REPORT YOUR INJURIES
Far too many\workers are needlessly injured. Injuries
and illnesses are preventable.
Workplaces that take their health and safety duties seriously will want to
identify situations that can result in injuries or illness and eliminate them
immediately so that no one else is hurt. This is why ensuring your
supervisor or employer knows you've been injured is important. What
they know about, they can fix. A scrape caused by a malfunctioning
machine today may result in a far more serious injury to someone else
tomorrow if adjustments to correct the problem aren't made
• No fault insurance
• Protection is provided for you and your employer
regardless of who caused the work injury. The
workers’ compensation system is funded through
the payment of premiums by employers with
• Most employers and workers are covered by
WCB; however, some industries are not required
to have this coverage. If you are unsure whether
you have WCB coverage, ask your employer.
• Seek proper first aid no matter the injury
Importance of Prevention and Reporting
• What is a near miss?
• Why record a near miss?
• When should incidents be reported to WCB?
• When should incident be reported to WS&H?
• How soon should injuries be reported to WCB?
• Whose responsibility is it to report an injury to
If You Are Hurt at Work What Do You
• REPORT THE INJURY RIGHT AWAY!
• The sooner you are able to get medical attention the better off you will be.
• It is important that your supervisor is aware of injuries that require
medical treatment as well has injuries that don’t so that improvements or
prevention measures can take place.
• When you attend the doctor tell them that it is work related and also
speak to the doctor about work capabilities.
• Claims are started by 3 potential sources 1) the worker 2) the employer 3)
What is Disability Management?
• Proactive formal workplace approach to
helping injured workers return to safe and
productive work as soon as physically possible.
• Disability management programs take place in
RTW is Good For Workers
• Maintains employment
– Maintain social ties to the workplace
– Keep up to date with co-workers and other workplace changes
– Keep work skills current and up to date
– Protects the resume
– Maintain regular rate of pay and continue earning salary and vacation
– Ensures consistent income flow
– Keeps EI and CPP contributions current and up to date
– Uninterrupted medical/dental coverage
RTW is Good For Workers
– RTW is part of the recovery process
– RTW programs assist with physical reconditioning
– Relationships with family and friends
– Reduces possibility of developing secondary condition such as depression
– Maintain normal routine of daily living
– Less uncertainty for the future
– Keep the focus on rehabilitation not future employment status
– Maintain personal relationships
– Maintain workplace relationships
– Minimizes FEAR
RTW is Good For Management
• Labour relations- Successful disability management programs build trust between workers,
unions, and management.
• Financial- Minimize WCB claim costs
– Rate/premium implications
• Maintain productivity
• Corporate image
• Recruitment of new workers
• Reduce costs associated with training and recruiting replacement staff.
• Keep experienced/knowledgeable staff in the workplace.
• Legal obligations
– Human Rights Legislation
– Duty to Accommodate
– WCB Re-employment obligations
RTW is Good For Unions
• Preserves jobs, seniority, and contributions to company
benefit/pension plans for union members.
• Increased awareness that union is there to protect worker’s interests
• Promotes co-operative labour management relationships.
• Legal obligations
– Human Rights Legislation
– Duty to accommodate
– Re-employment obligations
Make sure you have filed the WCB
• The Association of Workers' Compensation Boards of Canada
(AWCBC) publish accepted time-loss injuries and fatality reports
under the National Work Injuries Statistics Program (NWISP)
according to the following categories:
• Nature of Injury (the type of injury or disease)
• Part of Body affected by the injury or disease
• Source of the Injury (immediate cause of the injury)
• Event (type of accident resulting in the injury, for example, "fall")
• Industry in which worker was employed at time of the accident
• Occupation of the injured or ill worker
• Province or Territory in which the injury, disease or fatality occurred
• Gender (sex) and Age (in age groups)
• It is important to remember that these reports do not
include all workplace injuries: they only include
accepted time-loss injuries. The AWCBC defines a time-
loss injury as "an injury for which a worker is
compensated for a loss of wages following a work-
related accident (or exposure to a noxious chemical) or
receives compensation for a permanent disability with
or without time lost in his or her employment". An
example of the latter kind of time-loss injury is a
worker who receives compensation for a loss of
hearing caused by excessive workplace noise even
though the worker may have not missed any time from
work because of this injury.
• To be included in the statistical report, the injury must have been
accepted by a workers' compensation board or commission. This
means that cases not accepted by a workers' compensation agency
would not be included in the reports. Other examples of excluded
• injuries that were never reported to the WCB (e.g. the injury was
considered minor or "first aid" only, etc),
• injuries among some work groups that are not covered by WCB
(such as the self-employed),
• incident rates (e.g., number of time-loss injuries per 100 workers),
• costs of accidents, or
• amount of time lost.
We all need to Understand what is
• Risk Management:
– Understand methods for WC risk management:
• Risk avoidance.
• Risk financing.
• Loss prevention.
• Loss reduction.
Date of Injury is IMPORTANT
Date of Injury The worker’s fitness level Required Accommodation
Factors that influence the employer’s
Date of Injury = Date the Worker is Unable to Work
For re-employment purposes, date of injury is the first date the worker is unable to work at their
WCB Services at a Glance
$ out to
Assessment Rehabilitation and
$ in to
Fit for Essential Duties
Can I go back safely
When a worker is able to perform the essential duties
of the pre-injury job, the employer is required to:
– Offer to re-employ the worker in the position held on the
date of injury
– Provide alternative employment similar to and at earnings
comparable to the employment on the date of injury.
Your protection if you file properly
• The Act sets out responsibilities with respect
to such things as:
– Determining compensation for workers and
– Funding the system - assessment of employers
– Health and safety
• The legislation is established by the Provincial
or State Government
First Report of Occupational Injury or Disease
1. WCB FILE NUMBER (if known):
EMPLOYER’S FIRST REPORT OF OCCUPATIONAL INJURY OR DISEASE
• With in 72 hrs
1a. OSHA 300 CASE NUMBER (if applicable):
REASON FOR REPORT (check all that apply)
2a. LOST TIME - ONE OR MORE DAYS 2b. WAS EMPLOYEE PAID FOR ½ DAY OR MORE ON DAY OF INJURY? YES NO
3. LOST EARNINGS BUT NO LOST TIME 4. MEDICAL/HEALTH CARE 5. FATALITY DATE OF DEATH: _____/_____/_____
MM DD YYYY
6a. OCCUPATIONAL DISEASE 6b. DATE OF LAST EXPOSURE: _____/_____/_____ 6c. DATE OF DIAGNOSIS AS OCCUPATIONALLY RELATED: ____/_____/_____
MM DD YYYY MM DD
of the incident
7a. CORRECT PRIOR REPORT 7b. DATE OF CORRECTION: _____/_____/_____ 7c. DATE CORRECTION SENT TO WCB: _____/_____/_____
MM DD YYYY MM DD YYYY
8. STATE EMPLOYER UNEMPLOYMENT 9. FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN): 10. EMPLOYER NAME:
INSURANCE ACCOUNT NUMBER (UIAN):
• A Worker and
11. STREET/P.O BOX MAILING ADDRESS: 12. CITY: 13. STATE: 14. ZIP: 15. TELEPHONE NUMBER:
16. PRIMARY BUSINESS PERFORMED BY 17. EMPLOYER LOCATION IF DIFFERENT FROM 18. DID INJURY OR EXPOSURE OCCUR ON EMPLOYER’S PREMISES? YES NO
EMPLOYER WHERE INJURY OCCURRED: MAILING ADDRESS: IF NO, THEN GIVE NAME AND PHYSICAL ADDRESS OF THE EMPLOYER WHERE THE EMPLOYEE
WAS INJURED OR EXPOSED:
(check one) INSURER THIRD PARTY ADMINISTRATOR (TPA) SELF-ADMINISTERED EMPLOYER
19. INSURANCE / TPA COMPANY NAME: 20. POLICY NUMBER: 21. INSURER FILE NUMBER:
22. STREET/P.O. BOX MAILING ADDRESS: 23. CITY: 24. STATE: 25. ZIP: 26. TELEPHONE NUMBER:
report must be
27. LAST NAME: 28. FIRST NAME: 29. MI: 30. TELEPHONE NUMBER: 31. SOCIAL SECURITY NUMBER: 32. GENDER:
( ) MALE FEMALE
33. STREET/P.O. BOX MAILING ADDRESS: 34. CITY: 35. STATE: 36. ZIP: 37. DATE OF BIRTH:
filed with the
MM DD YYYY
38. OCCUPATION/JOB TITLE: 39. DATE OF HIRE: 40. WEEKLY WAGE AT TIME OF INJURY: 41. DOES EMPLOYEE WORK FOR ANOTHER EMPLOYER?
YES NO IF YES, GIVE NAME AND ADDRESS:
MM DD YYYY
42. DATE OF INJURY OR ILLNESS: 43. DATE OF INCAPACITY: 44. TIME EMPLOYEE BEGAN WORK 45. DATE EMPLOYER NOTIFIED INSURER/TPA:
(e.g. 7:30 a.m.):
_____/_____/_____ _____/_____/_____ _____/_____/_____
MM DD YYYY MM DD YYYY MM DD YYYY
46. TIME OF INJURY (e.g. 1:10 p.m.): 47. HAS EMPLOYEE RETURNED TO WORK? YES NO
DATE EMPLOYER NOTIFIED: DATE EMPLOYER NOTIFIED:
IF YES, GIVE DATE: _____/_____/_____
_____/_____/_____ _____/_____/_____ MM DD YYYY
MM DD YYYY MM DD YYYY
48. SPECIFIC INJURY OR ILLNESS 49. BODY PART(s) AFFECTED (e.g. lower right forearm): 50. ALL EQUIPMENT, MATERIALS, OR CHEMICALS EMPLOYEE WAS
(e.g. second degree burn or toxic hepatitis): USING WHEN THE EVENT OCCURRED (e.g. acetylene torch, metal plate):
51. SPECIFY ACTIVITY THE EMPLOYEE WAS ENGAGED IN WHEN THE EVENT 52. HOW INJURY OR ILLNESS OCCURRED. DESCRIBE THE SEQUENCE OF EVENTS AND INCLUDE ANY OBJECTS OR
OCCURRED (e.g. cutting metal plate for flooring.): SUBSTANCES THAT DIRECTLY INJURED OR MADE THE EMPLOYEE ILL. (e.g. worker stepped back to inspect work and
slipped on some scrap metal. As worker fell, worker brushed against hot metal.):
WAS ACTIVITY PART OF NORMAL JOB DUTIES? YES NO
53. HOSPITALIZED OVERNIGHT AS INPATIENT? 55.
54. WAS THE EMPLOYEE TREATED HEALTH CARE PROVICER NAME: 56. MAILING ADDRESS: 57. TELEPHONE NUMBER:
YES NO IN AN EMERGENCY ROOM? ( )
58. PREPARER NAME AND TITLE (TYPE OR PRINT): 59. TELEPHONE NUMBER: 60. DATE SENT TO WCB:
( ) _____/_____/_____
MM DD YYYY
WCB-1 (01/02) The State of Maine does not discriminate on the basis of disability in admission to, access to, or operation of its programs, services or activities. This material can be made available in alternate formats by
contacting your Department ADA Coordinator.
DISTRIBUTION: COPY (1) MAINE WORKERS’ COMPENSATION BOARD, 27 STATE HOUSE STATION, AUGUSTA, MAINE 04333-0027, (2) EMPLOYEE, (3) INSURER, (4) EMPLOYER.
They work for you when your
injured and can not
• Ensure that policy appropriately guide the
provision of health care benefits and services.
• Resolve disputes regarding the provision of
health care benefits and services which result
in client dissatisfaction, reviews and appeals.
• Provide appropriate benefits and services to
the most seriously injured to alleviate the
effects of the injury and improve their quality
Protection of Information
and Personal Privacy
Your medical information and items are
protected from those you don’t want to share
Your assigned a Case Managers
• Project Manager
Cost-effective Return-to-work Services
The WCB will consult with the worker to jointly develop an appropriate
and cost-effective return-to-work plan that is consistent with the
worker's abilities, skills, and potential. The return-to-work plan is
considered appropriate if the worker has a reasonable probability of
successfully achieving the vocational goal.
• In most cases, the WCB determines cost-effectiveness by
• a) the total estimated costs of required vocational services
• b) the remaining compensation benefits that the worker is entitled
• c) the estimated cost of alternative return-to-work plans, and
• d) the estimated benefit costs if no return-to-work services are
What do we need from you?
• Plan on how to get workers back to pre-injury
job or to alternate work.
• Need to know the following:
– What are their main barriers to a full return to
– How do we remove these barriers?
– What are the workers’ limitations & restrictions?
– What is the prognosis?
– How long will they require treatment?
We are committed to fairness
• We protect employers and workers from the uncertainty, cost and
delays of legal action by providing no-fault coverage.
• We compensate injured workers for lost employment income.
• We cover the cost of health care and other costs associated with a
work-related injury or illness.
• We add stability to the compensation system through the balanced
application of the Workers’ Compensation Act.
We focus on return to work
• We support workers’ safe return to work through case plans that
set clear goals.
• We help employers bring their workers back to work through strong
disability management and modified work programs.
No false statements please
• Protecting the workers' compensation system
• WCB is committed to deterring, detecting and prosecuting
those who abuse the funds held in trust for workers and
employers. While fraud is a rare occurrence, it is possible.
• What constitutes fraud?
• falsely reporting an accident as one that occurred at work
• falsely reporting your income when filing a claim with WCB
• not informing WCB once you have returned to work or are
able to return to work and continuing to accept wage
replacement benefits thereafter
• In simplest terms, abuse occurs when an individual is
intentionally dishonest in order to obtain money, goods or
services to which he or she is not entitled.
• Now that you have successfully filed your WCB
Report – we too need a little help
• PLEASE FILL OUT THE COMPANY INCIDENT
REPORT AND FILE A COPY WITH YOUR
SUPERVISOR AND SAFETY