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External KSM Definitions
  • 1. Number of Claims Reported
  • Intent of Measure
  • To measure the volume of claims reported reflecting adjudicative activity for the year.

  • Definition
  • Number of new claims reported within the reference year regardless of injury year.

  • Calculation
  • Includes all lost-time, no lost-time, health care only, occupational disease and fatal claims. Count self-insurer claims and Inter-Jurisdictional Agreement claims where reported. Count only those claims that have been assigned a claim number by the end of the reference year.

  • 2. Total number of Lost-Time Claims
  • Intent of Measure
  • To measure the volume of compensated lost-time claims resulting from injuries, which occurred in the reference year, and diseases, which were diagnosed/reported in the reference year.  Also a system cost driver.

  • Definition
  • A lost-time claim is a claim where an employee is compensated for a loss of wages following a work-related injury (or exposure to noxious substance), or receives compensation for a permanent disability with or without any time lost in his or her employment (for example, if an employee is compensated for a loss of hearing resulting from excessive noise in the work place).  For assessable and self-insured employers.

  • Calculation
  • The standard reference period for reporting lost-time claims statistics is the calendar year.  This KSM counts lost-time injuries which occurred in the reference year (or which were reported/diagnosed in the case of disease) which were accepted for payment during the reference year, or the three-month period immediately following the reference year.  Note:  This is consistent with the definition used for the National Work Injuries Statistics Program (NWISP).

  • 2.1. Number of New Lost-Time Claims for Assessable employers
  • Intent of Measure
  • To measure the volume of compensated lost-time claims resulting from injuries, which occurred in the reference year, and diseases, which were diagnosed/reported in the reference year. Also a system cost driver.

  • Definition
  • A lost-time claim is a claim where an employee is compensated for a loss of wages following a work-related injury (or exposure to noxious substance), or receives compensation for a permanent disability with or without any time lost in his or her employment (for example, if an employee is compensated for a loss of hearing resulting from excessive noise in the work place). For assessable employers only.

  • Calculation
  • The standard reference period for reporting lost-time claims statistics is the calendar year. This KSM counts lost-time injuries which occurred in the reference year (or which were reported/diagnosed in the case of disease) which were accepted for payment during the reference year, or the three-month period immediately following the reference year. Note: This is consistent with the definition used for the National Work Injuries Statistics Program (NWISP).

  • 2.2. Number of New Lost-Time Claims for Self-Insured employers
  • Intent of Measure
  • To measure the volume of compensated lost-time claims resulting from injuries, which occurred in the reference year, and diseases, which were diagnosed/reported in the reference year. Also a system cost driver.

  • Definition
  • A lost-time claim is a claim where an employee is compensated for a loss of wages following a work-related injury (or exposure to noxious substance), or receives compensation for a permanent disability with or without any time lost in his or her employment (for example, if an employee is compensated for a loss of hearing resulting from excessive noise in the work place). For self-insured employers only.

  • Calculation
  • The standard reference period for reporting lost-time claims statistics is the calendar year. This KSM counts lost-time injuries which occurred in the reference year (or which were reported/diagnosed in the case of disease) which were accepted for payment during the reference year, or the three-month period immediately following the reference year. Note: This is consistent with the definition used for the National Work Injuries Statistics Program (NWISP).

  • 3. Number of Fatalities Accepted
  • Intent of Measure
  • To measure in aggregate the most serious workplace injuries within the system. Useful for monitoring trends.

  • Definition
  • A fatality is a death resulting from a work-related incident(including disease) that has been accepted for compensation by a Board/Commission.

  • Calculation
  • A fatality is recorded during the year when the claim was accepted by a Board/Commission, not the year when the incident causing the death occurred. Note: This is consistent with the definition used for the National Work Injuries Statistics Program (NWISP).

  • 3.1. Number of Fatalities Accepted - Occupational Disease
  • Intent of Measure
  • To identify, among the accepted fatalities reported in KSM 3, how many result from an occupational disease.

  • Definition
  • Number of accepted fatalities that are related to occupational disease.

  • Calculation
  • If a jurisdiction already separates KSM3.1 and KSM3.2 for any publication, those figures are used. Each jurisdiction uses its own definition of Occupational Disease.
     
    Note: The total of KSM3.1 (Occupational Disease) and KSM3.2 (Injury) must equal KSM 3.
  • 3.2. Number of Fatalities Accepted - Injury
  • Intent of Measure
  • To identify, among the accepted fatalities reported in KSM 3, how many result from a work injury.

  • Definition
  • Number of accepted fatalities involving work-related incidents or injuries.

  • Calculation
  • If a jurisdiction already separates KSM3.1 and KSM3.2 for any publication, those figures are used.
     
    Note: The total of KSM3.1 (Occupational Disease) and KSM3.2 (Injury) must equal KSM 3.
  • 4. Current Year Benefit Costs Incurred ($millions)
  • Intent of Measure
  • Definition
  • As of 1999, KSM 4 (Current Year Benefit Costs Incurred) was split out into assessable and self-insured employers. See KSM 4.1 and 4.2.

  • Calculation
  • 4.1. Current Year Benefit Costs Incurred for Assessable employers. Excludes admin. costs ($millions)
  • Intent of Measure
  • To measure the cost of benefits related to injuries and diseases that occurred in the year.

  • Definition
  • Total benefit costs incurred for injuries that occurred in the reference year and diseases that were reported/diagnosed in the reference year. For assessable employers only.

  • Calculation
  • The cost is composed of two items: (1) the payments made during the year for the injuries that occurred in the reference year and diseases that were reported/diagnosed in the reference year, and (2) the benefits liabilities related to those injuries and diseases at December 31 of the year. Includes all benefits (i.e. short-term disability, long-term disability, survivors’ benefits, healthcare and rehabilitation services). Excludes any administration expense.

  • 5. Benefit Payments for All Years Paid During the Year. Excludes admin. Costs ($millions)
  • Intent of Measure
  • Definition
  • As of 1999, KSM 5 (Benefit Payments for All Years Paid During the Year) was split out into assessable and self-insured employers. See KSM 5.1 and 5.2.

  • Calculation
  • 5.1. Benefit Payments for All Years Paid During the Year for Assessable employers. Excludes admin. Costs ($millions)
  • Intent of Measure
  • To measure payments made for compensation during the year.

  • Definition
  • Total benefit payments made, for current and prior injury years, for all benefits types (i.e. short-term disability, long-term disability, survivors’ benefits, healthcare and rehabilitation services) as reported in Annual Report. For assessable employers only.

  • Calculation
  • Total amount of benefits paid for assessable employers. The data is generally available in the financial statements note concerning benefit liabilities. Excludes any administration expense. Includes the costs of treatment and direct services to injured workers provided by rehabilitation centers managed by the Board/Commission. Excludes self-insured employers.

  • 6. Benefit Costs Incurred - excludes admin. costs ($millions)
  • Intent of Measure
  • To measure the expenditure in the statement of revenues and expenditures directly related to the compensation system.

  • Definition
  • Amount of expenditure with respect to benefits paid to injured workers incurred in the reference year as reported in the Annual Report.

  • Calculation
  • This is the sum of two elements: (1) all payments made during the year for the injuries and diseases irrespective of the year in which they occurred, and (2) the difference between the liabilities as at December 31 of the reference year and the liabilities of the prior reference year. Benefits types are short-term disability, long-term disability, survivors’ benefits, healthcare and rehabilitation services, including commuted values which are incurred. Excludes any administration expense. Data of self-insured employers should be included as long as liabilities are calculated for these employers and this should be disclosed in a footnote.

  • 7. Total Benefit Liabilities. Excludes admin. costs ($millions)
  • Intent of Measure
  • Definition
  • As of 1999, KSM 7 (Total Benefit Liabilities) was split out into assessable and self-insured employers. See KSM 7.1 and 7.2.

  • Calculation
  • 7.1. Total Benefit Liabilities for Assessable employers. Excludes admin. costs ($millions)
  • Intent of Measure
  • To measure the liabilities related to benefits of assessable employers.

  • Definition
  • Total benefit liabilities for assessable employers only.

  • Calculation
  • The benefit liabilities are the present value of future payments to be made for injuries that occurred and diseases that were reported/diagnosed as at the valuation date. Excludes any administration expense. 7.1 is for assessable employers. 7.2 is for self-insured employers.

  • 8. Administration Costs for Assessable Employers ($millions)
  • Intent of Measure
  • To measure the cost of administering the system (except OH&S and other legislated obligations). To provide a comparable administration cost figure, focusing on the administration of claims and employer services, with inclusions and exclusions from the financial statement figure due to operating or legislated differences between jurisdictions.

  • Definition
  • Incurred expenses, which relate to the management and administration of the Board/Commission.

  • Calculation
  • Use, as a basis, the financial statement administration cost figure appearing in the note to the financial statement which describes in detail the components of administration costs (rather than the dollar amount shown in the Income Statement). In order to capture the value of administration costs incurred for the year, exclude administration cost liabilities. Use the costs prior to the deduction of claims administration costs. Deduct any administration expense recovered from self-insured employers and miscellaneous revenue/recoveries related to operational activities. Examples of costs to be included in the administration costs are internal health staff not directly involved in the treatment of injured workers, consulting costs, professional fees (except certain types of medical and legal fees) and professional dues. Examples of costs to be excluded are: treasury costs, legal costs incurred for subrogations or recoveries, external medical service providers and external medical review panels, cost of external appeals and cost of employer or worker advisor offices, grants for research on prevention or occupational health and safety, prevention and occupational health and safety administration costs. Explain in a footnote any exclusion or inclusion which is judged particular to your jurisdiction.

  • 9. Total OH&S Costs Paid by Boards During Year ($millions)
  • Intent of Measure
  • To measure monies invested in occupational health and safety activities. Due to legislative and operating differences, occupational health and safety costs vary considerably from jurisdiction to jurisdiction.

  • Definition
  • The cost of all activities of the Board/Commission in occupational health and safety for assessable employers.

  • Calculation
  • Occupational health and safety (OH&S) costs can be broken down into the following components :

    (a) Levies collected for Occupational Health and Safety
    Funds collected by the Board/Commission to pay for the administration of the OH&S Act. These funds are transferred to a governmental body in charge of applying the OH&S Act, generally the Ministry of Labour.

    (b) Internally administered prevention programs (exclude related overhead)
    The cost of developing and implementing programs designed to raise awareness and increase knowledge on prevention practices. Programs are designed and implemented by Board/Commission staff. These programs may be legislated or Board/Commission initiatives. They can also be sector specific. Examples of prevention programs are : Farm Safety initiatives, Mine Rescue programs.

    (c) Inspection costs
    Costs of enforcement of safety rules and of inspection of work environments in those jurisdictions where it is a specific mandate of the Board/Commission.

    (d) Research Grants
    Any research grant paid by the Board/Commission including sums paid to research institutes devoted to the study of occupational health and safety.

    (e) Funding of OH&S associations
    Funds paid to associations devoted to the promotion of occupational health & safety.

    (f) Amounts paid to public health system to conduct OH&S activities
    Amounts paid by Board/Commission to public health boards which manage the health system of the jurisdiction and which are involved in occupational health and safety activities.

    (g) Other (specify in footnote)
    Other OH&S costs which are not already included in a prior category. May include non recurrent prevention activities (ex: prevention training sponsored by Board/Commission but executed by an external provider).|

    (h) Self-Insured Portion (negative number)
    Any costs attributable to self-insured employers and financed by these employers. These costs are deducted from the total OH&S costs paid during the year.

  • 10. Assessment Revenue for Assessable Employers ($ millions)
  • Intent of Measure
  • To measure the charges made to assessable employers for the current assessment year and the adjustments to assessment revenues of previous assessment years.

  • Definition
  • Assessment income received and accrued from rate assessed employers during the reference year for all assessment years.

  • Calculation
  • Includes the amounts accrued for the current assessable year and any adjustment regarding previous assessable years. Includes interest and penalties, experience rating surcharges and discounts, variation of receivable provisions and variation of any other adjustment. Should be net of assessment bad debts expense, if any. Amounts are usually available in the statement of operations for assessable employers. Excludes self-insured employers.

  • 11. Total Premium Revenue ($millions)
  • Intent of Measure
  • To measure the total income from employer contributions during the year as reported in the Annual Report.

  • Definition
  • Sum of Assessment Revenue (KSM #10) and any income received from self-insured employers.

  • Calculation
  • KSM #10 plus any premium revenue accrued from self-insured employers. Includes interest and penalties, experience rating surcharges and discounts, variation of receivable provisions and variation of any other adjustment. Should be net of assessment bad debts expense, if any.

  • 12. Assessable Payroll for Assessable employers ($billions)
  • Intent of Measure
  • To provide a measure of economic activity of assessable employers through their collective payroll.

  • Definition
  • Rate assessable payroll for the reference year.

  • Calculation
  • Payroll of rate assessable employers for a given reference year including reported actual payroll and payroll estimated for cut-off purposes in preparing the audited financial statements for all rate assessed, insured employers. When unavailable, use the assessable payroll known 3 months after the end of the reference year (for example, if fiscal year ends December 31, this would be March 31). Excludes self-insured employers.

  • 13. Actual Average Assessment Rate
  • Intent of Measure
  • Definition
  • See Definition for KSM 13.1.

  • Calculation
  • 13.1. Actual Average Assessment Rate for Assessable Employers
  • Intent of Measure
  • To measure the average rate actually collected from the assessable payroll. Comparison of this rate with the forecasted rate (KSM #13.2) gives information on the changes in the mix of economic activity.

  • Definition
  • Assessment revenue related to the reference year only divided by the assessable payroll.

  • Calculation
  • Total rate assessed income for the reference year (including experience rating adjustments and other adjustments) divided by assessable payroll for the fiscal year for all rate assessed, insured employers (KSM #12), as of the date used in Board/Commission financial statements. Expressed per $100 of assessable payroll.

  • 13.2. Provisional Average Assessment Rate for Assessable Employers
  • Intent of Measure
  • To measure the financial rate assessed income needed for the year.

  • Definition
  • The established average assessment rate, which is set prior to the beginning of the reference year, based on estimates of costs charged to employers.

  • Calculation
  • In some jurisdictions, this rate is decreed (and rates for each risk class are calculated in another step). In other jurisdictions, unit rates are set first and the provisional rate is the average of these rates weighted by the estimated assessable payroll. The breakdown (included in the Preface report to accompany the Key Statistics) reflects estimates that cover compensation costs, administration expenditures, OH&S costs, the amortisation of past deficits or surplus, the credit for anticipated investment earnings expected in the assessment year, and any other items unique to individual jurisdictions. Expressed per $100 of payroll.

  • 14. Market Rate of Return
  • Intent of Measure
  • To measure gross investment performance of the fund during the year irrespective of any smoothing mechanism.

  • Definition
  • Rate of investment return for the reporting period on a market value basis for all portfolio assets, including investment cash, net of external investment expenses.

  • Calculation
  • 2I/ (A+B-I) where

    I : total investment income on a market value basis net of external investment expenses
    A : market value of assets at the beginning of the year
    B : market value of assets at the end of the year.

  • 15. Percentage Funded
  • Intent of Measure
  • To measure the overall financial situation for the reference year.

  • Definition
  • Ratio of total assets to total liabilities.

  • Calculation
  • Total assets divided by total liabilities x 100.

  • 16. Average Calendar Days from Injury to First Payment Issued
  • Intent of Measure
  • To measure the performance of the industry as it relates to service to injured workers with respect to income continuity for those entitled to compensation. Thus, measures industry performance from the injured worker’s point of view.

  • Definition
  • Time period from date of injury to date of first payment issued for all new lost-time claims.

  • Calculation
  • Total number of calendar days from the date of injury, to the date of first payment for all new lost-time claims where a claim number has been assigned within the reference year, divided by the number of new lost-time claims for the reference year (KSM # 2). Includes occupational diseases and self-insured employers. Excludes the conversion period for those claims where no lost-time claims are converted to lost-time claims. Excludes payments made to employers. Excludes appeals.

  • 17. Average Calendar Days from Registration to First Payment Issued
  • Intent of Measure
  • To measure industry performance as it relates to service delivery to injured workers from the Board/Commission’s point of view and from the injured worker’s point of view.

  • Definition
  • Time period from date of registration to date of first payment issued for all new lost-time claims.

  • Calculation
  • Total number of calendar days from date injury is first reported to the Board/Commission, to date of first payment for all new lost-time claims where a claim number has been assigned within the reference year, divided by number of new lost-time claims for the reference year (KSM #2). Includes occupational diseases, and self-insured employers. Excludes the conversion period for those claims where no lost-time claims are converted to lost-time claims. Excludes payments made to employers. Excludes appeals.

  • 18. Average Composite Duration of Claim
  • Intent of Measure
  • To provide a system measure of injury severity. System cost driver. Is related to the effectiveness of return to work efforts and disability management. Tries to reflect the number of days lost from work.

  • Definition
  • The estimated total number of calendar days compensated for short-term disability over the first five calendar years of duration/lifetime of a typical lost-time claim if current conditions are continued for the future years. Short-term disability benefits are all income benefits during the initial period after the injury, before the injury has stabilized, plateaued or consolidated.

  • Calculation
  • The composite method is the days paid in the reference year for each injury year, divided by the number of lost-time claims (KSM #2) of the corresponding injury year, then the results are added together for the designated number of years. All short-term disability benefits related to income loss including rehabilitation benefits are included up to the point where long-term disability benefits commence. The days paid for claims that are not in KSM #2 are removed and the claims in KSM #2 for which no days are paid are also removed. The current year plus four prior injury years are to be used in the calculation.

  • 19. Average New Impairment Award Percentage
  • Intent of Measure
  • To provide a system measure of injury severity. One of two measures used to monitor trends in permanent impairment awards over time. System cost driver.

  • Definition
  • The average permanent impairment percentage adjudicated to claims awarded permanent impairment for the first time during the reference year.

  • Calculation
  • Total of the percentage of impairment for new awards divided by the number of new impairment awards for the period. In WCBs with a pension system, this represents the percentage rating at which pension benefits are calculated. In WCBs with a “dual award” system, this represents the lump-sum benefit corresponding to the non-economic loss or pain and suffering portion of the total long-term disability award. Includes new awards for current year and prior years claims and is the amount at the time the award is made. Excludes fatalities.

  • 20. Proportion of Claims Awarded Impairment Benefits
  • Intent of Measure
  • To provide a system measure of injury severity. One of two measures used to monitor trends in permanent impairment awards over time. System cost driver. Also used to monitor trends in permanent impairment awards over time.

  • Definition
  • The estimated proportion of lost-time injuries, which are eventually awarded permanent impairment benefits if current conditions are continued for future years.

  • Calculation
  • The composite method is used where the number of new awards of impairment benefits in the reference year for a certain number of injury years are divided by the lost-time claims of each injury year (KSM #2), then the results for the designated number of years is added together. The accuracy of the composite proportion increases with the number of components (injury years) used in the calculation. Practically, the number of components has to be limited. Use 10 injury years, or indicate number of years used if less than 10.

    Note: The injuries awarded impairment benefits should follow the same selection criteria as specified in the calculation of KSM #19. The total number of awards of KSMs #19 and #20 should be equal if the same number of injury years are retained.

  • 21. Injury Frequency (per 100 workers of assessable employers)
  • Intent of Measure
  • To measure the risk of workplace injury for workers in each jurisdiction in terms of the proportion of workers who suffer a lost-time work injury.

  • Definition
  • Number of new lost-time claims for assessable employers per 100 workers of assessable employers.

  • Calculation
  • Injury frequency = N / C1 x 100

    N = total number of new lost-time claims for assessable employers (KSM # 2.1).
    C1 = number of workers of assessable employers or self-employed workers opting for coverage.

    This is the first component of the numerator of the percentage of workforce covered (KSM #22).

    Caveat
    The reliability of the injury frequency is subject to limitations of its denominator, described in the calculation of the percentage of workforce covered.

  • 22. Percentage of Workforce Covered
  • Intent of Measure
  • To measure the proportion of the employed labour force that is eligible for benefits under the provincial, territorial and federal workers’ compensation system.

  • Definition
  • The percentage of the workforce that is effectively covered by the compensation system. The number of persons covered by the compensation system is the sum of two main components, the first being the workers of assessable employers and self-employed workers opting for coverage, the second being the workers of self-insured employers and workers of the government of Canada. Excluded from this measure are persons eligible for personal coverage not opting for coverage and workers explicitly excluded by the jurisdiction's legislation.

  • Calculation
  • Percentage of workforce covered = C / P x 100.

    C = C1 + C2 where
    C1 = number of workers of assessable employers or self-employed workers opting for coverage.
    C2 = number of workers of self-insured employers and workers of the Government of Canada.
    P = the reference population. This is the "employed labour force" such as published by Statistics Canada or an alternate for territories where this statistic is not available.

    The numerator is calculated by each jurisdiction through the technique that is most suitable to its circumstances. The numerator should represent the average number of covered workers during the year. In order to achieve consistency with the denominator, each part-time worker must be considered as one worker. Two families of methods are used. One of them is applied in jurisdictions where the law covers all salaried workers with minor exceptions only. The number of excluded workers is calculated by using general statistical data on the labour force. The number of self-employed workers is extracted from the database of the Board/Commission. The other family of methods consists of estimating the number of workers covered from the assessable payroll provided to the Board/Commission by employers. This is achieved by dividing the payroll by the appropriate average salary.

    Caveat
    The reliability of this indicator is subject to certain limitations resulting from the absence of a detailed count of workers in the database of the Boards/Commissions. In order to achieve a reasonable result, each Board/Commission uses the technique that best suits its circumstances. The techniques involve the setting of assumptions that are subject to a degree of uncertainty. Full accuracy is not achievable at a reasonable cost in terms of collecting data in each jurisdiction. Nevertheless, this indicator is considered the best estimate of the proportion of the employed labour force that is eligible to benefits provided by the workers’ compensation system in case of work injury. Prudence is recommended to the users of these statistics.

  • 23. Real Rate of Return to Discount Fully Indexed Benefits (previously called Discount Rates)
  • Intent of Measure
  • To measure the strength of liabilities or the expectations regarding future investment performance.

  • Definition
  • Interest rate net of increases in the Consumer Price Index used in the valuation of liabilities.

  • Calculation
  • { (1+i) / (1+P) } - 1, where i is the nominal rate of interest and P is the change in the Price Index for the twelve months period. When i and P have changing values over the projection period, the ultimate ones are reported and explanations regarding the other ones are given in footnotes. Footnotes may also include information regarding the discount rate used for benefits not linked to the Price Index.

  • 24.1. Percentage of Lost-Time Claims Receiving Wage-loss Benefits at the end of the 2nd year after the injury year
  • Intent of Measure
  • To provide a system measure of the persistency of claims on wage-loss benefits. Is related to the severity of claims. To measure the extent to which injured workers are unable to return to work in the longer term. System cost driver.

  • Definition
  • Ratio of the number of lost-time claims receiving any type of wage-loss benefits for December 31 of the second/sixth calendar year after the injury year to the total number of lost-time claims reported for that injury year.

  • Calculation
  • Let t = the calendar year under report

    Percentage of Lost-Time Claims Receiving Wage-Loss Benefits at the End of the 2nd Year After the
    Injury Year = 
                  A/B x 100

    A = Number of claims for injury year t-2 with any wage-loss benefits >$1 paid for December 31 of year t regardless of payment interruptions prior to this date. In counting claims receiving payment, files should be read by March 31 of the third calendar year after the injury year.

    B = Number of lost-time claims for injury year t-2 (KSM #2)

    Percentage of Lost-Time Claims Receiving Wage-Loss Benefits at the End of the 6th Year After the
    Injury Year = 
               C/D x 100

    C = Number of claims for injury year t-6 with any wage-loss benefit >$1 paid for December 31 of year t regardless of payment interruptions prior to this date. In counting claims receiving payment, files should be read by March 31 of the seventh calendar year after the injury year.

    D = Number of lost-time claims for injury year t-6 (KSM #2)

    In counting the number of claims with any wage-loss benefit, exclude survivor benefits. Indicate in a footnote when this KSM is influenced by lump-summing or pension review practices.

    Claims from all types of employers should be included (assessable employers and self-insured).

    Example :
    t : Year 2006 (reference year under report)
    C : Number of claims for injury year 2000 with any wage-loss benefits >$1 paid for December 31, 2006
    D : Number of lost-time claims for 2000 (KSM #2)

  • 24.2. Percentage of Lost-Time Claims Receiving Wage-loss Benefits at the end of the 6th year after the injury year
  • Intent of Measure
  • To provide a system measure of the persistency of claims on wage-loss benefits. Is related to the severity of claims. To measure the extent to which injured workers are unable to return to work in the longer term. System cost driver.

  • Definition
  • Ratio of the number of lost-time claims receiving any type of wage-loss benefits for December 31 of the second/sixth calendar year after the injury year to the total number of lost-time claims reported for that injury year.

  • Calculation
  • Let t = the calendar year under report

    Percentage of Lost-Time Claims Receiving Wage-Loss Benefits at the End of the 2nd Year After the
    Injury Year = 
                 A/B x 100

    A = Number of claims for injury year t-2 with any wage-loss benefits >$1 paid for December 31 of year t regardless of payment interruptions prior to this date. In counting claims receiving payment, files should be read by March 31 of the third calendar year after the injury year.

    B = Number of lost-time claims for injury year t-2 (KSM #2)

    Percentage of Lost-Time Claims Receiving Wage-Loss Benefits at the End of the 6th Year After the
    Injury Year =
                 C/D x 100

    C = Number of claims for injury year t-6 with any wage-loss benefit >$1 paid for December 31 of year t regardless of payment interruptions prior to this date. In counting claims receiving payment, files should be read by March 31 of the seventh calendar year after the injury year.

    D = Number of lost-time claims for injury year t-6 (KSM #2)

    In counting the number of claims with any wage-loss benefit, exclude survivor benefits. Indicate in a footnote when this KSM is influenced by lump-summing or pension review practices.

    Claims from all types of employers should be included (assessable employers and self-insured).

    Example :
    t : Year 2006 (reference year under report)
    C : Number of claims for injury year 2000 with any wage-loss benefits >$1 paid for December 31, 2006
    D : Number of lost-time claims for 2000 (KSM #2)

  • 25.1. Percentage of Wage-Loss Claims off Compensation at 30 days
  • Intent of Measure
  • To measure how soon injured workers leave the wage-loss compensation system permanently.

  • Definition
  • Percentage of new lost-time claims, as determined according to KSM #2, that have received their last day of wage-loss benefits 30 days after the injury. The last day of wage-loss benefits is determined at December 31 of the year following the reference year.

  • Calculation
  • The components of the measure are as follows:

    P30 = C (D≤30) ÷ LTC

     

    Where :

     

    D = The difference, in days, between the injury date and the last date for which an injured worker received any wage-loss benefits. The last date of benefits is determined on December 31 of the year following the reference year. One-day medical visits or appointments can be excluded when determining the last date of benefits.

     

    C(D<30) = The number of claims for which the difference D is smaller or equal to 30.

     

    LTC = The total number of lost-time claims (KSM #2).

     

    Caveat

    This is not a return to work measure although it can be seen as a proxy. Injured workers may stop receiving wage-loss benefits for a number of reasons other than returning to work. Also note that the measure makes no distinction with regards to what happens between the injury and the last day of wage-loss benefits. For instance, a worker that has temporarily returned to work before experiencing an aggravation is treated the same as if the wage-loss benefits never stopped. All aggravations or claim reopenings that occur after December 31 of the year following the reference year are not accounted for.

  • 25.3. Percentage of Wage-Loss Claims off Compensation at 90 days
  • Intent of Measure
  • To measure how soon injured workers leave the wage-loss compensation system permanently.

  • Definition
  • Percentage of new lost-time claims, as determined according to KSM #2, that have received their last day of wage-loss benefits 90 days after the injury. The last day of wage-loss benefits is determined at December 31 of the year following the reference year.

  • Calculation
  • The components of the measure are as follows:

     

    P90 = C (D≤90) ÷ LTC

     

    Where :

     

    D = The difference, in days, between the injury date and the last date for which an injured worker received any wage-loss benefits. The last date of benefits is determined on December 31 of the year following the reference year. One-day medical visits or appointments can be excluded when determining the last date of benefits.

     

    C(D<90) = The number of claims for which the difference D is smaller or equal to 90.

     

    LTC = The total number of lost-time claims (KSM #2).

     

    Caveat

    This is not a return to work measure although it can be seen as a proxy. Injured workers may stop receiving wage-loss benefits for a number of reasons other than returning to work. Also note that the measure makes no distinction with regards to what happens between the injury and the last day of wage-loss benefits. For instance, a worker that has temporarily returned to work before experiencing an aggravation is treated the same as if the wage-loss benefits never stopped. All aggravations or claim reopenings that occur after December 31 of the year following the reference year are not accounted for.

  • 25.4. Percentage of Wage-Loss Claims off Compensation at 120 days
  • Intent of Measure
  • To measure how soon injured workers leave the wage-loss compensation system permanently.

  • Definition
  • Percentage of new lost-time claims, as determined according to KSM #2, that have received their last day of wage-loss benefits 120 days after the injury. The last day of wage-loss benefits is determined at December 31 of the year following the reference year.

  • Calculation
  • The components of the measure are as follows:

     

    P120 = C (D≤120) ÷ LTC

     

    Where :

     

    D = The difference, in days, between the injury date and the last date for which an injured worker received any wage-loss benefits. The last date of benefits is determined on December 31 of the year following the reference year. One-day medical visits or appointments can be excluded when determining the last date of benefits.

     

    C(D<120) = The number of claims for which the difference D is smaller or equal to 120.

     

    LTC = The total number of lost-time claims (KSM #2).

     

    Caveat

    This is not a return to work measure although it can be seen as a proxy. Injured workers may stop receiving wage-loss benefits for a number of reasons other than returning to work. Also note that the measure makes no distinction with regards to what happens between the injury and the last day of wage-loss benefits. For instance, a worker that has temporarily returned to work before experiencing an aggravation is treated the same as if the wage-loss benefits never stopped. All aggravations or claim reopenings that occur after December 31 of the year following the reference year are not accounted for.

  • 25.5. Percentage of Wage-Loss Claims off Compensation at 180 days
  • Intent of Measure
  • To measure how soon injured workers leave the wage-loss compensation system permanently.

  • Definition
  • Percentage of new lost-time claims, as determined according to KSM #2, that have received their last day of wage-loss benefits 180 days after the injury. The last day of wage-loss benefits is determined at December 31 of the year following the reference year.

  • Calculation
  • The components of the measure are as follows:

     

    P180 = C (D≤180) ÷ LTC

     

    Where :

     

    D = The difference, in days, between the injury date and the last date for which an injured worker received any wage-loss benefits. The last date of benefits is determined on December 31 of the year following the reference year. One-day medical visits or appointments can be excluded when determining the last date of benefits.

     

    C(D<180) = The number of claims for which the difference D is smaller or equal to 180.

     

    LTC = The total number of lost-time claims (KSM #2).

     

    Caveat

    This is not a return to work measure although it can be seen as a proxy. Injured workers may stop receiving wage-loss benefits for a number of reasons other than returning to work. Also note that the measure makes no distinction with regards to what happens between the injury and the last day of wage-loss benefits. For instance, a worker that has temporarily returned to work before experiencing an aggravation is treated the same as if the wage-loss benefits never stopped. All aggravations or claim reopenings that occur after December 31 of the year following the reference year are not accounted for.

  • 25.6. Percentage of Wage-Loss Claims off Compensation at 360 days
  • Intent of Measure
  • To measure how soon injured workers leave the wage-loss compensation system permanently.

  • Definition
  • Percentage of new lost-time claims, as determined according to KSM #2, that have received their last day of wage-loss benefits 360 days after the injury. The last day of wage-loss benefits is determined at December 31 of the year following the reference year.

  • Calculation
  • The components of the measure are as follows:

     

    P360 = C (D≤360) ÷ LTC

     

    Where :

     

    D = The difference, in days, between the injury date and the last date for which an injured worker received any wage-loss benefits. The last date of benefits is determined on December 31 of the year following the reference year. One-day medical visits or appointments can be excluded when determining the last date of benefits.

     

    C(D<360) = The number of claims for which the difference D is smaller or equal to 360.

     

    LTC = The total number of lost-time claims (KSM #2).

     

    Caveat

    This is not a return to work measure although it can be seen as a proxy. Injured workers may stop receiving wage-loss benefits for a number of reasons other than returning to work. Also note that the measure makes no distinction with regards to what happens between the injury and the last day of wage-loss benefits. For instance, a worker that has temporarily returned to work before experiencing an aggravation is treated the same as if the wage-loss benefits never stopped. All aggravations or claim reopenings that occur after December 31 of the year following the reference year are not accounted for.

  • IR1. Administration Costs Per $100 of Assessable Payroll
  • Intent of Measure
  • To measure the observed cost of administering the system per $100 of assessable payroll to make it comparable between Boards/Commissions. Useful for monitoring trends.

  • Definition
  • Total administration costs for assessable employers, divided by the assessable payroll.

  • Calculation
  • 100 x A / ( B x 1000 )
    A = Administration Costs ($ millions) (KSM #8)
    B = Assessable Payroll for Assessable Employers ($ billions) (KSM #12)
    Express in dollars per $100 of assessable payroll.

  • IR2. Current Year Benefit Costs Per $100 of Assessable Payroll
  • Intent of Measure
  • To measure the fully funded cost of injuries occurring in the year from a rate setting point of view. To provide an indication of what rate should have been charged to finance the cost of injuries occurring in the year when compared to the component for the compensation costs in the provisional assessment rate (available in the Preface Reports). To improve comparability of key statistical measures. Useful for monitoring trends.

  • Definition
  • Total benefit costs incurred for injuries that occurred in the reference year and diseases that were reported/diagnosed in the reference year, divided by the assessable payroll. For assessable employers only.

  • Calculation
  • 100 x A / ( B x 1000 )
    A = Current Year Benefit Costs Incurred for Assessable Employers ($ millions) (KSM #4.1)
    B = Assessable Payroll for Assessable Employers ($ billions) (KSM #12)
    Express in dollars per $100 of assessable payroll.

  • IR4. Occupational Health & Safety Costs paid by Boards/Commissions. per $100 of Assessable Payroll
  • Intent of Measure
  • To measure the cost of occupational health and safety activities from a rate setting point of view. To provide an indication of what rate should have been charged to finance the cost of occupational health & safety (OH&S) when compared to the component for the OH&S costs in the provisional assessment rate (available in the Preface Reports). To improve comparability of key statistical measures.

  • Definition
  • Total occupational health & safety costs for assessable employers, divided by the assessable payroll.

  • Calculation
  • 100 x A / ( B x 1000 )
    A = Total OH&S Costs Paid by Boards/Commissions during Year ($ millions) (KSM #9)
    B = Assessable Payroll for Assessable Employers ($ billions) (KSM #12)
    Express in dollars per $100 of assessable payroll.

  • IR5. Current Year Average Benefit Cost per Lost Time Claim
  • Intent of Measure
  • To measure the average severity per lost-time claim in monetary terms. System cost driver. To improve comparability of key statistical measures. Useful for monitoring trends.

  • Definition
  • Total benefit costs incurred for injuries that occurred in the reference year and diseases that were reported/diagnosed in the reference year, divided by new lost-time claims of the reference year. For assessable employers only.

  • Calculation
  • 1000000 x A / B
    A = Current Year Benefit Costs Incurred for Assessable Employers ($ millions) (KSM #4.1)
    B = Number of New Lost-Time Claims for Assessable Employers (KSM #2.1)
    Express in $.

  • IR6. Administration Costs per Lost Time Claim
  • Intent of Measure
  • To give an indication of the cost of administering the system from the compensation mission point of view measured by the total amount of resources spent per lost-time claim. To improve comparability of key statistical measures. Useful for monitoring trends.

  • Definition
  • Administration costs, divided by new lost-time claims during the year. For assessable employers only.

  • Calculation
  • 1000000 x A / B
    A = Administration Costs ($ millions) (KSM #8)
    B = Number of New Lost-Time Claims for Assessable Employers (KSM #2.1)
    Express in $.

Source: Association of Workers’ Compensation Boards of Canada (AWCBC)