1)To be eligible for WSIB insurance benefits, you must:
· Have a worker-employer relationship with an employer covered by the WSIB
· Have an injury or illness directly related to your work.
· Promptly file a claim with the WSIB
· Provide all relevant information requested by the WSIB to help us determine your benefits.
· Consent to the release of functional abilities information to your employer by the health care professional treating you.
2) Benefit for Loss of Earnings (LOE)
Benefit for Non-Economic Loss (NEL)
Loss of Retirement Income (LRI) Benefit
Benefit for Future Economic Loss (FEL)
Health Care Benefits
The Occupational Disease and Survivor Benefits Program
Benefits for Seriously Injured Workers
3) After January 1st, 1998, you would get 85% of your Take Home Pay. Ta Da ^_^
4) Loss of earnings benefits continue until you are no longer impaired by your work- related injury or illness, or until you no longer have a loss of earnings, or until you reach age 65.
If you are still impaired at age 65, LOE benefits stop, but loss of retirement income benefits may apply. If you are 63 years old or older at the time of injury, you can receive LOE benefits for up to two years as long as you have loss of earnings.
5) In addition to loss of earnings benefits, WSIB benefits pay for a number of costs related to workplace injury and illness, including:
· Health care
· Prescription drugs
· Medical devices and orthotics
· Transportation costs associated with work-related injury or illness.
6) The WSIB provides a team of professionals to help workers get back to work after illness or injury. This team includes an adjudicator and a nurse case manager (a nurse trained to deal with workplace injury). The team may also call on mediators, ergonomists, advisors, and outside providers to help the worker get back to work.
7) Most people who have a workplace injury or illness are able to return to some type of work even while they are still recovering, provided the work is medically suited to the injury or illness. Returning to daily work and life activities can actually help an injured worker's recovery and reduce the chance of long- term disability. In fact, worldwide research shows that the longer you are off work due to injury or illness, the less likely it is that you will return to work.
1. Get proper medical treatment immediately following a work-related injury or illness and follow the recommendations of your health care providers
2. Report your injury to your employer as soon as possible.
3. Contact your employer as soon as possible after the injury or illness occurs. Stay in contact with your employer throughout your recovery, to keep the company informed about your progress and status. (For your own benefit, keep a record of those contacts.)
4. Help your employer identify suitable work that is available, that is consistent with your functional abilities, and that restores pre-injury earnings when possible.
5. Give your adjudicator or nurse case manager any information requested concerning your return to work.
6. Report any significant change in your medical condition or income that may affect your benefits (also called a "material change"). If you are in doubt about whether a change is material, contact your adjudicator. You must report any material change in your status within 10 days of the change occurring.
7. Cooperate with your employer and the WSIB in your early and safe return to work.
9) Your employer is required to:
1. Report your injury to the WSIB.
2. Contact you as soon as possible after your injury and stay in contact throughout your recovery.
3. Offer to re-employ you if you are medically fit to do the essential duties of your job or suitable work if: · there are 20 or more people working at your company, and · you have worked at the company continuously for at least one year.Note: Different rules apply to Construction Sector companies. Contact your adjudicator for more information.This duty to re-employ you remains in effect for the earliest of: · one year after you are declared fit to return to the essential duties of your pre-injury job or other suitable work · two years from the date of injury/illness · the date the worker reaches age 65
4. Attempt to provide you with suitable work. This is work that: · is safe and within your physical capabilities · you have the skills to do or that you can learn the skills to do · restores your pre-injury earnings as much as possible
5. Give the WSIB any information requested about your return to work.
10) The WSIB will:
1. Help you understand : · What to expect through the Return to Work (RTW) process · What you and your employer are expected to do · Your rights and obligations · Who to ask for help
2. Monitor your activity, progress, and cooperation between you and your employer throughout the RTW process.
3. Obtain and clarify functional abilities information.
4. Assess the need for a Labour Market Re-entry (LMR) Plan if early and safe return to work is unlikely.
5. Help resolve difficulties and disputes through the Return to Work and Labour Marke Re-entry process.
6. Provide ergonomic and/or mediation services, and/or site visits to help you and your employer through the RTW/ or LMR process.
7. Make decisions on all claim-related and compliance issues.
11) Most workers and employers cooperate in the return to work process. In cases, however, where the WSIB determines either party to be non-compliant with their legal obligations, they may be penalized.
Your benefits may be reduced, suspended, or even stopped if the WSIB determines that you are not co-operating in the Return to Work (RTW) process.
Your employer, too, can be penalized for not fulfilling their re-employment obligations.
12) Your adjudicator will help you with procedural matters concerning your claim and can:
· Intervene if you think your employer is not fulfilling his or her responsibilities in helping you return to work · Involve a WSIB return to work mediator to help you and your employer resolve disagreements · Call on a WSIB ergonomist to help you and your employer find ways to modify your workstation, and/or parts of your job to ensure these are suited to your physical capabilities. For more information about how ergonomics can work for your workplace, download our Making Ergonomics Work (138k, pdf) brochure. · Identify and coordinate any services you may need that are beyond what the WSIB provides.
13) First, ask your adjudicator to help you resolve the dispute. If this is not successful, then you can request return to work mediation.
Return to Work Mediation is a conflict-resolution process based on fairness, privacy, self-determination, and the best interests of you and your employer.
Within the parameters of the return to work provisions of the Act and the WSIB's policies and procedures, a mediator can reduce the obstacles to communication, help you explore alternatives, and address the needs of everyone involved.
The goal of mediation is to help you and your employer arrive at your own solution, because decision-making authority rests with you.
14) This Program provides specialized services to workers, dependents, and employers affected by certain serious occupational illnesses such as:
· Cancer · Asthma · Asbestosis and Silicosis · Inhalation of substances and fumes · Noise-induced hearing loss
If you are a worker with one of the above illnesses or conditions, or are a survivor of a worker who died from such illnesses, you'll benefit from the expertise offered by this program's specially trained personnel.
15) If you are still impaired at age 65, LOE benefits stop, but loss of retirement income benefits may apply. If you are 63 years old or older at the time of injury, you can receive LOE benefits for up to two years as long as you have loss of earnings.
· Injured workers with the following injuries or circumstances:
1. Hemiplegia, Paraplegia, Quadriplegia, or Paraparesis;2. Major amputations; 3. Blindness;4. Major burns5. Brain injuries that require major cognitive interventions, prevent the worker's living independently or the handling of the worker's own affairs.6. Serious crushing injuries to chest,abdomen,or pelvis such as those requiring transfer to a major trauma hospital.
17) You'll receive an LOE payment every two weeks. After 72 months, the LOE benefit is made permanent. It may be turned into a lump sum payment if the amount of the benefit is less than 10% of what you would have received if you were unable to work at all.
18) The adjustment is increasing. For 2004, you will receive a 1.6 per cent cost of living increase in the payment rates for these allowances:
· Independent Living Allowance - $ 3,177.57 for the year
· Personal Care Allowance/Skilled Rate - $ 17.13 per hour
· Personal Care Allowance/Personal Rate - $10.70 per hour
· Guide Dog Allowance - $860.75 per year
In addition, the Personal Care Allowance/Basic Supervisory Rate will rise to $7.15 per hour, based on the new minimum wage of $7.15 per hour. You can expect to see these increases reflected on all cheques issued after January 1, 2004.
20) That your injury has healed, that you have gone back to work, and that you are receiving any other money from somewhere else.