For health care providers

Learn about your responsibilities in the claim process when your patient has been injured at work or is suffering from an occupational disease.

Stage 1: Report an injury

Helping injured workers recover and safely return to work is at the core of what we do. A big part in making this happen is through our partnerships with health care providers like you—physiotherapists, chiropractors, physicians, surgeons and other specialists.

Reporting to WCB within 48 hours of providing treatment or assessment is a key component of the worker's claim. Regular medical updates are needed to determine entitlement under the Workers’ Compensation Act.

You must report accidents to WCB if your patient will remain injured or is likely to have physical restrictions beyond the day of accident.

To make reporting easier for you, online reporting is available. Using our electronic injury reporting tool:

  • Physicians can submit first reports, progress reports, consultation reports and invoices.
  • Chiropractors can submit first reports, progress reports and invoices.
  • Physiotherapists can submit assessment reports, status reports and invoices.

For instructions on how to complete an injury report, see Report an injury: For health care providers.


Go to Stage 2: Rehabilitation and return to work

Stage 2: Rehabilitation and return to work

As a health care provider, you play a major role in the health and well-being of workers injured on the job. Partnering with us, we can help your patient achieve a successful recovery and safe return to work. With a diagnosis being the first step, safe and productive rehabilitation is the road that will lead them there.

As a health care provider, you may provide and/or refer your patient to a range of rehabilitation services over the course of his or her recovery (and duration of his or her claim). Rehabilitation services that we offer include:

  • medical exams
  • physiotherapy
  • chiropractic treatment
  • diagnostic testing
  • surgery

Assessing your patient's illness or injury, and deciding upon their treatment, may require a variety of services. You can request these assessments on behalf of your patient. We may be able to help with your patient's progress by expediting some medical testing and treatment, arranging for medical assessments and providing return-to-work planning support.

Working while recovering

Temporarily changing a job or job duties so injured workers can work while recovering keeps them connected to their jobs and colleagues, and helps them maintain normalcy in their lives. It also helps recovery.

As a health care provider, it's so important to talk to your patient about safe modified work alternatives—the earlier the better. To start, it can be as simple as a conversation and asking a few questions during your first visit. For example, if your patient has a shoulder injury, ask them what they do for work and what kinds of tasks they perform each day. Based on this knowledge, you can then advise on how they may be able to modify their job so they can continue to work safely while recovering.

We are here to work with you and your patient along the way, ensuring that the modified work process supports your medical recommendations and is meaningful for the worker.

Modified work includes changes in:

  • tasks or functions
  • workload (e.g. hours or work schedules)
  • environment or work area
  • equipment

It can also include work normally performed by others.

Modified work needs to be:

  • Achievable: Given your patient’s injury, can he or she physically do it.
  • Safe: A modified work plan should not endanger the worker’s recovery or safety, or the safety of others.
  • Constructive: A modified work plan should contribute to the worker’s rehabilitation and skill development and their return to full duties.
  • Productive: Duties should be meaningful to the organization.


Go to Stage 3: Claim decision and billing

Stage 3: Claim decision and billing

Claim accepted

Once your patient's claim is accepted, an adjudicator will discuss with them what benefits and services will help them return to work.

Claim denied

The adjudicator may reject your patient's claim if any of the following is true:

  • Their injury did not arise out of employment.
  • Their diagnosis is for a condition not caused by work.
  • There is not enough information in their file to support that an injury or illness occurred.
  • Their claim was not filed within 24 months of their injury.
  • Their employer is not required to have workers' compensation coverage and did not purchase this for them.

Billing

You will be advised of the status of your patients claim and if applicable, you can bill for your services as outlined in the WCB fee schedule. Service fees are based on the Alberta health & wellness schedule of medical benefits as amended. To learn more, visit Billing information.