Workers Compensation Board of Prince Edward Island
When a claim is filed with the WCB, the medical information received from health care providers is reviewed with information provided by the injured worker and employer to determine the worker's entitlement to benefits.
In the decision-making process, the WCB takes into consideration whether:
If clarification or additional medical information is required to make a decision on a claim, the WCB may contact health care providers treating the worker. If the claim is accepted, the worker may be eligible for benefits and services. If time off work is required, the return to work process will begin.
An injured worker's entitlement to health care benefits may include, but is not limited to:
The Claim Process
When a claim is filed with the WCB, the medical information received from health care providers is reviewed with information provided by the injured worker and employer to determine the worker's entitlement to benefits.
In the decision-making process, the WCB takes into consideration whether:
- There is a reasonable relationship between the condition/injury and the workplace.
- The incident is of sufficient severity to result in the reported symptoms.
- Non-occupational factors have contributed to the condition.
- There is a documented need for time off work as a result of the condition/injury.
- The medical information is evidence-based and consistent with medical literature.
If clarification or additional medical information is required to make a decision on a claim, the WCB may contact health care providers treating the worker. If the claim is accepted, the worker may be eligible for benefits and services. If time off work is required, the return to work process will begin.
An injured worker's entitlement to health care benefits may include, but is not limited to:
- Medical, surgical, and dental aid.
- Hospital and nursing services.
- Chiropractic services provided by a registered chiropractor.
- Physiotherapy services provided by a licensed physiotherapist.
- X-ray and other diagnostics.
- Drugs, dressings, appliances, and apparatuses.