Conditions for Entitlement – Recurrence of a Compensable Injury Policy 21-102 | Effective Date: July 1, 2019

Policy 

A claim for a recurrence of a compensable injury is accepted when 1) there is no new accident and 2) there is medical compatibility or a combination of medical compatibility and continuity between the original compensable injury or disease and the worker’s current condition.

A reopening for planned medical interventions related to the original compensable condition is treated as a continuation of the initial period of disablement and not as a recurrence.

When a claim is accepted as a recurrence, the costs are charged to the original accident employer.     

Interpretation           

  1. When considering a claim for a recurrence of a compensable injury, WorkSafeNB will gather information and consider whether there was an event significant enough meet the definition of accident. If so, the claim is classified as a new accident and adjudicated using Policy 21-100 Conditions for Entitlement – General Principles.
  2. Medical compatibility exists when there is objective medical evidence linking the current symptoms and the original compensable injury. Objective medical evidence involves more than the same body part being affected and/or the worker experiencing the same symptoms as the original compensable injury. Medical compatibility is determined by weighing all evidence and making a determination based on a preponderance of evidence. For more information, see Policy 21-113 Decision-making.
  3. In cases where the worker is experiencing symptoms after a long period of general improvement or stabilization, WorkSafeNB considers the potential impact of non-work related factors on the worker’s current condition.
  4. When the preponderance of evidence does not clearly establish medical compatibility, a combination of medical compatibility and continuity is considered.
  5. Continuity is established when the worker has experienced ongoing symptoms, received additional or continued medical treatment, and/or has a permanent work restriction related to the original compensable injury.

 

Workers’ Compensation Act (RSNB 1973, c W-13)

34(1), 34(2), 34(4), 38.11(1), 38.11(2) and  38.11(3)

Case Law 

Derek Green v. The Workplace Health, Safety and Compensation Commission (New Brunswick Court of Appeal, 1997)

 

Accident – includes a wilful and intentional act, not being the act of a worker, and also includes a chance event occasioned by a physical or natural cause, as well as a disablement caused by an occupational disease and any other disablement arising out of and in the course of employment, but does not include the disablement of mental stress or a disablement caused by mental stress, other than as an acute reaction to a traumatic event (WC Act).

Evidence – information or things presented to prove a fact.

Preponderance of Evidence – it is more likely than not, based on the weight and strength of the evidence. (Adapted from Merriam-Webster Dictionary).

Recurrence – is the return or reactivation of the original compensable injury when there has been no new accident.

Reopening – is a known or planned future medical intervention for the original medical condition.

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