WCB Policy Change Proposal: Concurrent Conditions

Posted in: WCB Law,Workplace | Posted by Rebecca Ingram on February 27, 2017

On December 8, 2016, the Workers’ Compensation Board (WCB) of Alberta announced proposed changes to cost relief for concurrent conditions, which would directly affect Policy 04-02, Part II, Application 1, paragraph 11 and Policy 05-02, Part II, Application 1. The WCB further advised that drafts of the policy would be open for comment until March 9, 2017.

As with any organization, the WCB will periodically review policy to address issues of concern that have been identified, or make improvements to the current operating system. All policy changes are reviewed and approved by the WCB Board of Directors, which is composed of members representing the interests of workers, employers and public stakeholder groups.
The WCB Board of Directors not only determines policy and ensures that it is consistent with workers’ compensation legislation, but is responsible for revisions or modifications to existing policies. They are entrusted to take into consideration the impact any change would have on workers and employers.

The policy change proposes that obesity, smoking, and alcohol/drug abuse etc., will no longer be considered concurrent conditions by the Alberta Workers’ Compensation Board and as such, these conditions will NOT be considered for cost relief implementation, even when there has been a delay in the recovery period as a result of these concurrent conditions.

This proposal is particularly concerning because these concurrent conditions pose a high risk for delayed recovery from workplace injuries.

  • Obesity has an inherent risk related to deconditioning, diabetic/hypertension issues, increased and altered biomechanical stress on the spine, lower extremity joints and soft tissues – all of which can lead to injury and/or delayed recovery from injuries.
  • Smoking is known to negatively impact recovery periods for injuries such fractures, open wounds, surgical incisions, and soft tissue damage. Smoking can cause circulatory and oxygen distribution compromise, which can also impede recovery periods.  
  • Drug and alcohol abuse can lead to neurological compromise, systemic pathology and psychological/psychosocial complications, which also negatively impact recovery from workplace injuries.

To suggest that obesity, smoking and drug/alcohol abuse should NOT be considered concurrent conditions in the context of work related injuries is flawed. These ARE  non-compensable concurrent conditions, which DO impede recovery. Cost relief should be afforded to all employers when these concurrent conditions have prolonged the recovery from a work related injury.

If adopted, these proposed changes will most certainly have a negative impact on employers, and may negatively impact workers as well.

Employers who are currently participating in the WCB’s Industry Custom Pricing program (Cost Relief Option) (ICP-CR), still have cost relief available for concurrent conditions, which lead to prolonged recovery periods from a workplace injury.

To confirm, employers participating in ICP-CR that are unable to pursue cost relief for aggravations of pre-existing conditions leading to a prolonged recovery periods, are still able to request cost relief for concurrent conditions.

Therefore, if the proposed changes to Policy 04-02 and Policy 05-02 are approved, employers participating in ICP-CR will NOT be afforded the opportunity to seek cost relief when significant concurrent conditions (obesity, smoking, drug and alcohol abuse) have delayed recovery from a work related injury.

For employers not participating in ICP, these proposed changes will further impede their ability to pursue cost relief when concurrent conditions increase claim costs by delaying the recovery period.

Employers should not be responsible for increased claim costs caused by concurrent conditions, which are clearly unrelated to employment. Workers’ Compensation is meant to provide treatment and benefits for work related injuries, not non-compensable concurrent issues which delay medically reasonable recovery periods from workplace injuries.

If cost relief for these concurrent conditions will not be an option, then WCB needs to re-examine their current entitlement practices. Responsibility and associated entitlement on these claims should end at the point where the concurrent condition impedes the medically established Disability Duration Guidelines recovery period for the work related injury sustained.  
With the proposed changes, employers will have no financial protection in these instances;  they will see heightened claim costs and a rise in premium rates, as a result of concurrent conditions leading to prolonged recovery periods from workplace injuries.  Over the years, unwittingly or not, the WCB has become somewhat of a long term disability provider in situations where non-compensable conditions, such as obesity, smoking, drug/alcohol abuse are impeding recovery from compensable injuries. If the proposed changes are approved this situation will continue and perpetuate an even greater financial burden on the WCB system and ultimately employers pocketbooks.

At this point, the proposed policy changes place the WCB in a position where they will be extending benefits and treatment to workers for non-work related issues that are delaying recovery from workplace injuries. As a result, employers will be charged with claims costs that are not directly related to a workplace injury and this will, inevitably, impact their WCB premiums.

If the Board of Directors truly wants to understand the impact of the proposed policy changes, then perhaps they should place themselves in the role of the employer and consider:

  •         the frustration of absorbing the rising claim costs associated with concurrent conditions (obesity, smoking, drug and alcohol abuse) which are unrelated to the worker’s employment and  impede recovery from a work related injury.
  •         having no avenues available to help relieve or manage costs, when concurrent conditions increase claim costs. Then watching a rise in claims costs which result in increased premiums and ultimately impact the ability to bid for work.
  •         being an employer in ICP (Cost Relief option) with no opportunity to pursue cost relief for aggravated pre-existing conditions, who is now further restricted from obtaining cost relief  for concurrent conditions which lead to prolonged recovery periods.

Additionally, the WCB Board Members should place themselves in the role of a worker who suffers from any of these concurrent conditions and, as such, may be denied job opportunities because employers are trying to reduce their risk of WCB claim costs, increased WCB premiums and potential lost time claims.

The WCB welcomes and encourages input from workers, employers and other stakeholders to assist with their policy development and consultation process. Without understanding the full impact that proposed changes can have on workers, employers and the WCB system, it impossible for the WCB Board of Directors to make informed and responsible decisions regarding policy revisions. Comments and submissions regarding the proposed changes to Policy 04-02 and Policy 05-02 will be accepted until March 9, 2017 and it is important the WCB hear directly what effect the changes may have.

If you would like further information regarding the proposed changes to the WCB policies, how it may impact you or how to submit your comments to the WCB, you can reach us via email at [email protected], [email protected], contact us directly, during business hours, using our chat feature or by phone, at 1-844-377-9545 and you can always connect with us on Facebook Twitter , or LinkedIn.