How to Navigate the WSIB Claims Process in Ontario

WSIB Claims Process in Ontario: How To Navigate It

In Ontario, navigating the Workplace Safety and Insurance Board (WSIB) claims process might seem daunting, particularly when dealing with the aftermath of workplace injury or illness. 

This guide will provide you with all the information you need, covering the steps to file a WSIB claim, what employees and employers should do, and more.

The Steps to File a WSIB Claim

Filing a Workplace Safety and Insurance Board claim in Ontario involves several crucial steps:

  • Immediate Reporting: Notify your employer about your workplace accident or disease. If your condition requires more than first aid, your employer should complete a report (Form 7) and send it to the WSIB within three days.
  • Medical Attention: Seek immediate medical assistance. Ensure to inform your healthcare provider that your condition is work-related, as they are required to send a Health Professional’s Report (Form 8) to the WSIB.
  • Filing a Claim: To apply for WSIB benefits, complete the Worker’s Report of Injury/Disease (Form 6), which is available on the WSIB website. Employees have six months from the date of injury or from the date of the disease diagnosis to claim benefits by reporting their injury or illness to the WSIB.

If applicable, also report the incident to your union or health and safety representative.

What Employees Should Know About WSIB Claims

As an employee in Ontario, you have responsibilities when it comes to Workplace Safety and Insurance Board claims. Therefore, it is essential to understand these to ensure successful worker compensation claims:

  • Medical Help: In case of a workplace injury or illness, seek first aid immediately. If necessary, visit a doctor or hospital for further treatment.
  • Documentation: Report your injury or illness and any subsequent medical treatment to your employer as soon as possible.
  • Reporting to WSIB: If your injury or illness requires treatment beyond first aid or results in you being unable to work, earning less, or receiving fewer work hours, submit a Worker’s Report of Injury/Illness (Form 6) to the WSIB.
  • Stay in Touch: Communication is key during the recovery process. WSIB works with you and your employer to help you recover and return to work safely.

If you have questions about navigating the WSIB claims or appeals process, consult with an experienced employment lawyer to advise you.

Responsibilities of Employers regarding WSIB

As an employer in Ontario, you have specific responsibilities in the event of a workplace injury or illness:

  • First Aid: You are responsible to provide first aid to your employees and cover any further treatment costs, such as transportation to the hospital or doctor, on the day of the injury.
  • Investigation and Record Keeping: Investigate the accident and keep a detailed record. Document what happened, the steps taken to correct the issue, and future preventative measures.
  • Reporting: If an employee’s condition requires more than first aid, you should submit an Employer’s Report of Injury/Illness (Form 7) to the WSIB within three days. Also, provide a copy of the report to your employee. There are consequences for employers who do not report an incident to WSIB or try to discourage employees from reporting their accident to WSIB.

If your employee can return to work with accommodations, you have an obligation to accommodate the employee to the point of undue hardship.

If you have questions about your obligation as an employer regarding workplace accidents, consulting with an experienced employment lawyer can help you reduce your exposure to liability.

WSIB Benefits

You may be eligible for benefits if:

  • Your workplace is covered by the WSIB.
  • Your injury or illness is work-related.
  • Your injury or illness is reported to the WSIB, and your claim is approved.
  • You provide the necessary information requested by the WSIB.
  • You agree to share information about your functional abilities (i.e., your restrictions and ability to work due to your injury or illness) with WSIB and your employer.

There are several types of WSIB benefits available depending on your circumstances, including:

  • Loss-of-Earnings Benefit: Covers lost wages if you are unable to work due to a work-related injury or illness.
  • Non-economic Loss Benefit: This benefit may apply if your work-related injury or illness leads to permanent impairment.
  • Health-care Benefits: Includes benefits for treatment, medical devices, equipment and supplies, and prescription drugs required for your recovery.

When you are receiving WSIB benefits, you need to:

  • Notify WSIB about significant changes in your circumstances within 10 days of the change, such as returning to work, starting to receive other income or government benefits, or crucial changes in your medical condition.
  • Follow your healthcare provider’s recommendations.
  • Participate in health exams or assessments as required by WSIB.
  • Cooperate in the return-to-work process. Non-cooperation can affect your benefits.
  • Provide any requested information about your claim to WSIB.

Conclusion

Navigating the WSIB claims process in Ontario may seem overwhelming at first. By following the steps to file a WSIB claim, both employees and employers can fulfill their responsibilities and ensure a smooth process. Additionally, being aware of the available WSIB benefits and the requirements when receiving those benefits is crucial. 

Remember to stay in touch with WSIB, communicate any significant changes, and provide the requested information within the prescribed timelines. By being proactive and informed, you can navigate the WSIB claims process and access the benefits you are entitled to in a timely manner. 

Contact Achkar Law

If you are an employer in Ontario looking to understand your responsibilities regarding the Workplace Safety and Insurance Board claims process or if you’re an employee who has recently experienced an injury or illness while on the job and needs advice on your rights, our team of experienced WSIB lawyers at Achkar Law can help. 

Contact us by phone toll-free at 1 (800) 771-7882 or email us at [email protected], and we will be happy to assist.

Need a WSIB Lawyer? Achkar Law Can Help

Dealing with the complexities of Workplace Safety and Insurance Board (WSIB) claims can be challenging. Whether you are filing a claim, dealing with a denial, or seeking to understand your entitlements, Achkar Law is here to support you. Our WSIB lawyers specialize in workers’ compensation claims, providing you with the guidance and representation needed to secure the benefits you deserve.

 

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