The claims process

When there's been a work-related injury or illness, as a worker, you can help speed your recovery by staying at work and doing modified duties where possible. Medical literature shows that staying at work is one of the most important factors for overall health.

We have a basic process for most claims. These are the steps for workers.

File a claim

Once we receive a Worker's Report of Injury/Illness, we gather information from you, the employer and the health care provider. We can usually provide a decision on whether a claim is accepted within an average of 14 days. We may need more time for some claims.

Receive benefits and services for accepted claims

Once a claim is accepted, we let you know about the benefits and services you will receive. The services help you recover and safely resume usual job duties.

You are entitled to receive health care assistance in the form of services, devices or equipment that provide relief from the injuries, as approved by us. This includes health care services, hospital expenses, medication and aids to independent living.

If you require treatment in another province we will pay for travel costs to attend treatment.

If you are unable to work or participate in modified work duties as a result of the work-related injury, you are entitled to loss of earnings benefits.

We will cover your earnings for the days you would have worked had you not been injured. We will pay loss of earnings benefits based on your average weekly earnings at the time of the injury.  Benefits are calculated based on 75 percent of your gross average weekly earnings at the time of the injury, up to the maximum wage rate.

Loss of earnings benefits are not taxed. However, you must report your benefits to the Canada Revenue Agency. We’ll issue you a statement of benefits paid on a T5 form every year in February.

You may also be entitled to a permanent impairment award for your injury as well as an annuity if you meet certain conditions set out in the legislation. These benefits will be explained to you by your case manager.

Recover and return to work

We share with you the goal of getting you back to your pre-injury duties at work. All of our assistance supports the strong medical connection between recovery and work. See our Return-to-Work Guide for Employers.

It's important to follow up with your health care providers, and with us, if your condition doesn’t resolve or you are concerned you may miss time from work.

You must actively seek to recover. Return-to-work services will work with you to help get you back to work. A case management team (you, your employer, health care providers) will work collaboratively with you to get you back to work as soon and safely as possibility to prevent long term disability. Case management involves early intervention, ongoing communication and a team approach.

You must co-operate and participate in all required treatment and actively seek to improve your health.

You may choose your own physician, however, other health care providers (such as psychiatrists, psychologists, physiotherapists, chiropractors) must be licensed and have an agreement with us before we approve them. While you’re receiving compensation, you may not unreasonably change your health care providers.

Appealing a decision made on your claim

If you are not satisfied or disagree with a decision made about your injury or claim, you have the right to appeal the decision.

Your employer also has the right to appeal a decision made on your claim.

You have 24 months from the date of the decision made to appeal the decision to an internal hearing officer who will review the issue. See Appeal a claims decision.

If you are still not satisfied or disagree with the hearing officer’s decision you have the right to appeal the hearing officer’s decision to the Workers’ Compensation Appeal Tribunal, an independent tribunal.

You have 24 months from the date of the hearing officer’s decision to file an appeal with the tribunal. See the Workers’ Compensation Appeal Tribunal website for further information on how to appeal.

Access to claim file information

Your claim file contains a lot of information about you that informs decisions about your claim—from determining entitlement and benefits to assessing medical conditions, treatment, fitness for employment and rehabilitation.

You are entitled to see your file. As well, your employer is entitled to see information that is relevant to an issue which is the subject of a review or an appeal.

If your employer has made a request to access relevant information from your claim file relating to a review or appeal of a decision, you have 14 days to respond or object to the relevancy of the information. If there is a dispute about the relevancy of the information, the President of the Yukon Workers' Compensation Health and Safety Board will determine what information is relevant to the issue on review or appeal, which can be further appealed to the appeal tribunal.

For access requests, please submit a Request for Disclosure form. Once the disclosure is prepared, you may come down to our offices and view the file under supervision. Or we can provide a copy. There is no charge for the first copy. After that, we charge a photocopying fee of $0.25 per page or $50 to copy the file.