September 13, 2018 | Frank MacDonald |

What is the WSIB and How to File a WSIB Claim



If you live in the province of Ontario and you’re employed, you’re probably covered under the Workplace Safety and Insurance Board (WSIB). Knowing how to file a claim if you’re injured is important to ensure you receive benefits.

There are a lot of questions surrounding workplace insurances claims. To help, we compiled a list of the 10 most frequently asked questions and found answers.

Note: Superior Glove is not affiliated with the Workplace Safety Insurance Bureau and you should direct any questions to the Board.

 

1. What is the WSIB?

The Workplace Safety Insurance Board is Ontario’s provincial agency that provides support and insurance for workers injured on the job.

This insurance exists so, in the event of an accident, the worker will receive compensation for lost time.

Workplace insurance entitles workers to benefits, ranging from loss of earnings and loss of retirement income to occupational disease and compensation for survivors.

A full list of WSIB benefits can be found here.

 

2. How Do You File a WSIB Claim?

If you’re injured from a workplace accident or illness, you must do the following:

  • Tell your employer about the accident or illness.
  • Seek medical attention immediately, whether that’s first aid, emergency room, or family doctor.
  • Report the accident to your union rep or health and safety rep (if you have one).

 
To apply for WSIB benefits, you must complete and sign the Worker’s Report of Injury/Disease (Form 6).

Although you might be in pain or anxious while receiving treatment, it’s important that you tell the health care worker treating you to send a Health Professional’s Report (Form 8) to WSIB.

 

3. Is the Employer Required to Report Anything?

As an employer, you have to report a workplace incident to the WSIB within 3 days if any of the following apply to the worker:

  • She/he loses time from work
  • She/he earns less than a regular day’s pay
  • She/he receives health care treatment

 

4. What is a Form 6 and Do I Have To File It?

To receive insurance benefits you must sign form 6, the Workers Report of Injury or Disease Form.

By signing form 6 you agree to allow your doctor to release information about your functional abilities to your employer.

This information lets your employer know what work you can and cannot do.

After filing a form 6, you should receive a letter from the WSIB with a claim number. This doesn’t mean that your claim has been approved, but rather verifies that a file has been started.

This claim number will be needed each time you contact WSIB.

If you do not receive a number, it means that the insurance board isn’t aware of your claim and you will need to contact them.

 

5. What Happens If I Don’t File a Form 6?

If you elect not to file a form 6, it means your employer will not be aware of your functional abilities.

By not signing a form 6, WSIB will pay no more than two weeks of benefits.

 

6. Is WSIB Mandatory for Employers in Ontario?

Most businesses in Ontario with workers — even family or sub-contractors — need to register with WSIB within 10 days of hiring their first full- or part-time worker.

By registering, you’ll have workplace insurance coverage for all workers.

There are a few industries that don’t have to register, including:

  • Banks, trusts, and insurance companies
  • Private day cares
  • Photographers
  • Barbers, hair salons, and shoe-shine stands

You can see the whole list here.

 

7. Can I Use Private Insurance Instead of WSIB?

There is some confusion about whether small businesses, private contractors and sub-contractors require coverage provided through the Workplace Safety and Insurance Board.

There are a few industries listed above that don’t require insurance coverage through the WSIB. But if you are uncertain about whether you apply to these groups or not, contact the board.

Failure to insure your employees and workplace can have costly repercussions.

 

8. What Happens If My Benefits Are Delayed?

Most often if benefits are delayed, it’s because all required information was not received by WSIB. This might be your doctor’s report or employer’s report.

A delay doesn’t necessarily mean that your claim has been denied.

However, if you do not receive a letter of explanation within a few weeks, you should contact the WSIB.

 

9. Can I Appeal a Decision?

Whether you are the employer or the employee, you have the right to appeal a decision made in a claim.

You would first appeal to the Appeals Services Division, an internal division of the WSIB.

There is also a second and final level of appeals called the Workplace Safety and Insurance Tribunal, which is external to the Board.

Visit the appeals section to find the appropriate forms.

 

Can I Submit My Claim Online?

Yes, employers, employees and health care professionals can submit forms online.

This is highly recommended since all of the necessary forms are available 24/7.

 

Is it the Employer or Employee’s Responsibility to Purchase PPE?

Find out now.

 

Frank MacDonald
About Frank MacDonald

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