Workers' Compensation A worker injured by work, or sick with a disease caused by work, might qualify for workers' compensation benefits. Ontario's Workplace Safety and Insurance Act explains which workers qualify, and the benefits for which a worker qualifies. In Ontario, workers' compensation is administered by the province's Workplace Safety and Insurance Board (WSIB). WSIB decides, according to the Act, whether or not a worker receives compensation, and decides what the worker gets compensation for.
What compensation can a worker with a work injury or illness receive from the Workplace Safety and Insurance Board? Depending on the injury or illness, a worker can receive:
- 85% of her or his wages, which she or he can't earn because of the injury or illness
- transportation costs to a doctor's office or therapy session
- payment for pain and suffering
- a "Labour market re-entry assessment and plan" - that is, a plan organizing the worker's return to work when the worker cannot return to her or his pre-injury or pre-illness work
- an independent living allowance paying some of a worker's costs of living when she or he has been severely and/or permanently disabled
While the Workplace Safety and Insurance Board might pay a worker part of her or his wages lost due to injury or illness, it's the employer who pays the worker her or his full day of wages for the day the worker is injured.
Click here for more detailed information on workers' compensation benefits. Information on benefits is also available on the Community Legal Education of Ontario's website.
Are all workers covered by workers' compensation? An injured or ill worker who suspects she or he may not be covered can check with her or his union. A non-unionized worker can check with WSIB by calling toll free, 1-800-387-0750.
When a worker is injured, what should she or he do? An injured worker should get first aid and immediately report the injury to the supervisor. Next, the worker sees a doctor or nurse, letting the doctor or nurse know that the injury is a work injury. At workplaces without first aid, or if an injury requires it, the injured worker sees a doctor or nurse immediately. While the employer might recommend a doctor, the worker can go to the doctor of her or his choice. The employer pays for the worker's transportation to the doctor's office, hospital emergency or worker's house on the day of the injury.
When the injured worker meets with the doctor or nurse, the worker should tell the doctor how the injury is work related. By giving a detailed account of the incident, the worker can give the doctor all the facts needed to complete the medical report for WCB. Information on equipment and hazardous materials may be important for the medical report as well.
Not all injuries can be traced to a work accident. An injury or illness may not be obvious immediately after an accident - an injury or illness may develop over time. Workers can complete and send a Worker's Exposure Incident Form to the WSIB when there is no injury or illness, but there is:
- a leak, spill, explosion or release of a hazardous material that's not a part of the work
- unplanned contact with an infectious substance
Right now, the Program for Exposure Incident Reporting is only for construction workers, service workers and primary metals workers. Recording workers' exposure to hazardous materials makes the gathering of information easier in case workers do get ill at a later date.
Work related illnesses, or occupational diseases, like bronchitis or repetitive strain injury, can develop over time. An injury or illness may later be found to be caused by work. Or an injury or illness may later be found to have been caused, not entirely by work, but significantly by work. A worker's notes on her of his work injuries, illnesses and accidents can be used to trace how work may have caused, or played a significant part in, an injury or illness.
Back problems, broken bones, heart attacks, asthma, deafness, chronic pain and depression are some of the work illnesses and injuries for which a worker can receive compensation. A work injury or illness can be physical and/or psychological. For example, a person may experience depression when there's a painful physical injury.
Unions are interested in workers' stories of work related accidents, injuries and illnesses. By collecting information from workers, a union can judge whether to make employer recommendations on the use of safety equipment, worker training, equipment repair, etc.
How can a worker get compensation? A worker completes the Worker's Report of Injury/Disease Form 6 (PDF) if the worker:
- loses time from work because of the injury or illness
- loses wages because of the injury or illness
- needs to get health care (such as prescription drugs, glasses, prosthesis or services from a doctor or other health care provider)
The worker should answer the questions on the Worker's Report of Injury/Disease Form in great detail. In particular, the events leading to the accident or injury can be reported like a story, with a beginning, middle and end, including background details and the names of any witnesses. The worker keeps a copy of the completed report for her or his own records.
A friend, coworker, or family member can complete the report with the worker. For more online information on claiming workers' compensation, contact the Community Legal Education of Ontario. Information on workers' compensation benefits is available free of charge to non-unionized workers from the Office of the Worker Advisor. The Office of the Worker Advisor acts independently from WSIB.
A unionized worker can go to her or his union for information and assistance with completing the Worker's Report of Injury/Disease.
As WSIB decides whether or not to compensate a worker and the amount of compensation a worker receives, WSIB looks not only at the worker's report of injury, but also at the doctor's medical report and at the employer's report. The employer's report and the worker's report may contain differing information on the worker. The worker's report explains the worker's point of view. The injured or ill worker can get a copy of the employer's report from the employer – and, according to the law, the employer must give the worker a copy. On the employer's report, the worker can check to see whether or not the information is correct. The worker can speak to WSIB and to the Office of the Worker Advisor about information on the employer's report that may not be correct.
The employer can ask the worker to sign the employer's report on the worker's injury. Signing the employer's report does not mean that the worker agrees with the information on the employer's report. Signing the employer's report means that non-medical information on the worker's ability to work after an injury or illness can be made available to the employer. This information is made available to the employer, too, when a worker sends a Worker's Report of Injury/Disease Form to WSIB.
What should the worker do while off from work because of a work injury or illness? It is important for the worker:
- To speak with WSIB before changing doctors, since changing doctors may not be permitted
- To keep in contact with the doctor or other health care provider and follow all medical instruction (such as exercise programs, nutrition plans, the use of medical aids, etc.)
- To talk with the doctor or other health care provider about when it is safe to return to work
- To take detailed notes on conversations with health service providers
- To keep records of the names of doctors, nurses and other health service providers, health service appointments and treatments, health service providers' notes, and health expenses
- To keep all receipts for expenses related to the work injury or illness for a possible refund from WSIB
- To take detailed notes on conversations with WSIB workers and to keep copies of letters and information that the injured or ill worker sends to WSIB
- To take notes on conversations with the employer, to keep records of time taken off from work
- To tell WSIB about any plans to leave the province, even for a short stay, since WSIB benefits might stop while an injured or ill worker is away
What can a worker do if she or he disagrees with WSIB's decision? A worker can appeal WSIB's decision. This means a worker can ask WSIB to change its decision, or parts of its decision. The decision pertains to whether or not the worker receives benefits, the type of benefits a worker receives and the amount and length of time the worker receives benefits.
Appealing a WSIB Decision answers commonly asked questions on appeals. The Community Legal Education of Ontario also writes on WSIB appeals in Your Right to Appeal (PDF).
The Office of the Worker Advisor can work with a worker on appealing a WSIB decision. The Office of the Worker Advisor is an agency of the Ontario Ministry of Labour, and is independent from the Workers Safety and Insurance Board. The services of Worker Advisers are free of charge to workers who are not unionized.
A worker who is union member can contact her or his union for assistance and advice on appealing a WSIB decision.
WORKPLACE SAFETY AND INSURANCE BOARD 200 Front Street West
Toronto ON M5V 3J1