Payment of Health Care Benefits

Your doctor recommends a specific type of treatment, but, for whatever reason, the WSIB denies it; what do you do?

Unfortunately, this happens all too often. Your doctor recommends a specific type of treatment, only to be overruled by someone at the WSIB. Doesn't make a whole lot of sense.  According to the WSIB, the following health care treatment is covered under the law.  

    • medical treatment
    • hospitalization, including emergency care and surgery
    • prescription drugs
    • medical devices and orthotics
    • equipment and supplies
    • reasonable travel and accommodation expenses associated with your work-related injury or illness

How to ensure that you are getting the treatment recommended by your doctor and that you're not stuck with the bill if the WSIB refuses to pay for it? 

First, make sure that your doctor submits a request directly to the WSIB to have the proposed treatment covered by the WSIB, and do not proceed with the treatment until you have confirmation in writing from the WSIB that they are paying for said treatment.

Should you find yourself in a situation where the WSIB refuses to pay for the treatment and you wish to proceed with it anyway on the advice of your doctor, have your doctor write a note detailing why the treatment is medically essential for your recovery and submit it along with a request for a reconsideration of the WSIB's decision. Use our DECISION RECONSIDERATION REQUEST SETTLEMENT KIT, which is available in minutes.