Policy 31.05.10- Schedule "A" - Pre-existing Conditions

For claims where a pre-existing condition has affected the disability duration and/or associated costs, the WCB may provide cost relief.

The following pre-existing conditions will result in 100% cost relief to the employer:

• Where the prior condition is determined to be the primary cause of the accident, for example, epilepsy.
• Where the wearing of an artificial appliance is determined to be the primary cause of the accident.

For other claims involving a pre-existing condition where time loss exceeds 12 weeks, the employer will receive cost relief for 50% of the entire costs of the claim.

The accident employer will not be eligible for cost relief when the pre-existing condition relates to a previous accident with the same employer.

Cost relief for pre-existing conditions will be charged to the Cost Apportionment Fund and allocated to the class of the accident employer.
 

Administrative Guidelines

Return to Work Programs

Where a claim is significantly prolonged by a pre-existing condition, 50% cost relief may be available to the employer if the worker's time loss is greater than 12 weeks. The WCB will consider "time loss" to include absences from regular job duties or time worked during modified or alternate work programs. The payment of WCB wage loss benefits during a modified or alternate work program is not necessary to qualify for cost relief under Schedule Accordingly, where the claim is significantly prolonged by a pre-existing condition and the policy criteria are met, employers who accommodate injured workers in early return to work programs may be eligible for cost relief.