Auditor general finds WorkSafeNB’s deficiencies in managing injured worker claims prevent timely return to work16 January 2019
FREDERICTON (GNB) – Auditor General Kim MacPherson released today her second performance audit on WorkSafeNB. Focusing on the management of injured worker claims, this is the second and final phase carried out in response to a request by the government under Section 12(1) of the Auditor General Act.
The audit found WorkSafeNB’s claims management structure is reasonable and its policies are generally consistent with industry best practice, however numerous process deficiencies are preventing injured workers from achieving a timely return to work.
On average, injured workers in New Brunswick lost about 65 days of work per lost-time claim in 2017. According to experts, establishing an expectation for when injured workers would be ready to return to work is a critical part of the overall recovery process. However, the auditor general found WorkSafeNB has no initial contact with injured workers to assess the nature of injury and determine immediate steps to take. Further, WorkSafeNB does not develop injured worker case plans with return-to-work goals, proposed treatments and a forecasted recovery date. It was also found that WorkSafeNB does not track the medical progress of injured workers, and delays were found in referring for specialized treatment.
“It would be difficult to motivate a vulnerable injured worker to return to work without outlining their expected recovery in a comprehensive case plan,” said MacPherson. “Ultimately, WorkSafeNB is missing an early opportunity to communicate a critical part of the recovery process to injured workers.”
Allocating claims to case managers based on types of injuries, further training and adopting more computer automation for routine tasks were noted as examples which could improve efficiency.
“The deficiencies we found, whether large or small, collectively affect WorkSafeNB’s ability to proactively manage injured worker cases and can delay time-sensitive treatment,” said MacPherson. “Overall, our recommendations aim to promote a timely and safe return to work.”
MacPherson made 29 recommendations to WorkSafeNB to balance needs with the long-term sustainability of the workers’ compensation system by incorporating the concept of return to work as a focus and addressing the identified deficiencies.
The WorkSafeNB Phase II – Management of Injured Workers’ Claims chapter can be found in Volume II of the 2018 Auditor General Report. This volume and the one-page summary for this chapter are available online.16-01-19