Is there a time limit to request a review or an appeal?
Legislative changes on April 1, 2008 provide a worker or an employer with three years from the day of the decision to file a review or appeal.
How can my WSCC Case Manager make a decision that goes against what my doctor told me?
Did your doctor give the WSCC an opinion in writing? Did your doctor include what his or her opinion was based upon? Rarely will a Case Manager make a decision regarding a medical issue without first obtaining the opinion of a Board Medical Advisor. The Board Medical Advisor will review what your doctor wrote and inform the Case Manager what your doctor reported. The decision, however, is made by the Case Manager not the Board Medical Advisor. It is very important that your doctor include objective medical evidence in any report to the WSCC.
Why is my doctor’s opinion not good enough?
Medical decisions are based upon objective medical evidence. This means there must be proof of a problem. There are two kinds of proof: 1) clinical – your doctor can measure or test for it, and 2) diagnostic – it can be proven with tests such as an MRI, EMG, CT scan. When your doctor gives the WSCC their opinion of your condition, it will have greater meaning if they include objective medical evidence.
How can the WSCC determine that I am ready to return to work without their doctor even seeing me?
For many kinds of injuries such as soft tissue injuries, there is an established normal recovery period. If at the end of this period there is no new medical information supporting an extension, benefits will be terminated. For this reason, make sure you see your doctor regularly and that medical reports are sent to WSCC, as needed.
My WSCC pension is only a couple of hundred dollars a month. How does WSCC expect me to live on that when I can’t return to my old job?
Unlike most jurisdictions in Canada, the Workers’ Safety and Compensation Commission of the Northwest Territories and Nunavut’s practice is to base pension benefits on medical impairment, not loss of earning capacity. What this means is that a pension or permanent medical impairment (PMI) is presently calculated only on the physical or psychological damage and not the affect the injury has on your ability to work. If your injury stops you from returning to the kind of work you were doing at the time of your injury, the WSCC may be responsible for assisting you with finding another job or helping you develop new work skills.
How are my benefits calculated?
Total temporary disability (TTD) benefits are based on your income. If you are a salaried employee, your gross income is used as the starting point. The maximum income considered is known as year’s maximum insurable remuneration (YMIR). The YMIR is adjusted each year and is now about $90,600 (effective January 1, 2017). From this, your net income is determined by deducting income tax, CPP, and EI payments. Also considered is your Northern resident status.
If I also receive Canadian Pension Plan – Disability (CPP-D) benefits, will my WSCC benefits be affected?
For Nunavut and the Northwest Territories, your WSCC benefits are not affected if you also receive CPP-D benefits.
How do I find out what information WSCC has about my case?
You are entitled to a copy of your WSCC claim file at any time. Should you or your representative need a copy of your file, you must request it in writing. A form for requesting a copy of your file can be found at here . You are also entitled to ask for updates of any new information on your file. If you ask for any information the WSCC has already sent you, you will be asked to pay for the information.