WSIB (Workplace Safety & Insurance Board) Information

MORE TO KNOW ...

If an injury at work requires medical assistance, results in lost time from work or lost income, you may be entitled to file a claim for benefits with the Workplace Safety and Insurance Board (WSIB).

Fink & Bornstein has extensive experience in matters relating to the WSIB. Our legal counsel will:

*   Provide a legal opinion on your claim;  
*   Defend your interests, rights and responsibilities stemming from your injury;  
*   Help you receive the medical and financial support you are entitled to;   
*   Protect you from further injury at your workplace; and  
*   Ensure your return to work, with proper accommodation.

WSIB logo

Return to Work / Retraining

WSIB has a new Return to Work Policy obligation for employers, the Work Reintegration Program (WR).

In November 2010 the WSIB announced new policies to compel Employers to return injured Workers to their former place of employment. These policies apply to all injured Workers no matter what their year of accident, or status in the Labour Market Re-entry Program. Penalties are one year's benefits, plus LMR costs, anywhere from $20,000.00-$70,000.00.

Our firm has specialized in the management of Return to Work obligations for 20 years. We can help you come to the most expedient resolution. Return to Work meetings are quasi judicial proceedings where determinations are made with many thousands of dollars of potential liability at stake."tab2

WSIAT (Workplace Safety and Insurance Appeals Tribunal)

If you are having problems with the Workplace Safety and Insurance Board (WSIB), you should call RICHARD A. FINK!

RICHARD A. FINK is recognized by Lexis Legal information as being the number one advocate (in appearances) at the Workplace Safety and Insurance Appeals Tribunal (WSIAT). Richard A. Fink is a lawyer certified by the governing body of lawyers, (Law Society of Upper Canada) as a specialist. Richard has extensive experience with handling:

Workers Comp, WSIB, WSIAT, (OHSA) Occupational Health and Safety and Canada Pension Plan (CPP) Appeals for all types of benefits including: 

OCCUPATIONAL HEALTH AND SAFETY LAW IN ONTARIO

Every employer and employee wants to maintain a safe and healthy workplace. Employers, managers, supervisors, and ordinary workers have legal obligations under the Occupational Health and Safety Act (“OHSA”) to do just that.

The OHSA has three basic aims:
    
*    It sets out the legal duties of everyone in the workplace with respect to safety;
*    It establishes requirements to deal with workplace hazards; and
*    It creates an enforcement regime to ensure compliance with its rules and regulations.

                               

What you should know

  • A Worker’s Report of Injury (Form 6) should be filed if:

            - You were injured at work; and/or

            - You experience medical issues that could be from your job duties and/or work exposure at work (Ex. repetitive strain/sprain, hearing loss, chronic pain disability, PTSD, chemical exposure, etc.).

You have 6 months from the date of the injury or when you first knew of the medical issue, to file your Form 6. 

Notify your Employer of the work injury or medical issue, as soon as it is known to you. 

Seek medical attention for the work injury or medical issue, as soon as it is known to you. 

  • If you receive a WSIB Decision that you do not understand or disagree with, submit an Intent to Object Form to the WSIB. Make sure you keep a copy for your records. Always contact the WSIB within 5 business days, to ensure they have received your Intent to Object Form. You can also contact the WSIB and speak with the person assigned to your file, to get additional information.
  • There are strict time limits for objecting (appealing) WSIB Decisions. Every WSIB Decision letter will provide you with the deadline of either 6 months or 30 days (depending on the issue). Always make certain you submit the Intent to Object Form within the time limitations, or if you have questions about the WSIB’s Decision seek legal advice before the deadline.
  • The Workers' Compensation System is a "no-fault" insurance plan that provides compensation to workers hurt or disabled from work. In most cases, injured workers cannot sue for work-related injuries or diseases. Their only option is to make a claim for compensation to the Workplace Safety and Insurance Board (the WSIB). The Workplace Safety and Insurance Act (the Act) is the government legislation that covers the compensation system.
  • If your employer is covered under the Act and you are an eligible worker who was injured at work or out of the course of employment, you can make a claim for benefits. There is a 6 month time limit to make a claim.
  • Compensation is available to survivors and dependants of injured workers whose death is related to a work injury or a work-related disability/disease.
  • If your claim for benefits is rejected, you have six months to appeal the decision. The appeal process starts with the Intent Objection Form, which you must submit by the deadline indicated on the WSIB’s Decision letter. If you have new information you want the WSIB to consider, you should submit it with your Intent to Object Form. The appeal will then be reviewed, and if there is new information submitted, the Case Manager will reconsider the Decision.  
  • If the Decision is still not in your favour, the appeal will be sent to the Appeals Services Division. You will then deal with the issue(s) under appeal by either an Oral Hearing (in person) or by written submissions. 
  • If your appeal is denied by the Appeals Services Division, you can still appeal to a separate organization, the Workplace Safety and Insurance Appeals Tribunal(WSIAT). The WSIAT is the final level of appeals for WSIB matters in the Province of Ontario.
  • The Workplace Safety and Insurance Board (WSIB) was established by the Ontario government to provide health care and lost wages to those who were injured at work. The WSIB is a no fault system and will provide benefits, whether the accident was the worker’s or employer’s fault.

Right to Sue

Generally, if you have been injured at work you cannot sue your employer. If you want further information on this topic, contact our office.

Time Limits

There is a six (6)month time limit to apply for benefits (by submitting a Form 6) and thirty (30) days for appealing Return to Work or Work Transition Plan (Retraining) Decisions. If you have missed a time limit, you should seek help from a lawyer as soon as possible. Obtain a legal representative who is competent and experienced.

Complete a Form 6 and send it along with a letter explaining why the time limit was missed. The WSIB may extend the time limit for specific reasons in limited circumstances.

Loss of Earnings (LOE) Benefits

The benefits you are entitled to depend on the impact the injury has on you physically, mentally and financially. You are entitled to Loss of Earnings Benefits if you suffered a loss of income due to the work related injury. The level of benefits depends on the date of the accident.

After January 1st, 1998:

%

From January 1st, 1990:

%

Before January 1st, 1990:

%

Non Economic Loss Award (NEL)

It is a benefit received from the WSIB when they recognize that your injury has a permanent impairment on your life. A permanent impairment means any permanent physical or functional abnormality or loss (including disfigurement) which results from an injury, and any psychological damage arising from the abnormality or loss. To determine if you have a permanent impairment, the WSIB looks at the relevant medical information in your file.
The amount of your award is expressed as a percentage of the whole body and based on an independent assessment.

Health Care

The WSIB does pay for chiropractic and physiotherapy treatments as long they are recommended by your physician to treat your injury, and the treatment would improve your condition. You would usually receive 12 weeks of benefits for these treatments. An extension can be granted if your chiropractor or physiotherapist believes it is necessary and the Board agrees.
The WSIB will also pay for any medication that is needed for your injury, as long as entitlement is granted for that injury by the Board.

Prescription

In most cases when you are injured, you will require some form of medication. In many cases the WSIB will reimburse the injured worker for these expenses; however they must be pre-approved by the board. As an injured worker you must provide the WSIB with the original prescriptions and receipts for all health care prescriptions and supplies

Mileage

Many injured workers will need to travel for treatment and in some instances the WSIB will pay mileage or some travel expenses. However, approval must be obtained for out of town travel. If the treatment is outside of city limits but still local, the reimbursement is based on mileage. Treatment within the city limits is based on bus fare. In all cases it is important to ask for approval in advance.

Labour Market Re-Entry Program (LMR)

Often times an injured worker is unable to return to their original employment due to the severity of the injury. Injured workers are eligible for an LMR assessment if it is unlikely the worker will be re-employed by the accident employer due to the nature of the injury and or the injury employer is unable to arrange for suitable and available work. Based on the results of the LMR assessment, the WSIB decides whether a worker requires an LMR plan to return to the labour market. An LMR plan is tailored to each individual worker based on their existing transferable skills. A worker will receive benefits while co-operating with their LMR plan. If the worker does not agree with the suggested LMR plan they must appeal within 30 days in writing to the board.

Obtain Legal Representation

Far too often, disputes arise over what benefits are owed to you. Contact a lawyer who knows the worker’s compensation system. The Ontario law is complex. Employers are typically represented by competent experienced worker’s compensation lawyers who try to defeat the claim or minimize the benefits paid to you. You need a lawyer who will fight for you. We may be able to help. 

If you or your loved one has experienced a work related injury and want a Law Society of Ontario Certified Lawyer Specialist to evaluate the WSIB benefits thet you may be entitled to: Please Call 416-537-0108 to learn about our FREE Case Evaluation.