Determining Continued Eligibility for Loss of Earnings Benefits Policy 21-214 | Effective Date: January 1, 2020

Policy 

Legislation provides authority to WorkSafeNB to reduce, suspend, or end loss of earnings benefits payable to a worker in certain circumstances.

Interpretation

  1.  As a worker’s condition and circumstances change, WorkSafeNB is required by legislation to continuously evaluate if loss of earnings benefits should continue. 
  1. If circumstances warrant reducing or suspending benefits, WorkSafeNB reinstates the benefits when:
    • The injured worker attends, participates in, and does not obstruct the examination, treatment or rehabilitation; 
    • The injured worker cooperates in their early and safe return to work; or
    • The behaviours imperilling or impeding the rehabilitation have stopped or evidence concludes that the behaviours are being progressively modified.
  1. When a personal condition not related to the injury by accident or a circumstance not related to the injury becomes the dominant cause of the worker’s inability to return to work or participate in rehabilitation, WorkSafeNB gathers evidence and determines if benefits should be terminated. At the point in the claim when this is being evaluated, WorkSafeNB must conclude if it is more likely than not that the worker would have returned to work or continued rehabilitation but for the personal condition or circumstance.
  1. WorkSafeNB will terminate loss of earnings benefits when the injured worker reaches age of 65 or there is no longer a loss of earnings resulting from the injury. If injured workers remove themselves from the employment relationship with their accident employer by way of retirement, loss of earnings by reason of injury ceases and loss of earnings benefits will end.

 

Dominant Cause – a condition or circumstance that is the primary reason for the injured worker’s inability to return to work or participate in rehabilitation, as determined by WorkSafeNB. 

Examinations – assessments and evaluations authorized by WorkSafeNB to determine the medical and return to work status of an injured worker.

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