Expert. Confidential. Free The Office of the Employer Adviser Peterborough WSPS November 3, 2015 Lee Anne Farrow, Employer Specialist Claims Tips and Work Reintegration
Expert. Confidential. Free Claims Management Tips For 2015 Hiring Practices Day of Injury Accident Investigation Forms Work Reintegration Return To Work Document, Document, Document! Appeals WSIB Clearance Certificates Claims Cost Management Record of Employment Legislation WSIB eServices
Expert. Confidential. Free Tip No. 1 - Hiring Practices Request professional references, not personal contacts Worker Orientation is essential: -Verbally communicated -Follow-up with written policies - What to do if accident occurs, RTW program -Physical demonstration of position -Proper use of personal protective equipment -Health and Safety chats -Annual update and review of policies
Expert. Confidential. Free Tip No. 2 – Day Of Injury Determine severity of injury First Aid vs Medical Attention Return To Work envelope Taxi account Individual who accompanies injured party reminds Worker and Health Care Practitioners of RTW Policy and Procedures at workplace
Expert. Confidential. Free Tip No. 3 – Accident Investigation Purpose is to obtain details of what happened for WSIB reporting and Prevention Photographs and/or videos of work area Witness statements from Co-Worker(s) and Supervisor Interview Injured Worker and have Worker write incident report Use of translator, if required
Expert. Confidential. Free Tip No. 4 – Forms Form 6 Form 7 Form 8 FAF
Expert. Confidential. Free Tip No. 5 - Work Reintegration Return To Work Obligation Re-Employment Obligation Penalties WSIB Work Transition Specialist WSIB Return To Work Specialist 6
Expert. Confidential. Free Tip No. 6 – Return To Work Time of Hiring - Orientation Day of Injury Next Scheduled Shift Verbal Return To Work (RTW) Job Offer Follow-Up With Written RTW Job Offer Regular Contact With Worker Weekly Return To Work Plans / Journals Weekly/Bi-Weekly Functional Abilities Form WSIB Return To Work Specialist WSIB Work Transition Specialist Annual Review of RTW Successes, Failures and Trends
Expert. Confidential. Free Tip No. 7 – Document, Document, Document Critical to document everything, particularly all Return To Work efforts, conversations with the worker and WSIB Always keep WSIB informed! 8
Expert. Confidential. Free Tip No. 8 - Appeals Know Your Time Limits WSIB Direction Of Authorization New Forms Intent To Object Form (ITO) Appeal Readiness Form (ARF) Participant Form (PF) Respondent Readiness Form (RRF) Oral vs. Written Hearing Downside Risk Workplace Safety & Insurance Appeals Tribunal
Expert. Confidential. Free Tip No. 9 - WSIB Clearance Certificates Who is your worker? Clearance Certificate Mandatory for Construction workers (Bill 119) WSIB Independent Operator Questionnaire (non- construction) E-Clearance Certificate 10
Expert. Confidential. Free Tip No. 10 – Claims Cost Management MAP NEER CAD-7 Cost Relief - Second Injury Enhancement Fund (SIEF) - Cost Transfer - Third Party Cost Transfer Monitor WSIB Monthly Accident Cost Statements Rebate vs. Surcharge Workwell
Expert. Confidential. Free Tip No. 11 – Record of Employment Use of appropriate code: “illness/injury” “quit” “other” “ provide further information / explanation” 12
Expert. Confidential. Free Tip No. 12- Legislation Workplace Safety and Insurance Act Human Rights Code Occupational Health and Safety Act Employment Standards Act Human Resources Service Canada 13
Expert. Confidential. Free Tip No. 13 – WSIB e-Services eForm 7 eClearance ePayment ePremium eRegistration eStatement eWISR 14
Expert. Confidential. Free Tip No. 14 – Office of the Employer Adviser Confidential service Advice Representation Education Presentations and Webinars Website Follow us on Twitter!
Expert. Confidential. Free WORK REINTEGRATION (WR) PRINCIPLES Combines RTW and re-employment as a process Brings WT assessment in-house (formerly LMR assessment) High expectations for employer participation Non-cooperation penalties Maintain dignity and productivity of a worker Respond to RTW barriers with early support and intervention Best prospects for successful WR achieved by maximizing opportunities with the accident employer 16
Expert. Confidential. Free RTW Co-operation Obligations Initiate early contact and maintain appropriate communication throughout the worker’s recovery Identify and secure RTW opportunities for the worker Give the WSIB all relevant information concerning the worker’s WR Ensure that appropriate documentation is maintained Notify the WSIB of any dispute or disagreement 17
Expert. Confidential. Free The Board’s Role Meet with the WPPs at the worksite within 12 weeks after the date of injury if parties unable to arrange suitable and available work WSIB proactively engages appropriate medical support Help worker overcome his/her health recovery barrier Provide dispute resolution services Enforces WPP obligations Provides Work Transition (WT) if WPP unsuccessful 18
Expert. Confidential. Free Pre-injury job with the injury (accident) employer Pre-injury job with the injury employer, with accommodation Work comparable in nature and earnings to pre-injury job with the injury employer, with accommodation where required Alternate suitable work with the injury employer, with accommodation where required Work comparable in nature and earnings to pre-injury job in the labour market with accommodation where required Alternate suitable work in the labour market, with accommodation where required RTW Hierarchy
Expert. Confidential. Free Suitable Work Post-injury work that is Safe - worker has the functional ability to perform the tasks safely and to travel Productive – necessary skills to perform the tasks that provides objective benefit to employer’s business Consistent – with the worker’s functional abilities, and that, when possible, restores the worker’s pre-injury earnings In a unionized environment, the WSIB strives to respect the terms of the collective agreement whenever possible. Human Rights Code trumps collective agreement 20
Expert. Confidential. Free ( 21 ACCOMMODATION WSIB expects employers to provide accommodation if it results in suitable work becoming available Any modification to the work or the workplace, including reduced hours reduced productivity requirements provision of assistive devices WR must respect human rights legislation
Expert. Confidential. Free Resolving Disputes Worker notifies employer that job is not suitable and provides reasons Employer considers the reasons, and discusses issue with worker If WPPs unable to resolve a dispute themselves, the WSIB will assist the WPPs to reach agreement on the issue, or make a determination as to whether or not the offered work is suitable A dispute over job suitability does not mean WPPs being unco-operative in RTW activities 22
Expert. Confidential. Free Written Notice of Non-compliance Prior to making a finding or non-compliance or re- employment breach WSIB warns WPP about penalty Done orally (where possible) and in writing Non-cooperation penalties effective 7 WSIB business days after the date of the written notice Small Business (< 20 workers, 14 WSIB business days) 23
Expert. Confidential. Free Non-Co-operation Penalties 24 Penalty starts 7 business days from date on written notice Initial Penalty first 14 days of breach Ongoing Penalty 15th day of breach + Worker50% LOE100% LOE Employer50% LOE 100% LOE + 100% WT Costs Up to 12 Months
Expert. Confidential. Free Re-employment in WR Distinct obligation in addition to RTW Worker has a re-employment right if 1.worker unable to work because of a work-related injury 2.worker employed with the injury employer for at least one year before the date of injury, and 3.employer regularly employs 20 or more workers injury/disease # 2 and #3 do not apply to Construction industry 25
Expert. Confidential. Free Duration of Re-employment Obligation Employer must re-employ worker until the earliest of the second anniversary of the date of injury one year after the worker is medically able to perform the essential duties of their pre-injury employment, or the date on which the worker reaches 65 years of age In the Construction industry the above applies plus: the date the worker declines an offer from the employer 26
Expert. Confidential. Free Concurrent WR and Re-Employment Obligations An employer that breaches both a co-operation and re- employment obligation in the same claim will get a single penalty The WSIB will choose the penalty which will most likely lead to positive RTW outcome for the worker If breach at different periods in claim, may get more than one penalty 27
Expert. Confidential. Free QUESTIONS? Office of the Employer Adviser (OEA) Toll Free Telephone: Toronto Telephone: Website: Follow us on C. Office of the Employer Adviser 2015