WSIB - Ontario Nurses' Association

Workplace Safety andInsurance Board(WSIB)A Guide for ONA Members

Revised and printed October 2012copyright © Ontario Nurses’ Association

CONTENTSIntroduction. ................................................... 1Section A – Filing A Claim For WSIB. ............................. 2Section B – Return To Work And Work Reintegration................ 11Work Reintegration. ................................... 11Returning to Work/Modified Work. ....................... 13Return to Work Meetings ............................... 14Safety First .......................................... 16Section C – Claiming For Recurrence. ............................. 19Section D – Miscellaneous........................................ 20Reporting an Exposure Where the Worker Does notBecome Ill or Lose Time from Work .................... 20Other Important Points ................................. 20Workers’ Obligation to Reimburse Advancesand Recouping Taxes. ................................ 21Healthcare of Ontario Pension Plan (HOOPP). .............. 24Nursing Homes and Related IndustriesPension Plan (NHRIPP) .............................. 24Section E – Appeals............................................. 25ONA’s WSIB Appeal Procedures. ........................ 25ONA WSIB Case Representation Criteria. .................. 26Appeals to WSIB (Operations and Appeals Branch) .......... 29Appealing to WSIAT and ONA WSIAT Criteria. ............. 30Non-WSIB Benefits ................................... 32Section F – Work Transition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33Section G – Non-Economic Loss (NEL) Assessment And Award ........ 39Section H – Resources. .......................................... 41Ontario Nurses’ Association. ............................ 41ONA Offices. ........................................ 42Workers Health and Safety Centre ........................ 43Ontario Safety Association for Community and Healthcare. .... 44Ontario Federation of Labour. ........................... 44Occupational Health Clinic for Ontario Workers. ............ 45Criminal Injuries Compensation Board. .................... 46Canadian Centre for Occupational Health and Safety. . . . . . . . . 47Ontario Ministry of Labour. ............................. 48Office of the Worker Advisor ............................ 50Workplace Safety and Insurance Board (WSIB). ............. 53Section I – Glossary. ........................................... 55

INTRODUCTIONStatistics show there is a strong likelihood you will sustain a work-related injuryat some point during your working career.This Guide contains information on utilizing the Workplace Safety and InsuranceBoard (WSIB). It is vitally important that all ONA members understand how tonavigate through the WSIB process in the event that you do become injured onthe job.This Guide will help ease you through the process and may help prevent complicationswith your WSIB file.Copies of this Guide are available in the mailroom at ONA’s Toronto head officeand on ONA’s website at www.ona.org. Click on the Health & Safety tab at thetop of the screen or go to Booklets, Guides & Manuals under the Publications &Forms tab.If you have any concerns or questions about what to do if you feel your conditionor injury is related to work, or if you have any questions about the informationcontained in this Guide, contact your Bargaining Unit ONA representative and/orthe ONA WSIB Intake Officer for further guidance.Although very detailed, the information contained herein is only a guideline, anddoes not include every aspect of filing and maintaining a WSIB claim. Keep theseimportant points in mind at all times:• If it hurts or you’re ill – it may be related to your work – REPORT IT.• If you had a specific accident – REPORT IT. There is a better chance ofsuccessful claims!!!• Self-treating does not establish continuity of complaint.• SEE A DOCTOR/HEALTH PROFESSIONAL IMMEDIATELY.• COOPERATE, COOPERATE, COOPERATE! If you don’t agree with aWSIB decision say so, but make sure they know you are cooperating. Youcan appeal a WSIB decision!• IF IN DOUBT CALL YOUR BARGAINING UNIT ONA REPRESENT-ATIVE who may also direct you to call the ONA WSIB Intake line.1

SECTION AFILING A CLAIM FOR WSIBBy following some of these basic steps, you may be able to avoid the hardshipsexperienced by ONA members when claims for workplace injuries are denied byWSIB.Please note that the word “injury” as used in this document also means any easilyor not so easily identifiable strain, sprain, pull, illness, exposure, aggravation ofa pre-existing condition, etc., that may be related to the work that your perform.1. Try to understand how WSIB defines an accident.• A work-related injury is not just an identifiable accident, like when a patientgrabs your elbow unexpectedly for support and you suddenly developexcruciating pain in your elbow (these are easy claims to deal with).• An injury can also be something that happens gradually over time (thisis what WSIB calls a disablement). A disablement can also be somethingWSIB views as an unexpected result of working duties.• Illnesses, including conditions that develop as a result of exposures toblood-borne pathogens, mould, SARS, Norwalk Virus, etc., can also beconsidered a work-related injury.2. Report all injuries/illnesses/disablements/exposures immediately to youremployer when first sustained.• This includes any aches, pains, strains or a pull you felt in your body afterdoing any task related to your job.• Report any changes in your work, no matter how insignificant you maythink it is, ie. increase in workload, staff shortage, heavier or more acutepatients etc.• Report any witnesses to your injury/illness/disablement/exposure, or witnessesto any of your complaints.• The longer you wait to report the incident, the more likely you are to haveproblems with your WSIB claim.Some members have reported they thought they only had 24 to 48 hours toreport a work injury. This is not correct. Workers must file a claim as soonas possible after an accident and no later than six months from the date of anaccident or, in the case of an occupational disease, within six months of theworker learning of the disease.2

Workers must also consent to disclose their functional abilities information,which is provided by the treating health professional. If you wait too long tofile a claim, it will be difficult to win your case if denied by the WSIB. TheWSIB may extend the six-month deadline or waive the dual requirementsaltogether if, in WSIB’s opinion, it is just to do so.3. Employer’s Report of Injury/Disease (Form 7):Always notify your employer of any injury/illness/disablement/exposureimmediately and ask your employer to complete a WSIB Form 7.• Your employer’s incident form is not the correct form you need to officiallyreport an injury/illness/disablement/exposure to WSIB.• The official form your employer must complete to report your injury/illness/disablement/exposureto WSIB is called a Form 7. Your employer mustfill out and submit this particular form to meet their legal reporting obligations.The employer must provide the worker with a copy of the Form 7.4. WSIB policy states employers can be fined for failing to provide a copyof the Form 7 to the worker. Because failing to comply is also a provincialoffence, employers may be prosecuted.5. Employer’s Incident/Accident/Unusual Occurrence form:Also complete your employer’s incident form.• Make sure you identify all body parts that were injured and/or even bruisedor affected in any way by the injury or work you performed. Rushing to fillout this form is not advised. Be very specific about each and every detail. Incompleteforms can cause discrepancies and bring about issues of credibility.6. Write the WSIB a separate letter about any errors or omissions on theemployer’s completed WSIB Form 7.• Check the form to ensure dates are recorded correctly. Ensure the employerhas accurately reported the cause of the accident and body parts affected.Are witnesses to the accident reflected on the form and has the employerput down your correct hourly rate and average weekly hours?7. If your employer refuses to complete a Form 7, notify WSIB and completethe Worker’s Report of Injury/Disease (Form 6).8. Worker’s Report of Injury/Disease (Form 6)To officially claim for WSIB benefits a Form 6 must be completed, signedand sent to WSIB. You can initiate a claim for WSIB by writing to WSIB3

explaining the details of your accident, including the name of your employer,and request a copy of Form 6. If you have access to the internet, download acopy from www.wsib.on.ca. Complete, sign and send your Form 6 to WSIB.You must also provide a copy to your employer. Ensure Form 6 is clear andcomplete, and contains no errors or omissions. Make sure to write aboutevery ache and pain and body part affected by your work or by the injury, andwhat may have contributed to the injury or actually caused the injury.9. A claim for a recurrence must be filed within 10 days of the onset. Toclaim for a recurrence, the worker must complete Form REO6 – Worker’sContinuity Report. We recommend filing immediately with WSIB, your employerand your doctor (health professional).10. Workers meet their requirement to consent to disclose functional abilitiesinformation by signing Form 6 or a Functional Abilities Form (FAF), orin the case of a recurrence, by signing Form REO6. WSIB forms are availableat www.wsib.on.ca. The FAF may also be available from employers. Ifyour employer provides you with an FAF, you must submit it to your healthprofessional to complete.11. Your employer must report all injuries to WSIB if you require healthcare and/or:• Are absent from regular work.• Earn less than regular pay for regular work (e.g. part-time hours).• Require modified work at less than regular pay.• Require modified work at regular pay for more than seven calendar daysfollowing the date of your accident.• WSIB policies state they must receive your employer’s completed accidentreport (Form 7) within seven business days of your employer learning ofthe reporting obligation, however, Section 21 of the Workplace Safety andInsurance Act (WSIA) states “notify the Board within three days of learningof an accident…” (Business days are Monday to Friday, and do notinclude statutory holidays).12. Your employer must fill out Form 7, even if they don’t think your workis the cause of your injury/illness/disablement/exposure.• Your employer may try to convince you that your injury/illness/disablement/exposure is not a workers’ compensation claim, and you should insteadreceive benefits under your sickness and accident plan, i.e. short-termdisability (STD). Explain to your employer it is WSIB’s job, not theirs, todecide if your work is responsible for your injury.4

• If your WSIB claim is denied, the majority of full-time employees canapply for sickness and accident benefits under your collective agreement.Some collective agreements provide for an advance from STD benefitsduring the time WSIB is making a decision on whether to allow or denyyour case. If you request an advance, you may be required to sign an agreementto reimburse your employer once the WSIB decision is issued.• Even if WSIB accepts your condition as work-related and pays you benefits,where applicable, apply for Long Term Disability (LTD) benefitswithin the insurance carrier’s time limits. We advise this as in many casesa future dispute arises with WSIB and a worker’s WSIB benefits are discontinued.If the worker applied for LTD benefits within the insurance carrier’stime limits, the worker may then still be eligible for LTD benefits.Depending on the insurance carrier and the terms of your collective agreement,a member may also be entitled to an additional minimum $50 payoutfrom your LTD plan (e.g. HOODIP), while on WSIB benefits. If you areinjured or ill, immediately talk to your Bargaining Unit ONA representativeabout this benefit, because there are time limits to apply.13. See your treating health professional immediately and ask her/him tocomplete and send the appropriate first report form to WSIB (Form 8 –Health Professional’s Report).In early 2004, WSIB policy was amended whereby registered nurses (ExtendedClass) (RN [EC]) and physiotherapists may now treat an injuredworker and submit an accident report to WSIB on the newly revised Form 8.Doctors and chiropractors will also use this newly revised Form 8 to report anaccident.This is a key development for our members, but it is important injured membersnot use this policy as a means to forego visits to their family doctor. Itis still WSIB practice to always place more weight on the medical evidencereceived by a physician specialist, a family doctor and their own WSIB physicians.If an RN (EC) does the initial assessment and documentation and there is adiscrepancy, we believe WSIB will ask their own medical consultant to reviewthe file. Where the WSIB physician’s findings differ from the RN (EC),WSIB will likely deny the claim. Therefore we strongly recommend youdo everything in your power to be treated by a physician.In remote areas where a member does not have a family doctor and cannotaccess a hospital emergency room or clinic, our members should at least ac-5

cess an RN (EC) or physiotherapist to document the physical findings anddiagnosis when they are able to do so. Where there is no access to an RN (EC)or a physiotherapist, they should at least ask another RN to document the accidentand any physical findings observed within their scope of practice.When the injured worker does not have access to a doctor, chiropractor, RN(EC) or physiotherapist and they ask another RN to document their findings,the RN who does the assessment should simply send a letter to WSIB of theirfindings. Please ensure that, in these unique situations, the RN only sends inthe findings from a member’s assessment by way of written letter, and doesnot fill out any WSIB forms. (The WSIB will not pay an RN to write this letter,therefore, it would have to be done voluntarily.)The College of Nurses of Ontario (CNO) has indicated to us that an RN andRN (EC) can also authorize lost time. If you are injured and require time offwork due to your injury, and again are in an area where you have no accessto a doctor, you should at the very least have an RN (EC) authorize your losttime. Where you do not have access to an RN (EC), you should then ask anotherRN if they could authorize your lost time for you in writing and submitthis to WSIB.Understand that when using the RN (EC) and physiotherapist to fill outforms, or when using the RN to send a letter, we believe the injured memberwill likely be under close scrutiny by WSIB to ensure they first did everythingpossible to see a doctor.14. Make sure your health professional has physically examined you andthat s/he has documented all your physical findings in her/his clinical records(ie. range of motion – very important, spasm, etc.). Make sure yourdoctor/health professional provides this information on Form 8 to WSIB.15. If you are planning to make a claim with WSIB and you require time offfrom work, you will need authorization from your doctor/health professional.If your doctor/health professional believes you require time off work,s/he should not document any restrictions on Form 8 or Functional AbilitiesForm.16. If your doctor/health professional recommends time off, make sure s/hegives the reason for the time off on Form 8 or Functional Abilities Form.For example, if you have a back injury and are experiencing muscle spasm,usually you will require a period of rest to give the muscles a chance to relax.Rest is an appropriate treatment recommendation for WSIB claims, especiallyin the acute period after an injury, but WSIB claims adjudicators don’t6

always allow lost time benefits for “rest” unless it is justified by the treatingphysician.17. Initially, you may need to attend a hospital emergency department or awalk-in clinic. The first health professional to treat you must completeForm 8.• According to WSIB policies, you make your choice of health professionalwhen you accept treatment after the initial or emergency treatment.• Once you have seen the health professional in an emergency departmentor walk-in clinic and you go to your family doctor, chiropractor, physiotherapistor RN (EC), they will be considered by WSIB to be your choiceof health care professional. Should you wish to change this health careprofessional, you will need to provide acceptable reasons to the Board andget their approval.18. If you see your employer’s occupational health doctor (OHD) for treatmentafter the initial or emergency treatment, the OHD will be yourchoice of health professional for WSIB purposes.• Unless your collective agreement specifies otherwise, we recommend youdo not go to the OHD for treatment or to discuss your diagnosis, becausethe OHD works for your employer. You can discuss your functional abilitieswith the OHD and what type of work you might be able to return to,but be careful not to divulge too much information.• If you choose to see the OHD at your agency following treatment in anemergency department, that doctor will become your choice of treatingpractitioner and WSIB must approve a change to another physician.• Here’s an example of why you should not discuss your situation in greatdetail with the OHD. In one hospital, the doctor convinced ONA membersthey should be treated by him and give him full authorization to access alltheir medical records. He then used this information to get what is called“cost relief” from WSIB, which gives the employer a break on the cost ofthe claim. In another case, he used his knowledge of an ONA member’scondition to get WSIB to deny a claim for psychological impairment resultingfrom a work injury.19. If you do go to occupational health, check the notes on file, includingdoctor and nursing notes.• Make sure everything you said at the meeting is reflected in the notes.Often, important information about work-relatedness is left out.• When documented accurately, information in the occupational health file7

has often helped ONA win a case, especially when we argued the workerhad ongoing complaints of pain or reported the injury.20. Notify WSIB, in writing, about your injury well before the strict deadlineexpires.• In your letter, ask for entitlement and benefits and for WSIB to send youForm 6 to complete. Again, make sure you write about every ache and painand body part affected by your work or the injury, and what you think mayhave contributed to, or actually caused, the injury. Form 6 can be downloadedfrom the WSIB website at www.wsib.on.ca.• Say you asked your employer to complete Form 7.• Indicate if your employer refused to complete Form 7.21. If you have a pre-existing condition (work-related or non-work-related)that is either symptomatic or asymptomatic, and your work in any wayaggravates it, you should report this to your employer, WSIB and yourdoctor/health professional as a work-related injury.• WSIB policies allow you to be paid for the acute episode or phase duringwhich your condition is aggravated. If this flare-up never returns to yourpre-flare-up stage, WSIB benefits should continue and you may be entitledto what is called a Non-Economic Loss (NEL) award.22. The best way to avoid problems with WSIB is to report every incident,no matter how minor.• If your work has changed under any circumstances, i.e. nursing cutbacks,etc., and you believe that change is now causing additional demands onyour body to the point that you are starting to feel aches and pains, reportthis immediately to your employer. Identify what you think is causing theproblem. Do this even if you have not yet lost any work time or soughtmedical attention.23. Do not self-treat. See your doctor/health professional so she/he can documentyour complaints and anything you believe may have contributed toyour condition.• If you are diagnosed with any condition you believe is related to yourwork, make sure to report this to WSIB.24. See your doctor/health professional on a regular basis (every two weeksis recommended).• Documenting the problem and any ongoing concerns is key to having a8

problem-free WSIB claim. Again, make sure your physical findings aredocumented in your clinical records at each visit. To ensure sufficient timeis allotted for your assessment and that your doctor/health professional hastime to document all of your findings, you may need to book a half-hourappointment.25. If you have been injured from your work in any way, even if you think itis just a strain or pull, make sure your colleagues know you believe youraches or pains are from the accident or from the nature of your work.• Even if your colleagues did not witness an incident, make sure they areaware of your injury/illness/disablement/exposure.• Keep notes in a journal documenting who you reported to, who you toldabout the incident or even just your aches and pains. Document all treatmentyou received, who you saw and when you were seen, etc. It is veryimportant to maintain your own dated log.• If your problems surface a few hours or a few days later, it is easier to relateit back to the strain, pull or awkward lift, etc., if you reported it at the timeof the incident.• Keep all original receipts for health care benefits, i.e., medication, physiotherapy.Document related car mileage/kilometres. Health care treatmentsmust be approved in advance by WSIB. If successful in establishing a claim,ask WSIB to reimburse all appropriate health care benefits. If WSIB approvesthe treatment, have the health care professional bill WSIB directly.• In most cases, approved claim-related medications can be billed online byworkers’ pharmacists. Provide pharmacists with claim numbers and askthat prescriptions be processed through WSIB’s online system. If medicationcannot be approved electronically, complete a WSIB MedicationReimbursement Form.• Make sure you report it to your employer.26. Tell your employer, doctor/health professional/RN (EC) and WSIB if youare continuing to work in pain, but are getting assistance from your colleaguesin order to manage your job.27. When a claim is filed with WSIB, you should receive notification fromWSIB the claim has been received. If you have not heard from WSIBwithin a few weeks after the initial notice, call the WSIB Claims Adjudicatorassigned to your file, and ask if your claim has been reviewed forentitlement.• Document contacts with/for WSIB.9

• Subsection 131(4) of the WSIA states that WSIB must promptly notifyworkers of all decisions in writing and the reasons for the decisions.• If there is any indication of a delay or problem, call your Bargaining UnitONA representative immediately. Sometimes all it takes to get your claimallowed is for you to send in a witness statement verifying you told yourcolleagues about the incident.• Confirm all relevant conversations with WSIB and your employer in writingand keep copies of these letters for future reference.• Keep relevant WSIB and employer envelopes with the postmark evident.In the past, a letter from WSIB and/or an employer has been dated two tofour weeks prior to the date on the postmark.• Maintain a diary of events, i.e., health related events, problems, appointments,treatments/medication, diagnostic tests, WSIB related events andemployment related events.28. If you have a WSIB claim allowed by the Board or are awaiting approvalof a claim, you must get approval from WSIB to take vacation and/orleave town for any reason. This is especially important if the absencemight interfere with a treatment plan.10

SECTION BRETURNING TO WORK AND WORKREINTEGRATIONIn 2011 the WSIB restructured its return to work policies and programs. Now allreturn to work activities – formerly Early and Safe Return to Work (ESRTW) andLabour Market Re-Entry (LMR) – fall under the umbrella of Work Reintegration(WR). The main changes from the previous system are that WSIB decision-makerswill be actively involved in return to work from the earliest stages followinga work injury.WSIB’s involvement at the early stages is to assist the Workplace Parties (WPP)– Accident Employer (AE) and Injured Worker (IW) – “in achieving successfulWR outcomes.” The same obligations apply in the new system as in the old, butthere are additional obligations on workers and employers in WR. In the newprocess, there will be greater pressure on the AE to accommodate the IW in theform of fines for non-cooperation. This means there will be heightened pressureon injured workers to return to work as soon as possible as employers try to avoidhigher claim costs and fines.In addition to the advice provided below, you are urged to contact your BargainingUnit ONA representative as soon as you go off work due to a work-related injury.Your union must be involved in your return to work process because it may benecessary to file a grievance against the employer, which has time limits.Work Reintegration1. It is your obligation under the WSIA to cooperate in Work Reintegration.This can mean a return to work to your pre-injury job (with accommodationor not), or to other work that is “suitable” (safe) and available. Cooperationmeans you must:• Maintain communication with your employer throughout your recovery,even if you are not yet able to return to work.• Work towards identifying and securing WR “opportunities.” This meansidentifying needed modifications to your own job and/or other “suitable”(safe) and available jobs for you.• Fulfill your reporting obligation to WSIB and provide them with all relevantinformation concerning your recovery and work reintegration needs.• Notify your WSIB Case Manager (CM) of any dispute or disagreementconcerning your work reintegration, for example, if the employer is refusingto provide modified duties that are within your restrictions or refusing11

to provide a written job description of any accommodated work they areoffering.These cooperation obligations apply from the date of injury until the earlierof the following:• Your loss of earnings benefits can no longer be reviewed by the WSIB(usually 72 months after the date of injury).• There is no longer an employment relationship because you voluntarilyresign or the employer terminates your employment for reasons not relatedto the work injury or your WSIB claim.• The cooperation obligations also end when the WSIB is satisfied that nocurrent suitable work with the AE exists, or will exist in the reasonablyforeseeable future.2. If you are partially disabled, meaning your doctor/health professionalfeels you could return to some form of work with restrictions, the Boardwill expect you to cooperate with your employer in identifying a job thatmeets your restrictions.• Remember that while WSIB may first look at your original job, WSIBpolicies do not require them to bring you back to your former occupation.The Board’s primary concern is that you restore your pre-injury earningscapacity.3. If you believe you are unable to return to work but WSIB insists you can,it is likely your doctor/health professional’s reports have been evasiveand do not provide rationale for why you are unable to do any work inany capacity.• The onus will be on you, the injured worker, to prove why you are unableto perform any work from the time of the injury, and only objective medical/physicalfindings will suffice as “proof.”• Ensure your doctor/health professional is providing WSIB with a rationalefor your need to be off work completely and your physical findings.• Work Reintegration is based on the principle that the earlier a worker returnsto work after an injury, the better and that recovery should be completedat work. Therefore, if your doctor recommends that you be totallyoff work, s/he needs to explain (on the Form 8 or Functional AbilitiesForm) not only your limitations (e.g. “forward flexion decreased by 75 percent”), but also what benefit being off work is for your recovery from theinjury (e.g. “patient having muscle spasm throughout entire back; needscomplete rest to allow muscles to relax and thereby speed recovery.”)12

• Keep in mind that when WSIB feels you are partially disabled, it meansthey believe you can return to some type of job, but not necessarily in ahealth care setting.The following apply mainly to cases where the injured worker has beenoff work or on modified work/hours for 12 weeks or longer:• At 12 weeks after the date of injury, the WSIB will meet with the workplaceparties if they have been unsuccessful in arranging the worker’s returnto suitable and available work. A Work Transition (WT) Specialist(or Return to Work Specialist) will be assigned to your case and s/he willinitiate actions to assist in your work reintegration with your employer.• The Work Transition Specialist may refer you for a Psych/Vocational Assessment(formerly LMR Assessment) to assess your psychological andcognitive readiness for return to work and assess your skills and capabilitiesbased on your medical restrictions, as well as education, qualifications,training and work background. The assessor then presents work orjob options to the WSIB Case Manager who will, in consultation with theWork Transition Specialist, decide on the best option and whether a WorkTransition Plan is necessary.• Formerly Labour Market Re-Entry Plan (LMRP), a Work TransitionPlan is developed by the WT Specialist in consultation with the Case Managerand the WPPs to identify additional programs, training, upgradingand/or medical treatment (in consultation with the treating professional)that might be required for you to return to suitable work as identified inthe Psych/Vocational Assessment. SEE SECTION F OF THIS GUIDEFOR MORE INFORMATION ON WORK TRANSITION AND WTPLANS.• If WSIB believes you are partially disabled, but are not working with yourpre-accident employer, the Board expects you to mitigate your losses byapplying for jobs. You should keep records of all the jobs for which you researchand apply. If you have reason to believe it is unsafe for you to returnto particular work that is offered, see the section “Safety First” on page 11.Returning To Work/Modified Work4. If you are partially disabled and require modified work, speak to yourBargaining Unit ONA representative and your employer about a job accommodation.• Check your collective agreement for language regarding Return to WorkCommittees.13

• Employers are required by the Ontario Human Rights Code (supported byWSIA and WSIB policies) to accommodate disabled workers in the workplaceby modifying aspects of work, and unions and workers must participatein arranging such accommodation. An example of accommodationwould be if you can perform all tasks except manual lifting; the employermight have to purchase a mechanical lift suitable for your condition and forthe patients. Alternatively, the workplace parties may find another job foryou that does not require manual lifting. The employer can only escape thelegal duty to accommodate a disabled worker if it can demonstrate that anaccommodation will cause the employer “undue hardship.”• The importance of getting your Bargaining Unit ONA representatives involvedat the earliest stage cannot be over-emphasized. The Human RightsCode and your collective agreement hold employers to a higher standardfor accommodation than the WSIB does. So, for example, WSIB may recommenda job outside of the Bargaining Unit before the union and employerhave even explored options for modifying the pre-injury job. As thiswill impact your ongoing benefits with WSIB, you must have the unioninvolved to assist you.Return to Work Meetings5. To avoid adversely affecting your benefits, you need to cooperate fullywith WSIB and your employer in any Work Reintegration or WorkTransition activities. Cooperation does not mean you have to put yourhealth and safety at risk or work against your family doctor’s recommendations.Following the guidelines below will help prevent conflictthat could result in your benefits being reduced or suspended.• When you receive a call from WSIB or your employer about a return towork meeting, make every effort to attend. The only acceptable (to WSIB)reasons for not attending a meeting would be medical-related (e.g. a previouslyscheduled treatment or specialist appointment, or surgery).• Contact your Bargaining Unit ONA representative and confirm that youwill have a union representative present at the meeting. Arrange to meetwith your ONA representative before the meeting to prepare.• As soon as you go off work due to an injury, especially if you have apermanent impairment (see NEL Section, below) and/or are off for an extendedperiod of time, you should plan your return to work by investigatingother job options within your Bargaining Unit, as well as how your preinjuryjob can be accommodated to your restrictions.• Make sure you have updated restrictions from your doctor (including con-14

ditions or illnesses that are not related to your work injury) to bring to themeeting.• Be prepared, with the help of your ONA representative, to present optionsfor your return to work to the WSIB and your employer, including first ofall, accommodation options.• Maintain a “cooperative attitude.” This means not rejecting suggestions outof hand and discussing the options in a positive manner. For example, ifthe employer or WSIB makes a suggestion for another job in a clerical oradministrative position, instead of saying, “I can’t do that because I can’tsit for longer than 20 minutes” or “I can’t do that because I don’t have thetraining,” say: “I could do that job with computer training and an ergonomicwork station. I would also need to be able to change my positionfrequently, including being able to lie down periodically throughout theshift.”• If modified work is offered (temporary or permanent), do not refuse it; youshould always try the modified work and report any problems (includingincreases in pain or other symptoms) IMMEDIATELY to your employerand ONA representative. You should only “refuse” modified work underthe Occupational Health and Safety Act (OHSA) and only under the circumstancesdescribed below – “Safety First.”• PAIN: For most injured workers, an increase in pain is a warning signalthat something is wrong or the condition is worsening and it should not beignored. The WSIB, however, does not generally regard pain as a legitimaterestriction or limitation when it comes to return to work. Pain is consideredby WSIB to be purely subjective. This is why it is never enoughto report pain alone as a rationale for not returning to work or for not tryingmodified work. Pain should be reported by your doctor in terms ofthe physical, cognitive and mental limitations it causes to your functionalabilities. For example, a Functional Abilities Form allows the doctor tocheck off walking or sitting restrictions by time – i.e. walking 20 minutes;sitting 15 minutes. If any walking or sitting is painful, your doctor needs todescribe the tolerances, such as “can only walk with support of wall, cane,etc. and with frequent stops;” or “requires support of arms/hands whilesitting.” Many times it is pain that affects concentration and focus and thisneeds to be documented, as well as the effects of any medication you aretaking for pain.• Within the legal bounds of your confidentiality/privacy rights, make sureeveryone has all of the information about your condition and restrictions,including any non-work-related conditions, medications needed and theireffects, if any (confirmed by your doctor), treatment appointments, etc.15

The employer is entitled to functional abilities information only. The OccupationalHealth Department and WSIB have the legal obligation to maintainconfidentiality of your medical information.• Remember that the employer has the legal obligation to accommodate a jobto fit your medical needs and restrictions to the point of undue hardship.You are legally obligated to participate in the process of finding a reasonableaccommodation and cooperating in all WSIB’s Work Reintegrationactivities. If you are not involved early and prepared to suggest options,your employer may present the first available option and WSIB will acceptit if it meets your minimum physical restrictions.• If your employer does not accommodate your return to work within yourmedical restrictions, or refuses to accommodate your return to work, contactyour Bargaining Unit ONA representative to inquire about filing agrievance under your collective agreement.• At meetings with your employer to discuss modified work, request a copyof the job description and/or job duties for the modified work being offeredby your employer. WSIB expects a written job description. We recommendyou take the information provided to your health care practitioner for anopinion regarding the appropriateness of the duties and your ability to safelyperform the work offered. If your doctor believes the offered work isnot suitable or is against your restrictions, she/he should explain inwriting how it could affect your recovery if you performed this work.• The WSIB does not generally regard shorter work hours as a legitimaterestriction. They believe that if you can perform the modified duties,you should be able to perform them at your regular hours of work.If your restrictions include a reduction in work hours, your doctorneeds to explain in writing why this is necessary for your recovery.• If any WSIB staff person, including a Return to Work Specialist or WorkTransition Specialist, are bullying, disrespectful or threatening in any wayat a return to work meeting, make sure their behavior is documented by youor your ONA representative and make a complaint to WSIB immediately.Call the WSIB at: (416) 344-1000 and say you wish to speak to [NAMEOF WSIB STAFF PERSON]’s manager. Request a call back from him/herto make a complaint about [NAME OF WSIB STAFF PERSON] and followup the phone call with a letter to the manager with your complaint.Safety First6. If you find any health and safety hazards in your workplace when youreturn to work, advise your supervisor/employer. This is your obligationunder Section 28 of the Occupational Health and Safety Act (OHSA).16

• Ask your supervisor to correct the problem. If no action is taken, ask amember of your Joint Health and Safety Committee (JHSC) to make a recommendationin writing to your employer to correct the hazard and makeyour work environment safe.• If the danger is immediate and your supervisor will not correct the hazard,or you are not satisfied with the JHSC outcome, you can call the Ministryof Labour (MOL) yourself and launch a formal complaint (using thosewords), as you have an unresolved health and safety concern. If the dangeris immediate and significant and is not corrected, and you have reason tobelieve your health and/or safety is likely endangered, you may have aright to refuse work under the OHSA. In that instance, please call your LocalONA representative.7. If you have reason to believe the employer and/or WSIB are requiringyou to return to unsafe work, call the MOL with a formal Unioncomplaint. If necessary, you may be able to exercise your right to refuseunsafe work. Please call your Bargaining Unit ONA representative foradvice on refusing unsafe work under the OHSA.• It is ONA’s position that WSIB should not force a worker back to work ordiscontinue a worker’s benefits where the worker believes the work willharm her/him. It is our position that, in such cases, where the worker identifiesto the employer and/or WSIB that s/he has reason to believe the workoffered (modified or not) will likely endanger her/his health and/or safety,and turns down the work, it is a work refusal under OHSA. Therefore, theemployer must proceed to Stage 1 of the work refusal process, as outlinedin the OHSA (Supervisor and JHSC investigate).• WSIB currently has little regard for the OHSA and is known to discontinuea worker’s benefits on the basis of “a supposed suitable job offer from theemployer.” Rather than wait for WSIB to make a determination of a jobsuitability, which could take months, we believe our members have theright to have the supervisor and JHSC, followed by the MOL if necessary,properly investigate these work refusals before WSIB even gets involved.WSIB should be involved only when the work refusal has been investigatedand an agreement reached, or a determination is made by the MOL.8. If you are asked to attend a return-to-work meeting that only offers agradual return to work, when you believe aspects of the job exceed yourrestrictions, you should tell your employer this is a health and safetyhazard or concern.• Speak up. Tell your employer they must accommodate those tasks that donot fall within your limitations.17

• Many claims have been accepted initially and then denied because the employertold WSIB they had accommodated an ONA member. In reality,they only provided graduated hours and expected the ONA member to continueto do the heavy aspects of the work, i.e. lifting.• Make sure your concerns about your job are put in writing to the employerand WSIB.• Discuss with your doctor/health professional any concerns you have aboutcertain aspects of your job exceeding your restrictions. Ask your doctor/health professional to document all concerns s/he may have with the job.• Speak to your ONA Bargaining Unit Return to Work representative.18

SECTION CCLAIMING FOR RECURRENCE OF AN INJURY1. A worker is entitled to benefits for a recurrence of a work-related injury ordisease under an established claim number.A recurrence may result from an insignificant new accident, or may arise(flare up) even when there is no new accident.To identify a recurrence, WSIB confirms there is clinical compatibility betweenyour original injury or disease and your current condition, and/or thatthere is a combination of clinical compatibility and continuity (i.e., an ongoingconnection between original condition[s] and most recent problem[s]).The WSIB Recurrence Coordinator can now allow entitlement based solelyon clinical compatibility.If a significant new work-related accident occurs, WSIB may establish a newclaim.2. If you suspect you have a recurrence, seek medical attention immediately.Advise your treating health professional to send the appropriate forms toWSIB.3. If you suspect you have a recurrence, notify your employer immediately.Complete in detail the Employer Incident Form(s) and all WSIB forms.4. With a recurrence of a workplace injury or disease, you re-instate and/or continueto cooperate with all WSIB requirements for your claim.5. To determine earnings (rate of pay) for Loss of Earnings (LOE) – Recurrences,where a worker has returned to work following a work-related injuryand then has a recurrence, the earnings will be the higher of:(a) Earnings at time of original injury; or,(b) Earnings at the time of the recurrence6. Your Case Manager may, under certain criteria, refer your claim to the RecurrenceSpecialty Team for a decision.19

SECTION DMISCELLANEOUSReporting an Exposure Where the Worker Does notBecome Ill or Lose Time from Work• Exposures where the worker does not become ill or lose time from workshould be reported to WSIB on their Program for Exposure Incident Reporting(PEIR) Form. You can download the form at the WSIB website at:http://www.wsib.on.ca/wsib/wsibsite.nsf/public/FormsWorkers.Click on the link to Form 3958A – Worker’s Exposure Incident Form.Other Important Points• If you resign or sever your employment relationship, you may adversely affectWSIB benefits and/or your WSIB appeal. This also applies if you changeyour employment status, i.e., transfer from full-time to regular part-time.Medical limitations may still include reduced hours of work.• You cannot be laid off by your employer while off work and in receipt of WSIBbenefits. You can be notified upon returning to work that you will be in a layoffsituation. You should discuss an employer layoff with your ONA BargainingUnit representative and the ONA staff person handling your WSIB case.• Once entitlement is granted, WSIB reimburses workers whose insurancepolicies paid for their health and welfare benefits, as if the benefits were paidfor by the workers themselves. Once workers receive this money from WSIB,they should notify the insurance company. Workers will have to reimbursethe insurance company.• If a member’s claim is allowed and they received STD, LTD, EmploymentInsurance (EI), welfare, etc., during the same period WSIB benefits are paid,these carriers will be reimbursed by WSIB for 85 per cent of the worker’s netaverage earnings. If one of these groups paid more to you than what WSIBpaid back to them, you may be asked to make up the difference.• The WSIA requires persons receiving WSIB benefits, or persons who maybe entitled to benefits, to notify WSIB of a material change in circumstanceswithin 10 days after the material change in circumstances occurs. A workerwho wilfully fails to inform WSIB of such a material change within 10 daysof when it happens, is guilty of an offence and may be prosecuted. A materialchange in circumstances is any change that affects a worker’s entitlement tobenefits and services under the WSIA. These changes include, but are notlimited to: changes in medical status; earnings/income; work status; avail-20

ability for, or cooperation in, health care or Work Reintegration activities; orWork Transition Plans.• WSIB encourages workers to phone the decision-maker responsible for theirclaim to promptly report material change. Workers should confirm the conversationand/or messages left on voice mail immediately, in a written letterto WSIB. Workers should send a copy of the letter to the ONA staff personhandling their WSIB case. Workers should not rely on others, such as familymembers, friends, health care professionals or their employer to notify WSIBof a material change in circumstances. There will be occasions when workerswill be asking WSIB for a decision on entitlement and benefits due to amaterial change, i.e., deterioration of medical condition or the employer’srefusal to continue accommodation.Workers’ Obligation to Reimburse Advances and RecoupingTaxesAdvice to members regarding:• Reimbursing the insurance carrier and/or the employer for any advancespaid in short term/long term benefits.• Obtaining a refund from the Canada Revenue Agency (CRA), formerlyknown as the Canada Customs and Revenue Agency or Revenue Canada.While WSIB considers income tax when establishing its benefits, WSIB benefitsare not taxable. When a worker’s appeal is allowed, WSIB will expect the workerto reimburse to the insurance carrier or their employer, any monies received fromthem during the time period that WSIB benefits are also paid. WSIB may reimbursethe employer or insurance carrier before releasing monies owed to the worker.Once a WSIB claim is established, it is normal for the insurance carrier and employerto have the worker sign a waiver agreeing to pay back the insurance carrierand employer if their WSIB claim or appeal is allowed.Sometimes the insurance carrier neglects to get the authorization. When this occurs,one of two things will happen when the claim is allowed:1. WSIB will try to get the worker to sign an authorization so the insurance carriercan be paid back by the WSIB, or2. WSIB will pay the worker in full and expect the worker to pay back the insurancecarrier.If the insurance carrier failed to obtain an authorization, WSIB cannot legallywithhold payment until an authorization is obtained.21

Reimbursing the insurance carrierWSIB only refunds to the carrier 85 per cent of the net average earnings. The carrier,in many cases, has paid the worker for the first 15 weeks full benefits (STDbenefits) and submitted to the CRA all taxes withholding.When WSIB agrees to allow the claim, the insurance carrier and employer arelegally entitled to receive the 85 per cent of net from WSIB monies, and alsoreceive from the worker the taxes the carrier submitted to the CRA on her/hisbehalf.Obtaining a refund from CRAOnce all monies are refunded to the insurance carrier, a credit memo is issued thatcan be used as a tax deduction, like an RRSP. This credit memo is only issuedonce a year, usually around the end of February. ONA staff cannot provide financialadvice. ONA advises members to hire an accountant or get someone they trustto do a readjustment on their taxes (ONA does not pay for this).The CRA advised ONA years ago this credit memo could be used to offset taxableincome in any of the previous four tax years, or in any of the three tax yearsforward. This meant that if the worker’s credit memo is worth $50,000, and s/heonly had taxable income in year 2000 totaling $10,000, and in 2001 had taxableincome of $20,000 and in year 2002 had taxable income of $20,000, the workercould offset all of the income in all three years and get back a refund from theCRA of the taxes that s/he paid in those three years.If the worker had no taxable income in 2000, but had income in 2001 of $20,000and in 2002 and 2003 had no taxable income, s/he would be able to completelyoffset the income of $20,000 in 2001, and use the remaining $30,000 to offsetincome in any of the three years forward.We contacted the CRA in January 2004 to ensure this information was still accurate,and were advised that a refund can actually be requested back to 1985 asa result of the “Fairness Legislation.” As you can see this is quite confusing, andit is for this reason we recommend the member hire someone who knows the insand outs of filing an adjustment on taxes.The worker can normally be out of pocket for up to a year, or in some cases even abit longer, depending on when they pay back the insurance carrier and when theyre-file their taxes and get a refund from the CRA.To reduce out-of-pocket expenses, especially when the worker’s WSIB claim ispaid in the earlier part of the year (e.g. from January to August), we advise the22

worker to explain to the insurance carrier that s/he does not have the money topay in full at that time, but can make monthly payments up until December of thatyear, when it will be paid off in full.Where the insurance carrier agrees to this plan, the worker is only minimallyout of pocket throughout the year, and only fully out of pocket for two monthsin January and February until they get the credit memo from their carrier, re-filetheir taxes and get their money back from the CRA. Workers should know that ifthey don’t reimburse the carrier/employer by year end and wait until the followingyear, they will likely have to wait an entire year for a credit memo.ONA was previously advised by an insurance carrier that if a member can’t affordto pay all of the taxes withholding that were forwarded to the CRA, they couldarrange a payment plan.Reimbursing the employerWSIB only refunds to the employer 85 per cent of the net average earnings. Theemployer, in many cases, has paid the worker for the first 15 weeks full benefits(Short Term Disability sick pay benefits) and submitted all taxes withholding tothe CRA. Many collective agreements provide for an advance to be paid to theworker equal to what the worker would receive from WSIB while awaiting a decisionin her/his claim. Check your collective agreement.When WSIB agrees to allow the claim, the insurance carrier and employer arelegally entitled to receive the 85 per cent of net from WSIB monies, and alsoreceive from the worker the taxes that the carrier/employer submitted to the CRAon behalf of the worker. If the worker was paid an advance of full STD benefits,the employer is legally entitled to request re-payment of the difference paid fromSTD and the amount reimbursed by WSIB.Remember, the employer can also request the worker pay back the taxes the employersubmitted to the CRA on behalf of the worker. If this happens, the workershould be able to write off any re-imbursement to the employer as a deductionon their income tax return, as noted earlier.Once WSIB or the worker reimburses the employer for sick time advances, workersshould obtain a written statement from their employer about the amount ofmoney from any sick bank/advances the employer originally paid to the worker,including the amount the employer paid to the CRA as taxes for any sick leavebenefits paid in the interval of the WSIB decision/appeal.WSIB routinely sends out its tax statements to injured workers every February.23

Workers should submit these statements to obtain a rebate from the CRA for taxesthat were deducted by their employer for any sick time advances during the WSIBdecision/appeal.For information, the worker can call their District Taxation Office – General Inquiry.If a member received LTD benefits, EI or welfare, income tax was likelydeducted. Members should again ensure they receive the appropriate statementsand tax rebates. Once the worker’s employer is reimbursed by WSIB for any sicktime advances, workers should also ensure their sick time bank is restored.Healthcare of Ontario Pension Plan (HOOPP)If you are a member of HOOPP you will have obligations and responsibilities regardingyour pension contributions while receiving WSIB benefits. Contact youremployer and HOOPP to review these obligations.Nursing Homes and Related Industries Pension Plan (NHRIPP)If you are a member of NHRIPP, you may contact the Plan Administrator andmake arrangements to make self payments during your absence. If approved bythe NHRIPP Board, the Plan will match your contributions while you make selfpayments.If you are a member of a pension other than HOOPP or NHRIPP, e.g. OntarioMunicipal Employees Retirement System (OMERS), you should contact youremployer or the pension administrator to review your obligations while in receiptof WSIB benefits.24

SECTION EAPPEALSONA’s WSIB Appeal ProceduresIf you have an adverse decision from WSIB and you meet the ONA representationcriteria, ONA will represent you in your appeal to WSIB. We may provideyou with self-help kits if you do not meet ONA’s criteria. Decisions to proceedwith an appeal are based on the evidence available and chances of success. If youwant ONA to represent you, you should not, either verbally or in writing, objectto a WSIB decision. You should not set meeting or hearing dates. Contact ONA assoon as you receive the adverse decision.Time limits to notify WSIB of an appealDecisions made on or after January 1, 1998:Six-month time limit1. The six-month time limit on appeals applies to all WSIB decisions made onor after January 1, 1998.2. If the WSIB makes a decision you do not agree with, the decision letter willinform you about the time limit and procedures for appealing the decision. Ifyou want ONA to appeal a decision, you must notify us within the time limitsspecified below.30-day time limit1. The 30-day time limit applies to decisions on Work Reintegration or WorkTransition plans made on or after January 1, 1998.2. If the WSIB makes a decision you do not agree with, you will be advised inthe decision letter about the time limit and procedures for appealing the decision.If you want ONA to appeal a decision, you must notify us within thetime limits specified below.Criteria for extending the time limitsThe WSIB does have the authority to extend the time limit to appeal at any time ifit considers it advisable. To avoid any disappointments all appeals should be filedwithin the time limit.25

Time limits to notify ONA• Within one week of the date of the adverse decision if it is a 30-day appeal.• Within four weeks of the date of the adverse decision if it is a six-month appeal.• Within one week of receiving notice of an employer appeal.• It is the usual practice of WSIB Case Managers to call a worker to informhim/her of a decision on the same day the written decision is mailed. You donot have to wait for the written decision before contacting ONA.• If you want ONA to represent in an appeal, you do not send any letters toWSIB or advise them you will be appealing the decision. Contact ONAWSIB Intake first (1-800-387-5580, press 0 for Toronto office, ask for WSIBIntake or dial extension 7721).ONA WSIB Case Representation CriteriaUnlike grievances, there is no legal obligation for ONA – or any union – to providerepresentation in WSIB appeals to its members. The ONA Board of Directorsapproved the development of criteria to enable us to provide this representationto the most vulnerable of our injured members. The criteria is applied on a caseby-casebasis by the Labour Relations Officers on the ONA WSIB Team as towhether your case meets ONA’s Representation Criteria. There may be unusualor mitigating circumstances in your case that would permit us to waive criteria,therefore, even for the “Issue-Specific” criteria you must contact a WSIB LROvia the ONA WSIB Intake line – ext. 7721 – to determine if we can represent youin an appeal.When you contact ONA about an adverse WSIB decision you wish to appeal, andyou have contacted us within the above ONA time limits, an LRO with expertisein WSIB matters will determine if your case meets our criteria for representation.These criteria will be revised on an ongoing basis based on experience, newlegislation, regulations and WSIB policies. Each individual case will be assessedon an ongoing basis for meeting the criteria, including the merits. For example,if it is initially determined your case meets our criteria, and then a medical reportobtained later through our investigation contradicts or does not support your case,we may review the merits again and decide not to proceed further.In most cases where ONA decides there is no merit to continue with the appeal,self-help kits are provided to the worker to proceed on her/his own if s/he sochooses. The worker may utilize an outside representative, however, ONA doesnot pay this cost. ONA also does not pay the cost of obtaining medical assess-26

ments and reports when we are not representing your appeal. In cases where ONAdoes not take on your appeal and closes your ONA WSIB file, this closure has noeffect on your WSIB file – it remains open.General cases where ONA will not provide representation1. Non-cooperationClaimants not prepared to cooperate with ONA staff trying to assist them.This includes claimants who are unwilling to file necessary grievances orto attempt necessary suitable accommodation as arranged through the LRO;claimants who don’t provide ONA staff with the requested information;claimants who do not provide assistance in obtaining medical informationand/or see another health care practitioner, if necessary. This also includesclaimants who had been previously represented by ONA on a WSIB issueand the claimant chose not to proceed, and that decision impacts negativelyon the current claim; claimants who didn’t respond to calls and letters; claimantswho obtained another representative after ONA staff had begun work ontheir case.2. Alternative representativeThis includes members who elected to be represented by persons other thanONA; persons whose claims are or have been handled by other representatives(unless the person is a member of a newly certified bargaining unitand it is a different issue); persons who elect to sue a third party. This alsoincludes claimants who elected to represent themselves on issues for whichONA would normally provide representation. This does not include personswhose prior alternative representation in previous issues or claims has noimpact on the current claim or issue.3. Cases with no realistic chance of successThis includes cases unsupported by medical documentation; situations wheresignificant and necessary evidence from a witness is not available; there is noor minimal evidence that the claimant was cooperating at the time in question;WSIA regulations and policies do not support the claimant’s position.4. Non ONA membersThis includes persons whose bargaining unit has decertified; members whoseinjuries occurred at a non-ONA site; persons who were injured with an ONAemployer and who are now members of another union, unless that person’sappeal was initiated while being an ONA member. This does not includepersons who were ONA members at the time of the original accident where a27

claim was initiated, and who were not responsible for severing the employer/union relationship because modified work was not available and/or becausethe grievance was settled. It also does not include members of newly certifiedbargaining units when the issue(s) in dispute are new.5. Pre-Bill 99 claimsONA does not provide direct representation on pre-Bill 99 claims where thedate of injury was prior to January 1, 1998.Issue-specific cases where ONA will not provide representation1. Permanent Impairment and Non-Economic Loss (NEL) awards: Increasesand arrears, unless the increase would significantly affect other entitlements/benefits.ONA would represent if a claimant’s condition had deterioratedand needed change in Future Economic Loss (FEL)/LOE awards, or ifdue to deterioration, the claimant needed a temporary or permanent supplementwith permanent disability award.2. Commutations (requests for lump-sum payments).3. Health care benefits, unless they would have a dramatic effect on other entitlements.4. Employer access to the WSIB claim file. ONA will have discretion to providerepresentation, if an employer’s request for access to a claimant’s WSIBfile is being used to harass a member.5. Employer requests for medical assessments. Staff will have discretion toprovide representation if an employer’s request for a medical assessment isbeing used to harass a member.6. Recovery of overpayments. ONA will represent when the issue is reallyabout overturning the initial entitlement, if it meets other criteria or there isanother issue being appealed by ONA. ONA will look at what created theoverpayment to determine representation on this issue.7. Earnings basis calculations.8. Second Injury Enhancement Fund, unless a successful employer appealcould dramatically reduce other entitlements, i.e. NEL award being reducedand this will adversely affect other benefits.9. No lost-time claims where there is no Permanent Impairment (PI) evi-28

dent. ONA will represent if the claimant: has likely PI; likely recurrences/flare up; sensitivity, i.e., latex allergy; likely future lost time, i.e., expectedsurgery; future symptoms/breathing problems.10. Claims for less than two weeks entitlement, where there is no PI evident.ONA will represent if the claimant: has likely PI; likely recurrences/flare up;sensitivity, i.e., latex allergy; likely future lost time, i.e., expected surgery;future symptoms/breathing problems.Appeals to WSIB (Operations and Appeals Branch)Please note: the WSIB appeals procedures are in the process of being restructured.The points below describe the process in general and the basic stepsinvolved.• There is no guarantee of the time frame for ONA to do your appeal.• If at any time during the appeals process you decide to represent yourself orobtain an external representative, your ONA WSIB appeal file will be closedand your WSIB file will be returned to you.• To meet legislative time limits to appeal and to obtain a copy of your claimfile, ONA sends a letter to WSIB that you intend to appeal the adverse decisionand reasons for the appeal/objection.• ONA requests the Objection Form (which must be completed and submittedwith the final appeal documents) and the WSIB claim file.• If the WSIB sends the file directly to you, leave the file in the order in whichyou received it. Forward the file to the ONA WSIB team member handlingyour appeal.• ONA will obtain any necessary evidence and use it to try to convince yourWSIB Case Manager (CM) (formerly Claims Adjudicator) OperationsBranch to change the decision. If unsuccessful, ONA will complete and sendWSIB the formal appeal with written submission and any supporting newevidence we have gathered in our investigation of your case. You will receivea copy of our submissions and any correspondence with WSIB.• After reading the submission, the CM has another opportunity to change thedecision. If the CM maintains her/his decision, the matter is referred to WS-IB’s Appeals Branch, where it is assigned to an Appeals Resolution Officer(ARO).• In authorizing ONA to act as your representative, you are giving ONA theauthority to have carriage of the appeal in the most appropriate forum, suchas a telephone conference, written submission, or in-person hearing. Current-29

ly, there is a “60-Day Decision Option” which, if chosen, involves a paperreview of your file only with no opportunity for a hearing at the AppealsBranch level.• If the decision is not reversed or changed by the ARO, after we have exhaustedall appropriate options at the Appeals Branch, ONA will determine ifan appeal to the Workplace Safety and Insurance Appeals Tribunal (WSIAT)is appropriate.Appealing to WSIAT and ONA WSIAT CriteriaThe ONA WSIAT representation criteria establishes a process whereby pre- andpost-Bill 99 appeals to WSIAT will be reviewed in the same way arbitration decisionsare reviewed before a judicial review proceeds. The following criteriawould apply:1. Review file for merit on medical and WSIB policy.2. Impact on membership – future and existing.3. Unusual circumstances and exceptional cases.BenchmarksA claim must meet the first point and at least one of the other criteria for ONAto consider WSIAT representation. The ONA CEO/Strategy Team will make thefinal decision on whether ONA will proceed to WSIAT. Should the CEO/StrategyTeam decide not to proceed to WSIAT, the ONA appeal file will be closed, theclaim file will be returned to the worker and the worker will be notified that she/he is entitled to proceed to WSIAT on her/his own.Help ONA Help youTo facilitate the handling of your claim, you will be asked to actively participatewith the ONA WSIB Labour Relations Officer. This will help move your claimthrough the WSIB system as quickly as possible, and minimize any delays withinour control. To help the process move forward:• Sign and return all requested authorization forms within two weeks of beingmailed to you. Do not send the WSIB Direction of Authorization form directlyto WSIB but return it with all the forms to the ONA WSIB LRO.• You can pick up ONA requested medical reports and encourage your healthcare professional(s) to have the report ready in a timely manner.• Obtain witness statements and any documentation requested by the ONAWSIB LRO.30

• You are required to attempt to mitigate any losses and you must provide jobsearch or educational upgrade information when requested.• Provide up-to-date information at least every four months outlining medicalappointments, treatments, specialists, referrals, diagnostic tests, etc.• Notify the ONA WSIB LRO of any modifications that may have been madeto accommodate your restrictions caused by the workplace accident.• Notify the ONA WSIB LRO of any change(s) in your condition or workstatus.• Notify the ONA WSIB LRO of any change(s) in your telephone number(home and work number), mailing address, email address and fax number, ifany.• Provide up to date information to the ONA WSIB LRO on all lost time youare claiming. This also includes updating the ONA WSIB LRO on any futurelost time, i.e. due to a flare up/recurrence, surgery, etc.If you do not choose ONAYou may have only one WSIB representative, however, if you do not want ONAto represent you:1. You do have the right to an external representative, but ONA does not paythe cost for an external representative. ONA also does not pay the cost ofobtaining medical reports/assessment and other documents to support yourappeal.2. You may represent yourself.3. You may be eligible for legal aid.4. If you are no longer a member of a union bargaining unit, the Office of theWorker Adviser may represent you.Other IssuesIn seeking ONA’s assistance in your appeal, you are authorizing ONA to shareinformation, including medical information, with other ONA staff as required.Also, if ONA staff were/are representing you in another proceeding, i.e., grievancearbitration, ONA shares information in order to represent you in all relevantproceedings.Whenever there is an issue in dispute, the employer may write WSIB for access toyour claim file including access to all relevant medical information. You will beasked by WSIB whether you object to the release of the medical documentation31

and why. Review the file yourself and identify to WSIB any non-compensableinformation you believe should be excluded from your employer’s access to yourclaim file. Ultimately, the Board will decide if the medical is relevant to yourwork-related injury and what medical will be released to your employer.If you have already received or are receiving benefits from WSIB, there is a possibledownside risk to appealing a decision. If WSIB believes it made an error inyour file, amounts of monies may be reduced and it also may result in overpayment.Non-WSIB BenefitsYou may be eligible for other benefits while you are in the process of appealing aWSIB decision. Such benefits may include: STD sick time benefits; employmentinsurance (EI) sick benefits; employer LTD benefits; ONA LTD benefits; drugbenefits, assistive devices program; or social assistance. Discuss this matter withyour Bargaining Unit ONA representative.Regardless of whether you are in the process of appealing a WSIB decision and/or receiving WSIB benefits, depending on your collective agreement, rememberyou may still be eligible for a minimum $50 per month payment under your LTDplan, e.g. Hospitals of Ontario Disability Income Plan (HOODIP).When injured or ill, speak to your Bargaining Unit ONA representative about thisbenefit immediately. All workers should apply for LTD benefits, if available, regardlessof whether or not the worker is entitled to the $50 per month minimumavailable in some plans. They should do so prior to the insurance carrier’s qualifyingperiod, in order to meet the insurance carrier’s time-limit requirements for filing.You may be entitled to maintaining employer benefits plans, i.e., extended healthcare plan, dental plan. You would pay your portion of the premium for these plansto the employer and the employer would pay its share of the premium. Again,discuss this with your Bargaining Unit ONA representative.If you are from the hospital sector, your employer should request a health leaveunder the Healthcare of Ontario Pension Plan (HOOPP) during the first 15 weeksof WSIB entitlement. Providing you continue to pay your portion of the cost ofHOOPP benefits, your contributory service will continue. If you are not back towork after 15 weeks, considered to be totally disabled and supporting medicalrequested by HOOPP has been provided, you should be eligible for free accrualfor as long as you continue to qualify.In other sectors, your employer should advise the Pension Plan Administrator thatyou are on leave related to WSIB.32

SECTION FWORK TRANSITION(Formerly Labour Market Re-Entry)OverviewThis document is not all-inclusive and varies for each worker. WSIB legislationand policies should be reviewed and applied to each individual case.Under the prior WSIB system, which many workers may still be involved in pre-2011, the WSIB only became active in return to work issues when there was aspecific request from the workplace parties (e.g. for return to work mediation) orwhen the AE advised them they were not able to or could no longer accommodatea worker. At that point, the WSIB would refer the worker to an outside ServiceProvider for a Labour Market Re-Entry Assessment (LMRA). The same outsideService Provider would make a recommendation to the Claims Adjudicator ofthree options for Suitable Employment or Business (SEB) for the worker. TheService Provider would then construct a Labour Market Re-Entry Plan (LMRP)for the worker, depending on which SEB option the Claims Adjudicator chose.While LMRPs were developed to facilitate the worker’s return to the labour forceat or outside of the accident employer, in practice the WSIB rarely followed up onreturn to work opportunities with the AE.In the new Work Reintegration model, all of the services previously provided byoutside Service Providers are conducted by WSIB staff members, namely WorkTransition Specialists (WTS), and Work Transition services may be introduced asearly as 12 weeks after an injury. Also, unlike LMR, WT applies to re-employment,accommodation and reintegration of the worker with the accident employeras well as outside of the accident employer.Work Transition services may include referrals for medical treatment or rehabilitation,medical or vocational assessments, psychological evaluations and aptitudetests, Functional Restoration Programs, or mediation/dispute resolution. In WorkReintegration, the WTS makes recommendations to the Case Manager who maintainsall decision-making authority. The main role of the WTS is to identify andrecommend a Suitable Occupation (SO) for the worker based on all the testingor assessments made. There may or may not be a Work Transition Plan (WTP).While we do not have much experience with the new system yet, especially withWTPs, we do know that with this new system has come increasing pressure oninjured workers – even those who have previously been found by the WSIB to beunemployable and off work for several years – to return to work.33

Suitable Occupation (SO)The Work Transition Specialist will meet with the worker and employer (and yourBargaining Unit ONA representative(s)) to begin the process of identifying suitablework within the accident employer. It is important that you make sure all optionsare explored towards accommodating you in your pre-injury job, includingbundling of duties, before you agree to a job outside your previous occupation,non-ONA job.The WTS will request job descriptions from the employer and evaluate themagainst any test or assessment results as well as medical restrictions. Rememberthat they can not divulge your confidential information, including medical diagnoses,psychological test results, etc.The WTS will normally recommend a suitable occupation regardless of your disability.The WTS can recommend, and WSIB can provide a WTP to assist you toremain with the AE, i.e. purchasing special equipment, retraining to stay at work.However, this is not the normal practice.The SO does not have to be in the same field of employment and often may notbe. The WTS will investigate a number of different options before making anyrecommendation to the Case Manager. They will not make any recommendationregarding your level of impairment or whether you are in fact employable.The WTPThe WTP is supposed to contain all the steps necessary to enable you to re-enterthe labour market in the identified SO. It is hard to predict what SOs will besuggested and whether additional training/education will be recommended. SomeWTSs and CMs deem workers’ SO at an RN job, i.e., working as a communitycare nurse at no wage loss, or as an RN in a doctor’s office at a minimal wage loss,or training for a short job search course or computer course. Some WTSs mayrecommend longer educational training, including at the university level.Given that the entry level to nursing practice is now BScN, no WTP should deeman RN position as a SO for a diploma nurse, unless the plan includes upgrading toBScN. Since RN entry level is a BScN and there is a huge cost for this education,WSIB frequently takes the position that the diploma nurse is equivalent to onewith a BScN and will only provide computer training and resume writing.Also, it is important that you are given the right WTP. If you are unable to completethe plan provided, your benefits will be cut off.34

How to get the most out of your WTP?We recommend you do some information gathering regarding jobs and educationthat you are interested in prior to the first meeting with the Work Transition Specialist.Providing the WTS with detailed information regarding job interests thatare truly suitable for your condition is your best chance at getting a plan that canactually help you restore your pre-injury earnings basis. To sell the WTS on youridea, you can get course and job information, including retraining period, costof retraining, earnings information from possible future employers, professionalorganizations, unions, universities and colleges, newspaper ads, Employment andImmigration Canada, etc. The training course and physical job demands can alsobe reviewed by your physician regarding medical suitability and medical sustainability.A WTS will take into account: your interests; if the training and resulting job ismedically suitable; if you will be able to complete the training; and which SO willmost likely reduce WSIB’s liability to pay you a partial or full loss of earningsbenefit to age 65. The WTS will also have to consider if the job is likely medicallysustainable, i.e., is your condition expected to deteriorate and make the job unsuitable.Are there sustainable jobs available in the community?What will WSIB consider and what components of a WTP can WSIB approve?If WSIB agrees to retrain, they can and should pay for anything associated withthe retraining and needs of your injury. These costs include LOE benefits, tuition,books, travel, professional registration exam costs, accommodation needs like adual set of books, a home computer and ergonomic workstation etc. Anythingpertaining to the retraining or accommodation of your restrictions must normallybe included in the plan at the time it is submitted to WSIB for approval, or youmay have a difficult time getting add-ons approved at a later date.In considering retraining, WSIB looks at whether you are likely to complete theprogram, whether the proposed job is medically suitable, and how lengthy theretraining program is when compared to the other SOs identified by the WTS.Although WSIB is not keen on approving lengthy plans, we have been successful(especially in cases where the worker is well prepared before the first meeting)in having university programs approved, i.e. upgrade to Bachelor’s in Nursing,nurse practitioner course. WSIB looks at whether the cost of retraining is reasonableand whether there is no other suitable employment available to the worker.They consider the age and educational background of the worker, i.e., if the workeris older, lengthy training will likely not be approved.35

If a plan includes any work hardening program, we also recommend it includerevisiting the plan in the event you are unable to return to the deemed job.It is hard to estimate the length of any training, since we do not know what thetraining will entail. Since WSIB pays necessary and appropriate expenses for theplan, an estimate of the plan costs should also be included as part of the plan.What happens if you can’t find work in the proposed SO?It appears the WSIB’s number one goal is to have a WTS propose a SO that approximatesthe pre-injury earnings (part-time at similar part-time wages). If a dollar-for-dollarSO proposal cannot be achieved given your condition, etc., WSIBwill pay the difference between the deemed job (SO) and the pre-injury job, whetheryou are able to find employment in the deemed job. If you do not obtain a jobin that approved SO after retraining, etc., you will have to live off of the differencebenefits (partial LOE benefits) paid to you by WSIB. This is why it is so importantto ensure a proper WTP/SO is developed by the WTS and accepted by WSIB.Once the SO has been identified, deemed earnings are based on the current wageguide information. There are a number of WSIB policies that address LOE benefits,deemed jobs, deemed earnings and reviews. You should ask the WTS andCase Manager (CM) for wage earnings information, including whether this isthe entry level wage, middle level wage, etc. for the deemed SO. Expected wageearnings for the SO should be included in the WTP. WSIB looks at whether therewill be good job prospects on completion.While WSIB must consider the availability of the SO before deeming your Lossof Earnings benefits, under the new system, the WSIB can enforce the relocationof a worker to another geographical location for a SO and they are not requiredto pay moving expenses. So, if you choose not to relocate, your earnings will bedeemed and benefits reduced.What if you choose not to cooperate in this process?If you do not cooperate in any stage of Work Reintegration, including Work TransitionPlans, WSIB benefits will cease or be reduced until cooperation beginsagain. If your benefits are re-started, you will still not receive benefits for theperiod during which you were in non-cooperation.What to do if you disagree with the plan but don’t want your benefits discontinued?We routinely recommend workers try to include in the plan a provision that statesthe worker’s restrictions will also be accommodated while attending school. This36

may include having an ergonomic assessment done of the school environment.Some accommodations that have been made for workers have included purchasingtwo sets of books, so the worker does not have to carry books back and forth,having an ergonomically-designed desk and chair, having a writer to take notes ifthe injury is related to the hands/arms, speech recognition software, etc.We also routinely recommend you try to include in the plan that it will be revisitedif future events preclude the original activities from unfolding as planned, i.e.,sometimes the recommended educational course may be discontinued based onclass size. We also recommend you try to get in to the plan six to 12 months ofLOE benefits after any retraining is completed, to provide for LOE benefits whileyou conduct a job search and seek sustainable employment. We also recommendyou write on the plan, “this is without prejudice to my right to appeal the plan,”before you sign it.You should, at all times, stress you are prepared to cooperateSome workers and their doctors may feel the training and/or deemed job are somedically unsuitable, even if accommodated, it might result in harm to the worker’shealth and safety. The worker then must weigh the health risks versus thefinancial, employment and discontinuation of LOE benefits risks. As we havesaid, the WTP and deemed SO can be appealed; there is never a guarantee of successon appeal, and the worker may have no money coming in while the appealis in process if they chose not to cooperate while appealing. It is usually best fora worker who is not satisfied with the plan to continue to cooperate, but appealin the meanwhile. That way the worker’s benefits cannot be discontinued, i.e.cooperate in meetings, in particular until a deemed SO and future LOE benefitshave been determined.Re-employment obligationsWorkers may also meet the criteria and fall under the “two year from date ofinjury re-employment” employer obligations under the WSIA. These provisionsdo not guarantee a worker will return to the pre-accident employer, but if an employerdoes not try to accommodate the worker when a job is available, the employercould be fined.Whenever possible, it is in the worker’s best interest to return to the accident employer,i.e. due to: loss of seniority; loss of LTD benefits (most future LTD plansdo not allow for a pre-existing condition); loss of other benefits, such as extendedhealth care plans; level of STD sick time benefits; no guarantees the worker willget a job in the deemed SO; usually only one WTP; the worker develops a noncompensablecondition and cannot continue with the plan, and therefore LOEbenefits are discontinued.37

Other optionsEven though the worker should participate in the WTP and emphasize with WSIBthat s/he is fully prepared to cooperate, including participating in the plan, i.e.,training, cooperation does not necessarily mean agreement. The worker shouldstill discuss filing a grievance with the Bargaining Unit ONA representativeagainst the accident employer for failure to accommodate, and should not resign.Also, it may be suggested the accident employer pay for the training and give theworker a job after completion of the training. This will decrease the employer’sadministrative costs to WSIB, and make the worker eligible for a first future WTP,if necessary, as this discussion usually takes place in the early Work Reintegrationstage.It is always hard to predict what will happen over the course of Work Reintegrationor Work Transition meetings. Future discussions change factors; there maybe an unsatisfactory WTS, the CM might not agree, and any other variables mayoccur that cannot be predicted in advance.Final reviews of FEL awards and LOE benefitsFinal reviews of FEL awards or LOE benefits will be deferred until after theLMRP or WTP has been completed for workers who were actively involved in anLMRP or WTP continuing through or started up after November 26, 2002. Oncethe LMRP or WTP has been completed, WSIB would then have 30 days to completethe final review of the FEL awards or LOE benefits.Note: WSIB can conduct a further review of the FEL award or LOE benefits afterthe final review, based on a significant deterioration of the worker’s condition thatresults in an increased permanent impairment on or after November 26, 2002 (thedate the WSIB changes the impairment).Workers who are claiming a significant deterioration first undergo treatment toimprove their condition as much as possible. Once no further improvement islikely, a NEL assessment should be arranged. The NEL award must be increasedbefore WSIB can review the FEL award or LOE benefits.This review after a significant deterioration does not apply to workers who werenever assessed for a NEL award or received a zero NEL award prior to the finalreview.38

SECTION GNON-ECONOMIC LOSS (NEL)ASSESSMENT AND AWARDNEL awards are paid to workers who have a work-related permanent impairmentfor all accidents on or after January 2, 1990. A permanent impairment means anypermanent physical or functional abnormality or loss, including disfigurement,which results from an injury, and any psychological damage arising from the abnormalityor loss.The degree of permanent impairment is expressed as a percentage of total permanentimpairment of the whole person. WSIB will determine that you have reachedmaximum medical recovery, there is no chance for significant improvement andyou still have a residual impairment. The Board will send you a roster of physiciansand ask you to choose a name from that list and respond to the Board within35 days. If you do not choose a physician, the Board will choose one for you.Do some research on the names provided and choose one you know has someexperience/familiarity with your type of medical condition. For example, if youhave functional limitations as a result of a low-back injury, you should choose anorthopaedic surgeon, neurosurgeon, neurologist, physical rehabilitation medicinespecialist etc. While all the physicians on the list have training in doing assessments,a physician who specializes in your type of condition might do a morethorough assessment.You can call the phone number on the letter that accompanied the roster, and requesta list of the specialties of those doctors.If you are told they don’t need to provide the information, tell them you havespoken to your Union and have the right to the information. You can also researchthe names on the College of Physicians and Surgeons of Ontario (CPSO) websiteat www.cpso.on.ca.Once you have the information, take the list to your family doctor and ask for her/his opinion on which doctors on the list are more worker-friendly, and/or moreexperienced with your type of medical condition.Physicians on the list must not be employed by WSIB, have treated you for thesame condition, have treated you or a member of your family, have acted as aconsultant in your treatment or have acted as a consultant to your employer. Theseconditions can be waived by WSIB for workers who live in small or remote communities,or if the worker and employer agree to the selection of a particularphysician in writing.39

When having your assessment, it is advised to stop when the pain first starts. Thismethod should be practiced at all assessments, not just for the NEL. That way atrue measurement of your range of motion and objective medical findings is alwaysbeing accurately documented. If you push yourself too much, not only couldyou re-injure yourself, you could potentially get a zero NEL assessment, whichcould disqualify you for future WSIB benefits.If you are attending this type of appointment, contact ONA’s WSIB Intake foradditional advice. You can reach them by phoning 1-800-387-5580, press “0,” andaccess the WSIB Intake line at extension #7721.Once the Board receives the assessment report, they will decide the percentage ofimpairment, and based on a formula, will assign a dollar value to the impairment.NEL benefits may be paid monthly or as a lump sum, depending on whether thebenefit is under or over a threshold rate determined by WSIB. If the dollar value isat or under the threshold, it is automatically paid to the worker as a lump-sum payment.If the dollar value is over the threshold, it is paid to the worker as a monthlypayment to age 65, unless the worker elects to receive payment as a lump sum.WSIB may consider a request from a worker for a re-determination of an existingNEL award, in cases where there has been a significant permanent deteriorationof the work-related medical condition and providing 12 months have passed sincethe last NEL decision.40

Ontario Nurses’ AssociationSECTION HRESOURCESThe Ontario Nurses’ Association (ONA) is dedicated to providing all memberswith the information and support they need in the important area of occupationalhealth and safety.Here’s what we offer:• ONA provides support to each bargaining unit’s occupational health andsafety representative when there is a perceived violation to the OHSA.Through Local activities, the bargaining unit is the primary provider of occupationalhealth and safety services to membership. That includes ensuringthere is a functioning JHSC at the bargaining unit level when requiredby the legislation. Resource support is provided to bargaining units by theLROs on the WSIB Team, which includes planning and coordinating theoccupational health and safety services provided in ONA’s five regions.• Additionally at the provincial level, support is provided to staff and membershipby the provincial Vice-President who holds the portfolio for occupationalhealth and safety, the LROs that specialize in occupational healthand WSIB matters, and the professional practice specialists.CONTACT USIf you have any questions about this booklet, your WSIB claim orother WSIB issues, contact the ONA WSIB Intake Line:8:30 a.m. 4:30 p.m., Mon. – Fri.:(416) 964-8833, ext. 77211-800-387-5580, ext. 7721After hours:(416) 964-8833; enter ‘0’ for Toronto office; enter ext. 77211-800-387-5580; enter ‘0’ for Toronto office; enter ext. 7721Ext. 7721 is monitored by the ONA WSIB Intake Officerand your call will be returned within 48 hours41

ONA OfficesProvincial Office – Toronto85 Grenville Street, Suite 400Toronto, ON M5S 3A2Tel: (416) 964-8833Toll-free: 1-800-387-5580, dial “0” for TorontoFax: (416) 964-8864Website: www.ona.orgWSIB Intake Line: ext. 7721Regional OfficesHamilton OfficeSudbury Office2 King Street West, Unit 2R 764 Notre Dame Avenue, Unit 3Dundas, ON L9H 6Z1 Sudbury, ON P3A 2T4Tel: (905) 628-0850 Tel: (705) 560-2610Toll-free: 1-800-387-5580, ext. 1 Toll-free: 1-800-387-5580, ext. 6Fax: (905) 628-2557Kingston OfficeThunder Bay Office4 Cataraqui Street, Suite 201 Woodgate CentreKingston, ON K7K 1Z7 1139 Alloy Drive, Suite 200Tel: (613) 545-1110 Thunder Bay, ON P7B 6M8Toll-free: 1-800-387-5580, ext. 2 Tel: (807) 344-9115Fax: (613) 531-9043 Toll-free: 1-800-387-5580, ext. 7Fax: (807) 344-8850London OfficeTimmins Office750 Baseline Road East, Suite 204 330 Second Avenue, Suite 203London, ON N6C 2R5 Timmins, ON P4N 8A4Tel: (519) 438-2153 Tel: (705) 264-2294Toll-free: 1-800-387-5580, ext. 3 Toll-free: 1-800-387-5580, ext. 8Fax: (519) 433-2050 Fax: (705) 268-4355Orillia OfficeWindsor Office210 Memorial Avenue, Unit 126A 3155 Howard Avenue, Suite 220Orillia, ON L3V 7V1 Windsor, ON N8X 3Y9Tel: (705) 327-0404 Tel: (519) 966-6350Toll-free: 1-800-387-5580 ext. 4 Toll-free: 1-800-387-5580, ext. 9Fax: (705) 327-0511 Fax: (519) 972-081442

Ottawa Office1400 Clyde Avenue, Suite 211Nepean, ON K2G 3J2Tel: (613) 226-3733Toll-free: 1-800-387-5580, ext. 5Fax: (613) 723-0947Workers Health and Safety CentreThe Workers Health and Safety Centre (WHSC) is one of the Safe WorkplaceAssociations (SWA) funded by WSIB. Based in Ontario, this worker-driven organization’smandate is to effectively develop and provide occupational healthand safety leadership, training and education programs and information servicesthat meet workers’ needs and are consistent with labour’s principles. Their mandatealso includes promoting activities that involve workers in health and safetymatters and improve working conditions and worker well-being. Their websitealso contains information on training programs and a service allowing you to askhealth and safety-related questions.Head Office and Central Ontario102-15 Gervais Dr.Don Mills, ON. M3C lY8Tel: (416) 441-1939Toll-free 1-888-869-7950Fax: (416) 441-2277Website: www.whsc.on.caRegional OfficesWHSC Regional OfficesEastern OntarioSouth Central Ontario2255 St. Laurent Blvd., Suite 201 500 Parkdale Ave. N.Ottawa, ON K1G 4K3Hamilton, ON L8H 5Y5Tel: (613) 232-7866 Tel: (905) 545-5433Fax: (613) 232-3823 Fax: (905) 545-3131North Eastern OntarioSouth Western Ontario110-43 Elm St. 2-1403 Michigan Ave.Sudbury. ON P3C IS4Sarnia, ON N7S 0B1Tel: (705) 522-8200 Tel: (519) 541-9333Fax: (705) 522-8957 Fax: (519) 541-944443

North Western Ontario2114 Bordeau Cres.Thunder Bay, ON P7K 1C2Tel: (807) 473-3634Fax: (807) 473-3655Or call from anywhere in Ontario: 1-888-869-7950Ontario Safety Association for Community and HealthcareOSACH is a not-for-profit organization, designated as an SWA under the WSIA(S.O. 1997). The mandate of OSACH is to educate and guide their health-care andcommunity services clients to proactively adopt occupational health and safetybest practices and strategies that will prevent workplace fatalities, injuries andillnesses.Head Office4950 Yonge St., Ste. 1505Toronto. ON. M2N 6KITel: (4 16) 250-7144Toll-free: 1-877-250-7444Fax: (4 16) 250-9190Website: www.osach.caOntario Federation of LabourThe Ontario Federation of Labour (OFL) issues position papers and statements,lobbies the provincial government and the opposition, and coordinates organizedlabour activities on occupational health and safety issues.Head Office15 Gervais Dr, 2nd FloorDon Mills, ON. M3C 1Y8Tel: (416) 441-2731Web site: www.ofl-fto.on.ca44

Occupational Health Clinic for Ontario WorkersThe Occupational Health Clinic for Ontario Workers (OHCOW) is a non-profitorganization. It is one of the SWAs funded by WSIB.OHCOW’s mission is to prevent occupational illnesses and injury, and to promotethe highest degree of physical, mental and social well-being of all workers.OHCOW strives to accomplish this through the identification of workplace factorsthat are detrimental to the health and well-being of all workers, through thedistribution of excellent occupational health, hygiene and ergonomic informationto increase knowledge among workers, employers and the general public; andthrough the provision of services designed to produce changes to improve workplacesand the health of workers.Staffed by a multi-disciplinary team of doctors, nurses, hygienists, ergonomists,researchers and administrators, each OHCOW clinic provides comprehensive occupationalhealth services and information in five areas:• An inquiry service to answer work-related health and safety questions.• Medical diagnostic services for workers who may have work-related healthproblems.• Group service for workplace health and safety committees and groups ofworkers.• Outreach and education to increase awareness of health and safety issues,and promote prevention strategies.• Research services to investigate and report on illnesses and injuries* The clinic’s services are free of charge to workplace parties.OHCOW Provincial Office15 Gervais Drive, Suite 601Don Mills, ON M3C 1Y8Tel: (416) 510-8713Toll-free: 1-877-817-0336Fax: (416) 443-9132Website: www.ohcow.on.caEmail info@ohcow.on.ca45

TorontoWindsor970 Lawrence Ave. West, Suite 110 3129 Marentette Avenue, Unit #1.Toronto, ON M6A 3B6 Windsor, ON LXM 1L9Tel: (416) 449-0009 1-800-596-3800 Tel: (519) 973-4800 1-800-565-3185Fax: (416) 449-7772 Fax: (519) 973-1906Email toronto@ohcow.on.caEmail windsor@ohcow.on.caHamiltonSarnia-Lambton848 Main Street East 171 Kendall StreetHamilton, ON L8N 1L9Point Edward, ON N7V 4G6Tel: (905) 549-2552 1-800-263-2129 Tel: (519) 337-4627Fax: (905) 549-7993 Fax: (519) 337-9442Email Hamilton@ohcow.on.ca Email sarnia@ohcow.on.caSudbury84 Cedar Street, 2nd FloorSudbury, ON P3E 1A5Tel: (705) 523-2330 1-800-461-7120Fax: (705) 523-2606Email Sudbury@ohcow.on.caCriminal Injuries Compensation BoardThe Criminal Injuries Compensation Board can award compensation to victims ofcrimes of violence occurring in Ontario.Head Office439 University Ave., 4th FloorToronto, ON M5G IY8Tel: (416) 326-2900Toll-free: 1-800-372-7463Fax: (416) 326-2883Website: www.cicb.gov.on.ca46

Canadian Centre for Occupational Health and SafetyThe Canadian Centre for Occupational Health and Safety (CCOHS) promotes asafe and healthy working environment by providing information and advice aboutoccupational health and safety.CCOHS fulfills its mandate to promote workplace health and safety, and encourageattitudes and methods that will lead to improved worker physical and mentalhealth, through a wide range of products and services. These products and servicesare designed in cooperation with national and international occupationalhealth and safety organizations with an emphasis on preventing illnesses, injuriesand fatalities. They provide a variety of both public service initiatives at no chargeto the user, such as occupational health and safety answers, the person-to-personInquiry Service, the electronic newsletter and public presentations. Services forspecialty resources provided on a cost recovery basis include database subscriptions,manuals and training programs.CCOHS Head Office135 Hunter Street EastHamilton, ON L8N 1M6Tel: (905) 572-2981Toll-free: 1-800-668-4284 (Canada and USA)Fax: (905) 572-572-2206Website: www.ccohs.caInquiries and Client ServicesHave a question? The CCOHS Inquiries and Client Services team is dedicated toanswering any questions you may have, whether a health or safety concern aboutthe work you do or about their many products and services. This person-to-personservice is offered via web, phone or fax.Tel: (905) 570-8094 (8:30 a.m. to 5 p.m. Eastern Time)Toll-free: 1-800-668-4284 (Canada and USA)Fax: (905) 572-4500Web: Inquiries online form47

Ontario Ministry of LabourEstablished in 1919 to develop and enforce labour legislation, the Ministry ofLabour’s (MOL) mission is to advance safe, fair and harmonious workplace practicesthat are essential to the social and economic well-being of the people ofOntario.Through the Ministry’s key areas of occupational health and safety, employmentrights and responsibilities, labour relations and internal administration, the Ministry’smandate is to set, communicate and enforce workplace standards whileencouraging greater workplace self-reliance. A range of specialized agencies,boards and commissions assist the Ministry in its work.MOL Main Office – TorontoOccupational Health and Safety Branch400 University Ave, 14th FloorToronto ON M7A 1T7Tel: (416) 326-3835Fax: (416) 326-7761Website: www.labour.gov.on.caOccupational Health and Safety Inquiries:Province-wide: 1-800-268-8013 or (416) 325-3835Central or Western Region: 1-877-202-0008MOL Regional OfficesTo report fatalities and critical injuries during day-time hours, contact the numberfor the region applicable to you. To report fatalities and critical injuries afterhours, call (416) 325-3000 or toll-free 1-800-268-6060.NORTHERN REGIONNorth BayTimmins101 McIntyre Street West, 2nd Floor Ontario Government ComplexNorth Bay, ON P1B 2Y5 D WingTel: (705) 497-52345520 Highway 101 EastToll-free: 1-877-717-0778South Porcupine ON P0N 1H0Fax: (705) 497-6850 Tel: (705) 235-1900Toll-free: 1-800-461-9847Fax: (705) 235-192548

SudburyThunder Bay159 Cedar Street, Suite 301 435 James Street South, Ste. 222Sudbury ON P3E 6A5 Thunder Bay, ON P7E 6S7Tel: (705) 564-7400 Tel: (807) 475-1691Toll-free: 1-800-461-6325 Toll-free: 1-800-465-5016Fax: (705) 564-7437 Fax: (807) 475-1646Sault Ste. Marie70 Foster Drive, Ste. 480Sault Ste. Marie, ON P6A 6V4Tel: (705) 945-6600Toll-free 1-800-461-7268Fax: (705) 949-9796WESTERN REGIONHamilton/Halton/BrantWindsorEllen Fairclough Building 4510 Rhodes Drive, Suite 610119 King Street West Windsor, ON N8W 5K5Hamilton, ON L8P 4Y7 Tel: (519) 256-8277Tel: (905) 577-6221 Toll-free: 1-800-265-5140Toll-free: 1-800-263-6906 Fax: (519) 258-1321Fax: (905) 577-1200NiagaraKitchener – Waterloo301 St. Paul St, 8th Floor 155 Frobisher Drive, Unit G213St. Catharines, ON L2R 7R4 Waterloo, ON N2V 2E1Tel: (905)704-3994 Tel: (519) 885-3378Toll-free: 1-800-263-7260 Toll-free: 1-800-265-2468Fax: (905) 704-3011 Fax: (519) 883-5694London/Sarnia217 York St., 5th FloorLondon, ON N6A 5P9Tel: (519) 439-2210Toll-free: 1-800-265-1676Fax: (519) 672-026849

CENTRAL REGIONCENTRAL REGION OFFICE5001 Yonge Street, Suite 1600North York, ON M7A 0A3Tel: (647) 777-5005Fax: (647) 777-5010EASTERN REGIONOttawaPeterborough347 Preston Street, 300 Water Street NorthTower III, 4th Floor3rd Floor, South TowerOttawa ON K1S 3J4Peterborough, ON K9J 8M5Tel: 613-228-8050 Tel: (705) 755-4700Toll-free: 1-800-267-1916 Toll-free: 1-800-461-1425Fax: 613-727-2900 Fax: (705) 755-4724KingstonBeechgrove Complex51 Heakes LaneKingston, ON K7M 9B1Tel: (613)545-0989Toll-free: 1-800-267-0915Fax: (613) 545-9831Office of the Worker AdvisorThe Office of the Worker Adviser (OWA) is an independent agency of the provincialMinistry of Labour. The OWA provides free services to non-unionized injuredworkers and their survivors in workplace insurance matters (formerly calledworkers’ compensation).The OWA was established in 1985, along with the Office of the Employer Adviser(OEA) and (WSIAT). The OWA is not part of WSIB.Head Office – Toronto123 Edward Street, Suite 1300Toronto, ON M5G 1E2Tel: (416) 325-8570Toll-free: 1-800-660-6769Fax: (416) 325-4830Website: www.owa.gov.on.ca50

TORONTO AND EASTERN ONTARIO REGIONMississaugaScarborough10 Kingsbridge Garden Circle, 305 Milner Avenue,Suite 512 Suite 918Mississauga, ON L5R 3K6 Scarborough, ON M1B 3V4Tel: (905) 568-2359 Tel: (416) 325-9846Toll-free: 1-800-263-9209 Toll-free: 1-800-268-4343Toll-free: 1-800-387-8806 Fax: (416) 325-9855(519/705 area code)Fax: (905) 568-1086KingstonPeterboroughSatellite OfficeSatellite OfficeGreen Ridge Plaza300 Water Street105 Sutherland Drive Peterborough, ON K9J 3C7Kingston, ON K7K 5V6 Toll-free: 1-800-268-4343Toll-free: 1-800-267-6599Ottawa347 Preston Street, 3rd FloorOttawa, ON K1S 3H8Tel: (613) 728-2006Toll-free: 1-800-660-6769Fax: (416) 325-4830CENTRAL REGIONDownsviewWaterloo1201 Wilson Avenue 155 Frobisher Drive, Unit G (213)Building C, Suite 125Waterloo, ON N2V 2E1Downsview, ON M3M 1J8 Tel: (519) 888-9063Tel: (416) 235-5550 Toll-free: 1-800-265-2466Toll-free: 1-800-387-7495 Fax: (519) 883-5659Fax: (416) 235-5594SOUTHWEST REGIONHamiltonLondon119 King Street West, 13th Floor 495 Richmond Street, Suite 810Hamilton, ON L8P 4Y7London, ON N6A 5A9Tel: (905) 577-1301 Tel: (519) 873-4490Toll-free: 1-800-263-9209 Toll-free: 1-800-265-7924Fax: (905) 540-9355 Fax: (519) 873-450051

St. CatharinesSarnia301 St. Paul Street, 9th Floor Satellite OfficeSt. Catharines, ON L2R 7R4 171 Kendall StreetTel: (905) 704-3945Point Edward, Sarnia, ON N7V 4G6Toll-free: 1-800-414-4512 Tel: (519) 344-7261Fax: (905) 704-3019 Fax: (519) 336-1133Windsor100 Ouellette Avenue, 4th FloorWindsor, ON N9A 6T3Tel: (519) 254-7558Toll-free: 1-800-265-5649Fax: (519) 254-1741WaterlooNORTHWEST REGIONElliot LakeSault Ste. Marie50 Hillside Drive, North 70 Foster Drive, Suite 480Elliot Lake, ON P5A 1X4Sault Ste. Marie, ON P6A 6V4Tel: (705) 848-6413 Tel: (705) 945-5861Toll-free: 1-800-398-3228 Toll-free: 1-800-461-6023Fax: (705) 848-2408 Fax: (705) 759-6788Thunder BayTimminsOntario Government Building 60 Wilson Avenue, 3rd Floor, Suite 303435 South James Street Timmins, ON P4N 2S7Suite 335, 3rd Floor Tel: (705) 268-3454Thunder Bay, ON P7E 6E3 Toll-free: 1-800-461-9854Tel: (807) 475-1280 Fax: (705) 267-3633Toll-free: 1-800-465-3966Fax: (807) 475-1283Sudbury159 Cedar Street, Suite 304Sudbury, ON P3E 5A5Tel: (705) 564-1621Toll-free: 1-800-461-6372Fax: (705) 564-412652

Workplace Safety and Insurance Board (WSIB)WSIB promotes workplace health and safety, and provides a workers compensationsystem for Ontario employers and workers. There is extensive informationon its website about prevention, forms, health issues, return to work programs andlinks to other health and safety organizations.Head Office – Toronto200 Front Street WestToronto, ON M5V 3J 1Tel: (416) 344-1000Toll-free: 1-800-387-0080TTY: 1-800-387-0050Fax: (416) 344-4684 or 1-888-313-7373Website: www.wsib.on.caAll claims-related mail is to be sent to the above addressOFFICESGuelphHamilton(deals with Agricultural sector only. 120 King Street WestFor all other small business services Hamilton, ON L8N 4C5in the area, see Kitchener).Mailing Address:1 Stone Road West, 2nd Floor P.O. Box 2099 – Station LCD1Guelph, ON N1G 5L3120 King Street WestTel: (519) 826-7490Hamilton, ON L8N 4C5Toll-free: 1-888-259-4228 Tel: (905) 523-1800Fax: (519) 826-4678 Toll-free: 1-800-263-8488Fax: (905) 521-4502KingstonKitchener234 Concession Street, Suite 304 55 King Street West, 3rd FloorKingston, ON K7K 6W6 Kitchener, ON N2G 4W1Tel: (613) 544-9682 Tel: (519) 576-4130Toll-free: 1-800-267-946 1 Toll-free: 1-800-265-2570Fax: (613) 544-1510 Fax: (519) 576-2667LondonNorth Bay148 Fullarton Street, 7th Floor 128 McIntyre Street WestLondon, ON N6A 5P3 North Bay, ON P1B 2Y6Tel: (519) 663-2331 Tel: (705) 472-5200Toll-free: 1-800-265-4752 Toll-free: 1-800-461-9521Fax: (519) 663-2333 Fax: (705) 472-980153

OttawaSarnia Liaison Office180 Kent Street Lambton Shared Services CentreTower H, Suite 400Bayshore MallOttawa, ON K1P 0B6Sarnia, ON N7T 8H3Tel: (613) 237-8840 Tel: (519) 344-7926Toll-free: 1-800-267-9601 Fax: (519) 344-7202Fax: (613) 239-3321Sault Ste. MarieSt. Catharines153 Great Northern Road 301 St. Paul Street, 8th FloorSault Ste. Marie, ON P6B 4Y9 St. Catharines, ON L2R 7R5Tel: (705) 942-3002 Tel: (905) 687-8622Toll-free: 1-800-461-6005 Toll-free: 1-800-263-2484Fax: (705) 942-7582 Fax: (905) 687-7117SudburyThunder Bay30 Cedar Street 1113 Jade Court, Suite 200Sudbury, ON P3E 1A4 Thunder Bay, ON P7B 6V3Tel: (705) 675-9301 Tel: (807) 343-1710Toll-free: 1-800-461-3350 Toll-free: 1-800-465-3934Fax: (705) 675-9367 Fax: (807) 343-1702TimminsWindsor119 Pine Street, South, Suite 310 2485 Ouellette AvenuePine Plaza Windsor, ON N8X 1L5Timmins, ON P4N 2K3 Mailing Address:Tel: (705) 267-6427 P.O. Box 1617Toll-free: 1-800-461-9856 Windsor, ON N9A 7B7Fax: (705) 264-9131 Tel: (519) 972-4254Toll-free: 1-800-265-7380Fax: (519) 972-418154

SECTION IGLOSSARYAROCACMCRAEAESRTWFELHOOPPHOODIPJHSCLMRLMRALMRPLOELTDMOLNCMNELNOCOHCOWAppeals Resolution OfficerClaims AdjudicatorCase ManagerCanada Revenue AgencyEligibility AdjudicatorEarly Safe Return to WorkFuture Economic LossHealthcare of Ontario Pension PlanHospitals of Ontario Disability Income ProtectionJoint Health and Safety CommitteeLabour Market Re-EntryLabour Market Re-Entry AssessmentLabour Market Re-Entry PlanLoss of EarningsLong Term DisabilityMinistry of LabourNurse Case ManagerNon-Economic LossNational Occupational ClassificationOccupational Health Clinics for Ontario Workers55

ONAOH & SOHDOHSARN ECSEBSOSTDSWAWRWTWTPWTSWSIAWSIATWSIBOntario Nurses’ AssociationOccupational Health & SafetyOccupational Health DoctorOccupational Health and Safety ActRegistered Nurse Extended ClassSuitable Employment and BusinessSuitable OccupationShort-Term DisabilitySafe Workplace AssociationWork ReintegrationWork TransitionWork Transition PlanWork Transition SpecialistWorkplace Safety and Insurance ActWorkplace Safety and Insurance Appeals TribunalWorkplace Safety and Insurance Board56