As a union member, you benefit from expert representation that protects your rights and advocates on your behalf if you are injured or become ill as a result of your job.
If you are injured or become ill as a result of your job, your illness or injury MUST be reported to the Workers’ Safety and Insurance Board (WSIB). You are entitled to WSIB benefits if you cannot work and lose earnings because of your illness and injury.
KEEP COPIES OF ALL DOCUMENTATION!
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It is vital you carefully maintain your own file of all documents relating to your claim. This includes doctor’s notes, copies of all forms (Form 6, Form 7, Form 8) and all correspondence from the WSIB, the employer or any other involved parties.
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Your employer and supervisor don’t get to determine whether your accident, injury, illness, or onset of pain is work-related or not. That’s why it’s important to visit a doctor and contact your union representative.
WSIB Questions Answered
How Do I make a WSIB Claim?
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REPORT! Notify your supervisor, manager and health and safety representative as soon as possible about the accident or occupational disease. This step must be completed, whether you do it right away or after seeking medical attention. Your claim may be denied if there is a reporting delay.
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YOUR EMPLOYER MUST COMPLETE TWO FORMS: Ask your employer to complete an Employer Incident Report and a Form 7 (Employer’s Report of Injury/Disease). Ask for copies of both completed forms – Your employer is required to provide you with copies.
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SEEK MEDICAL ATTENTION & ASK YOUR DOCTOR FOR A FORM 8. Visit your family doctor, walk-in clinic or emergency room. Inform the doctor that you have a work-related injury and explain your job duties and symptoms. If injury is not immediate but occurs gradually over time, visit the doctor when you first begin to experience symptoms you believe are work-related. Your family doctor is preferrable as they have your past health record and may better assess the injury – ensure to follow up with them regularly. Ask the doctor (or the physiotherapist) to complete a Form 8 (Health Care Practitioner’s Report) and send it to WSIB. Request a copy.
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INFORM YOUR UNION REPRESENTATIVE AND UNION STEWARD. Contact your union so we can provide you or your co-workers with information and resources on this process.
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COMPLETE WSIB FORM. Inform WSIB about your injury and request a Form 6 (Worker’s Report of Injury/Disease). Alternatively, download this form from wsib.on.ca. Send completed form to WSIB immediately.
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CASE DENIED? Contact the union’s WSIB department to navigate the process.
What if you have a health problem caused by job but did not have an actual accident at work?
When the worker did not have an actual accident at work but an injury emerged gradually, it is a gradual onset disablement. Repetitive Strain Injuries typically fall into this category (e.g., Carpel Tunnel Syndrome, Golfer/Tennis Elbow, Tendinitis, Rotator Cuff/Overhead Work). It is still considered a work injury even the worker did not experience an accident in the traditional sense.
While filing a gradual onset disablement claim, the date of injury is established using the date of first medical attention which led to the diagnosis, or the date of diagnosis, whichever is earlier.
What is an occupational disease?
An occupational disease is a health problem caused by exposure to a workplace health hazard.
An Occupational Disease Includes:
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a disease resulting from exposure to a substance (for example, chemicals, dust, fumes or viruses) relating to a particular process, trade, or occupation in an industry (for example, asbestosis from exposure to asbestos in mining, manufacturing or construction)
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a disease peculiar to, or characteristic of, a particular industrial process, trade or occupation (for example, operating drills used in mining or construction or using tools such as chainsaws may result in Hand Arm Vibration Syndrome)
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a medical condition that in the opinion of the Workplace Safety and Insurance Board (WSIB) requires you to be removed from exposure to a substance because the condition may lead to an occupational disease, or
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a disease mentioned in Schedule 3 or 4 of the Regulations to the Workplace Safety and Insurance Act, 1997.
How long do WSIB benefits last?
Various degree of injuries can take from days to years to recover from. As long as you are deemed to be totally disabled and the disability is considered by the WSIB to be temporary, WSIB benefits will continue.
When do loss of earnings payments apply?
If your employer offers modified duties, and your doctor agrees that you are physically able to work the modified duties, you must return to work on the modified duties. Failure to do so may negatively impact your WSIB benefits, including loss of earnings benefits.
The WSIB normally pays the LOE benefit beginning the day after the injury (your employer must pay your wages for the day of the injury), or whenever your loss of earnings begins.
The LOE benefit stops:
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If you return to work and your earnings are the same or greater than what you were earning before your injury,
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If you participate in a work transition assessment or plan, and it is deemed that you could potentially have earnings (in suitable employment or business) that are the same or greater than what you were earning before the injury.
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When you turn 65 years old. For workers who are 63 years old or older at the time of the injury, your LOE benefit can be paid for up to two years from this date, as long as you have a loss of earnings because of the workplace injury or disease.
Does the LOE benefit always stay the same?
The loss of earnings benefit is based on your average earnings. For the first 12 weeks the WSIB calculates your benefits based on your take-home pay from all your current employers at the time of the injury. If your recovery lasts longer than 12 weeks the adjudicator will review your long-term earnings and adjust the benefits as needed.
As well, your LOE benefit may be reviewed by the WSIB every year, or if you report a material change in your circumstances, up until the 6 thyear after the injury. The benefit will not change after that, up until you turn 65 when it stops, unless we learn of a material change that occurred before the six-year-mark, that you did not report to the WSIB.
What is income replacement insurance?
If you miss time from work because of a work-related injury or disease, and lose pay as a result, the WSIB will provide payments for loss of earnings (LOE). The amount paid for loss of earnings is based on 85 per cent of your pre-injury, take-home earnings, less any earnings you may have after the injury. There is an annual maximum.
What is modified work?
Modified Work is any job, task, or function, that a worker who is temporarily disabled can perform safely without risk of re-injury or exacerbation of their condition, and will pose no risk to others during their recovery. The work must however be productive and result of the work must have value.
Usually, modified work is a temporary vehicle designed to help workers be re-integrated into the workplace, to their pre-injury/illness jobs. Such modifications may include reduced hours, rotation of job duties, more frequent or shorter rest periods, the use of such equipment as ladders, step stools, chairs or many other types of modifications especially designed to suit the medical needs of each individual.
