer. When a worker is fit for modified work, the decision maker negotiates a return to modified duties with the worker and their employer. The plan is monitored until the worker is able to return to full duties or the work restrictions are confirmed to be permanent. Refer to the 3-1 Modified work procedure. Both the worker and the employer have a duty to cooperate in the return-to-work process. For information about expectations of cooperation and participation in the return-to-work plan, refer to Policy 04-11, Part II, Application 1 - General. The worker's return-to-work plan depends on their fitness level, work restrictions and job availability. There are four (4) possible fitness to work outcomes:
When a worker is cleared to return to their pre-accident job or modified work, the decision maker communicates the fit-to-work decision, discusses the return-to-work plan with the worker and the employer, and determines if the worker is eligible for wage replacement benefits and the type of benefit payable. Wage replacement benefitsA worker is eligible for temporary wage replacement benefits when there is medical evidence the work-related injury has resulted in temporary work restrictions which prevent the worker from resuming pre-accident employment or other suitable employment. The decision maker reviews the worker's fitness level and most appropriate wage replacement benefit payable. Temporary total disability (TD01) benefits are payable while the worker is not fit for any work. These benefits are payable until the worker has a fitness level. Temporary partial disability (TD02) benefits are payable when the worker is fit for modified work, but they are earning less than their pre-accident salary. These benefits are payable until the worker is earning equal to or greater than their pre-accident earnings or the maximum compensable earnings for the date-of-accident year when the pre-accident earnings are higher. Refer to Policy 04-01, Part II, Addendum A - Maximum Annual Compensable Earnings. Refer to Policy 04-02, Part II, Application 1 - General. In certain situations, when a worker possesses a fitness-for-work level but the date-of-accident employer is unable to offer appropriate modified work, the decision maker evaluates the worker's fitness level and readiness to engage in re-employment services. A worker is not ready to begin re-employment services if they are in the acute phase of recovery (less than six weeks from the date-of-accident), they are participating in a return-to-work program or significant improvement is expected. Significant improvement means the worker is expected to advance to a higher work‑capacity level (e.g., from light duty to medium duty). If a worker can make minor gains (such as slightly better grip strength or range of motion) but is not expected to progress beyond the light‑duty level, they are considered job‑ready. In this case, RE services may begin to move the worker into the next phase of their return‑to‑work plan. A worker is ready to participate in re-employment services when treatment is completed, the worker is still in treatment, but their fitness level is not expected to improve for 8 to 12 weeks, or the worker has reached the best level of function expected (a medical plateau) and no further improvement is expected. Re-employment (VR) benefits are payable when:
Re-employment (VR01) interim benefits start when a fitness-for-work decision letter is sent, the worker is ready to participate in re-employment services, and a referral for a triage assessment is completed. These benefits switch to RE assistance (VR04) the day they begin SJS, and to retraining allowance (VR02) if the worker starts a full-time training program (i.e., full-time training is 30 hours per week or more). Refer to the 7-2 Supported job search or the 7-4 Retraining programs procedure. In some circumstances, a worker's injury results in a permanent disability that impacts their earning capacity. When the worker's condition stabilizes, WCB determines the impairment (loss) of earning capacity by assessing the impact the permanent compensable work restrictions will have on the worker's ability to earn in any suitable employment. Refer to Policy 04-04, Part II, Application 1 - Determining Impairment of Earning Capacity. |
