The Office of the Employer Adviser Claims Tips

The Office of the Employer Adviser Claims Tips and Work Reintegration Peterborough WSPS November 3, 2015 Lee Anne Farrow, Employer Specialist Expert. Confidential. Free. www. employeradviser. ca 1 -800 -387 -0774

Claims Management Tips For 2015 • • Hiring Practices • Record of Employment Day of Injury • Legislation Accident Investigation • WSIB e. Services Forms Work Reintegration Return To Work Document, Document! • Appeals • WSIB Clearance Certificates • Claims Cost Management Expert. Confidential. Free. www. employeradviser. ca 1 1 -800 -387 -0774

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. www. employeradviser. ca 2 1 -800 -387 -0774

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 3 Expert. Confidential. Free. www. employeradviser. ca 1 -800 -387 -0774

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. www. employeradviser. ca 4 1 -800 -387 -0774

Tip No. 4 – Forms • Form 6 • Form 7 • Form 8 • FAF 5 Expert. Confidential. Free. www. employeradviser. ca 1 -800 -387 -0774

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. www. employeradviser. ca 1 -800 -387 -0774

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. www. employeradviser. ca 7 1 -800 -387 -0774

Tip No. 7 – 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. www. employeradviser. ca 1 -800 -387 -0774

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. www. employeradviser. ca 9 1 -800 -387 -0774

Tip No. 9 - WSIB Clearance Certificates • Who is your worker? • Clearance Certificate Mandatory for Construction workers (Bill 119) • WSIB Independent Operator Questionnaire (nonconstruction) • E-Clearance Certificate 10 Expert. Confidential. Free. www. employeradviser. ca 1 -800 -387 -0774

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. www. employeradviser. ca 11 1 -800 -387 -0774

Tip No. 11 – Record of Employment • Use of appropriate code: • “illness/injury” • “quit” • “other” • “provide further information / explanation” 12 Expert. Confidential. Free. www. employeradviser. ca 1 -800 -387 -0774

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. www. employeradviser. ca 1 -800 -387 -0774

Tip No. 13 – WSIB e-Services • • e. Form 7 e. Clearance e. Payment e. Premium e. Registration e. Statement e. WISR 14 Expert. Confidential. Free. www. employeradviser. ca 1 -800 -387 -0774

Tip No. 14 – Office of the Employer Adviser • Confidential service • Advice • Representation • Education • Presentations and Webinars • Website • Follow us on Twitter! Expert. Confidential. Free. www. employeradviser. ca 15 1 -800 -387 -0774

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. www. employeradviser. ca 1 -800 -387 -0774

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. www. employeradviser. ca 1 -800 -387 -0774

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. www. employeradviser. ca 1 -800 -387 -0774

RTW Hierarchy • 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 19 required • Alternate suitable work in the labour market, with Expert. Confidential. Free. www. employeradviser. ca 1 -800 -387 -0774 accommodation where required

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. www. employeradviser. ca 1 -800 -387 -0774

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 21 Expert. Confidential. Free. ( www. employeradviser. ca 1 -800 -387 -0774

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 22 being unco-operative in RTW activities Expert. Confidential. Free. www. employeradviser. ca 1 -800 -387 -0774

Written Notice of Non-compliance • Prior to making a finding or non-compliance or reemployment 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. www. employeradviser. ca 1 -800 -387 -0774

Non-Co-operation Penalties Penalty starts 7 business days from date on written notice Initial Penalty first 14 days of breach Ongoing Penalty 15 th day of breach + Worker 50% LOE 100% LOE + 24 100% WT Costs Up to 12 Months Employer Expert. Confidential. Free. www. employeradviser. ca 1 -800 -387 -0774

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 Expert. Confidential. Free. www. employeradviser. ca 25 1 -800 -387 -0774

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 Expert. Confidential. Free. www. employeradviser. ca 26 1 -800 -387 -0774

Concurrent WR and Re-Employment Obligations • An employer that breaches both a co-operation and reemployment 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. www. employeradviser. ca 1 -800 -387 -0774

QUESTIONS? Office of the Employer Adviser (OEA) Toll Free Telephone: 1 -800 -387 -0774 Toronto Telephone: 416 -327 -0020 Email: askoea@ontario. ca Website: www. employeradviser. ca Follow us on Twitter: @askoea C. Office of the Employer Adviser 2015 28 Expert. Confidential. Free. www. employeradviser. ca 1 -800 -387 -0774