FAQs

An occupational disease results from exposure to a substance relating to a particular process, trade or occupation in an industry, a disease peculiar to or characteristic of a particular industrial process, trade or occupation, a medical condition that in the opinion of the Board requires a worker to be removed either temporarily or permanently from exposure to a substance because the condition may be a precursor to an occupational disease, a disease mentioned in Schedule 3 or 4 or a disease prescribed in Schedule 3 or 4, or a disease prescribed under clause 15.1(8) (d)

If you have been exposed to toxic substances at work and have developed a physical condition that keeps you from working, you may be entitled to workers’ compensation benefits. We work with you at all stages of a WSIB case stemming from an occupational disease, helping you gather all the necessary information so that you can properly prepare and file your claim for benefits.

We protect the rights of workers who have developed any type of occupational disease, such as sarcoidosis, leukemia, heart attacks, rheumatoid arthritis, asbestosis, mesothelioma, occupational asthma, cancer, multiple chemical sensitivities or lung and skin diseases. If you or your loved one has been exposed to hazardous substances that have led to the onset and development of an occupational disease, contact us today to schedule a case evaluation.

It’s to your benefit to cooperate in your return to health and your safe return to work. As a person receiving WSIB benefits, it’s also your responsibility. Most workers are helpful and cooperative in this matter. But in rare cases where a worker is determined by the WSIB to be uncooperative, the worker’s benefits may be reduced to 50%, or discontinued after a continued period of non-cooperation.

To receive WSIB benefits, you must:

• Cooperate in your recovery by following the treatment and health care prescribed by your healthcare professionals.
• Have health examinations as required by the WSIB. The WSIB may require a health exam if it will help us make a decision as to your case, or if it will help you re-enter the job market. Your employer may request a health exam if it will provide significant new information regarding your case.
• Cooperate in your Work Reintegration program or your Work Transition program.
• Report any material change in your circumstances to the WSIB. Some examples of material changes are:
  • Any change to your income
  • Significant changes in your medical condition
  • Returning to work
• Provide any information that the WSIB needs to assess your claim.

Sudden Onset Injuries (Chance Events) : An example of a sudden onset injury is the Worker is all right one moment and injured the next. The cause of the injury is known. Entitlement to compensation in these cases depends on whether or not the injury “arose out of and in the course of employment”

Gradual Onset Injuries (Disablements) : These type of injuries include repetitive strain injuries, injuries from unaccustomed workloads, injuries, and disease that result from workplace substance exposures, heart attacks, disabilities caused by heat or by cold to name a few.

There is no limit to the number of ways that people can become injured as a result of work. In some of these cases, the injuries come on while the worker is still on the job. In other cases, there can be many years of delay, or latency, between the workplace exposure to hazards and the onset of disability.

Recurring Injuries : Workers who have been off work on Workers’ compensation will often return to work for a period of time and then once again be forced to leave work when the old injury flares up. These Workers will want to claim benefits for the new period of disability.

Secondary Conditions : Workers who suffer a secondary condition as a result of the original compensable injury or treatment, is entitled to benefits. Secondary medical conditions could include, injuries due to the use of Board approved artificial appliances, complications of compensable treatment, adverse reaction to prescribed medications, and the effect of an altered gait on other weight-bearing joints.

Aggravation Basis : Workers with disabling injuries at work resulting directly from a pre-existing medical condition are compensable and benefits are generally paid until the injury heals.

• Report it to your employer. A delay in reporting may mean a denial of your claim.
• Get immediate medical attention as soon as possible. If you cannot see your family doctor immediately or you don’t have a family doctor, you must go to a walk-in clinic or emergency room at a hospital and report it as – a WSIB injury. A follow-up with your family doctor is necessary.
• Report your injury to your family doctor and have him/her complete a WSIB Health Professional’s Report (Form 8). You must tell the treating medical practitioner that it is work related and explain the job duties performed. Walk-in clinics or the Emergency Room at a Hospital can also fill out a Form 8.
• Have the employer complete the WSIB Employer’s Report of Injury/Disease(Form 7). Ensure that your employer provides you with a copy of the Form 7. It is your right to immediately receive a copy of the Form 7.
• Complete the Form 6.
• Inform a co-worker or witnesses of your injury. Obtain the name, addresses and phone numbers of any witnesses. Keep a journal of all your symptoms, medical appointments, tests, and surgeries.
• Maintain a list of all the medication you must take.
• Keep in contact with your employer regarding modified duties. You have a duty to cooperate with your employer.
• Cooperate with your employer and the WSIB.
• Keep a diary of the conversations you have with your employer and the WSIB.
• Have all Functional Abilities Forms completed within 1 week.
• Appeal all decision within the time limits set out by the WSIB's decision letters.
• KEEP COPIES OF ALL DOCUMENTATION RELATED TO YOUR WSIB CLAIM!

If your Employer fails to file a report with the WSIB, the Worker should contact the WSIB to insist that a Form 7 be filed. The Employer, in every case, must complete and submit a Form 7 within 3 days of learning of the Worker’s workplace injury if there is time lost from work or health care is required. Even if the Employer is disputing the Worker’s WSIB claim, they must still file.

If the Employer refuses to file a Form 7, the Worker can contact the WSIB directly by telephone or in writing or by going to the WSIB’s offices. Note that if the WSIB receives a doctor’s Form 8 first, the process of starting a WSIB claim will be started even without an application from the Worker or Employer.

If you have a WSIB claim these are some of the benefits you are entitled to. The type and amount of benefits available is determined by the Ontario government law. The following is a brief description of what is currently available under the WSIB system:

HEALTH CARE BENEFITS: If you require treatment because of your injury, the WSIB will consider paying for it, based on the laws and its own policies.

LOSS OF EARNINGS BENEFITS: If you are unable to do your own job, you are paid benefits based on a percentage of net your net income. For all accidents after January 1, 1998, that amount is 85% of your net average earnings. You will receive full benefit entitlement if you are totally disabled from any job, or partially disabled (that is, you can’t do your own job, and the employer is unable to provide you with work within your restrictions). You and your employer are expected to work together to get you back to work as soon as possible, including modified work if that is available.

WORK TRANSITION PLANS (formerly called Labour Market Re-entry Plans (LMR)): If your employer cannot accommodate you with a permanent job in keeping with your restrictions, the WSIB will prepare a plan to determine the best way to return you to the workforce in a suitable position. If that involves retraining, the WSIB will pay for same.

NON-ECONOMIC LOSS (NEL) AWARD: You may be entitled to this if you sustain an injury that becomes permanent, and the WSIB recognizes this as a permanent impairment. A permanent impairment is defined as any permanent physical or functional abnormality or loss (including disfigurement) which results from an injury, and any psychological damage arising from the abnormality or loss. This is usually a one-time lump sum payment to reflect pain and suffering, and loss of enjoyment of life. However, it is calculated on a fairly arbitrary basis.

The WSIB provides you with a list of doctors from which you will choose one, and undergo an examination. The doctor will write a report reflecting the extent of your physical limitations, and the WSIB will perform a calculation of your entitlement. There may be further benefits available to you depending on the date of your accident, and the circumstances involved in your specific case that is not mentioned here.

If a Worker suffers a work-related injury or disease, there is no option to waive compensation either at the choice of the Worker or at the request of the Employer.

Some Employers will try to persuade Injured Workers not to claim Workers’ Compensation. An Employer will sometimes prefer that the Worker applies for the company’s private short-term or long-term insurance programs instead.

Payments from these insurance programs are usually taxable, short duration and as a rule, have limitations on drug payments. In comparison to WSIB, insurance programs are sometimes less expensive for the Employer to finance, and the Employer is not subject to the WSIB’s intervention.

By not applying for Workers’ compensation, Workers give up return-to-work opportunities and possible awards for permanent impairment.

When you are notified by the WSIB that a decision is being made on your claim, make sure you request that decision in writing. Once you receive the decision letter from the WSIB and you disagree with the decision, you must provide notice of your intent to appeal the decision by completing and submitting an Intent to Object Form. Instructions to complete the Intent to Object Form is provided in the Worker Instruction Sheet accessible from the WSIB’s website.

The decision letter will inform as to when the time limit to appeal may be, which most often will be 6 months from the date of the decision and 30 days for Return to Work, Labour Market Reentry (LMR) or Work Transition services. Send your Intent to Object Form within the specified time limits in the decision letter by fax or registered mail, so that you have proof of submission.

Once you submit your Intent to Object Form, the WSIB will provide you with a complete copy of your WSIB file along with an Appeal Readiness Form.

When you are ready to proceed with your appeal, you must submit a completed Appeal Readiness Form to the WSIB Appeals Services Division.

In the Appeal Readiness Form, you must indicate if you want your appeal decision in writing or oral hearing. If you request an oral hearing, you must provide reasons why. The WSIB Appeals Services Division will decide whether to proceed with an oral hearing.

Note that your employer has the right to participate in the Appeals Process. They also have the right to appeal any decisions made by the WSIB.

You have had an unfortunate accident at work. That, in itself, is a very traumatic event in your life. Now comes the hard part. Learning to cope with the stress of possibly changing careers, lifestyles and domestic life is overwhelming. We know the burden this places on you and your family. You are injured and do not know the system! Dealing with WSIB and law is another matter

However, there can be many complications that are unexpected from the onset of your injury. Such as other areas of your body that may be affected by the accident that without Professional help, may go by with no additional entitlement, unless the relationship with the injury is recognized by the WSIB.

We are here to help you and look after your interests. Decisions made can affect your future!

We have the experience and expertise to fight for your rights, from adjudication to Hearings at the Workplace Safety and Insurance Board – WSIB Appeals Services Division and/or the Workplace Safety and Insurance Appeals Tribunal.