There is one particular strategy which is often overlooked and undervalued by businesses when looking to reduce their WSIB claims costs. We're referring to the critical importance of completing an organization's own Incident Report/ Worker’s Statement, Supervisor’s Report of Injury and Witness Statements.
One of the ways to reduce claims costs recommended by Clear Path involves developing and actually using a “toolkit” that is ready in the event of a workplace injury. What is sometimes discounted as unimportant is the Worker’s Statement and other similar statements, which should be contained in an organization’s toolkit. What is often misunderstood is the value these forms play in not only the management of claims post initial entitlement, but also in the objection of a questionable claim.
The Value of The Worker’s Report
Part of successfully managing a claim is in the submission of a Form 7, which is the employer’s chance to paint an accurate picture of the workplace injury. Many companies complete the form from only one perspective – the employer’s. This can sometimes lead to an erroneous summary of the incident and often will result in a disadvantage to the employer. In our experience, especially when dealing with doubtful claims, an organization's own Incident Report from the worker's perspective can often come in handy when trying to convince an Eligibility Adjudicator of the claim’s merit.
Example: Clear Path managed to have a questionable claim denied after submitting the Worker’s Report of Injury along with a Form 7. The worker reported a workplace injury to his neck without providing concrete details or witnesses to the event. Upon completing the Worker’s Report of Injury (Form 6), the worker wrote that he believed the incident may have occurred because he “slept funny the previous night.” The Eligibility Adjudicator denied the claim stating she was unable to establish a workplace injury due to the Worker’s Report of Injury.
It is important to note that a worker often does not have an opportunity to complete WSIB’s Worker’s Report of Injury (Form 6) until weeks after the commencement of a claim. Eligibility Adjudicators will send a blank form to the worker by regular mail, which sometimes does not make its way back to WSIB. Eligibility Adjudicators also attempt to obtain incident details from workers by telephone, but again, this sometimes does not take place until days or weeks after the actual event. It is easy for details to be misconstrued or forgotten, resulting in a costly claim for an employer.
By having workers complete your own custom Incident Reports or Worker Statements, and submitting it along with a Form 7, Eligibility Adjudicators are provided with details the worker may easily deny or later change.
Witness Statements can serve the same useful purpose. As part of your investigation process after a workplace accident, it makes a lot of sense to question any workers who may have firsthand knowledge of the incident. If a worker claims that another employee witnessed the accident, that employee should be interviewed for details that either confirm or deny the claim and this information could be provided to WSIB.
The same can be said for Supervisor Reports. Since supervisors are usually the first person on scene, employers should train supervisors in their investigation processes and return to work program. This program should include the initial investigation of a workplace injury, including the information and forms that should be completed for WSIB reporting purposes.
Clear Path consultant Jennifer Wright-Tahiraj explains that the possession of more than one workplace party statement increases the likelihood of potential discrepancies. She further explains that discrepancies between statements can “assist an employer in proving a Worker Report to be false, and therefore convincing an Eligibility Adjudicator in the denial of a claim.”
Example: Jennifer Wright-Tahiraj shares an example of an appeal decision which was denied loss of earnings (LOE) due to the information provided in a Supervisor Statement. The worker claimed a gradual onset injury to his right thumb after being advised that he, along with 26 other employees, would be placed on temporary lay-off due to a lack of work. In their statement, the supervisor was able to confirm that the worker could not report specifics of the alleged injury and nor were there witnesses to the incident.
The ARO decision upheld the denial of LOE by stating there were inconsistencies in the Worker’s Report compared to details provided by the supervisor. Specially, the decision stated that “…there is no evidence that the modified duties requested by the worker to the Supervisor were due to a workplace injury. There is insufficient evidence to conclude that the right thumb injury arose out of and in the course of employment as there is no compatibility between the history of the right thumb injury and worker’s job duties.”
Bringing It All Together
Successful claims management begins with preparation.
Prepared organizations utilize a “toolkit” which contains the documents described above, along with procedures for workplace injury investigations. Part of this investigation should include obtaining details from all those involved, most importantly, the worker! Organizations should train their workforce in this process so that employees know what is expected of them when workplace injuries may occur.
Never underestimate the value of the worker’s voice.
WSIB policy is clear that when faced with a situation when each parties’ position weighs 50/50, the benefit of the doubt goes to the worker. In order to help tip the scales in the favour of the Employer, provide facts and evidence that support your concerns, such as information provided by the worker’s own hand!
Compare and point out discrepancies.
If you come across discrepancies between statements, do not be afraid to discuss them with an Eligibility Adjudicator, especially if a claim is questionable. An Eligibility Adjudicator’s role is to decide the merit of a claim and investigate yellow flags. Remember that a worker is not likely to come forth with such information that may deny their claim!
Have a question about WSIB claims management? Like some advice from someone with over 20 years of claims management experience? Why not book a free 15-minute consultation with Anna Aceto-Guerin? Book your appointment now!
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There is still time for employers to get compliant with their obligations under the AODA, but the January 1, 2016 deadline is coming up fast!
Worried about getting your company compliant with the AODA? Learn more about Clear Path's Do-It-Yourself Package.
The Accessibility for Ontarians with Disabilities Act (AODA) was passed in 2005 aiming to make the province fully accessible by 2025. The legislation is being phased in through various "standards" that each have unique deadlines based on the size of your business.
The first "standard" was the AODA Customer Service Standard (CSS), which entails 11 specific requirements for businesses to provide their goods and services in a way that is accessible. The deadline for compliance with all aspects of the CSStandard was 2012 or earlier. The deadline for submitting your compliance report to the government was Dec 31, 2013.
The next "standard" is called the Integrated Accessibility Standard Regulation (IASR), which combines three formerly stand-alone standards known as the AODA Employment Standard, the AODA Information & Communications Standard, and the AODA Transportation Standard.
It lays out numerous obligations for businesses and has distinct deadlines for various aspects within it -- as well as different deadlines for businesses with over 50 employees and those with under 50 employees. There are several elements due by Jan. 1, 2016.
Jan. 1, 2016 deadlines for private sector companies with 50 or more employees:
Jan. 1, 2016 deadlines for private sector companies with between 1-49 employees:
Additionally, the Accessibility Standard for the Design of Public Spaces, requires public sector (government) organizations to be compliant with numerous elements by Jan 1, 2016. Note that large private sector businesses must be compliant with these elements by 2017 and small private sector businesses by 2018 (although they are exempt from certain aspects).
If you have any questions about the AODA and would like to book a complimentary 15 minute consultation with Clear Path's Anna Aceto-Guerin, book your appointment now.
You may also be interested in our easy-to-use DIY AODA Compliance Package for the IASR as well as our DIY Package for the CSS if your company is not yet compliant.
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