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External KSM Definitions
  • 1. Claims Reported
  • Intent of Measure
  • To measure adjudicative activity.

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

  • Calculation
  • Includes:

    • all lost time, no lost time, healthcare only, occupational disease and fatality claims reported in the reference year regardless of injury year;
    • claims for assessable and self-insured employers;
    • Interjurisdictional Agreement claims where reported.

     

    Excludes:

    • claims that have not been assigned a claim number by the end of the reference year.

     

  • 2. Total Lost Time Claims
  • Intent of Measure
  • To measure the volume of compensated Lost Time Claims resulting from injuries and diseases. Also a system cost driver.

  • Definition
  • A Lost Time Claim is when a worker: (a) is compensated for a loss of wages following a work-related injury or disease; or (b) receives compensation for a permanent disability with or without any time lost in his or her employment.

  • Calculation
  • Includes:

    • claims where a worker is compensated for a loss of wages following a work-related injury (or exposure to noxious substance);
    • claims where a worker receives compensation for a permanent disability with or without any time lost in his or her employment (for example, if a worker is compensated for a loss of hearing resulting from excessive noise in the workplace);
    • only Lost Time Claims within the reference period (below);
    • assessable and self-insured employers.

     

    Excludes:

    • claims without compensation to the worker for a loss of wages or permanent disability;
    • healthcare only claims.

     

    Reference Period:

    • This KSM counts Lost Time Claims which (a) occurred in the reference year (or which were reported/diagnosed in the case of disease); and (b) which were accepted for payment during the reference year, or the three-month period immediately following the reference year.

     

    Formula:

    A + B, where:

         A = Lost Time Claims for Assessable Employers (KSM #2.1).

         B = Lost Time Claims for Self-Insured Employers (KSM #2.2).

     

    Note: This is consistent with the definition used for the National Work Injuries Statistics Program (NWISP).

     

  • 2.1. Lost Time Claims for Assessable Employers
  • Intent of Measure
  • To identify, among Total Lost Time Claims, how many are related to assessable employers.

  • Definition
  • Number of Total Lost Time Claims (KSM #2) related to assessable employers.

  • Calculation
  • Includes:

    • only the portion of Total Lost Time Claims (KSM #2) related to assessable employers.

     

    Excludes:

    • the portion of Total Lost Time Claims (KSM #2) related to self-insured employers.

     

    Note: The total of Lost Time Claims for Assessable Employers (KSM #2.1) and Lost Time Claims for Self-Insured Employers (KSM #2.2) must equal Total Lost Time Claims (KSM #2).

     

  • 2.2. Lost Time Claims for Self-Insured Employers
  • Intent of Measure
  • To identify, among Total Lost Time Claims, how many are related to self-insured employers.

  • Definition
  • Number of Total Lost Time Claims (KSM #2) related to self-insured employers. 

  • Calculation
  • Includes:

    • only the portion of Total Lost Time Claims (KSM #2) related to self-insured employers.

     

    Excludes:

    • the portion of Total Lost Time Claims (KSM #2) related to assessable employers.

     

    Note: The total of Lost Time Claims for Assessable Employers (KSM #2.1) and Lost Time Claims for Self-Insured Employers (KSM #2.2) must equal Total Lost Time Claims (KSM #2).

     

  • 3. Fatalities Accepted
  • Intent of Measure
  • To measure the most serious workplace injuries and occupational diseases.

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

  • Calculation
  • Reference Period:

    • 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.

     

    Includes:

    • assessable and self-insured employers.

     

    Formula:

    A + B, where:

         A = Fatalities Accepted – Occupational Disease (KSM #3.1).

         B = Fatalities Accepted - Injury (KSM #3.2).

     

    Note: This is consistent with the definition used for the National Work Injuries Statistics Program (NWISP).

     

  • 3.1. Fatalities Accepted - Occupational Disease
  • Intent of Measure
  • To identify, among Fatalities Accepted, how many result from an occupational disease.

  • Definition
  • Number of Fatalities Accepted (KSM #3) that are related to occupational disease.

  • Calculation
  • If a jurisdiction already separates fatalities into occupational diseases and/or injuries for any publication, those figures are used. Each jurisdiction uses its own definition of occupational disease.

     

    Includes:

    • only the portion of Fatalities Accepted (KSM #3) related to occupational disease;
    • assessable and self-insured employers.

     

    Excludes:

    • the portion of Fatalities Accepted (KSM #3) related to injury.

     

    Note: The total of Fatalities Accepted - Occupational Disease (KSM #3.1) and Fatalities Accepted - Injury (KSM #3.2) must equal Fatalities Accepted (KSM #3).

     

  • 3.2. Fatalities Accepted - Injury
  • Intent of Measure
  • To identify, among Fatalities Accepted, how many result from a work-related injury (as opposed to an occupational disease).

  • Definition
  • Number of Fatalities Accepted (KSM #3) involving work-related incidents or injuries (as opposed to occupational diseases).

  • Calculation
  • If a jurisdiction already separates fatalities into occupational diseases and/or injuries for any publication, those figures are used.

    Includes:

    • only the portion of Fatalities Accepted (KSM #3) related to injury;
    • assessable and self-insured employers.

     

    Excludes:

    • the portion of Fatalities Accepted (KSM #3) related to occupational disease.

     

    Note: The total of Fatalities Accepted - Occupational Disease (KSM #3.1) and Fatalities Accepted - Injury (KSM #3.2) must equal Fatalities Accepted (KSM #3).

     

  • 4.1. Current Year Benefit Costs ($ millions)
  • Intent of Measure
  • To measure the cost of benefits related to injuries and diseases that occurred in the year. For assessable employers only.

  • 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. Excludes administration costs.

  • Calculation
  • The cost is composed of two items: (1) the payments made during the year for 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).
    • assessable employers only.

     

    Excludes:

    • any administration expense.
    • self-insured employers.
    • latent occupational diseases yet to be reported/diagnosed.

     

  • 5.1. Benefits Paid During the Year ($ millions)
  • Intent of Measure
  • To measure benefit payments made during the financial year (for claims of all current and prior injury years). For assessable employers only.

  • 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 the Annual Report. For assessable employers only. Excludes administration costs.

  • Calculation
  • Total amount of benefits paid for assessable employers. The data is generally available in the financial statements’ note concerning benefit liabilities.

     

    Includes:

    • all benefits types (i.e. short-term disability, long-term disability, survivors’ benefits, healthcare and rehabilitation services) as reported in the Annual Report;
    • current and prior injury years;
    • the costs of treatment and direct services to injured workers provided by rehabilitation centres managed by the Board/Commission;
    • assessable employers only.

     

    Excludes:

    • any administration expense;
    • self-insured employers.

     

  • 6. Benefit Costs Incurred ($ millions)
  • Intent of Measure
  • To measure the expenditure in the statement of revenues and expenditures directly related to the compensation system. For assessable employers only.

  • Definition
  • Benefit costs incurred in the reference year for: (a) injuries that occurred in, and diseases that were reported/diagnosed in, the reference year (KSM 4), PLUS (b) injuries that occurred in, and diseases that were reported/diagnosed in, prior years. For assessable employers only. Excludes administration costs.

  • Calculation
  • Includes:

    • short-term disability, long-term disability, survivors’ benefits, healthcare and rehabilitation services, including commuted values which are incurred;
    • current and prior injury years.

     

    Excludes:

    • any administration expense;
    • self-insured employers’ liabilities;
    • latent occupational diseases yet to be reported/diagnosed.

     

    Formula:

    This is the sum of two elements: A + B, where:

         A = all payments made during the year for injuries and diseases regardless of the year in which they occurred; and

         B = the difference between the liabilities as at December 31 of the reference year and the liabilities of the prior reference year.

     

  • 7.1. Benefit Liabilities ($ millions)
  • Intent of Measure
  • To measure the liabilities related to benefits of assessable employers.

  • Definition
  • Total benefit liabilities for assessable employers only. Excludes administration costs.

  • Calculation
  • 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.

     

    Includes:

    • assessable employers only.

     

    Excludes:

    • any administration expense;
    • self-insured employers;
    • latent occupational diseases yet to be reported/diagnosed.

     

  • 8. Administration Costs ($ millions)
  • Intent of Measure
  • To measure the cost of administering the workers’ compensation 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. For assessable employers only.

  • Definition
  • Incurred expenses related to the management and administration of the Board/Commission. For assessable employers only.

  • Calculation
  • As a basis, the financial statement’s administration cost figure appearing in the note to the financial statement is used which describes in detail the components of administration costs (rather than the dollar amount shown in the Income Statement). Costs prior to the deduction of claims administration costs are used. Exclusions or inclusions which are particular to a certain jurisdiction are explained in the footnotes.

     

    Includes:

    • internal health staff not directly involved in the treatment of injured workers;
    • consulting costs;
    • professional fees (except certain types of medical and legal fees);
    • professional dues;
    • claims administration costs;

     

    Excludes:

    • administration cost liabilities;
    • any administration expense recovered from self-insured employers and miscellaneous revenue/recoveries related to operational activities;
    • 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;
    • self-insured employers’ administration costs;
    • OH&S and other legislated obligations.

     

  • 9. OH&S Costs ($ millions)
  • Intent of Measure
  • To measure occupational health and safety costs paid by Boards/Commissions. Due to legislative and operating differences, OH&S costs vary considerably from jurisdiction to jurisdiction.

  • Definition
  • The cost of all Board/Commission occupational health and safety (OH&S) activities carried out during the reference year. For assessable employers only.

  • Calculation
  • Occupational health and safety (OH&S) costs are 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 paid to a governmental body in charge of applying the OH&S Act, generally the Ministry of Labour.

    (b) Internally administered prevention programs (excluding 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: 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 studying 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 the 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 (specified in footnote)

    Other OH&S costs which are not already included in a prior category. May include non-recurring prevention activities (e.g. prevention training sponsored by the Board/Commission but executed by an external provider).

    (h) Self-insured portion (negative number)

    Any costs attributable to and financed by self-insured employers. These costs are deducted from the total OH&S costs paid during the year.

     

    Formula:

    (a) Levies collected for occupational health and safety + (b) Internally administered prevention programs + (c) Inspection costs + (d) Research grants + (e) Funding of OH&S associations + (f) Amounts paid to public health system to conduct OH&S activities + (g) Other + (h) Self-Insured portion (negative number).

     

  • 10. Assessment Revenue for Assessable Employers ($ millions)
  • Intent of Measure
  • To measure the revenue received from assessable employers.

  • Definition
  • Assessment income received and accrued from rate assessed employers during the reference year for all assessment years. Includes adjustments to assessment revenues of previous assessment years. For assessable employers only.

  • Calculation
  • Amounts are usually available in the statement of operations for assessable employers.

     

    Includes:

    • the amounts accrued for the current assessable year and any adjustment regarding previous assessable years;
    • interest and penalties;
    • experience rating surcharges and discounts;
    • variation of receivable provisions;
    • variation of any other adjustment;
    • assessment bad debts expense, if any;
    • assessable employers only.

     

    Excludes:

    • self-insured employers.

     

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

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

  • Calculation
  • Includes:

    • the amounts accrued for the current assessable year and any adjustment regarding previous assessable years;
    • self-insured employers;
    • interest and penalties;
    • experience rating surcharges and discounts;
    • variation of receivable provisions;
    • variation of any other adjustment;
    • assessment bad debts expense, if any.

     

    Formula:

    A + B, where

         A = Assessment Revenue for Assessable Employers (KSM #10).

         B = any premium revenue accrued from self-insured employers.

     

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

  • Definition
  • Assessable payroll for the reference year. For assessable employers only.

  • Calculation
  • Payroll of assessable employers for a given year including reported actual payroll and payroll estimated for cut-off purposes in preparing the audited financial statements for all assessable employers. When unavailable, the assessable payroll known 3 months after the end of the reference year is used (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 investment performance of the fund.

  • Definition
  • Rate of investment return for the year on a market value basis for all portfolio assets, including investment cash. Measures gross investment performance of the fund during the year.

  • Calculation
  • Includes:

    • investment cash.

     

    Excludes:

    • external investment expenses/fees.

     

    Formula:

    2I / (A+B-I), where:

         I = total investment income on a market value.

         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 of Boards/Commissions at the end of the reference year.

  • Definition
  • Ratio of total assets to total liabilities.

  • Calculation
  • Formula:

    A / B x 100, where:

         A = total assets.

         B = total liabilities.

     

  • 16. Average Days from Injury to First Payment
  • Intent of Measure
  • To measure timeliness of the first payment and worker’s income continuity from the injured worker’s point of view.

  • Definition
  • Average time period (calendar days) 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 Total Lost Time Claims (KSM #2).

     

    Includes:

    • all new Lost Time Claims (including occupational diseases) where a claim number has been assigned within the reference year;
    • occupational diseases;
    • self-insured employers.

     

    Excludes:

    • the conversion period for those claims where no lost time claims are converted to Lost Time Claims;
    • payments made to employers;
    • appeals.

     

    Formula:

    A / B, where:

         A = 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).

         B = Total Lost Time Claims (KSM #2).

     

  • 17. Average Days from Registration to First Payment
  • Intent of Measure
  • To measure operational performance in handling new claims.

  • Definition
  • Average time period (calendar days) from date of registration to date of first payment issued for all new Lost Time Claims.

  • Calculation
  • Total number of calendar days from the date injury is first reported to the Board/Commission 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 Total Lost Time Claims (KSM #2).

     

    Includes:

    • all new Lost Time Claims (including occupational diseases) where a claim number has been assigned within the reference year;
    • occupational diseases;
    • self-insured employers.

     

    Excludes:

    • the conversion period for those claims where no lost time claims are converted to Lost Time Claims;
    • payments made to employers;
    • appeals.

     

    Formula:

    A / B, where:

         A = 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).

         B = Total Lost Time Claims (KSM #2).

     

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

  • Definition
  • The estimated total number of calendar days compensated for short-term disability over the first five calendar years of a typical Lost Time Claim (if current conditions are continued for future years). Short-term disability benefits include all income benefits during the initial period after the injury, before the injury has stabilized, plateaued or consolidated.

  • Calculation
  • The composite method used is the days paid in the reference year for each injury year, divided by Total Lost Time Claims (KSM #2) of the corresponding injury year, then the results are added together for the designated number of years. The current year plus four prior injury years are used in the calculation.

     

    Includes:

    • all short-term disability benefits related to income loss including rehabilitation benefits up to the point where long-term disability benefits commence.

     

    Excludes:

    • days paid for claims that are not included in Total Lost Time Claims (KSM #2);
    • claims in Total Lost Time Claims (KSM #2) for which no days are paid.

     

    Formula:

    A + B + C + D + E, where:

         t = reference year.

         A = days paid during Year t for Lost Time Claims of Year t ÷ Total Lost Time Claims (KSM #2) of Year t.

         B = days paid during Year t for Lost Time Claims of Year t-1 ÷ Total Lost Time Claims (KSM #2) of Year t-1.

         C = days paid during Year t for Lost Time Claims of Year t-2 ÷ Total Lost Time Claims (KSM #2) of Year t-2.

         D = days paid during Year t for Lost Time Claims of Year t-3 ÷ Total Lost Time Claims (KSM #2) of Year t-3.

         E = days paid during Year t for Lost Time Claims of Year t-4 ÷ Total Lost Time Claims (KSM #2) of Year t-4.

     

  • 19. Average Impairment Rating (%)
  • Intent of Measure
  • To measure injury severity. Also a system cost driver.

  • Definition
  • The average impairment percentage awarded on a permanent impairment claim. Applies only 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 Boards/Commissions with a pension system, this represents the percentage rating at which pension benefits are calculated. In Boards/Commissions 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;
    • assessable and self-insured employers.

     

    Excludes:

    • Fatalities;
    • incremental awards for claims previously awarded permanent impairment benefits.

     

    Formula:

    A / B, where:

         A = total of the percentage of impairment for new awards.

         B = number of new impairment awards for the period.

     

  • 20. Proportion of Claims Awarded Impairment Benefits
  • Intent of Measure
  • To measure injury severity. Also a system cost driver.

  • Definition
  • The estimated proportion of Lost Time Claims that are awarded permanent impairment benefits (if current conditions are continued for future years).

  • Calculation
  • The composite method is used where the number of new impairment awards in the reference year for a certain number of injury years are divided by the Total Lost Time Claims (KSM #2) of each injury year, then the results are added together. Accuracy increases with the number of injury years used in the calculation. Practically, the number of components has to be limited, so 10 injury years are used unless otherwise noted.

     

    Note: The injuries awarded impairment benefits follow the same selection criteria as in Average New Impairment Award Percentage (KSM #19). The total number of awards of KSMs #19 and #20 should be equal if the same number of injury years are retained.

     

    Includes:

    • assessable and self-insured employers.

     

    Formula:

    A + B + C + D + E + F + G + H + I + J, where:

         t = reference year.

         A = number of new impairment benefits awards in Year t for claims of Year t ÷ Total Lost Time Claims of Year t.

         B = number of new impairment benefits awards in Year t for claims of Year t-1 ÷ Total Lost Time Claims of Year t-1.

         C = number of new impairment benefits awards in Year t for claims of Year t-2 ÷ Total Lost Time Claims of Year t-2.

         D = number of new impairment benefits awards in Year t for claims of Year t-3 ÷ Total Lost Time Claims of Year t-3.

         E = number of new impairment benefits awards in Year t for claims of Year t-4 ÷ Total Lost Time Claims of Year t-4.

         F = number of new impairment benefits awards in Year t for claims of Year t-5 ÷ Total Lost Time Claims of Year t-5.

         G = number of new impairment benefits awards in Year t for claims of Year t-6 ÷ Total Lost Time Claims of Year t-6.

         H = number of new impairment benefits awards in Year t for claims of Year t-7 ÷ Total Lost Time Claims of Year t-7.

         I = number of new impairment benefits awards in Year t for claims of Year t-8 ÷ Total Lost Time Claims of Year t-8.

         J = number of new impairment benefits awards in Year t for claims of Year t-9 ÷ Total Lost Time Claims of Year t-9.

     

  • 21. Lost Time Injury Frequency
  • Intent of Measure
  • To measure the proportion of covered workers who had a Lost Time Claim.

  • Definition
  • Number of new Lost Time Claims per 100 covered workers. For assessable employers only.

  • Calculation
  • Excludes:

    • self-insured employers.

     

    Formula:

    N / C1 x 100, where:

         N = Lost Time Claims for Assessable Employers (KSM #2.1).

         C1 = number of workers of assessable employers and 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 (KSM #22).

     

  • 22. Workforce Covered (%)
  • Intent of Measure
  • To measure the proportion of the employed labour force eligible for workers’ compensation benefits.

  • Definition
  • Percentage of the workforce that is covered by workers’ compensation. The number of persons covered is the sum of two main components: (1) the workers of assessable employers and self-employed workers opting for coverage; and (2) the workers of self-insured employers and workers of the Government of Canada. Excludes persons eligible for personal coverage not opting for coverage and workers explicitly excluded by the jurisdiction's legislation.

  • Calculation
  • The numerator is calculated by each jurisdiction using the technique most suitable to its circumstances. The numerator represents the average number of covered workers during the year. For consistency with the denominator, each part-time worker is considered as one worker. Two methods are used: (1) in jurisdictions where the law covers all salaried workers with only minor exceptions, the number of excluded workers is calculated using general statistical data on the labour force. The number of self-employed workers is extracted from the database of the Board/Commission; (2) The other method estimates 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.

     

    Includes:

    • workers of assessable employers and self-employed workers opting for coverage;
    • workers of self-insured employers and workers of the Government of Canada;
    • part-time workers (counted as one worker).

     

    Excludes:

    • persons eligible for personal coverage not opting for coverage;
    • workers explicitly excluded by the jurisdiction's legislation.

     

    Formula:

    C / P x 100, where:

    C = C1 + C2.

         C1 = number of workers of assessable employers and 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.

     

    Caveat

    The reliability of this indicator is subject to limitations due to the absence of a detailed count of workers in the databases of the Boards/Commissions. To achieve a reasonable result, each Board/Commission uses the technique that best suits its circumstances. The techniques involve 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. Prudence is recommended to the users of these statistics.

     

  • 23. Real Rate of Return Assumption (%)
  • Intent of Measure
  • To present the most significant economic assumption used in the calculation of benefit liabilities. To measure the strength of liabilities or the expectations regarding future investment performance.

  • Definition
  • Actuarial assumption for the real rate of return used in the valuation of benefit liabilities, i.e. the rate used to discount fully indexed benefits.

  • Calculation
  • Formula:

    { (1+i) / (1+P) } - 1, where:

         i = the nominal rate of interest.

         P = the change in the Price Index for the twelve month 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. Claims on Wage-Loss Benefits after 2 years
  • Intent of Measure
  • To measure injury severity as the persistency of claims on wage-loss benefits and the extent to which injured workers are unable to return to work in the longer term. Also a system cost driver.

  • Definition
  • Ratio of: (a) the number of Lost Time Claims receiving any type of wage-loss benefits for December 31 of the second calendar year after the injury year; to (b) the Total Lost Time Claims for that injury year.

  • Calculation
  • Includes:

    • 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;
    • claims for assessable employers and self-insured employers.

     

    Excludes:

    • survivor benefits claims.

     

    Reference Period:

    • In counting claims receiving payment, files are read by March 31 of the third calendar year after the injury year.

     

    When this KSM is influenced by lump-summing or pension review practices, this should be indicated in a footnote.

     

    Formula:

    A / B x 100, where:

         t = reference year.

         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 = Total Lost Time Claims for injury year t-2 (KSM #2).

     

    Example:

         t: year 2014 (reference year).

         A: number of claims for injury year 2012 with any wage-loss benefits >$1 paid for December 31, 2014 as seen on March 31, 2015.

         B: Total Lost Time Claims for 2012 (KSM #2).

     

  • 24.2. Claims on Wage-Loss Benefits after 6 years
  • Intent of Measure
  • To measure injury severity as the persistency of claims on wage-loss benefits and the extent to which injured workers are unable to return to work in the longer term. Also a system cost driver.

  • Definition
  • Ratio of: (a) the number of Lost Time Claims receiving any type of wage-loss benefits for December 31 of the sixth calendar year after the injury year; to (b) the Total Lost Time Claims for that injury year.

  • Calculation
  • Includes:

    • 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;
    • claims for assessable employers and self-insured employers.

     

    Excludes:

    • survivor benefits claims.

     

    Reference Period:

    • In counting claims receiving payment, files are read by March 31 of the seventh calendar year after the injury year.

     

    When this KSM is influenced by lump-summing or pension review practices, this should be indicated in a footnote.

     

    Formula:

    C / D x 100, where:

         t = reference year.

         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 = Total Lost Time Claims for injury year t-6 (KSM #2).

     

    Example:

         t: year 2014 (reference year).

         C: number of claims for injury year 2008 with any wage-loss benefits >$1 paid for December 31, 2014 as seen on March 31,2015.

         D: Total Lost Time Claims for 2008 (KSM #2).

     

  • 25.1. Percentage of Wage-Loss Claims off Wage-Loss Benefits at 30 days
  • Intent of Measure
  • To be a proxy of return to work. To measure how soon injured workers leave the wage-loss compensation system permanently.

  • Definition
  • Percentage of Total Lost Time Claims (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
  • Formula:

    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 = Total 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 Wage-Loss Benefits at 90 days
  • Intent of Measure
  • To be a proxy of return to work. To measure how soon injured workers leave the wage-loss compensation system permanently.

  • Definition
  • Percentage of Total Lost Time Claims (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
  • Formula:

    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 = Total 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 Wage-Loss Benefits at 120 days
  • Intent of Measure
  • To be a proxy of return to work. To measure how soon injured workers leave the wage-loss compensation system permanently.

  • Definition
  • Percentage of Total Lost Time Claims (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
  • Formula:

    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 = Total 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 Wage-Loss Benefits at 180 days
  • Intent of Measure
  • To be a proxy of return to work. To measure how soon injured workers leave the wage-loss compensation system permanently.

  • Definition
  • Percentage of Total Lost Time Claims (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
  • Formula:

    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 = Total 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 Wage-Loss Benefits at 360 days
  • Intent of Measure
  • To be a proxy of return to work. To measure how soon injured workers leave the wage-loss compensation system permanently.

  • Definition
  • Percentage of Total Lost Time Claims (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
  • Formula:

    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 = Total 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 cost of administering the system from a rate setting point of view. To compare to the administration costs component of the provisional assessment rate (available in the Breakdown of Assessment Rates).

  • Definition
  • Administration costs per $100 of assessable payroll. Ratio of: (a) Administration Costs for Assessable Employers; to (b) Assessable Payroll for Assessable Employers. For assessable employers only.

  • Calculation
  • Excludes:

    • self-insured employers.

     

    Formula:

    100 x A / (B x 1000), where:

         A = Administration Costs for Assessable Employers ($ millions) (KSM #8).

         B = Assessable Payroll for Assessable Employers ($ billions) (KSM #12).

     

    Expressed in dollars per $100 of assessable payroll.

     

  • IR2. Current Year Benefit Costs Per $100 of Assessable Payroll
  • Intent of Measure
  • To measure benefit costs from a rate setting point of view. To compare to the component for the compensation costs in the provisional assessment rate (available in the Breakdown of Assessment Rates Report).

  • Definition
  • Current year benefit costs per $100 of assessable payroll. Ratio of: (a) Current Year Benefit Costs Incurred for Assessable Employers; to (b) Assessable Payroll for Assessable Employers. For assessable employers only.

  • Calculation
  • Excludes:

    • self-insured employers.

     

    Formula:

    100 x A / (B x 1000), where:

         A = Current Year Benefit Costs Incurred for Assessable Employers ($ millions) (KSM #4.1).

         B = Assessable Payroll for Assessable Employers ($ billions) (KSM #12).

     

    Expressed in dollars per $100 of assessable payroll.

     

  • IR4. OH&S Costs per $100 of Assessable Payroll
  • Intent of Measure
  • To measure occupational health and safety costs from a rate setting point of view. To compare to the OH&S costs component of the provisional assessment rate (available in the Breakdown of Assessment Rates).

  • Definition
  • OH&S costs paid by Boards/Commissions per $100 of assessable payroll. Ratio of: (a) OH&S Costs Paid by Boards/Commissions; to (b) Assessable Payroll for Assessable Employers. For assessable employers only.

  • Calculation
  • Excludes:

    • self-insured employers.

     

    Formula:

    100 x A / (B x 1000), where:

         A = OH&S Costs Paid by Boards/Commissions ($ millions) (KSM #9).

         B = Assessable Payroll for Assessable Employers ($ billions) (KSM #12).

     

    Expressed 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. Also a system cost driver.

  • Definition
  • Current year average benefit cost per Lost Time Claim. Ratio of: (a) Benefit Costs Incurred for Assessable Employers; to (b) Lost Time Claims for Assessable Employers. For assessable employers only.

  • Calculation
  • Excludes:

    • self-insured employers.

     

    Formula:

    1,000,000 x A / B, where:

         A = Current Year Benefit Costs Incurred for Assessable Employers ($ millions) (KSM #4.1).

         B = Lost Time Claims for Assessable Employers (KSM #2.1).

     

    Expressed in dollars.

     

  • IR6. Administration Costs per Lost Time Claim
  • Intent of Measure
  • To measure the cost of administering the system. To measure the amount of resources spent per Lost Time Claim.

  • Definition
  • Administration costs per Lost Time Claim. Ratio of: (a) Administration Costs for Assessable Employers; to (b) Lost Time Claims for Assessable Employers. For assessable employers only.

  • Calculation
  • Excludes:

    • self-insured employers.

     

    Formula:

    1,000,000 x A / B, where

         A = Administration Costs for Assessable Employers ($ millions) (KSM #8).

         B = Lost Time Claims for Assessable Employers (KSM #2.1).

     

    Expressed in dollars.

     

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