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Injury at work place – WSIB Appeal Process

WSIB appeals process for injured workers:WSIB appeals process

There is no denying that accidents occur at a work place. The risk level at a workplace is different for every profession. For example a construction site or a mine is a risky place to work and is more prone to accidents that other places, like an office building in the CBD where an IT company is conducting their business.

As per the statistics recently published approximately 4600 workers were killed while on the job in the year 2012. In a very sad incident that occurred in Turkey in May this year (2014), more than 250 miners were killed and they happened to be from many different countries besides Turkey.

But the issue of health and safety cannot be taken lightly by any employer. It is in fact the duty of an employer to provide a safe and secure environment for the workers to work in. There are some tasks and situations that are risky however if the correct guidance and training is provided, most these accidents can be avoided. If the employees are aware of the danger involved and are informed of what precautions to take it is likely that there will be lesser accidents.

However when accidents do occur there is a support system in place that can help you in every step of the way. You are entitled to make claims with the WSIB for compensation. The claim process involves filing the WSIB Accident Report as well as the WSIB Injury report. After the WSIB claims process makes the decision is not in the favor of the worker, there is a WSIB Appeals process too. Then have the right to appeal as well.

Multiple Appeal Levels:

The Ontario Worker’s Compensation system has two levels of appeal. The two levels of appeals are:

  • The Internal Appeal at the Workplace Safety and Insurance Board (WSIB) which is to be made before the Appeals Resolution Officer (ARO).
  • The external Appeal at the Workplace Safety and Insurance Appeals Tribunal (WSIAT).
  • The appeals process usually takes place on an issue by issue basis and it must pass through each level. In general it is quite common for workers to bring up several issues during an appeal and also appeal several times during a claim process.

The time factor:

A claim in general takes time to be processed and is not instant; like just about any other claim process. However prior to that happening an initial decision process takes place. Here is a brief list of them.

  • The WSIB Case Manager makes the initial benefit decision.
  • The Nurse Consultant makes the initial decision about health care.
  • The Work Transition Specialist makes the decision about the work transition or re-entry.

There is time limit to the appeals process for each decision as well. In general the initial decision processes have approximately 6 month time limit. However the Work Transition decision will have only a 30 day time limit. This time limit will always be conveyed at the end of the decision letter that you receive. The worker can object with the intent to object form that is available from the WSIB website. At times it may be necessary to send several forms to comply with the various time limits. These time limits are usually quite strictly followed and it is only in rare cases that you can obtain an extension in the time of appeal.

Appeal Readiness:

Once the intent to object form is sent the relevant will review the issue under appeal. In the case where no changes are made to the claim decision, a copy of the file along with the appeal readiness form will be sent to the worker. The worker in turn needs to then complete this form and submit it back to the WSIB. However, this time there is no time limit for submitting this form.

Appeals Resolution officer (ARO) Appeal:

The WSIB Appeals manager makes the decision on whether the appeal requires an oral hearing or if a written submission is sufficient before the decision is made on the basis of the Appeal Readiness form that was sent by the worker. This is then passed on to the ARO. The ARO reviews the file and conducts the oral hearing if necessary during which the worker will need to testify. The final decision made by the ARO will be in the form of a written submission. The duration of this process can extend up to 20 months, however in general it takes 12 – 20 months.

Appeals Tribunal appeal:

The workers can appeal on the decision of the ARO as well once he makes his decision. They can make an appeal to the Appeals Tribunal by submitting the ‘Notice of Appeal’ form along with the decision of the ARO. This ‘Notice of Appeal’ form is easily available from the website of WSIAT however the appeal to the Appeals Tribunal needs to be made within 6 months of the decision of the ARO since it is almost impossible to get an extension of time after 6 months.

This process in this appeal is usually more thorough and then the ARO one. There are two additional forms, the readiness form and the confirmation of appeal form involved. In addition to this prior to the hearing taking place there is a telephone contact with the tribunal legal worker. Each process takes a lot of time at the end of the oral hearing the decision is finally made. The duration of this process is typically 12 – 243 months.

The decision made by the Appeals Tribunal is usually the final one and there is very little that can be done to change this decision.

How Safety First can help:

Safety First

Safety First is one of the few organizations that has the experience and means to help organizations in the matter of health and safety. Their courses are specially structured to help employees gain a better understanding of their respective working environments and thus prevent and incident from occurring. They have a strong team of certified professional safety consultants that can help businesses of all sizes and a wide range of industries as well.

Safety First Consulting Professional Corporation is a licensed paralegal firm regulated by the Law Society of Upper Canada (LSUC). Our paralegal team provides a widespread WSIB claims Ontario management system that is designed to reduce and control an employer’s costs associated with workplace injuries and illnesses. Our pro-active program begins at the point of occurrence and continues to the final resolution of the claim with a rapid response.

The professionals at Safety First Consulting can show you how to navigate the sometimes technical and often confusing OSHA regulations with health and safety program ontario. They can help you figure out what regulations apply in your workplace and what you need to do to comply. Just know About us, take one of our classes, or request a Contact us form.

About the author

Sophie MooreSophie Moore is a Digital Marketing Analyst, in charge of many digital marketing projects that involve SEO, Social Media and mobile web strategy. Moore has a background in IT, strong experience on website development and web interface, degrees in both traditional and digital marketing at Duke University, North Carolina.

Moore has a wide experience of internet projects and keeps herself up to date with the latest technologies and trends. Moore always explains that social media is her passion, SEO a motivation and a dynamic challenge where she is involved every day.

Learn more about her at her personal site. Follow her on Twitter, on Google +Sophie or become a friend on Linkedin

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The role of WSIB in case of workplace accidents

In case of injury or illness: overview

The role of WSIB in case of workplace accidents

Workplace injury is a sad reality of daily life. There are some workplaces that are more risky than others. For example a construction site and even a mine are two places that are very risky to work. And this is based on real facts on not just assumptions.

WSIB (Workplace Safety & Insurance Board) is an Ontario government agency which used to be called the workers compensation board at one stage. This now plays a big role in case of any workplace accidents and is helpful to both the employers as well as the workers (employees). This article explains the role of WSIB in more detail.

Reporting the injury or illness:

There are a few things to keep in mind when a worker is injured at the workplace as mentioned here:

  • First Aid should be given immediately making sure proper standard is followed. In addition to which the incident should be reported as soon as possible.
  • Ideally the employee should get in touch with their WSIB account representative so that WSIB can make sure appropriate help and is provided to all concerned.
  • It is the duty of the employer to arrange transport of the injured worker to get medical treatment and go back to his house if necessary.
  • It is good practice for the employer to pay the injured worker the full day’s wages as well keeping in mind that the WSIB injury of earnings benefit doesn’t start till the day after the incident.
  • The employer should make sure he learns from every accident that occurs and does his best to make sure he does the necessary to avoid similar incidents happening the future.
  • In case of fatal incidents it is important to notify the Ministry of Labor, providing them all the circumstances of the incident.

You must report the incident to the WSIB within 3 days:

Any incident involving a worker needs to be reported for the wsib claims as soon as possible. Whatever the case is an injury or an illness the incident needs to be reported within three days.

The report is usually made using the WSIB Accident Report Form, Form. The form is accompanied along with a Form 7 reference guide. In addition to which there is also an e-Form available for the same which makes it easier and more convenient for employers to handle the reporting.

In general it is a legal requirement to report the any such incident with 3 days of it occurring.

Reporting Workplace Accidents:

There are certain situations in which you must report an incident to the WSIB within three days with wsib injury report; they are as below:

  • If the worker loses time from work.
  • If a worker earns less than a regular day’s pay.
  • If a worker gets health care treatment.

There are many things covered include the health care costs, doctor’s visits, the prescriptions, even the care in hospitals and other health care facilities.

Additionally physiotherapy, chiropractor’s visits and eye glasses and processes are also covered.

However there are several conditions in which the incident does not need to be reported as mentioned here:

  • If the minor cuts and bruises or scratches of the worker only need cleaning.
  • If the worker needs treatment of a minor burn.
  • The minor injury of the worker needs applying of a bandage, a cold compress or an ice bag.

There are also some cases in which you can wait up to 7 days to report an incident as mentioned here:

  • If the worker requests for modified work at full pay. This often happens when a worker is injured or suffering from an illness. In such cases either his working hour are reduced or a different set of duties are changed.
  • In cases where the workers are exposed to infectious diseases.

How to initiate a WSIB Claim:

The process of initiating a WSIB claim and Wsib injury report is easier than you think, besides the benefits of doing so far out weight the consequences of not doing so. To file a claim for the benefits simply follow the steps below:

Reporting the incident: As soon as you come to know about the an injury of or illness of an employee it is necessary to fill in the necessary details in the ‘Form 6’ provided for wsib accident report form. The advantage of doing this is that you have all the facts with you at the time and thus will be in a better position to fill the form. There is usually a time limit for filing claim, to make successful claims. A claim must be filed within 6 months of an incident; whatever the case be an accident or an illness.

Physical and mental condition of the injured: The functional abilities of the injured are required to be assessed by the physician. In addition that the worker needs to provide consent that his medical condition be shared with his employer. The advantage of doing this is that all concerned are made aware of the limitations of the worker due to the injuries sustained. This is required if you to make a claim.

Few Important Tips:

  • It is important to understand what WSIB defines as an accident. An injury that is caused due to falling, or a gradual injury being developed over time or even a illness caused due to the exposure to harmful substances are easy incidents which are easy to wsib claims.
  • It is vital that you as a worker give a detailed report of the injuries or illness immediately to the employer. A small incident like ache, pains or muscle pull should be reported as soon as possible since such injuries can develop into something more serious very fast.
  • It necessary to fill in the employee incident form too.
  • It is also necessary for the doctor who examines you to make a note of his observations in the Form 8 to the WSIB.
  • At times it is possible to change the set of duties while the injury still persists. This helps the process of getting back to work after an injury.

How Safety First Consulting can help with WSIB injury report:

As per the statistics released in 2012 approximately 4628 workers were killed while on the job. A more recent example is the accident that occurred in the mines in Turkey. This occurred in May 2014 and more than 250 people from many different countries were killed.

Safety First Consulting gives priority to the safety of your company. Their team of expert, experienced and dedicated professionals are aware of every rule in the book and are able to guide you in the right direction. Besides which they do there every bit to make sure everyone concerned is treated well. This is one firm that offers are wide range of services and WSIB related help is one of them.

Safety First Consulting is a well known licensed paralegal firm. They are well known for their work in providing widespread WSIB claims management system. Their work and system is structured towards making sure the employer’s costs associated with workplace injuries and illnesses stay low.

In case of an incident of some kind, Safety First Consulting will be with you all the way, right from the after occurrence of an incident to the final resolution of the claim. In addition to which Safety First Consulting also strives to make sure the process of getting the worker back to work is easy, safe and comfortable.

Safety First Consulting Professional Corporation is a licensed paralegal firm regulated by the Law Society of Upper Canada (LSUC). Our paralegal team provides a widespread WSIB claims Ontario management system that is designed to reduce and control an employer’s costs associated with workplace injuries and illnesses. Our pro-active program begins at the point of occurrence and continues to the final resolution of the claim with a rapid response.