Work Accident?

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0 height="100%"><tr> <td valign="top" width=185 BGCOLOR="#003333" TEXT="#F7F7FF" background="05bb9c00dduajq.jpg"> <div> <B> <TABLE BORDER="0" CELLPADDING="2" CELLSPACING="0" WIDTH="70" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 76 WIDTH="66"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="76" ALIGN="bottom" WIDTH="66" HSPACE="0" VSPACE="0"></tD> </tR> </TABLE></B></div> <div> <A HREF="id33.htm" TARGET="_top" TITLE="Car Accident?"><U>Car Accident?</U></A></div> <div> <A HREF="id35.htm" TARGET="_top" TITLE="Other type of injury?"><U>Other type of injury?</U></A></div> <div> <A HREF="id41.htm" TARGET="_top" TITLE="Illness?"><U>Illness?</U></A></div> <div> <B>Work Accident?</B></div> <div> <A HREF="id6.htm" TARGET="_top" TITLE="Links"><U>Links</U></A></div> <div> <A HREF="id7.htm" TARGET="_top" TITLE="Contact Us"><U>Contact us</U></A></div> <bR> <DIV ALIGN="LEFT"></DIV> <div> <B>iaminjured.com</B></div> </td> <td valign="top" BGCOLOR="#FFFBF0" TEXT="#080000"> <div> <FONT SIZE="5" COLOR="#000000" FACE="Arial" ><B>iaminjured.com</B></FONT>    |     <A HREF="index.htm" TARGET="_top" TITLE="iaminjured.com"><U>home</U></A></div> <div> <FONT SIZE="1" COLOR="#000000" FACE="Arial" >back to</FONT>  <A HREF="id5.htm" TARGET="_top" TITLE="Type of Injury"><U><B>Type of Injury</B></U></A></div> <div> Work Accident?</div> <div> <I><B>New! </B></I><I>If you feel you have been unfairly treated by the Board, you can now file a complaint with the Fair Practices Commission.  They cannot get involved in appeals or negative decisions, but can try to help if there is unfair treatment in the day to day handling of your case.  See their </I><A HREF="http://www.fairpractices.on.ca/index.htm" TARGET="_top" TITLE="http://www.fairpractices.on.ca/index.htm"><U><I>website</I></U></A></div> <bR> <bR> <div> If you are hurt while working in Ontario, the first question to ask is whether or not you work in an industry that is covered by the Workplace Safety and Insurance Board (also known more commonly as workers' compensation).</div> <bR> <div> Most industries and businesses in Ontario are covered.  </div> <bR> <div> Workers' compensation works essentially as a no-fault insurance plan.  Employers pay "premiums" each year into a fund that is used to pay benefits to workers who are hurt.  It does not matter who is to blame for causing the injury - the benefits are the same.  Ontario law regulates the workers' compensation system.  </div> <bR> <div> You cannot sue your own employer for an injury that would be covered by the WSIB.  This is the law of Ontario.  In most cases, you cannot sue other employers for such injuries.</div> <bR> <div> The type and amount of benefits available is determined by the Ontario government law.  The following is a brief description of what is available.</div> <bR> <div> <B>Temporary disability benefits:</B>  if you are unable to do your own job, you are paid benefits based on a percentage of net (after tax income).  You will get 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).  </div> <bR> <div> 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.</div> <bR> <div> If you have a permanent impairment (usually determined after 12 months), the temporary disability benefits will stop, and you will be assessed for <B>future economic loss </B>and a <B>non-economic loss benefit.</B></div> <bR> <div> <B>Future Economic Loss (FEL award): </B>this represents the difference between your normal full benefit level, and the amount of net income the board believes you could make in some alternative employment that they decide is within your capability.  It is paid as a monthly amount, and is subject to further review if circumstances change.  It normally continues until age 65, although the board does have a provision for a pension-like amount after that time.</div> <bR> <div> <B>Non-economic loss (NEL award) :</B> 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 board 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 board will perform a calculation of your entitlement.  </div> <bR> <div> <B>Health care benefits: </B>if your require treatment because of your injury, the board will consider paying for it, based on the laws and its own policies.  </div> <bR> <div> <B>Labour Market Re-entry Plan </B><B>(LMR):  </B>if your employer cannot accomodate you with a permanent job in keeping with your restrictions, the board will prepare a plan to determine the best way to return you to the workforce in a suitable position.  If that involves retraining, the board will pay for same.  </div> <bR> <div> <B>DECISIONS AND APPEALS:</B></div> <bR> <div> Your case is initially handled by an adjudicator at the WSIB. This person makes decisions on entitlement to various benefits in your claim.  Often that person may make decisions that you disagree with.  What can you do about it?</div> <bR> <div> You must file an objection with 6 months for most decisions, and within 30 days for LMR plan decisions.  Failure to meet this time limit could be fatal to your claim.</div> <bR> <div> You should submit a formal written letter objecting to the adjudicators decision.  The Board will forward a Notice of Objection form along with access to your file.  You must complete the form and send it in.  </div> <bR> <div> If the adjudicator will not change his or her decision, the file will go to an Appeals Officer in Toronto.  Be aware that due to backlogs, it may be several months before your file is assigned to an appeals officer.  At that point a decision may be made to hold a hearing, or decide based on the written materials.  If a hearing is scheduled, you will have to attend and probably give evidence to support your claim.  The Appeals Officer will then prepare a written decision.</div> <bR> <div> If you disagree with the Appeals Officer's decision, you have one final level of appeal - to the Workplace Safety and Insurance Appeals Tribunal.  This tribunal is independent of the board, although must follow written board policies.  Again, you must file a Notice of Appeal <B>within 6 months</B> or likely lose your right to appeal.  The Tribunal will hold a hearing.  As a practical matter, you can expect to wait many months for a hearing to be scheduled.</div> <bR> <div> The employer is entitled to participate at all levels of the appeal process and to argue against your claim.</div> <bR> <div> <B>OTHER POSSIBLE BENEFITS:</B></div> <bR> <div> There are other possible benefits that you can apply for even while you are collecting or applying for workers' compensation:</div> <bR> <div> <A HREF="id51.htm" TARGET="_top" TITLE="Canada Pension Plan"><U>Canada Pension Plan Disability Benefits</U></A></div> <div> <A HREF="id55.htm" TARGET="_top" TITLE="Employment Insurance"><U>Employment Insurance</U></A></div> <div> <A HREF="id54.htm" TARGET="_top" TITLE="Private Plans"><U>Private Plans</U></A></div> <div> <A HREF="id56.htm" TARGET="_top" TITLE="Ontario Disability Support Plan"><U>Ontario Disability Support Plan</U></A></div> <bR> <bR> </td> </tr></table></body>