You have been injured in the workplace if your injury/exposure happened at work, or while you were working.
If your injury occurred in a motor vehicle accident while you were working, you may also be entitled to receive accident benefits from your insurance company. See Motor Vehicle Accidents.
Am I entitled to Workplace Safety and Insurance Board (WSIB) benefits?
You may be entitled to WSIB benefits if you are not capable of performing your pre-injury or modified employment.
Is there a time limit to apply?
While you should apply for WSIB benefits as soon as possible, your application must be made within 6 months of the accident or the confirmation of your injury.
Can I recover my lost income?
Depending on your level of impairment, you may be entitled to receive up to 85% of your net average earnings, up to a maximum rate that varies depending on the year of your accident.
If you receive benefits for 12 continuous months or longer, you may also receive loss of retirement benefits. This benefit gets paid into a separate account that becomes available to you after age 65.
Will the WSIB assist me in returning to work?
The WSIB may work with your employer to assist you in returning to work on a modified basis, if possible.
If your injury prevents you from returning to your old job, or if your old job cannot be modified, the WSIB may assist you with retraining for a new job.
What about my pain and suffering?
If your condition stabilizes, but you do not fully recover, you may be entitled to recover a non-economic loss benefit. This benefit compensates you for the physical, functional, or psychological loss you suffer as a result of your injury.
The amount of this benefit is based on the severity of your injury, and your age at the time of the accident. Depending on the amount of this benefit, you may have the option to select either a lump sum or monthly payments.
What about my treatment costs?
The WSIB will pay for the costs of most treatments, such as prescriptions, assistive devices, transportation to treatment, physiotherapy, chiropractic therapy, massage therapy, and psychological therapy. Specific rates are applicable depending on the treatment. Please note the following:
- All treatment must be pre-approved by the WSIB.
- While there is no set maximum, the WSIB will only pay for treatment in the acute phase of your injury.
Does the amount of my benefits depend on my injury?
Depending on the nature of your injury, you may qualify for the WSIB’s Serious Injury Program. Many of the additional benefits associated with the program are determined subsequent to the Non-Economic Loss (NEL) rating.
If you qualify for the Serious Injury Program, you may be entitled to receive additional benefits, such as: an independent living allowance, unlimited prescriptions, financial assistance for hobbies, a clothing allowance, occupational assessments, and home modifications. Additionally, you may receive additional assistance in re-entering the workforce.
Can I sue my employer, or another party?
Generally speaking, receipt of WSIB benefits will bar any lawsuit against either your employer or any other party.
Depending on the circumstances of your injury, you may have the right to select whether to receive WSIB benefits or sue a party (other than your employer) responsible for your injury. It is important that you consult an experienced personal injury lawyer before electing to receive WSIB benefits. Once you have made your election, you may not be able to change your mind.
How do I apply for WSIB benefits?
You must advise your employer about your injury. Depending on the severity of your injury, your employer will have to file a report to the WSIB within 3 days. If your employer refuses, you can contact the WSIB and file a “Worker’s Report of Injury”, which you will be required to complete in any event.
As with all personal injuries, you should seek medical attention as soon as possible. When doing so, advise your doctor to file a report with the WSIB.
What happens if the WSIB denies my claim?
If the WSIB denies your claim, you must object to this decision within a specified time period. Typically, this time period will either be 30 days or six months, and will be clearly identified in the WSIB decision.
The first step in objecting to the WSIB’s decision is an internal appeal. Depending on the circumstances, you may have a further appeal to the Workplace Safety and Insurance Appeals Tribunal.
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