Workers Compensation Insurance

Understanding And Knowing Workers’ Compensation In Ontario

Workers’ Comp insurance is a special type of insurance that can protect your employees in a variety of situations. It can protect them in the event that they fall ill or get injured on the job site. It will not only pay for their medical costs, but it can cover some of the wages that they lose due to the injury or illness. There are even certain arrangements and reimbursements that can be made to the employee’s family in the event that the employee dies on the job. This insurance policy relinquishes that employee’s right to sue the employer in the event that he or she is injured or suffers sickness or death on the job.

Know The Statutory Limits In Canada

When workers’ comp was first introduced in Canada, it was favored by employees and employers alike. It was Chief Justice William Meredith that outlined the system and got it set in place. Worker’s comp was instituted in Ontario in 1915, in Manitoba is 1916, and in British Columbia in 1917.

Employees not only reap the benefits of this program, but the employers can reap the benefits as well, as it protects them from getting sued. However, employers are required to partake and of course the price can vary depending on several different factors. Some of these factors include payroll, the type of business, the history of claims, and the location of the business. Any worker that gets injured on the job that was the result of an accident while on the job is required to these reimbursements under the Workplace Safety and Insurance Act.

Know The Stipulations

There are certain stipulations that prevent an employee from obtaining workers’ comp. And, it is extremely important for employees to understand the stipulations.

  • Mental Stress If an employee experiences an acute reaction or unexpected trauma during their employment that is the result of their employer’s decisions or action relating to employment, the employee may not be able to collect workers’ comp. For instance, if a boss punishes an employee and it causes mental anguish, the employee may not be able to collect workers’ comp if he or she has to spend time out of work because of the mental stress.
  • Occupational Disease – If the worker develops an occupational disease like mesothelioma, it will be considered a personal injury that happened off the job, unless it can be proven otherwise.
  • Heart Injuries – Firefighters and fire investigators that suffer from heart issues will also be considered personal injuries, unless it can be proven otherwise.

Notifying The Board

The employer must notify the workers’ comp board within three days after the employee’s injury takes place. The employer must also give a copy of the statement to the employee to let them know they have gone to the board.

Claiming The Benefits

Workers can file claims immediately after the incident takes place. However, a claim cannot be filed after six months of the incident. Of course, in the case of the occupational disease and heart injuries there may be some exceptions to the six-month rule. If there is no claim filed with the board, it will be impossible for the employee to claim any benefits through workers’ comp.

Being Able To Return To Work

The employer and injured employee must cooperate in order to get the employee to safely return to work, if possible.

Re-employing The Injured Worker

The employer must offer the injured employee re-employment up until the time frame of one-year. After one-year, the employer can choose not to rehire the employee.

Employer’s Duty

The employer is required to alter the work and workplace for the worker, unless it causes the employer undue hardship.

Obligation Time Period

The employer’s obligation will continue until one of the following happens.

  • The worker turns 65-year-old.
  • One year after the employee is physically able to perform their old duties
  • On the second anniversary of the injury date

Workers’ Comp payouts

  • Death benefits
  • Severity of permanent impairment
  • Non-economic loss compensation
  • Loss of retirement income payments
  • Loss of earnings payments

Loss Of Earnings Payments

When the worker suffers a loss of earnings due to their injury, they’ll be entitled to payments. The payments should begin when the loss occurs. It will continue until one of the following happens.

  • When the worker is no longer impaired
  • Two years after the injury if the worker was 63 when injured
  • When the worker reaches 65 if they were younger than 63 at the time of the injury
  • When the loss of earnings ends

Non-Economic Loss Compensation

There is a chance that the worker is going to suffer an injury that leads to permanent impairment. If that happens, the worker will be entitled to compensation for their non-economic loss. Figuring out the amount of compensation will be easier than you might believe. The benefit is calculated by multiplying the whole person impairment percentage by a specific base dollar value. The base dollar value is specified in the Workplace Safety and Insurance Act or WSIA. The base amount for the specific year that you made it to the maximum medical recovery is also used. The amount is then adjusted based on the worker’s age when they got injured.

Non-Economic Loss Benefit Calculation Example

As an example, you should imagine that you were 53 when you were injured. That would put you 8 years over the age of 45. You have reached the maximum medical recovery in 2018. The base amount of workers reaching maximum medical recovery for that yeas is $59,981.69. The adjustment amount will be $1,333.42. With that in mind, you need to subtract the age adjustment factor from the base amount.

  • Multiple $1,333.42 by 8 – 10,667.35
  • Subtract 10,667.36 from the base amount of $59,981.69 = 49,314.33

Now, you need to multiple the base amount by your whole person impairment rate. If the number if 15%, you would use the following

  • $49,314.33 multiplied by 15% would be $7,397.15

Once you’ve done the calculations, you should figure out precisely what your non-economic loss compensation would be.

How the Process Works

After you’ve suffered from a workplace accident, it is absolutely pertinent to make sure that your supervisor contacts emergency services. They’re obligated to do so. When you arrive at the hospital, you should let the staff know that you’ve suffered a workplace injury. The doctor will report it to the Workplace Safety and Insurance Board. Your employer will send you a copy of the details. They’ll also send a copy to the board. Within a week or so, you should receive a letter from the WSIB. You’ll receive Form 6. Be sure to get it filled out and submitted right away.

An adjudicator will take over your case. They’ll specify any and all doubts associated with your claim. You should receive your first payment within one or two weeks. Remember that you’ll need to remain in contact with the employer to ensure that all board of regulations are followed.

Keep reading…. Cost of workers compensation.