FAQs
What is the Workers’ Advisor Office?
The Workers’ Advisor Office (WAO) is established in the Workers’ Compensation Act to help Workers and their families navigate the Workers Compensation system. We are able to provide advice and represent workers in reviews or appeals (where there is merit).
We are separate and independent from WSCC and able to help you better understand how the system works.
If you are interested in our assistance, please contact our office and we can set up a meeting.
If I disagree with a WSCC decision, what do I do?
Typically, WSCC would advise that you if disagree with a decision, your next course of action would be a review, but depending on the decision, that may not be your best step forward.
A decision letter should contain the reasons for the decision. If further information is needed for WSCC to consider what is being asked, then your best option may be to address the gaps identified in the letter. In many circumstances, it may be beneficial to bring the decision letter to a medical professional to see if they are able to offer further clarification. With new evidence, WSCC may be able to reconsider any previous decision.
If you feel that all the information needed for a decision is already in your WSCC file, then it may be appropriate to proceed with a review. Information for the review process can be found there.
If you are interested in working with the WAO for your review or appeal, we would need time to read through your claim and assess whether there is merit to pursue a review or appeal. Please contact our office to set up an appointment to discuss further.
Is there a time limit to request a review or an appeal?
A worker or an employer would have three years from the day of the decision to file a review or appeal.
What is the difference between a review and an appeal?
A review is the first level of appeal. The Review Committee is a committee internal to the WSCC that can hear your concerns and then can maintain, reverse, or change your case manager’s decision. A review can take some time so before pursuing a review, you will want to ensure that all the relevant information is in your WSCC file.
If you have gone through the Review Committee process and disagree with the Review Committee’s decision, you can escalate to the Northwest Territories & Nunavut Workers’ Compensation Appeals Tribunal. They are the second and final level of appeal in the WSCC system. The Appeals Tribunal is independent and is not part of the WSCC, and they can maintain, reverse, or change the Review Committee’s decision.
If you are interested in knowing more, there is information on the WSCC website here or you can contact our office to set up a meeting.
I want to legally challenge a WSCC Decision in court. Can I do that?
Currently in legislation, there is no judicial review for WSCC and Appeal Tribunal Decisions – meaning that most decisions cannot be challenged in court. This clause prevents courts from re-examining the merits of the decision, limiting challenges to where there has been a denial of natural justice or an excess of jurisdiction.
If you are considering your legal options, we recommend speaking to a lawyer who is licenced to practice in the NWT or Nunavut.
The WAO does not provide legal advice.
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.
The form for requesting a copy of your file can be found at here (Request for Disclosure).
Once filled out, this form would be returned to your Case Manager and WSCC will email a link where you can access a PDF copy of your disclosure. This link is temporary, so workers are encouraged to download their file.
The PDF will not be updated once sent, so if you require new information, you will need to ask your case manager for an update.
How are my benefits calculated?
The WSCC determines a worker’s annual remuneration as the amount the worker would earn in that calendar year if their work-related injury or disease did not occur.
The WSCC includes all the worker’s income earned through the performance of their work. Generally, this includes the worker’s regular salary or wages including, but not limited to:
- salaries, or basic hourly, weekly, bi-weekly, or monthly wages
- regular overtime
- cost of living allowance, such as northern living allowance
- payment for shift differentials, commissions, bonuses, and tips
- the dollar value of board and lodging, store certificates, or credits
- any other taxable remuneration in kind or substitute for money provided to the worker which, the claim owner determines should be included in the worker’s annual remuneration.
In general, taxable benefits are considered income for the purpose of determining or estimating annual remuneration, whereas non-monetary taxable benefits and non-taxable benefits, allowances, or reimbursements are not. A worker’s annual remuneration does not include the value of the reimbursement for clothing, materials, transportation, board or lodging provided to the worker, either in-kind or monetary, due to the remote nature or location of their employment.
A worker’s annual remuneration cannot exceed the Year’s Maximum Insurable Remuneration (YMIR) for the year of their injury. The YMIR is adjusted each year and the table for the current YMIR can be found here.
From a worker’s annual remuneration, their net income is determined by deducting income tax, CPP, and EI payments.
The WSCC determines Total Disability (TD) compensation by multiplying the worker’s Net Monthly Remuneration by 90%.
WSCC can also consider Partial Disability (PD) compensation when a worker returns to work but is not able to work regular, full-time hours. The WSCC determines PD compensation by multiplying the worker’s TD compensation by the worker’s loss of earnings percentage.
Policy 03.07 Calculation of Disability Compensation has further information regarding the calculation of wage loss compensation. The WSCC Policy Manual can be found here.
WSCC doesn’t seem to be listening to my doctors, what can I do?
Your WSCC case manger will base their decisions on objective medical information. If you feel that there is a disconnect between what your doctor is advising and what WSCC is approving, bring the WSCC decision to your doctor and ask them to provide clarification where possible. If your doctor is making recommendations related to your workplace incident, sometimes it helps if they explicitly reference the incident so that it is clear to WSCC that the recommendations are related to the WSCC claim. With new information, your case manager may be able to reconsider their previous decision.
My doctor said they need a WSCC Form, where do I find those?
WSCC is able to make decisions based on information that is sent in from your doctor.
The information can be in the form of chart notes, which are a chronological, detailed records of a patient’s encounter in healthcare, documenting subjective feelings, objective findings (vitals, exam), assessments (diagnoses), and treatment plans or they can use the specific WSCC forms found here.
Your case manager would be able to consider anything sent in from your doctor, as long as the information being sent back to WSCC is clear on how your current condition and doctors’ recommendations are related to your workplace injury.
How can the WSCC determine that I am ready to return to work without their doctor even seeing me?
For many kinds of injuries, there is an established normal recovery period. If at the end of this period there is no new medical information supporting an extension is needed or that your injury is preventing you from returning to any form of work, WSCC will move forward with a return to work. For this reason, make sure you see your doctor regularly and that medical reports are sent to WSCC, as needed.
What is Vocational Rehabilitation (VR)?
VR services and programs are offered to workers where a work-related disability or permanent impairment prevents the worker from returning to their pre-injury work or to employment comparable to their pre-injury work, but indication of regaining employability with vocational rehabilitation is strong. Vocational rehabilitation is also offered where the employer has not developed a return-to-work plan.
The goal of VR is to assist workers to regain employability and/or become employed, but VR does not guarantee employment.
The WSCC Case Manager, worker, and VR counsellor work together to determine the VR programs best suited to the worker. Possible programs include Job Search, where WSCC would sponsor the worker to apply for jobs for a maximum of 13- weeks, On the Job Training or Academic Programs/ Upgrading.
If you have questions about VR, please contact our office or your case manager to discuss further.
What is a WSCC Pension?
When a workplace injury is deemed to be permanent, a worker may be eligible for a WSCC Pension..
A WSCC Pension is not like a traditional workplace pension and is more of an impairment benefit. It is recognition that you have a permanent injury resulting from your WSCC compensable claim./p>
A WSCC Pension will represent a fraction of your TD payments and is typically not meant to be a livable wage.
My WSCC Pension is not a livable wage, what should I do?
There are provisions within policy where WSCC may pay an injured worker additional compensation if the WSCC determines the Basic Pension Benefit is significantly inadequate because:
- the worker’s injury or disease results in a loss of earning capacity that is greater than the permanent impairment compensation the worker is entitled to; or
- the worker’s Net Annual Remuneration before their injury did not fairly represent the worker’s probable earning capacity.
The is called Additional Compensation – and a worker would need to request this with their Case Manager. The request would need to be approved by the Vice President WSCC Northwest Territories. Each case will be judged on its own merits and justice.
If you are interested in knowing more about this, please contact our office or have this conversation with your case manager.
Even with Additional Compensation, you may want to explore supports outside of WSCC to ensure that you have a livable wage. Canada.ca has a benefits finder that is helpful for finding federal and territorial/provincial programs that workers may be eligible for. If you are interested, you can access the benefits finder here.
I think my Permanent Medical Impairment (PMI) rating is wrong, what do I do?
When WSCC is assessing a PMI rating, they are strictly looking at the injury that is officially accepted on your claim.
A PMI rating is done according to the American Medical Associations Guide to the Evaluation of Permanent Impairment (AMA Guide), and this is meant to provide a reliable, repeatable measurement framework for permanent impairment. Any doctor certified to do this assessment should come to the same percentage with the same medical information for the same compensable injury.
If you think WSCC erred in your percentage, bring this information to your medical professional and see if they are able to weigh in. If there is more information, WSCC may be able to reassess your PMI rating.
It is also important to remember that WSCC is strictly looking at your accepted injuries – so if you feel your rating should include secondary injuries that aren’t currently officially accepted as part of your claim, these will need to be officially added to your claim before they can be considered for a PMI.
If you are looking to have secondary injuries added to your claim, please contact our office to chat about this further.
What happens if I am not able to return to any form of work?
Currently, once a workplace injury is considered permanent and further treatment would be unlikely to improve a worker’s condition, WSCC’s obligation to provide wage loss compensation would end. If a worker is not able to work in any capacity, then it would be unlikely the worker would qualify for Vocational Rehabilitation and a WSCC Pension may only represent a fraction of a livable wage.
If you are not able to return to any form of work, you may need to look at financial supports outside of WSCC to cobble together a livable wage.
Canada.ca has a benefits finder that is helpful for finding federal and territorial/provincial programs that workers may be eligible for. If you are interested, you can access the benefits finder here.
Can I receive other income at the same time as I am receiving WSCC benefits?
While you are receiving Total Disability (TD) payments with WSCC, you cannot collect income from other sources. If you are receiving income from other employers or from government programs, you will need to inform your case manager so they can adjust your WSCC benefits accordingly.
If you are receiving income from outside sources and WSCC at the same time, you may be in an overpayment situation and need to repay benefits to WSCC.
If you are receiving a WSCC Pension, then you are able to collect income from other sources.
Policies can change, so it is always best to inform your case manager if you are receiving income from other sources so that you can avoid possible overpayments.
I have concerns about the amount of time a decision is taking, what can I do?
If you have concerns about timelines, you can definitely ask your case manager to provide anupdate. There are many reasons why there may be a delay and your case manager should beable to provide information on where your file is in the system.
If your case manager is not able to provide clarification or you are not able to reach them, youcan escalate your concern to their supervisor. Your case manager would be able to give you the contact information for their supervisor, or you can access the WSCC Staff Directory here. The WSCC Case Management team is located in the Claim Services tab. The supervisors and managers are clearly indicated for both the NWT and Nunavut.
When an injury is permanent and a file is being transferred to the Pension Department, this can take some time and can often pose a financial hardship on workers who are reliant on WSCC for their income. If you find yourself in this position, we recommend looking at supports outside of WSCC to help cobble together a livable wage. You can find the Canada.ca Benefits Finder here.