Skipping the Paperwork – New Legislation Addresses Claim Suppression
January 27, 2016 By: Peggy King Read Time: 2 minutes
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Under Bill 109, Employment and Labour Statute Law Amendment Act, 2015, changes were made to the Workplace Safety and Insurance Act (WSIA), creating a new offence that prohibits employer claim suppression, and increasing the penalty on conviction for an offence under the WSIA to a maximum of $500,000.

Claim suppression is a problem in Ontario, as reported in the 2013 study by Prism Economics and Analysis, which was commissioned by the Workplace Safety and Insurance Board (WSIB).

Examples of employer suppression include:

  • Pressure to not submit claims, such as by using threats, coercive pressure, and appeals to loyalty
  • Under-reporting, including not reporting lost-time injuries
  • Continuing earnings instead of filing a claim

It is difficult to know the incidence of under-reporting. Work absences are often not identified, either due to financial incentives on the part of employers, or avoiding health and safety investigations. The reality is that the true cost of not reporting an injury is borne by injured workers, not the employer. Many workers believe that they are being loyal to an employer by not reporting an injury; however, if the injury becomes permanent and they are not capable of their pre-accident duties, the likelihood of an employer maintaining their salary is slim to none. The injured worker is the party victimized by this process.

The longer the time frame between an injury and the reporting of it to the WSIB, the higher the chance of the claim being denied. In reviewing entitlement to benefits, the WSIB examines the proximity of the accident to the reporting of it and the seeking of medical attention. Where there are significant delays in either, the possibility of the claim being approved decreases.

It is important to understand that even where an employer does not want to report an injury, the injured worker should still report it directly to the WSIB. This will increase the likelihood of the claim being approved and the worker being able to access benefits, such as health care, return to work assistance and loss of earnings, to name a few. In addition, the WSIB will not assist in return to work efforts with an employer in the case of a denied claim.

In order to maximize the probability of a claim being approved, it should be reported immediately to the accident employer and to the WSIB. In the event that the employer does not or will not report the injury/illness to the WSIB, prompt reporting to the WSIB should be initiated.

The WSIB may be contacted directly at 1-800-387-0750 to confirm reporting protocols and to obtain the necessary forms.

To read more about WSIB claims, see our previous post on healthcare treatment for injured workers.

This content is not intended to provide legal advice or opinion as neither can be given without reference to specific events and situations. © 2019 Nelligan O’Brien Payne LLP.

Service: Insurance Law