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What to Expect

Entitlement

Who Is a Worker?

Only "workers" are entitled to receive compensation benefits. Others may purchase optional coverage.

The following people are workers, or have been deemed or designated by the YWCHSB to be workers:

• people who perform services for an employer under a contract of service, which can be express or implied. It means that there is a "master/servant" relationship between the worker and the employer;
• people doing mine rescue work after a catastrophe, if the work is authorized by the person in charge of a mine or of an authorized mine rescue crew;
• learners;
• registered apprentices in a recognized program;
• directors of corporations in the Yukon. Upon the application of a director, the YWCHSB may deem them not to be a worker;
• members of the Legislative Assembly;
• any person deemed by the board or by regulation to be a worker;
• members of a volunteer fire brigade or members of a volunteer ambulance brigade;
• people summoned to assist in controlling or extinguishing a fire by an authority empowered to do so;
• people who assist in any search and rescue operations at the request of and under the direction of a peace officer;
• people who assist in connection with an emergency that has been declared to exist by a mayor of a municipality or by the Commissioner in Executive Council;
• auxiliary members of a police force;
• people who are engaged in a work program or who are performing community service activities while serving a term of imprisonment in the Yukon, if the program or activity is conducted or designated by the Government of the Yukon;
• people who are engaged in a work program or who are performing community service activities as a requirement of their probation for an offense, if the program or activity is conducted or designated by the Government of the Yukon;
• Yukon College students receiving a training allowance from the Government of the Yukon to assist their attendance at Yukon College and who are engaged in a program of training in a work-place;
• students at a school other than a private school in the Yukon who are engaged in a program of training in a work-place;
• people who, with the consent of the Government of the Yukon, perform services on behalf of the Government as volunteers;
• people receiving disability insurance benefits, benefits under the Employment Insurance Act (Canada) in respect of unemployment caused by illness, assistance under the Social Assistance Act or services under the Rehabilitation Services Act, and who are engaged in a program of training in a work-place as directed by the Government of the Yukon.

The following people are not considered workers for the purpose of workers' compensation:

• an outworker - a person who repairs, cleans, or alters articles and materials on premises not controlled or managed by the person who gave the articles or materials;
• people employed on a casual basis, for purposes other than the employer's industry. Casual basis means employment that is irregular, unpredictable, sporadic and brief in nature;
• a person acting in a religious function as a duly ordained or appointed cleric, a member of a religious order or as a lay reader;
• a person working under a contract of service or apprenticeship outside the Yukon, who ordinarily resides outside the Yukon, and who is employed by an employer based outside the Yukon whose business in the Yukon is on a temporary basis (15 calendar days annually, or less);
• a sole proprietor - a self-employed person, or a partner in a partnership, who does not employ workers;
• some volunteers.

Optional coverage

Employers may purchase optional coverage for workers employed on a casual basis, otherwise than for the purposes of their industry, for outworkers, for people acting in a religious function as a duly ordained or appointed cleric, member of a religious order or as a lay reader, and for volunteers not already deemed to be workers.

Sole proprietors may purchase optional coverage for themselves.

Municipalities and First Nations may purchase optional coverage for their officials.

Who Is an Employee?

Under the Workers' Compensation Act (1992), an employer is any person, firm, association, organization or corporation who hires one or more workers in an industry. An industry is an establishment, an undertaking, a trade or a business that is carried on in the Yukon, except those that are excluded by regulation. At the moment, all are included.

Employers include the Government of the Yukon; the Government of Canada in cases where it submits to the Act¹; sole proprietors that the YWCHSB deems to be employers; a person who hires someone in their domestic service (unless it is on a casual basis); a trustee, receiver, liquidator, executor or administrator who carries on in an industry; and any other person that the YWCHSB deems to be an employer under the Workers' Compensation Act.

Under the Occupational Health and Safety Act, an employer is a person who employs at least one worker, or who contracts for the services of one or more workers. This definition includes contractors and subcontractors who undertake with owners, constructors, contractors or subcontractors to perform work or supply services.

¹Federal government employees are generally covered under the federal Government Employees Compensation Act, and claims from federal government employees in the Yukon who suffer a work-related disability are ordinarily handled by the Workers' Compensation Board of Alberta.

What Is a Disability?

In order to receive compensation, a worker must experience a work-related disability. The Workers' Compensation Act (1992) defines disability as a "work-related incapacity, as determined by the board, including post-traumatic stress, a permanent impairment, or a worker's death". A disability is the limiting, loss, or absence of the capacity of a worker to meet the demands of their work after a work-related injury, disease, post-traumatic stress. It can also be the death of a worker.

The YWCHSB uses the term "disability" in a more specific sense, when determining whether someone is eligible for loss of earnings reimbursement or retraining. If a work-related disability causes a worker to miss time from work, or to move to lower-paying work, they are eligible for loss of earnings benefits. "Disability" relates specifically to the worker's capacity to meet the demands of the job.

The YWCHSB uses the term "permanent impairment" when a worker's employment causes them to permanently lose or derange any body part, system or function. In this case, the worker is eligible for a permanent impairment award. The permanent award is based on the worker's age and on the degree of impairment as rated under the American Medical Association Guides. It is paid as a lump sum, or as an annuity.

In this context, a worker who is suffering from a disability may or may not have a permanent impairment; conversely, someone with a permanent impairment may not be suffering from a disability.

What Does "Work-related" Mean?

In order for a disease, injury or death to be compensable, it must be work-related. The Workers' Compensation Act (1992) defines "work-related" as "arising out of and in the course of employment". Whether an accident arose out of and in the course of employment determines whether the claim is accepted by the YWCHSB.

Section 5 of the Workers' Compensation Act (1992) directs the YWCHSB to presume that if a disability arose out of employment, then it also arose in the course of employment, and vice-versa. Therefore, the disability is considered work-related and the worker is compensated. However, if it is shown (not proven) with sufficient and reasonable evidence that the disability did not arise either out of employment, or in the course of employment, the disability is not considered work-related, and the worker is not entitled to compensation.

"Arising out of employment" means that a disability was caused by a worker's employment. It is linked to, originates from, or is the result of an activity or action undertaken because of the worker's employment.

"Arising in the course of employment" means that the disability is linked to the worker's employment in terms of time, place and activity. It is the direct result of an activity, action, procedure, or conduct undertaken during the worker's employment.

Rehabilitation

Overview

The purpose of rehabilitation is to help a worker overcome the effects of a work-related disability. It seeks to restore the worker's pre-disability level of personal, social, and economic functioning. This may be achieved through medical assistance, counseling assistance, job placement assistance, education, and training.

The disabled worker participates in making the rehabilitation plan. The program is sensitive to the worker's cultural background. Individual rehabilitation plans are periodically reviewed and may be adjusted. Workers must co-operate and actively participate in the rehabilitation process. Employers are also encouraged to be active participants.

Rehabilitation is not provided to a disabled worker who, in the opinion of the YWCHSB, is unlikely to benefit from rehabilitation.

Care Management

In 1996, the Claims Branch and Client Services Branch were amalgamated into a single, integrated service unit that reflects a new care management approach to improve the service to disabled workers. Each claimant is assigned to a team made up of an adjudicator and a rehabilitation counsellor. These individuals are jointly responsible for the care management of the worker.

The goal of care management is to minimize the social and economic costs of work injury. Studies show that the sooner injuries are reported and appropriate treatment and rehabilitation services are provided, the sooner injured workers are able to safely return to work. Care management combines the philosophy of early, pro-active intervention with a team approach to problem solving. The result is more efficient and effective claims handling. This reduces both the human and financial costs of workers' compensation claims.

Early Intervention

The early intervention philosophy recognizes the need to provide timely and effective medical and rehabilitation services. A comprehensive program may include treatment, exercise, education, and a step-by-step plan for returning to work. Early intervention also recognizes the importance of maintaining the employment relationship between a worker, who is off work due to a work-related accident and their employer. It emphasizes early cooperation among the various partners leading to the development of a successful return-to-work plan.

Team Approach

The key to successful care management is bringing the disabled worker together in a team with their employer, their union, board staff and members of the health care community. Within this framework, the adjudicator and rehabilitation counsellor work to promote effective communication and cooperation among the various team members. The objective is commitment to a plan that provides the right service at the right time, in a continuum that results in a quick and safe return to work.

Return-To-Work Programs

The Return-to-Work program is a beneficial, pro-active approach to returning disabled workers to a safe and productive work environment as soon as medically possible. It is designed to promote a worker's return to employability and ultimately, employment. It is a partnership involving workers, employers, health care providers and the YWCHSB. The goal is to minimize the impact of workplace injuries.

The principal goal of return-to-work programs is to rehabilitate workers so that they can safely return to work as soon as possible. A rehabilitation plan is developed with the worker to assist throughout the early return-to-work process or to assist the worker to become employable again.

The worker will preferably return to the same work with the same employer. If not, they may return to the same employer doing similar or new, suitable work. Otherwise, they may return to work for a different employer.

The program aims at preserving, as closely as possible, the worker's pre-disability earning capacity, at reducing the period of disability, at reducing or avoiding the negative effects of long term absences from work, and at retaining the employment skills of the worker. It also helps to maintain the worker's contact with their co-workers and employer, to improve the disabled worker's physical, social and psychological well-being, and assists the worker in maintaining dignity and self-esteem.

Different types of return-to-work programs exist:

• Graduated Return-To-Work
  This program allows the worker to return safely to work through a steady progression of hours and/or duties tailored to the needs of the worker. The worker's physical capabilities and psychological readiness to return to work are gradually improved. The program is also valuable in restoring a worker's job skills, and for ensuring that a worker can perform tasks without endangering their own safety or that of others.
  
  A graduated return-to-work program may be undertaken when a work-related disability prevents the worker from returning immediately to their pre-disability employment full-time, but the worker is able to return to work on a reduced basis.
  
  The YWCHSB and the employer share the cost of a graduated return-to-work program, either equally throughout the duration of the program, or on a descending/ascending scale. In the latter option, the YWCHSB pays the full cost during the first quarter of the program. During the second quarter, the employer contributes 25% of the worker's loss of earnings. In the third quarter, the YWCHSB and the employer each pay 50%. For the last quarter, the employer pays 75% of the worker's loss of earnings. The maximum duration of the program is eight weeks.
• Modified Work
  Modified work is the modification of a job, task, function or combination of tasks or functions, and the alteration in duties, hours or expectations related to a job so that a worker may reasonably be able to perform the work.
• Trial Work
  Trial work is a trial placement of a worker with an employer to test and assess a worker's functional capabilities in a job setting.
• Work Site Modification
  Work site modification is the alteration made to a work site, job, or tasks to accommodate a worker's abilities and/or functional limitations after the work-related disability.
• Transfer To An Alternate Job
  This program transfers the worker to a different job that is more appropriate to the worker's physical and psychological capabilities, skills, and aptitudes.
• On-The-Job Skill Development for Alternate Work
  On-the-job training aims at enhancing the worker's skills through employment in an alternate job. There are several advantages to this program, including that the worker's educational status is generally not important; their present skills can be utilized and upgraded; the worker usually gets a current rate for the job because the employer shares the cost with the YWCHSB, and possibly with other agencies; and the employer is able to train the worker to their specifications.

Re-Employment Assistance Allowance

The purpose of this allowance is to help workers support themselves and their dependents until they are able to establish themselves working, after a period of temporary disability.

The worker has to provide statements of monthly living expenses and income, a list of contacts made by the worker while job searching, and job referrals. The worker is expected to apply for Employment Insurance benefits if they are eligible. EI benefits are considered when calculating the amount of the allowance.