How Can I Get Help With My Worker’s Claim?
Many workers have come to my office needing assistance with their Worker’s Compensation Claims. Often these claims can be very complex, and WCB has very strict timelines for appeal. Here are a few resources that may be able to assist you.
Worker’s Advisor’s Office – This office provides a free service independent from Worksafe BC. They can assist you in understanding policies and procedures around Worker’s Compensation claims, and help you in appealing a WCB decision through the review division and WCAT. 1-800-663-4261.
Trade Unions – If you are part of a union, your union can be a very helpful advocate to ensure your rights are upheld. Many unions can assist workers through the two levels of WCB’s appeal process. Your union’s representatives can help support you through these stages.
Legal Services – There is always an option to obtain a lawyer to represent you through your appeal. If you cannot afford one, here is a list of low cost and free legal services, which can be found on the website of the Canadian Bar Association BC Branch. http://www.cba.org/BC/public_media/lawyers/430.aspx
Ombudsman – The Ombudsman receives inquiries and complaints about the practices and services provided by public agencies. While not an advocate, the Ombudsman can conduct impartial and confidential investigations to determine if a public agency such as WCB is being fair to the people it serves.
What Are Medical Services Plan and Premium Assistance?
Over the last few months, my office had many inquiries about Medical Services Plan and Premium Assistance that is being offered to individuals and families that are in financial need. There are two types of subsidies: Premium Assistance and Temporary Premium Assistance.
Regular premium assistance offers subsidies ranging from 20 to 100 %, based on an individual’s net income (or a couple’s combined net income) for the two preceding tax years, less deductions for age, family size and disability. If the resulting amount referred to as “adjusted net income” is $30,000 or below, a subsidy is available. In order to qualify for 100% Premium Assistance, your net income threshold must be under $22,000.
Temporary Premium Assistance offers 100% subsidy on a short term basis based on unexpected financial hardship. You must have show income verification through your Canada Revenue Agency Income Tax Return Information.
To apply for premium assistance, you need to complete and return an application form to MSP. The application can be found at:
https://www.healthservices.gov.bc.ca/exforms/msp/H119.pdf or by calling Medical Services Plan at 604 683-7151.
Pharmacare – What is Special Authority?
We all know that medications not fully covered under Pharmacare can be costly. A Special Authority grants full benefit status to a medication that would otherwise be a partial benefit or a limited coverage drug. Actual coverage is based on the patient’s eligibility and deductible criteria. Coverage is based on the Low Cost Alternative Drug Program, Maximum Days’ Supply, and Maximum Pricing Policy.
Special Authorities are granted for a specific drug for an individual patient. In rare cases, however, a Special Authority exemption may be granted to a physician or physician specialty group. These exemptions provide coverage of specific drugs for all the patients of a physician or specialty group.
To find out more whether a drug is eligible for special authority, you can go on the Pharmacare’s website: http://www.health.gov.bc.ca/pharme/.