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Workplace Safety and Insurance Board (WSIB)
Many members suffer work-related accidents. To access benefits from the Workplace Safety and Insurance Board (WSIB), it is important to understand the claim process and to follow it carefully.
When Should You File a WSIB Claim?
A claim should be filed immediately following a work-related accident, such as falling off a ladder, slipping and falling on wet floor or ice, or experiencing sudden back pain after lifting or twisting.
If you become aware that you have developed medical problems that may have been caused by work exposure (to noise, chemicals, dust, mould, etc.), file a WSIB claim immediately.
What Should You Do First?
Tell your employer about your accident or occupational disease. This generally means notifying the school principal, vice-principal and/or health and safety representative.
Ask the principal to submit a report to the WSIB. Your employer is required to send the WSIB a report of your accident/disease within three days of finding out about it.
Get medical attention right away (first aid, hospital emergency, family doctor, etc.). Advise the treating health care practitioner that you are being seen for a work-related injury and ask that they forward a report (Form 8) to the WSIB.
Is There a Time Limit for Filing a Claim for Benefits?
Yes. To get WSIB benefits, you must file a claim as soon as possible, and no later than six (6) months from the date of your accident, or from the date you find out you are suffering from an occupational disease.
How Do You File a Claim for Benefits?
You claim benefits by signing the Employer's Report of Injury/Disease (Form 7), or you can fill out and sign the Worker's Report of Injury/Disease (Form 6). Make sure you read the Form 7 (Employer's Report) before signing, and that you agree with the details in the report.
If you are unable to sign the employer's Form 7, you can file your claim by signing a Form 1492. This form should be available in your workplace. If you do not sign the Form 7 or a Form 1492, the WSIB will send you a Form 6 to complete.
Your treating health care practitioner can also initiate a claim by submitting the Form 8 to the WSIB.
If you have filed your claim by signing your employer's Form 7 or the Form 1492, the WSIB may not send you a Form 6 to complete.
If you do not receive a Form 6, phone WSIB and ask them to send you one. When filling out the form, give as much detail about the accident as you can. You should also contact WSIB and ask to be sent a Form 6 if you think that your employer has not reported your accident.
The employer must give you a copy of the Form 7 sent to the WSIB. If you fill out a Form 6, you must give your employer a copy.
What Should Happen Next?
After you have submitted the correct forms, you should get a letter from the WSIB giving you a claim number. This does not mean that your claim has been accepted. It only means that the WSIB knows about your claim and has opened a file on it. Use this number every time you contact the WSIB about your claim.
If you do not receive a claim number, it may mean that the WSIB does not know about your claim. In this event, you should contact the WSIB immediately to find out if there is a problem with your claim.
What if Your Benefits Are Delayed?
If your benefits are delayed, it could mean that the WSIB has not received all the information it needs to make its decision (e.g. the doctor's or the employer's report); it could mean that the WSIB is investigating your claim and that a decision will be made later.
If you do not receive a letter of explanation, call the WSIB and ask what is causing the delay. You should ask to speak to the claims adjudicator assigned to your file.
What if Your Claim is Denied?
If your claim is denied, you should get a letter telling you why the WSIB has decided not to grant you any benefits. You have six (6) months from the date of the WSIB decision to notify WSIB that you wish to appeal such a decision. Notification that you wish to appeal must be in writing, stating the reason(s) why you wish to do so.
For more information regarding members' rights and obligations call PRS at 416-962-3836 or 1-888-838-3836.