Proactive allowance limitations

BWC will not pursue proactive allowance and will always notify injured workers or their legal representatives to request the condition in writing when any of the following occurs:

• Any party to the claim, including the injured worker, employer or their representatives, disagrees with the allowance of the condition(s);
• The physician recommends psychiatric, degenerative or pre-existing conditions;
• The evidence does not clearly establish causality;
• BWC determines that a BWC physician review or exam is needed.

If the Physician's Request for Medical Service or Recommendation for Additional Conditions for Industrial Injury or Occupational Disease (C-9) and/or medical evidence date exceeds one year from the date of injury, BWC may still consider it for proactive allowance if the evidence clearly supports the condition and causal relationship is established.