3912 - 29 Street NE Calgary, AB T1Y 6B6 Phone: 403-242-6672  Fax: 403-209-0528

FOR ALL STAFF INJURED AT WORK

A workplace injury is considered serious and must be reported. You must submit a report if there’s lost time, a work modification, or any medical treatment beyond first aid or treatment that required a medical expense. (Ex: Call for repetitive strains, hearing loss, respiratory problems, or vehicle accident-including police report if available.) You must complete an incident report on the incident regarding the injury or potential injury even if a WCB form is deemed to not be required.

Worker:

  1. A. Emergencies – Call 911 and provide first aid.
  1. Disabling Situations – Provide first aid and immediately see a medical doctor. (Complete the WCB Medical Form and NAS Practitioner’s Statement – available on NAS website). Staff will be paid until the end of their shift for that day if they do not have flex time available, for medical attention.
  2. Minor Situation – Provide first aid if necessary.
  1. Immediately report to your NAS immediate supervisor or on call the date of the injury, description of the injury and circumstances, then complete an Incident Report regarding injury immediately, and give to your supervisor or On-Call within12 hours of the incident. Be available while the incident report is reviewed in case you need to provide more information. The incident report can include both situations with the client and the staff injury. When addressing the staff injury ensure clarity of the injury, if First Aid was provided, and if so, what, if not, why not. . If not, why not. If at this point a medical doctor has not been seen, and the injury requires medical attention make an appointment to see your medical doctor. If medical attention was provided, where and by who, what was done, results, recommendations and requirements
  2. Fill in WCB documentation according to the injury category as outlined:
  1. For any work related injury that will require the worker to be off work or may require beyond the day of injury.
  2. Any work related injury that requires modified work beyond the day of injury.
  3. Any work related injury that requires physiotherapy, massage, chiropractic, ongoing medical treatment (medication, counselling, etc)
  4. List of injuries or activities that require medical attention and may result in a permanent disability

-Car accident

-Falls

-Muscle strains, sprains, tears

-Client bites

-Repeated physical assault or if it has caused an injury (including hair pulls)

-Cuts or abrasions requiring medical attention or may be infected

-Fractures, Dislocation

-Burns requiring medical attention or may become infected

-Injury by tool or machinery

-Exposure to harmful substances (gas, chemical, fire, electricity)

-Emotional trauma

-Repetitive Injuries

  1. For all injures the worker must complete declaration and consent form preferable online
  2. If worker is volunteering hours – explain under the Worker’s Report accident details #5 and page 2 employment type as permanent. Under accident details that you were working outside normal shift as unpaid labour.
  3. If there is any of the following additional forms also need to be completed and submitted:
  1. Automobile Accident Report - Injury by automobile. Provide NAS with a copy of the police report.
  2. Worker’s Progressive Injury Questionnaire – when an injury has been medically classified as progressive.
  3. Information Questionnaire for Emotional Injury – when emotional trauma is experienced.
  4. Damaged Eyeglasses Non-Personal Injury
  5. Wage Loss
  6. Authorization of a Representative
  7. Election to Claim Under the AB WCB - Out of the Province Accident
  8. Election to Claim Under the AB WCB – Out of Province Resident
  1. If not submitted online, provide the Worker Reports to your supervisor or On-Call within 12 hours of the incident. If submitted online,advise your supervisor on On-Call the date and time you submitted your report.
  2. Be available while the form is reviewed in case you need to provide more information.

Claims will be reviewed by a WCB Alberta adjudicator and they will call your medical doctor. Claim, if approved will be discussed with NAS to create a case plan definition which will determine standards for safe return to work. Follow-up with your supervisor. The Claim, when approved, allows for NAS Inc. to have some or all of the costs go through NAS instead of WCB. NAS will request that specific costs submitted to NAS if we will be covering all or part of the costs.

Employer:

NAS as an employer has a mandatory 72 hours to submit the Employer Report of Injury form, or be penalized by up to $25,000 for not reporting the injured worker. Therefore the following timelines must be adhered to:

Within 24 hours the immediate supervisor (on-call) must have completed:

  1. Review Incident Report to understand the details of the situation and review NAS responsibilities. Supervisor must ensure the Incident Report has clarity and sufficient detail in each area. Seek clarification as required.
  2. Ensure workers WCB Forms are completed either online or obtain from the worker the completed and signed forms (as required under employee section). Seek clarification as required.
  3. Ensure staff has seen the doctor and obtain the employer copy of Physician’s Invoice and Report, and the completed NAS Practitioners Statement (or note if staff can return to work with no accommodation or staff will be missing the work).

-If staff can do light duties it is important to reassign them for day following injury.

-Staff must be paid to end of shift on the day of injury.

-If staff will miss only 1-3 days of work and have no flex time available NAS may choose to pay this time while off work.

-Conversation regarding the decision to be made must include Administration and Human Resource.

  1. Immediate supervisor completely fill in an Employer Report and submit to administration.
  2. Submit all documentation to Administration by hand.

Administration receives information no later than 24 hours after incident.

  1. Date and Time stamp all WCB documentation
  2. Hand deliver all documentation to the Admin WCB representative or delegate.
  3. Review all documentation to understand the details of the situation and that they are correctly and sufficiently filled in within 60 hours from date of injury. Seek clarification as required.
  4. Transfer Employer Report form to online form and submit.
  5. Submit all additional documentation required
  1. Verify if the Worker Report’s was submitted online or if not fax them in.
  1. File all documentation.