Triage assessment referral

Review the claim to consider if a referral for RE services may be appropriate. Indicators that a worker may be ready for RE services could include:

• The worker requires “skilling upSkilling up may include assessments or training to upgrade computer skills, ESL (English as a second language), customer service skills or general diploma, etc.” for a modified work position with their pre-accident employer. Skilling up is appropriate when it is purposeful and will enhance the worker's return to work with their employer.
• The worker is  job readyA worker is job ready when they are non-job attached or all attempts to negotiate modified work are exhausted, they are fit for some level of work, and they are not expected to have a significant increase in their functional abilities over the next eight weeks. A fitness decision can be made..
• The worker is two-thirds through their return-to-work program, permanent work restrictions are anticipated, and modified work is not available or the worker is not job attachedThe worker is no longer employed with the date of accident employer.. Note:  A worker's TD01 benefits may continue instead of transitioning to RE (VR) benefits when the worker begins RE services while in a program and permanent work restrictions are expected. 

Note:  A worker with psychological restrictions that only prevent them from returning to work with their pre-accident employer (i.e., they have no restrictions from working in the same job with other employers) may be eligible for limited RE services (e.g., SJS). 

If the worker was referred for a triage assessment while participating in a Return-to-Work program, continue to step 5 to participate in the case conference. 

For workers employed by one of the five designated public service employers, a triage assessment referral is typically not required, except when a resume is needed to help the employer identify suitable accommodation, training is required for a permanent accommodation, or the worker severs their employment). 

Refer to the Re employment services offered by contracted providers section for a list of the services that are available through the RE provider.

When a referral for RE services appears appropriate, a discussion with the worker and employer about the referral typically occurs at the same time the fitness-for-work decision is made. If the referral for RE services:

• was previously discussed with the employer and the worker, continue to step 4.
• was not previously discussed with the employer and the worker, proceed to step 2 of the 1-8 Fitness for work decision procedure to have a collaborative discussion with both parties about the worker's fitness for work, work restrictions, change in benefits and the reason for the referral. Ensure all options for accommodation with the pre-accident employer have been explored.

RE services are not appropriate or the worker is not eligible

When a referral is not appropriate, such as when the worker is job attached or is not job ready (e.g., is making meaningful gains and progressing in treatment), continue to monitor for indicators that a triage assessment is appropriate. Do not continue with this procedure.

If the work restrictions end, the worker is no longer eligible for RE services because they are capable of returning to their pre-accident duties, even if they are no longer employed with their pre-accident employer. Suggest alternative services and/or free or low-cost basic skilling-up options that may be available to them in the community, including: 

• Referral to the WCB's Community Support programThe Community Support program can connect workers with various agencies and organizations across the province for additional support outside of the workers’ compensation system.. If the worker agrees, complete the referral.
• Programs outside of WCB-Alberta such as government and community supports.

RE services are appropriate

Before referring for a triage assessment, confirm all the referral details including the compensation rate are accurate. This ensures the RE provider looks for job options that are suitable to the hour range and salary required. 

Consider the following:

• If the worker's pre-accident job involved a complex shift cycle, ensure the compensation rate accurately reflects the worker's pre-accident earnings and includes the complex shift cycle. This may involve calculating the average hours worked. Refer to the Pre-accident complex shift cycle section for more information.
• If the worker worked regular overtime, add the overtime hours to the regular hours and include the combined amount in the referral. Note: Overtime hours are not included in a worker's shift cycle on the eCO screen. Example: If the worker worked 40 regular hours per week and an additional 17 hours of overtime per week, the hours on the referral should reflect 57 hours per week. The section 56 rate includes both regular earnings and overtime earnings. In some cases, it may be reasonable to consider a full-time and part-time job to recover the earnings. Refer to the 8-1D CPL - New WLS based on actual earnings in the Resource Library.
• If the worker has a recurrence of disability (section 61) rate and the work restrictions changed (new or increased) as a result of the recurrence, provide the gross earnings used to set the section 61 rate in the referral. If this exceeds the maximum compensation amount for the accident year, provide the maximum compensation amount instead. However, if the worker recovers to their pre-recurrence state (i.e., there is no change in work restrictions as a result of the recurrence), a referral for RE is not required and the worker would be eligible for any wage loss in place before the recurrence.
• If the worker has an apprentices (section 67) or young workers or students (section 68) rates, provide the gross earnings used to set the rate in the referral. If this exceeds the maximum compensation amount for the accident year, provide the maximum compensation amount instead.
• If the worker is an apprentice but their journeyman rate will be effective at a future date provide the gross earnings used to set the future section 67 rate in the referral. If the gross earnings exceed the maximum compensation amount for the year, provide the maximum compensation amount instead.
• If the worker was working two jobs (known as concurrent employment) on the date of accident, determine if they have work restrictions preventing them from returning to one or both jobs. Refer to the Concurrent employment section for details.
• If the pre-accident (or concurrent) job is seasonal, provide the base-rate gross annual earnings amount in the referral.
• If the worker does not live in the same location within Alberta that they did on the date of accident or lives outside of Alberta, indicate the appropriate geographical location for the RE services. Refer to the Geographical location section for details. 

Note: When completing the referral, ensure to include the shift cycle for the compensation rate being used. 

Once the information is confirmed, send a referral for a triage assessment with an authorized Alberta provider. When the worker is unable to travel to Alberta, the triage assessment may be completed virtually or by phone with an authorized Alberta provider. 

Workers who are not job-attached and will be (or are expected to be) fit for full duties when they complete treatment, may be eligible for a triage assessment and assistance with creating a resume. They are only eligible for the period of time they have work restrictions (i.e., RE services should be discontinued once the work restrictions resolve). Consider a referral to WCB's Community Support ProgramWCB’s Community Support Program can also connect workers with various agencies and organizations across the province for additional support outside of the workers’ compensation system. if the worker no longer has work restrictions. 

Together, with the worker and the RE provider, discuss the outcome of the triage assessment and the recommended RE services which may include one or more of the following: 

• Transitional support modules (TSM)TSM is a series of workshops scheduled over one week relating to values and perception, motivation and finding a support network, communication, conflict resolution and goal setting. TSM should be considered when a worker is making a significant career change and is struggling with change.
• Standard SJSSuitable for workers who have a clear job path with strong transferable skills, allowing them to immediately look for work without needing further services to assist them to become employable. Also suitable for workers who will likely have a difficult time identifying job options..
• Integrated SJSSuitable workers who have uncertainty about what is next and need help building a plan. Workers receive help with job planning while also participating in a supported job search. which includes job planning supports.
• General ResumeA general resume is a document that summarizes a worker's professional experience, skills, education and achievements. A resume is used to submit an application for a job posting.
• Ergonomic assessmentAn ergonomic assessment explores aides and equipment that may help the worker return to their pre-accident job or open  up opportunities for modified work with the date of accident employer.
• Skilling-upSkilling up may include assessments or training to upgrade computer skills, ESL (English as a second language), customer service skills or general diploma, etc. opportunities to support modified work or new employment such as:
  • Computer assessment and/or computer training
  • ESL assessment/ESL trainingEnglish as a second language assessment/training
  • Canadian Adult Education Credential (CAEC)Effective May 3, 2024, the Canadian Adult Education Credential (CAEC) replaces the General Diploma Assessment (GED) and/or training. assessment/training.
  • Customer service and communication courses
• Computer purchase 

For more information about the above RE services, refer to the 7-2 Supported job search procedure and/or the 7-4 Retraining programs procedure.

Workers may go straight into SJS, part-time skilling up while continuing with the SJS or treatment (if they are not yet  job ready)A worker is job ready when they are non-job attached or all attempts to negotiate modified work are exhausted, they are fit for some level of work, and they are not expected to have a significant increase in their functional abilities over the next eight weeks. A fitness decision can be made., or they may require full-time retraining. When skilling up or retraining is recommended, ensure it supports the worker's return-to-work plan. Refer to step 1. 

The decision maker approves the recommended services during the case conference and confirms whether the provider will arrange the recommended services.

When the referral was for a documentary service, participate in the case conference with the RE provider. Once a suitable job optionA suitable job option refers to a position that can be done safely and is consistent with a worker's physical, vocational, social and psychological ability. and job leadJob leads are ads, postings or other job opportunities (i.e. training-on-the-job). A job lead is viable when it is available for the worker to apply for in their locale and during their support job search service. The worker also meets the core requirements for the job and the job is within the worker’s work restrictions. are found, the provider completes the documentary service and submits the job option report.

Note: To ensure timely implementation of services, triage recommendations must be approved within two business days of notice by the RE provider.  If the decision maker or alternate is not able to respond within two business days, reporting will be completed and sent to file and any recommended services will proceed.

Call the employer to discuss the worker's RE plan including approved services, supports, expected durationThe length of time needed for the worker to participate in the recommended services for re-employment. , and related costsIncludes costs for retraining, ergonomic equipment, etc..  

If the worker is job readyA worker is job ready when they are non-job attached or all attempts to negotiate modified work are exhausted, they are fit for some level of work, and they are not expected to have a significant increase in their functional abilities over the next eight weeks. A fitness decision can be made., determine the wage loss benefitThe type of wage loss benefit payable will depend on the recommended service the worker will be participating in (e.g., retraining, supported job search, etc.). Refer to the appropriate procedure for assistance in determining the wage loss benefit payable.  The type of wage benefit payable will depend on the recommended service the worker will be participating in (e.g., retraining, supported job search, etc.). Refer to the appropriate procedure for assistance in determining the wage loss benefit payable.payable. If the worker is:

1. Starting any type of full-time training (30 hours per week or more), issue Retraining Allowance (VR02) benefits effective from the start date of the training. Typically, when a worker is participating in skilling up or part-time retraining (i.e., less than 30 hours per week), VR04 benefits are paid as the worker is participating in part-time SJS and retraining. However, in some cases, the worker's concurrent participation in SJS and retraining may not be reasonable (e.g., learning difficulties, virtual training versus skilling up, the worker's age). It is important to consider whether job searching at the same time could impact on the worker's ability to successfully complete their training.
2. Waiting for training that begins within 12 weeks, issue Short-Term Retraining Allowance (VR05) benefits, and switch to VR02 once training begins. If training begins more than 12 weeks from now, assess whether the worker should seek short-term employment while waiting.
3. Starting a SJS program, issue RE Assistance (VR04) benefits effective the SJS intake date.

When an ergonomic assessment is recommended to support the worker’s return to work, discuss the recommendations with the clinician, worker and the pre-accident employer. Ensure the recommendations align with the worker's needs and consider how long the equipment will be needed. For example, if an item is required for a short period of time, consider whether there is another more cost-effective option (e.g., in-person computer training versus purchasing a computer). Make arrangements to purchase the equipment/aids, as appropriate.

Communicate the RE plan in writing.