The purpose of this policy is to:
This policy applies to all injured workers who:
When workers are injured in an accident arising out of and in the course of employment, WorkSafeNB may provide benefits, such as medical aid, loss of earnings, and return to work services, as required.
WorkSafeNB is required by legislation to determine the necessity, character, and sufficiency of medical aid to be provided to injured workers. This means that WorkSafeNB determines the:
WorkSafeNB may also provide injured workers with rehabilitation to lessen or remove barriers resulting from the injury that may limit opportunities for injured workers to return to work. In providing rehabilitation, WorkSafeNB may take measures and make expenditures it determines necessary to help an injured worker return to work.
WorkSafeNB’s commitment to providing the right care, by the right provider, and at the right cost is outlined in Policy 25-001 Medical Aid - Principles. These principles, and related policies and standards, guide staff and health care providers in the management of compensable injuries according to best practices.
Workers who suffer a workplace accident or disease also suffer from acute pain resulting directly from the injury. During the early stages of rehabilitation, this pain is expected and is a normal and healthy response to the healing of that injury. As rehabilitation progresses, the worker’s pain should improve.
WorkSafeNB recognizes that despite its best efforts to prevent chronic pain, acute pain may sometimes develop into chronic pain. In some cases, chronic pain is diagnosed when an injured worker’s recovery exceeds the usual healing time for the compensable injury. When this occurs, the chronic pain is regarded as a complication of the compensable injury and WorkSafeNB manages it accordingly.
WorkSafeNB considers chronic pain to be a treatable condition and believes that most injured workers with chronic pain can be rehabilitated.
2.0 Applying for Benefits
WorkSafeNB adjudicates claims for compensation by using section 7 of the WC Act and Policy 21-100 Conditions for Entitlement – General Principles. For a claim to be accepted, information must show that:
Pain in the absence of a personal injury by accident is not accepted as a compensable claim.
However, when an injured worker claims compensation benefits for chronic pain after treatment for a compensable injury has concluded and the claim has been closed, WorkSafeNB determines entitlement to compensation benefits by determining whether the claim for chronic pain is related to:
Based on the weight of the evidence, WorkSafeNB either:
3.0 Managing Claims Involving Chronic Pain
When a personal injury by accident is accepted as a compensable claim, WorkSafeNB provides benefits as appropriate.
WorkSafeNB also focuses on identifying risk factors linked to the development of chronic pain and implements early intervention strategies such as work conditioning, education, and early and safe return to work strategies to prevent the onset of chronic pain.
To assist in prevention and identification of risk factors, WorkSafeNB:
3.1 Loss of Earnings
If a worker develops chronic pain subsequent to a compensable injury and has a reduction in functional capacity that affects earning capacity, the worker may be entitled to continued loss of earnings benefits.
To determine entitlement to continued loss of earnings benefits, WorkSafeNB uses:
In situations where the injury and resulting chronic pain causes a permanent work restriction or reduced functional capacity that affects the worker’s earnings, WorkSafeNB determines the estimated capable earnings of the injured worker and pays benefits accordingly. If there is no work restriction or reduced functional capacity identified by WorkSafeNB, the injured worker is not entitled to loss of earnings benefits.
3.2 Treatment and Return to Work
When an injured worker develops chronic pain as a result of the compensable injury, WorkSafeNB determines the need for and extent of treatments to be provided based on the injured worker’s functional capacity and not on the pain itself.
WorkSafeNB determines if treatments are successful by measuring whether there is improvement or deterioration with respect to:
When managing claims with chronic pain, WorkSafeNB ensures that injured workers receive appropriate, necessary, and effective medical care based on the principles outlined in Policy 25-014 Medical Aid Decisions.
38.11(1), 38.11(2), 38.11(3), 38.11(3.1), 38.11(3.2), 38.11(4), 38.11(5), 38.11(6), 38.11(7), 38.11(8), 38.11(8.1), 38.11(9), 38.11(9.1), 38.11(9.2), 38.11(10), 38.11(11), 38.11(12)(a), 38.11(12)(b), 38.11(13), 38.11(14)(a), 38.11(14)(b), 38.11(14)(c), 38.11(14)(d), 38.11(15), 38.11(16), 38.11(17), 38.11(18) and 38.11(19)
Acute pain - pain having a rapid onset, severe symptoms, and a short course.
Appeals Tribunal – means the Workers’ Compensation Appeals Tribunal established under the WHSCC & WCAT Act.
Chronic pain - pain that persists beyond the usual healing time. This pain may continue in the presence or absence of demonstrable pathology.
Transitional return to work - a term used to describe gradual, modified, or alternate return to work tools that are used while an injured worker is still receiving clinical rehabilitation.
WorkSafeNB – means the Workplace Health, Safety and Compensation Commission or "the Commission" as defined by the WHSCC & WCAT Act.