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Work Related Accidents

Frequently Asked Questions

1. What is a work-related injury or illness?
2. What is an Occupational Disease?
3. Am I eligible for WSIB benefits?
4. What benefits can I receive?
5. What must I do while receiving benefits?
6. When do I File a Claim for Benefits with the WSIB?
7. How do I file a claim for benefits?
8. What are my reporting obligations?

a. What is a work-related injury or illness?

Work-related injuries or illnesses are those caused by physical, chemical, or biological hazards in your workplace. They can also include acute psychological trauma resulting from work.

Note that your employer must pay you a full day's wages for the day of the incident; WSIB coverage begins the first working day after the injury or illness occurs.

b. What is an Occupational Disease?

An occupational disease is a health problem caused by exposure to a workplace health hazard.

Your workplace should be healthy for your body and mind. You can help to keep yourself and your workplace healthy by being aware of health hazards in your environment.

These workplace health hazards can cause an occupational disease:

• dust, gases, or fumes
• noise
• toxic substances (poisons)
• vibration
• radiation
• infectious germs or viruses
• extreme hot or cold temperatures
• extremely high or low air pressure

c. Am I eligible for WSIB benefits?

To be eligible for WSIB insurance benefits, you must:

• Have a worker-employer relationship with an employer covered by the WSIB
• Have an injury or illness directly related to your work.
• Promptly file a claim with the WSIB
• Provide all relevant information requested by the WSIB to help us determine your benefits.
• Consent to the release of functional abilities information to your employer by the health care professional treating you.

d. What benefits can I receive?

Your workplace insurance entitles you to a range of benefits. The benefit most people are familiar with is the replacement of earnings you lose while disabled by workplace illness or injury (benefit for loss of earnings), but a number of other WSIB benefits are available to you.

• Benefit for Loss of Earnings (LOE)
• Benefit for Non-Economic Loss (NEL)
• Loss of Retirement Income (LRI) Benefit
• Benefit for Future Economic Loss (FEL)
• Health Care Benefits
• The Occupational Disease and Survivor Benefits Program
• Benefits for Seriously Injured Workers

e. What must I do while receiving benefits?

1. Cooperate in your recovery by following the treatment and health care prescribed by your health care professionals.
2. Have health examinations as required by the WSIB - The WSIB may require a health exam if it will help them make a decision as to your case, or if it will help you re-enter the job market. Your employer may request a health exam if it will provide significant new information regarding your case.
3. Cooperate in your Early and Safe Return to Work program or your Labour Market Re-entry program.
4. Report any material change in your circumstances to the WSIB. Some examples of material changes are:
   • any change to your income
   • significant changes in your medical condition
   • returning to work
5. Provide any information that the WSIB needs to assess your case.

f. When do I File a Claim for Benefits with the WSIB?

You must file a claim for benefits as soon as possible after being injured or after you become aware of an illness. You have up to six months to file a claim, but filing immediately is better and ensures uninterrupted benefits to which you are entitled.

You should immediately file a claim with the WSIB if you suffer a work-related illness or injury that causes you to:

• lose time from work
• lose earnings
• get health care; not just first aid.

Note that it doesn't matter whose fault the injury or illness is. WSIB benefits are no-fault.

g. How do I file a claim for benefits?

To file a claim for benefits you must:

1. Consent to release of your functional abilities information to your employer

Your functional abilities information is non-medical information from the health care professional treating you. It tells you and your employer what kinds of work activities your illness or injury permits. Without this consent, you cannot claim benefits.

You give consent by signing one of the following forms:

• The Employer's Report of Injury/Disease (Form 7)
• The Worker's Report of Injury/Disease (Form 6)
• Consent Form 1492

2. Report your illness or injury to the WSIB

If you sign a Form 7 or Consent Form 1492 your claim will be initiated when your employer submits the Form 7 to the WSIB. If you choose to complete a Form 6 you must submit this form to the WSIB to claim all benefits you are entitled to. Download a Form 6.

In either case, the WSIB will contact you if we need more information to assess your claim to benefits.

h. What are my reporting obligations?

You must notify the WSIB, within 10 calendar days, of any significant change in the status of your claim and eligibility for workplace disability insurance benefits (known as material change). Failing to report a significant change could result in reduction or suspension of your WSIB benefits.