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WCB

WCB PHYSICALTHERAPY PATIENT INFORMATIONWCB

Capilano Rehab Centre provides Physical Therapy Services to workers who are injured on the job. We work hard to get rid of your pain fast and help you return to work as soon as it is safely possible.

Capilano is proud to be a contracted Provider of Physical Therapy Services to injured Workers under the Workers Compensation Board Act (WCB) of Alberta.

REPORT YOUR WORKPLACE INJURY

If you have been injured at work or discover that you are suffering a work related injury, you must report it to your employer immediately and to The Workers Compensation Board (WCB). WCB advises the following:

1) Tell your employer the details of your injury. Your employer must report your injury to WCB within 72 hours if:
a. You need medical treatment beyond first aid
b. You cannot do your job beyond the day of accident
2) Tell your health care provider. Your health care provider must report your injury to WCB-Alberta within 48 hours.
3) Tell WCB and send your report of injury form to WCB right away. You can get forms from your employer.

To summarize: If you were injured at work, it is your responsibility to notify your employer, our reception staff, and your attending physiotherapist. In addition, you must contact WCB so that a claim number can be assigned to you and forwarded to Capilano Rehab Centre. Failure to follow the reporting guidelines may result in a delay in treatment authorization from a WCB adjudicator and a WCB denial of your claim.

THE WCB CLAIM PROCESS

Once WCB-Alberta has received your injury report(s), a claim file is started and reviewed by an adjudicator. The WCB adjudicator determines if the claim meets legislation and, if so, accepts the claim. The adjudicator may contact you if more information is required to reach a decision.

Whether or not a WCB adjudicator approves your claim the initial assessment to Capilano Rehab Centre will be covered by WCB, but WCB will need to review the file/claim prior to approval. If you continue to come for treatment while waiting on WCB’s decision and WCB denies your claim, any and all visits you attended for after the initial visit will be your responsibility to pay.

If your claim is denied you have the right to appeal your decision. If you continue to come for treatment after your claim has been denied, you will be responsible to pay Capilano Rehab Centre for all visits attended after the initial assessment.

You will be responsible to pay Capilano for any and all treatment costs incurred not approved and/or covered by the WCB.

WHEN DOES PHYSIO TREATMENT START?

Once your initial assessment has been completed, Capilano Rehab Centre staff submits a report to WCB. It is up to a WCB adjudicator whether or not your claim is approved or denied. Capilano Rehab does not adjudicate claims.

If WCB does not immediately approve your claim, your approved treatment time still starts at the first assessment, and NOT when WCB approves your claim.

WHAT ARE THE TYPICAL TREATMENT PARAMETERS

Capilano does not and cannot adjust the WCB treatment parameters. These are set by the WCB. Here are some current guidelines:

Sprains & Strains
For sprain or strain injuries, you are eligible for six (6) consecutive weeks or twenty one (21) visits at a maximum of three (3) visits per week. If you miss any appointments, those visits cannot be added to the end of your 6 week time period. It is either 6 weeks or 21 visits; you may not go over either one. You may only attend once per day.

Post-Surgery
For post-surgical Physical Therapy, you are eligible for a pre-set number of visits for your specific procedure over a pre-set time frame as established by WCB. The Capilano Rehab Admin Staff will advise you of your pre-set limits.

PATIENT RESPONSIBILITIES

It is your responsibility to attend the 3 (or other) visits per week as recommended by your attending physical therapist. Failure to attend the recommended booked appointments may result in the discontinuation of your claim by the WCB. WCB will not allow for treatments to be added to your treatment program to make up for missed appointments. Please be aware that Capilano Rehab Centre is required by law to notify WCB if you miss three (3) or more appointments.

INFORMATION ON HOT PACKS, COLD PACKS, AND HOME EXERCISE EQUIPMENT

For Workers being treated under WCB, Capilano Rehab Centre is able to provide Workers with certain pre-authorized homecare and exercise supplies, including hot packs, cold packs, exercise balls, and so forth. Ask your Capilano Physiotherapist whether these items will benefit your recovery. There is no charge to the Worker for this pre-approved equipment.

APPEALING A WBC DECISION

The Office of the Appeals Advisor (OAA) was formally established by the Workers’ Compensation Board of Alberta in 1992 to provide independent advice, assistance and advocacy services to injured workers, and their dependants, with respect to Workers’ Compensation entitlements in Alberta. As specialists in interpreting and applying the Workers’ Compensation Act and WCB policies, the OAA works independently within WCB to:

• advise injured workers whether or not they have grounds to seek a review of a WCB decision,
• suggest alternatives to filing a review or appeal,
• represent injured workers at any formal hearings on unresolved issues.

The OAA’s primary focus is on resolution prior to proceeding with a formal review or appeal. If a resolution cannot be made at an internal review level, the OAA will initiate a request for review on a client’s behalf and act as the worker’s representative throughout the review process: before the WCB, the Dispute and Decision Review Body and to the Appeals Commission.

You can contact an Edmonton Appeals Advisor via phone: 780-498-8640 or E-mail: appealsadvisor@workeradvocates.ca to assist you in your appeal.
(The above appeal information was gathered from http://www.wcb.ab.ca/)