Presentation on theme: "Used with permission from CAW Local 4212 WSIB Benefits HOW TO MAKE A WORKERS’ COMPENSATION CLAIM The following information will help you to make a workers'"— Presentation transcript:
Used with permission from CAW Local 4212 WSIB Benefits HOW TO MAKE A WORKERS’ COMPENSATION CLAIM The following information will help you to make a workers' compensation claim for yourself or to help your fellow workers establish a claim Author: Laura Burns, July 2006
CAW Local 4212 WSIB Benefits - Level 1 Obligations zIf you are injured you must: yReport the accident ySee your Doctor yFile a claim for Workers’ Compensation zMake sure you: yGet advice from your Union Representative yKeep notes and records yGet a list of any witnesses zYou are required to keep your employer informed about when you can return to work and about your medical restrictions
CAW Local 4212 WSIB Benefits - Level 1 Workplace Safety & Insurance Act - Bill 99 zYou have the right to workers' compensation if you are injured at work or if your injury or illness arises out of your work. zThis can include anything from a broken bone, to muscle injuries resulting from repetitive work, to diseases like asthma or cancer from toxic exposures at work. zOver the years workers have fought for recognition and better compensation for their workplace injuries. Through demonstrations, organizing campaigns, work refusals and occupations, injured workers have, step by step, gained greater rights. zBut since 1995 in Ontario, workers' compensation rights have suffered a major setback. The Harris government passed Bill 99, the Workplace Safety and Insurance Act, a complete rewrite of the Workers' Compensation Act. This gave companies greater power to stop claims for workplace injuries. As a result, employers are using changes in the law to intimidate injured workers to lower their costs.
CAW Local 4212 WSIB Benefits - Level 1 Reporting an Injury and Filing a Claim Important Information zBy not applying for workers’ compensation, workers also give up return to work opportunities and possible awards for permanent impairment. zIn addition, if workers fail to claim for compensation, companies will not have to address the fact that they have a Health and Safety problem on their hands. When in doubt, file a claim!
CAW Local 4212 WSIB Benefits - Level 1 What can be done to ensure a problem-free claim? zBeyond immediate reporting to the employer, the worker must seek immediate medical treatment or risk having the claim denied. Sometimes when there is a delay in getting treatment, benefits are denied for the period before treatment. zMake sure that all parts of the body that may be injured are listed on the employers Form 7. The same injuries should be reported to and recorded by the treating physician. The worker should be consistent when reporting the injuries. z Even if there is doubt about whether a particular part of the body was injured, included it in the initial reports. z There have been far too many cases where the “less serious” injury, not reported at the time of an injury, is the one that lasts longest. In these cases, compensation is terminated before the worker can get back to work because the less serious condition is not recognized as compensable because of the failure to report.
CAW Local 4212 WSIB Benefits - Level 1 Other Questions Raised by the Board may Include: zThe worker’s doctor will be asked to provide ongoing medial information on Doctor’s progress report forms and in medical reports. It is important that worker’s keep in regular contact with their doctors regarding their compensable medical conditions. zProviding the treating physician with an accurate job description is important in case the physician renders an opinion regarding the work-relatedness of the injury. Why was the injury not reported immediately? Were there witnesses to the injury? Was there ongoing Health Care? Did the worker modify the job or job site in any way, such as in getting help with particular tasks after the injury? Was there a non-compensable injury between the injury date and the (LOE) Loss of Earnings from work?
CAW Local 4212 WSIB Benefits - Level 1 Delayed Reporting zWhen the injury is not reported immediately after the injury, the Board will look carefully at the worker’s “continuity” of complaints, symptoms and treatment after the date when the claimed injury took place. zThe Board will review the worker’s continuity of complaints with doctors, the employer, co-workers and others to see if the complaints are consistent with injury history claimed. It is of mutual benefit to worker, employers and unions to establish some type of early resolution process that will enable the parties to reach a consensus before having the Board intervene.
CAW Local 4212 WSIB Benefits - Level 1 I WAS JUST INJURED ON THE JOB. WHAT DO I DO NOW? zReport every injury to your employer and to the first aid attendant, no matter how minor you may think it is. Make sure that your employer and the first aid attendant writes down everything you say about your accident. Keep notes about the report you make. This is very important. If you don't report your injury right away, it might be hard, even impossible, to prove later that it happened at work. zA work-related injury can be something that happens over time. For example, you might think it's normal to have back pain or wrist pain because you have it all the time. You might not connect your pain with your job because you didn't have an "accident". But in fact, your back pain could be caused by heavy or awkward lifting at work. Your wrist pain could be caused by repetitive motion. You therefore should apply for workers' compensation for these types of injuries.
CAW Local 4212 WSIB Benefits - Level 1 zReport to your supervisor and the first aid attendant if you are injured at work. If you cannot report right away, report before the end of your shift. Get the names of any of your co-workers who saw you get hurt. If no one saw you get hurt, make sure you tell someone about it right away. zNo. You have the right to choose the doctor you want. You do not have to be treated by the company doctor. In some provinces the company can ask you to go to their doctor. If you refuse, the company can appeal. However, if the WCB tells you to see one of their doctors, you have to go or you will be cut off benefits. Make sure you see your doctor regularly, every couple of weeks or so, or you may be cut off WCB benefits. DO I HAVE TO BE TREATED BY THE COMPANY DOCTOR? WHO DO I REPORT MY INJURY TO AT WORK?
CAW Local 4212 WSIB Benefits - Level 1 WHAT SHOULD I SAY IN MY REPORT TO THE WCB? zWhether you wait for the WCB to send you a Form 6, or you write to them before you get it, you will have to write a report of your accident. Give a lot of detail. zFor example, don't just say "I fell and hurt myself". Say, "I was walking through the north wing on the 4 th floor of the Nursing Home. I stepped in some water that was on the floor. My right leg went forward and I lost my balance. I fell backwards. I hit my shoulder on a wheelchair. I hurt my right shoulder on the whe. When I landed on the floor, I hurt my right wrist, my neck, and my right hip.” zKeep a photocopy of the Form 6. Keep notes on all telephone calls you may have with anyone from the WCB. They will. Keep copies of all letters you get from the WCB.
CAW Local 4212 WSIB Benefits - Level 1 DOES MY EMPLOYER HAVE TO MAKE A REPORT? zYes. Your employer has to report any injury that needs more than very minor first aid to the WCB. Once you report your accident, your employer has 3 business days to file a report. This report is called the Employer's Report of Accident, Form 7. This form is important to you because it gives the WCB information that affects your claim. It will affect the amount of money you might get in WCB benefits. It also gives the WCB an idea whether or not your employer will be fighting your claim. zAsk your employer for a copy of the Form 7. If your employer will not give it to you, get it from the WCB or through your union.
CAW Local 4212 WSIB Benefits - Level 1 IS THERE A TIME LIMIT ON MAKING A WCB CLAIM? zIt is best to make your workers' compensation claim as soon as possible after your accident. In some provinces you must apply within 6 months. WHAT SHOULD I DO IF MY EMPLOYER TRIES TO GET ME TO TAKE SICK PAY INSTEAD OF MAKING A WCB CLAIM? zDo not let your employer talk you out of making a WCB claim. If your injury is related to your work, you should claim WCB benefits. WCB benefits are often higher than benefits under other plans. Also, if your injury reoccurs, you are far better off with a WCB claim established in the first place.
CAW Local 4212 WSIB Benefits - Level 1 WHAT ELSE MUST MY EMPLOYER DO? zIn most provinces, the law says your employer must: pay you for the day you were injured pay for you to go to a hospital or a doctor, or to your home in Ontario, keep up their benefit plan payments for you for health care, life insurance, or pensions for one year in Ontario and Quebec, re-employ you if you are able to return to work within two years.
CAW Local 4212 WSIB Benefits - Level 1 Conclusion zWhen in doubt, file a claim! zReport all injuries to your employer immediately! zSeek immediate Medical Treatment! zContact your WSIB Benefits Rep.