Public Health Ontario publishes weekly epidemiological summaries regarding COVID-19 in Ontario. The most recent report, published October 7, 2022, noted a gradual increase in case trends and percent positivity over the past three weeks. Current projections suggest that weekly case numbers may continue to rise over the coming weeks.
Given forecasted increases, here is a reminder of how workplace COVID-19 claims are adjudicated by the Workplace Safety and Insurance Board (WSIB) and how costs are treated.
In 2021, costs associated with COVID-19 claims and adverse reactions to vaccines were not allocated at an employer or class level, but on a Schedule-wide basis for both Schedule 1 and Schedule 2 employers. This meant that no incident was shown against the employer's record and there was no impact on premium rates.
Over the summer, most public health restrictions were lifted across Ontario. Because there were multiple potential sources of COVID-19 in the community, at home and outside of work, it was difficult to establish work-relatedness when adjudicating claims. As such, the WSIB noted that most COVID-19 infections will not be work-related.
For a COVID-19 claim to be allowed, evidence must show that the worker's risk of contracting the disease through their employment is greater than the risk to which the public at large is exposed and that work significantly contributed to the worker's illness.
Schedule 1 Employers
As of July 1, 2022, costs and counts associated with COVID-19 related claims were applied in the calculation of the rates for Schedule 1 employers. This means that any COVID-19 related claims on or after July 1, 2022 would impact the employer's premium rates.
Any costs and counts for COVID-19 related claims allowed with accident dates on or before June 30, 2022 will be allocated on a Schedule-wide basis for Schedule 1 employers and the individual claims will not be applied in the calculation of the rates.
Schedule 2 Employers
As of January 1, 2022, Schedule 2 employers were individually liable for COVID-19 claims and adverse reactions to vaccines.
The WSIB discontinued the reimbursement for costs related to COVID-19 claims and ceased allocating these costs across Schedule 2 employers as of December 31, 2021. All Schedule 2 employers should have received their COVID-19 claim credits earlier this year for COVID-19 claim costs up to and including December 31, 2021.
As a reminder, all employers have an obligation to report that a worker contracted COVID-19 when they have reason to believe there was a potential workplace exposure.
Please contact your regular Hicks Morley lawyer should you have any questions regarding COVID-19 and WSIB claims costs.
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.