Generally, you cannot sue your employer in relation to an injury you incur at work or an illness or disease that you are diagnosed with that is related to your employment. If you think a third party (someone who is not your employer) may be involved or responsible, you should contact us as early as possible.
Does it matter that the accident that led to my injury was my fault?
The WSIB is a no fault system and will provide benefits even if the accident was the worker’s or employer’s fault.
Is there a time limit to apply for WSIB benefits?
Yes, there is a six-month time limit to apply for benefits with WSIB. If you miss a time limit, you should complete a claim for benefits form, known as a Form 6, immediately, and send it along with a letter explaining why the time limit was missed. The WSIB may extend the time limit for specific reasons in limited circumstances.
What will I be paid by WSIB if my claim is successful?
The amount of benefits paid depends on the impact the injury has on you physically, mentally and financially. You are entitled to Loss of Earnings Benefits if you suffered a loss of income due to the work-related injury or illness. The level of benefits paid may depend on the date on which your accident occurred or you received your diagnosis of an occupational illness.
What happens if my injury or illness has a permanent impact on my quality of life?
A Non economic loss award is paid by the WSIB when your injury has a permanent impairment on your life. A permanent impairment means any permanent physical or functional restriction, limitation or loss (including disfigurement) which results from an injury or illness, as well as any psychological damage arising from the injury. To determine if you have a permanent impairment, the WSIB looks at the medical information in your file.
The amount of your award is calculated using a pre-determined formula and will be assessed based on the medical reports provided by your doctors and other healthcare specialists such as physiotherapists, psychologists and occupational health specialists.
Does WSIB pay for my Health Care?
The WSIB does pay for chiropractic and physiotherapy treatments as long they are recommended by your physician to treat your injury, and the treatment would improve your condition. You would usually receive 12 weeks of benefits for these treatments. An extension can be granted if your chiropractor or physiotherapist believes it is necessary and WSIB agrees. The WSIB will only pay for these treatments until you reach a determined point of maximum recovery as assessed by WSIB.
The WSIB will also pay for any medication that is needed for your injury, as long as entitlement is granted for that injury by the Board.
Does WSIB pay for my Prescriptions?
In most cases when you are injured, you will require some form of medication. In many cases the WSIB will reimburse the injured worker for these expenses, however they must be pre-approved by WSIB.
As an injured worker you must provide the WSIB with the original prescriptions and receipts for all medications, assistive devices and supplies.
Does WSIB cover mileage to my medical appointments?
Many injured workers will need to travel for treatment and in some instances the WSIB will pay mileage or some travel expenses. Approval must be obtained for out-of-town travel. If the treatment is outside of city limits but still local, the reimbursement is based on mileage. Treatment within the city limits is based on bus fare. In all cases it is important to ask for approval in advance.
What happens if I cannot return to the job I had before my injury or illness?
Often times an injured worker is unable to return to their original employment due to the severity of the injury or the impact of an occupational illness. In such cases, injured workers are eligible for a Return-to-Work assessment if it is unlikely the worker will be re-employed by the accident employer due to the nature of the injury or the injury employer is unable to arrange for suitable and available work.
Based on the results of the assessment, the WSIB decides whether a worker requires a Return-to-Work plan to return to the wider labour market. The plan should be tailored to each individual worker based on their existing transferable skills. An injured worker will receive benefits while co-operating with their plan. If the worker does not agree with the suggested new area of work chosen (referred to by WSIB as the “Suitable Occupation” or “SO”) they must appeal that decision within 30 days in writing to WSIB. If you have any doubts that the Suitable Occupation is actually suitable you should appeal immediately.
Can I obtain legal representation to help me with my claim?
Yes you can – and you should! Far too often, disputes arise over what benefits are owed to you. The law in relation to workers’ compensation in Ontario is complex. Employers are typically represented by competent experienced worker’s compensation lawyers who try to defeat the claim or minimize the benefits paid to you. You need a lawyer who will fight for you. We have that expertise and will work hard to ensure that you get the benefits that you need and are entitled to – allowing you to get on with recovering from your injury or illness and, where possible, getting back to work.