Most employers in Ontario are required to have Workplace Safety and Insurance Board (WSIB) coverage for their employees.
If you are injured in a workplace accident or diagnosed with an occupational disease, you can submit a claim to the WSIB if the injury or illness causes you to receive healthcare, lose time from work or wages beyond the day of the accident/illness, or require ongoing modified duties.
To file a claim for benefits, you should notify your employer of your injury as soon as possible after the accident or becoming aware of your diagnosis, and report the injury or illness to the WSIB by completing a Worker’s Report of Injury (Form 6), submitting it to the WSIB and providing a copy to your employer.
Injured workers have six (6) months from the date of accident or date of diagnosis to make a claim for benefits. Some benefits that an injured worker can receive through the WSIB are:
- Loss of Earnings Benefits (LOE): income replacement benefits based on 85% of the worker’snet average earnings;
- Non-Economic Loss (NEL) Award: when a worker suffers a permanent impairment as a result of the injury or disease;
- Loss of Retirement Income: this is offered to workers who have received LOE benefits for 12 continuous months; it is paid at the age of 65;
- Healthcare benefits: these cover the cost of authorized treatment and services that are appropriate and necessary for a worker’s recovery;
- Serious Injury Program: a program that is devoted to managing claims for workers who suffer significant injuries; and
- Survivor benefits: these are payable when a worker dies because of their workplace injury or illness, and their spouse or dependents may be entitled to receive ongoing benefits including burial expenses, crisis intervention, counselling and assistance with re-entering the
Workers must not only contact their accident employer as soon as possible after an injury, but continue to update them throughout the recovery period. They are also required to assist the employer in the identification of suitable work that is available within the worker’s skills and functional abilities.
An employer is required to re-employ an injured worker who has been employed for 12 or more continuous months, so long as the employer regularly employs twenty (20) or more workers (note that all construction employees must be re-employed, regardless of length of service or number of workers). If the injured worker can perform the essential duties of his/her pre-injury job, the worker must be offered this job or a similar position once deemed capable of returning to work.
Re-employment obligations by the employer expire on the earlier of;
- Two (2) years from the date of injury;
- One (1) year after the WSIB advises the worker that he/she is medically fit for suitable work; and
- When the worker reaches the age of 65.
Any unfavourable decisions of the WSIB can be appealed within the documented time frames. Work re-integration, re-employment and return to work decisions must be appealed within thirty (30) days, and all other decisions must be appealed within six (6) months. If an injured worker wishes to appeal a final decision from the WSIB Appeals Branch, they can do so to the Workplace Safety and Insurance Appeals Tribunal within six (6) months of receiving the final decision of the Branch.
The above information is simply an overview of a worker’s rights, obligations, and potential benefits and should not be relied upon as legal advice. Should you have additional questions about a workplace injury, or if you have already been injured and need help navigating through the various steps and obligations of the WSIB, please contact a member of our Employment Law Group.