Workers' Compensation Safety Board of Nova Scotia

Health Services Policies and Position Statements

The WCB is responsible for making sure that injured workers get the healthcare they need for the treatment of work-related injuries. WCB policies 2.3.1R - Provision of healthcare Services and 2.3.5 - Medical Aid - General Principles guide the WCB when deciding whether or not to pay for a particular type of treatment, service, or device. Some factors the WCB considers:

  • That the healthcare fits the type of injury
  • That the healthcare is the best value
  • That the healthcare meets healthcare standards and practices
  • That the healthcare is delivered by doctors, physiotherapists, and chiropractors etc. that are WCB approved

Considering the Workers’ Compensation Act and the policies noted above, the WCB has written a series of position statements to help clarify the WCB’s approach to a number of topics related to injured workers’ healthcare.

If you have questions, please contact the Coordinator, Service Provider Relationships at healthservices@wcb.ns.ca 

Acupuncture
Bedding Systems
Braces & Supports
Dental Statement
Gym Memberships
Hearing Aids - Preventative Maintenance
Home Traction Devices
Hospital Physiotherapy
IV Lidocaine
Lost or Stolen Healthcare Goods
Miscellaneous healthcare Items
Massage Therapy
Child Care
Missed Appointments
OBUS Form
Orthotics & footwear
Osteopaths
Reimbursing Private Insurance Plans
Approved Clinics
Walk-in tubs
Snow removal and yard work
Travel Payment
Medical marijuana

Acupuncture -  Acupuncture is only covered if given by or under the direct supervision of a WCB approved physiotherapist, chiropractor, or doctor. The reimbursement will be made at the usual office visit rate.

Bedding Systems - There is no medical evidence that supports the use of standard bedding systems for injury treatment or sleep conditions. Therefore, the WCB does not pay for standard bed systems.

Specialized bedding systems (to treat pressure ulcers, control intra-abdominal pressure, etc) may be considered if they are recommended by a service provider to address a medical condition.

Braces and Supports - Chiropractors, physiotherapists, or doctors may prescribe supports and/or braces for injured workers as appropriate. The WCB generally approves these commonly requested braces:

 Brace Injured Area Circumstance
 Immobilizer Shoulder Rehab post-surgery (major rotator cuff repair)
 Tennis elbow brace Elbow Sprain/Strain
 Hernia belt Hernia Post-surgery
 Hip brace Hip Post-labral reconstruction/augmentation


The WCB does not generally approve the following braces in these specific circumstances:

 Brace Injured Area Circumstance
 Soft Collar Neck Not approved for sprain/strain, whiplash disorder
 Meniscal brace Knee Not approved for pre or post-surgery for meniscal tears
Cryotherapy & associated brace Any Not approved in any circumstance


Dental Statement -  A dentist must complete and submit an estimate (predetermination) to the WCB before booking a service to treat a compensable injury. Please refer to the Nova Scotia Dental Association’s Suggested Fee Guide for Dental Services to determine if the quote is appropriate.

Gym Memberships -  The WCB expects the WCB approved clinics to provide instructions on a home exercise program from the onset of treatment and so does not pay for gym memberships. The injured worker is expected to participate and comply with any recommended treatment, including a home exercise program.

Hearing Aids Preventative Maintenance -   Aside from a single, annual, appointment for preventative maintenance (i.e. ensuring aids are in good working order), WCB clients should not be solicited by the service provider or supplier for regular service at the expense of the WCB. Devices in need of repair will be covered by the WCB only after the manufacturer warranty has expired.

Home Traction Devices - are not covered as the risks associated with the device far outweigh the potential benefit:

1) There are liability concerns that the worker can overdo it and cause further injuries; and

2) Injured workers that need to be working on ROM issues for the shoulder at home can be educated on how to use a towel, stick or a table to do the same exercises.

Hospital Physiotherapy -  WCB will not pay for treatment at hospital outpatient physiotherapy clinics as these clinics have not entered into an agreement with the WCB to provide services.

IV Lidocaine -  IV lidocaine will not be approved due to a lack of data supporting its effectiveness and safety for the treatment of chronic pain or nervous system pain (neuropathic pain).

Lost or Stolen Healthcare Goods - The WCB does not generally cover lost or stolen healthcare goods.

Miscellaneous healthcare Items -  Miscellaneous items include magic bags, hot water bottles, hand exercise balls, therabands, stability balls, and water pillows. These items are not covered as they are not specific to injury or illness treatment and are considered easy for a worker to get on his or her own.

Massage Therapy -  WCB covers massage therapy if the massage is given by a massage therapist who is directly supervised by a WCB approved doctor, physiotherapist, or chiropractor. 

Child Care -  The WCB does not generally pay injured workers for child care, but this will be reviewed on a case by case basis.

Missed Appointments -  Generally, the WCB does not pay for missed appointments. It is the service provider’s responsibility to inform the worker of cancellation policies and the worker’s responsibility to be aware of cancellation policies.

OBUS Form -  The WCB may cover an OBUS Form if it is part of the treatment that is prescribed by the service provider.

Orthotics & footwear -  The WCB will cover orthotics in the instance of a leg length discrepancy of 2cm and greater. The WCB may cover orthotics in the case of ankle or foot injury, but will not in the case of knee or osteoarthritis injury. The WCB does not approve orthotics for the treatment of back pain due to the lack of medical research supporting its effectiveness. The WCB does not cover footwear as orthotics can be used with regular shoes. 

Osteopaths - Osteopaths (Doctor of Osteopathy) are not an approved service provider for the WCB as they are not licensed and not regulated within the province of Nova Scotia. WCB only covers osteopath treatment if the osteopath is directly supervised by a WCB approved doctor, physiotherapist or chiropractor.

Reimbursing Private Insurance Plans -  The WCB will only reimburse private insurance plans if the Workers’ Compensation Appeals Tribunal deems it appropriate through an appeal. In this case the WCB will reimburse the private insurance company for the full amount of the claims cost (to the limit of the benefit entitlement under the Workers’ Compensation Act).

Approved Clinics -  An injured worker can get care at any WCB approved clinic (physiotherapy or chiropractic clinic) within a reasonable distance of the injured worker’s home or workplace. 

Walk-in Tubs - The WCB does not generally cover walk-in tubs because they are not a cost-effective solution to help an injured worker. Instead, a tub cut-out or other cost-effective solution may be covered.

Snow removal and yard work - The WCB does not pay for snow removal or yard work for injured workers. These services are not considered medical aid or vocational rehabilitation under the Workers’ Compensation Act, and are not considered personal care under Policy 2.1.6R – Attendant Allowance.

Travel Payment - The WCB does not pay for travel to the drugstore to pick up prescriptions, as this does not constitute active medical treatment. The WCB does not pay travel expenses to an injured worker for 'ease back' to work. 

Medical Marijuana 

Herbal

The WCB does not approve the use of herbal medical marijuana under any circumstances.  This is because there is a lack of objective data supporting its effectiveness and safety.  Further, its use to treat injury is not good medicine practice in Canada.

Synthetic

The WCB may consider the approval of Dronabinol (Marinol®) or Nabilone (Cesamet®) for the management of severe nausea and vomiting associated with chemotherapy treatment for occupational cancer.  There is objective data supporting the effectiveness of these drugs when used in this manner.

Due to a lack of objective data supporting its effectiveness, the WCB does not approve the use of Sativex® under any circumstances

Please see the WCB paper Clinical Efficacy of Medical Marijuana: Summary of Evidence‐Based Research, 2011 for more information.