Expand all
Collapse all
|
1. Review the request
In special circumstances, a worker may submit a written request for a one-time financial assistance payment. The request must include documentation to support their claim of financial hardship or debt. Review the worker's written request, supporting documents, and any file information related to the struggles the worker is requesting financial assistance to help alleviate. Review Policy 04-07 - Services for Workers with Severe Injuries to determine whether the worker is considered severely injured. Consider whether the worker’s financial stability is seriously affected due to unusual circumstances related to their compensable injury. Proof of financial hardship or debt may include documents such as: - A copy of one or more outstanding bill(s).
- A copy of the loan agreement or letter from the lending institution.
- A breakdown of the worker's current monthly budget or other information supporting their need.
Consider whether granting financial assistance will likely support their rehabilitation. Confirm special financial assistance has not been provided previously. Special financial assistance is only provided on a one-time basis. All requests need supervisor approval.
|
Administrative tasks
If the worker requests financial assistance by telephone, advise them to submit the request in writing. Document the discussion in a file note (Contact/Worker contact). Note: For older claims, request a cost statement for payment codes SSF-02 (from 1993 to present) or NP92 (between 1973 and 1992) to determine if special financial assistance was previously provided. Refer to the internal Procedure 21.2F - Cost Statement Request.
|
2. Make the decision
Confirm the request meets the criteria for approval of special financial assistance: - The worker is severely injured,
- The assistance is likely to aid in the worker’s rehabilitation,
- The worker’s financial stability is seriously affected due to unusual circumstances related to the compensable injury, and
- Special financial assistance has not been previously provided
When approving the request, clearly outline on the claim file the exceptional circumstances and the rationale for how the financial assistance will likely enhance the worker's rehabilitation process. Obtain approval from the supervisor. Review the supervisor's recommendation, including any rationale or other suggested actions if the request was denied.
|
Administrative tasks
Send a file note (Compensation Payment) to the supervisor requesting approval for a special financial assistance payment.
|
3. Communicate the decision
Contact the worker to advise them of the decision. Once a decision is made, communicate the decision to the worker and employer verbally and in writing. Clearly express the rationale used to reach the decision during the conversation as well as within the letter. In the letter, address the worker’s concerns and personalize the letter based on the situation. If the request is accepted, confirm: - The decision and rationale for approving the request.
- This is a one-time payment only.
- A proof-of payment receipt will be required when the payment is made to the worker.
- If payments are issued to the worker in advance of a purchase or payment for a service, these payments will be considered a debt owing and will need to be repaid if a receipt is not provided.
If the request is denied, confirm: - The decision and the rationale for denying the request.
- Resources that may be available to the worker as they recover. This may include Employment Insurance benefits, long-term sick leave through Canada Pension Plan or sick benefits through an employer plan.
Consider a referral to WCB’s Community Support Program which can connect workers with various agencies and organizations across the province for additional support outside of the workers’ compensation system.
|
Administrative tasks
Document the discussion in a file note (Contact/Worker Contact). Send the Claimant Custom (CL000A) letter, outlining the decision and include the rationale for the decision. Refer to the WCB Community Support Program site located on the internal Electronic Workplace under the Business Tools tab.
|
4. Issue the payment
Issue the payment directly to the vendor(s) and/or creditor(s), in all cases, when possible. Gather the vendor or creditor information from the worker, along with the amount owed. If necessary, contact the vendor or creditor to confirm they will direct-bill to WCB. If direct payment to the vendor or creditor is not possible, inform the worker that they must submit a receipt as proof that the funds were used for the intended purpose. Upon receipt submission, process the payment to the worker. If funds are issued to the worker before the purchase or payment, refer the claim to the case assistant to monitor for the receipt to be submitted. If a receipt is not submitted, delete the payment and create an overpayment.
|
Administrative tasks
Send a task to the case assistant asking them to monitor for the receipt to be submitted. Send a file note to the Medical Aid Unit to request a payment be issued to the vendor(s) and/or creditor(s) or worker and the amount to be issued. The medical aid clerk will request payment to the vendor(s) and/or creditor(s) or the worker using the TOP/NOPThis is the code for the specific Type of Payment and Nature of Payment that the payment is issued under. code SSF02. Refer to the internal Procedure 5.1: Overpayment Collection for recovery of the overpayment.
|
