What happens if a workers compensation claim is declined

The insurer must formally notify staff if their claim has been declined:

• indicating the reason for the decision, and
• noting the available avenues of appeal.

After a claim is declined:

• Any ongoing medical costs are the responsibility of the staff member.
• The staff member should continue to submit any relevant medical certificates and leave forms to their supervisor.
• Where there are ongoing medical or work restrictions, the staff member and their supervisors can continue to get assistance in coordinating and monitoring a return to work plan.