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Ontario|Workers CompensationEmployees 635 How to apply for benefits If an injury or disease results from an accident at work, it is the employee's responsibility to report it to the employer. The employer must notify the Workplace Safety and Insurance Board of all accidents which may result in benefit entitlement under the Act. The employer will normally fill out the appropriate reporting form, ask the employee to sign it, and submit it to the Workplace Safety and Insurance Board. If the employer does not submit the report to the Workplace Safety and Insurance Board, the employee can do so by completing a special employee reporting form. In most cases, in reporting workplace accidents, the employer effectively begins the claim process. In every case, however, the employee must sign a claim form, otherwise benefits will not be paid.
Apart from the claim process, employers must take the necessary steps to ensure that the employee receives immediate medical attention and pay the employee for the day the accident occurred.
- Time for reporting injury or disease
Under the law, the initial accident reporting form should be filed within 3 days of when the injury or disease becomes known, and it should be received by the Workplace Safety and Insurance Board within seven business days. After completing and submitting the forms, the employer must give the employee a copy. If you require blank forms you can obtain them from the Workplace Safety and Insurance Board office or they can be ordered by telephone. Employees must be diligent in ensuring their claim for benefits is made within six months of the date of the accident or the date that knowledge of an occupational disease became available.
- Application process
Once the initial reporting form is received by the Workplace Safety and Insurance Board, they will send the worker a package with information and forms to be filled out and signed. The forms include a release of medical information to the employer and to the Workplace Safety and Insurance Board. Usually the doctor, nurse, chiropractor, or physiotherapist who is treating the injury or disease will have to fill out a form explaining the worker's functional abilities. This information assists the employee and the employer in returning the injured worker to work in suitable employment.
An employee is responsible for getting the forms filled out and giving appropriate copies to the employer. It is a good idea for the worker to keep an organized file with copies of all the forms, and ask the employer for copies of any forms that the employer submitted.
- Claim adjudication process
Once all the forms are completed and submitted to the Workplace Safety and Insurance Board, the Board will review the application. This process is called the Claim Adjudication Process. Depending upon whether all of the appropriate information has been provided, the claim adjudication process may take up to 6 weeks from the date of injury or disease before the worker receives the first benefit payment. The Workplace Safety and Insurance Board tries to start payments within the first two weeks of the accident. If a worker has already returned to work before receiving any benefits, then the payment will normally include the entire amount of benefits that the worker is entitled to based on the time they were off work.
For additional information on applying for benefits, you can contact a lawyer or call the Workplace Safety and Insurance Board. This office is listed in the Blue pages of your telephone book.
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