Dealing with the Workplace Safety & Insurance Board
("WSIB") can be a challenging and expensive process for
any employer. Each claim commenced in relation to a work-related
injury can have a significant financial impact on an organization.
Schedule 2 employers (as defined by the Workplace Safety and
Insurance Act) are required to pay the full cost of accident
claims filed by their workers plus an administration fee. For
Schedule 1 employers, a claim can impact the applicable experience
rating affecting the size of the rebate or surcharge they will
receive. As such, properly managing WSIB claims is critical in
keeping costs at a minimum.
The best way to reduce the cost of claims is the prevention of
workplace injuries. However, when a work-related injury occurs,
here are 5 tips to assist employers to better manage claims:
1 – Have an Accident Reporting Policy
All employers should have a policy regarding accident reporting
and investigation. A policy should cover such issues as what
constitutes an accident, the roles and responsibilities of all
involved, the accident investigation procedure along with the
accident investigation documentation to be completed. Having a
clear understanding of the accident and resulting injury is
critical if an employer wants to challenge a claim at a later
2 – Stay Actively Involved in the Process
Once a claim has been made, employers often believe that they
are simply bystanders in the process. However, employers must stay
informed about the status of the claim, requesting updates from the
WSIB case manager if needed. Given the financial consequences of
claims, an employer should assess whether decisions by WSIB should
be appealed and should consider being involved in any challenges
advanced by the employee.
3 – Documentation is Critical
It cannot be overstated how important accurate records are in
any WSIB claim. Employers should keep minutes of meetings and
telephone conversations with related parties, records of missed
meetings and phone messages, and information regarding return to
work activities. Accurate documentation is critical in an appeal
and allows the employer to know what has been done on a claim and
what steps have been taken to assist the employee.
4 - Red Flags
As a component of tip 2 (staying actively involved in the
process), an employer should assess whether the claims advanced by
an employee are legitimate. Some issues that an employer should
consider when assessing a claim include prior occupational claims
and absences, prior related medical issues, prior employment
history, known hobbies and activities, timing of the accident, and
any inconsistencies in reporting.
5 – Facilitate the Employee's Return to Work
The cost of a claim increases the longer an employee is off
work. As such, an employer should facilitate a worker's safe
return to work. Employers should maintain regular contact with the
injured worker to determine the status of any injures, find out how
he/she is recovering and determine when the worker is capable of
returning to regular or modified duties. However, employers must
ensure they follow the guidelines outlined in the WSIB Work
Reintegration policies during the return to work process.
The proper management of WSIB claims can significantly reduce
costs for employers. Employers should develop a comprehensive
claims management plan with the above noted tips in mind.
The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.
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