WSIB - Ontario Nurses' Association

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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
Page 1 and 2: Workplace Safety andInsurance Board
Page 3 and 4: CONTENTSIntroduction. .............
Page 5 and 6: SECTION AFILING A CLAIM FOR WSIBBy
Page 7 and 8: explaining the details of your acci
Page 9 and 10: cess an RN (EC) or physiotherapist
Page 11 and 12: has often helped ONA win a case, es
Page 13 and 14: • Subsection 131(4) of the WSIA s
Page 15 and 16: to provide a written job descriptio
Page 17 and 18: • Employers are required by the O
Page 19 and 20: The employer is entitled to functio
Page 21 and 22: • Many claims have been accepted
Page 23: SECTION DMISCELLANEOUSReporting an
Page 27 and 28: Workers should submit these stateme
Page 29 and 30: Time limits to notify ONA• Within
Page 31 and 32: claim was initiated, and who were n
Page 33 and 34: ly, there is a “60-Day Decision O
Page 35 and 36: and why. Review the file yourself a
Page 37 and 38: Suitable Occupation (SO)The Work Tr
Page 39 and 40: If a plan includes any work hardeni
Page 41 and 42: Other optionsEven though the worker
Page 43 and 44: When having your assessment, it is
Page 45 and 46: ONA OfficesProvincial Office - Toro
Page 47 and 48: North Western Ontario2114 Bordeau C
Page 49 and 50: TorontoWindsor970 Lawrence Ave. Wes
Page 51 and 52: Ontario Ministry of LabourEstablish
Page 53 and 54: CENTRAL REGIONCENTRAL REGION OFFICE
Page 55 and 56: St. CatharinesSarnia301 St. Paul St
Page 57 and 58: OttawaSarnia Liaison Office180 Kent
Page 59: ONAOH & SOHDOHSARN ECSEBSOSTDSWAWRW

WSIB - Ontario Nurses' Association

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