useful information concerning the more common aspects of a claim
Additional important information you should know concerning how a claim is filed with the Workplace Safety & Insurance Board (WSIB).
Important information about filing a claim with the WSIB
Filling a claim with the Workplace Safety & Insurance Board is quite simple and straight forward. However, it is important to keep in mind some important steps so that your claim doesn't get derailed right from the start.
These simple steps can help in making a claim and minimize or prevent potential problems down the road!
Additional information concerning how Loss of Earnings (LOE) and Health Care Benefits are determined by the WSIB.
Important information about Loss of earnings (LOE) benefits
The Workplace Safety & Insurance Act provides the WSIB with the authority to pay Loss of Earnings. If you miss time from work because of a work-related injury or illness and the WSIB allows your claim, you are entitled to receive LOE benefits.
What you need to know concerning the payment of LOE benefits.
HEALTH CARE BENEFITS
The WSIB is required to help you recover after a workplace injury or illness. This means that they will pay for all approved health care costs related to your claim, even if you have not missed time at work and even if you have insurance coverage.
If you have a workplace injury or illness, your primary health care provider will guide you to get appropriate treatment that the WSIB covers. If you need help to find a specialized health care provider, you can search the WSIB's Programs of Care Directory by clicking this link. You can also access the WSIB's Community Mental Health Network Psychologist Directory by clicking this link.
We suggest that you obtain the WSIB's approval prior to treatment, so that you have confirmation that they are paying for the treatment that is being prescribed.
Additional information concerning the Work Reintegration process, as well as what happens if your injury or illness results in a Permanent Impairment.
help with your Return to work following your injury or illness
The WSIB is required to help you with your return to work following your injury or illness.
A number of WSIB staff may be involved in assisting you with the return-to-work process and ensure that the appropriate help is available when you need it.
Some of the WSIB staff that could be involved in your claim:
| Eligibility Adjudicator | Case Manager | Nurse Consultant | Return-to-Work Specialist
These individuals will play supportive roles such as; determining your eligibility upon receiving your claim for benefits, supporting you and your employer in your return-to-work efforts by sharing any available information on your functional abilities, help set return-to-work and recovery goals, plan activities in collaboration with you, your employer and treating health professional to achieve return to work and recovery.
Additional information concerning the WSIB's Appeal Process.
APPEALING A WSIB DECISION
You have a right to appeal every decision made in your claim!
The WSIB appeal system is complex, intimidating and frustrating. It is laid-out in their 50 page document titled Appeals Services Division Practices & Procedures Document.
It is an extensive document containing policies and procedures, legislative amendments, that even seasoned professionals have trouble with.
With 30 years of hands-on experience representing injured and ill workers, we have cut through the red tape for you and created a system to empower you to obtain the benefits to which you may be entitled.
The most critical aspect of the appeal process is Appeal Time Limits. You have up to 30 days to object to a WSIB decision about return to-work or work transition issues, including re-employment decisions. You have up to six months to object to any other WSIB decision.
Here we have outlined for you some of the key steps relating to the appeal process.