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Ways To Reduce Your WSIB Claim Costs

10/15/2014

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WSIB logo
In the unfortunate event of a workplace injury, use of these "Essential 4" strategies, along with regular analysis of your company's NEER statements, are the best way to reduce your WSIB claim costs:


1. Effective claims management:
  • Regularly follow-up with all the relevant players involved in a claim: the worker, their manager, medical practitioners, and your WSIB adjudicator
  • Always review your Monthly Cost Statements (find out why) and your Quarterly NEER statements for inaccuracies
  • Object when you have any suspicions about the validity of a claim (when you suspect fraud, when a doctor's diagnosis does not seem to match with the nature of the accident, when the injury is a result of horseplay or from a situation where the employee was "removing themselves from the course of employment," or if you believe that an injury is due to a non-occupational situation. Note that there is a 6 month time limit on objections.
  • Utilize the WSIB appeal process when appropriate

2. Pursuit of SIEF cost relief:
  • If you believe that a worker's pre-existing condition may have contributed to the accident or is prolonging recovery, you should request SIEF cost relief
  • This will not impact the amount of benefits the worker will receive
  • Read our recent blog "What is SIEF" for more information

3. Active return-to-work efforts:
  • Ideally, aim to have all your claims as "no lost time" claims
  • Train your managers to refrain from saying "take a few days off"
  • Be prepared to offer modified duties
  • Any claim with over 4 weeks of lost time will incur significantly higher WSIB costs
  • Emphasis on early Return-To-Work (RTW) - this will increase the likelihood of a successful RTW and is better psychologically for the worker
  • Gradual RTW should focus on increasing a worker's stamina and ability to return to their previous duties if possible. Discourage workers from having physiotherapist appointments in the middle of the day (before or after work is preferred).
  • Communicate with the worker, their manager, treating practitioners, and the WSIB on a regular basis
  • Require the worker to meet their RTW obligations

4. Medical management of your claims:
  • Rather than passively waiting on the WSIB's resources, facilitate more timely execution of treatment through private medical providers. Although these will be out-of-pocket expenses, anything that keeps costs off your NEER statement and speeds up recovery will ultimately save you money
  • Utilize 3rd party expertise to help understand medical evidence and potentially question/challenge decisions. Medical consultants speak the "language" of medical practitioners and are more likely to engage them than lay people.
  • Medical consultant can be an advocate for the worker and encourage them through the RTW process

Conclusion:

By utilizing the "Essential 4" strategies + NEER analysis, you will achieve:
  • Optimal health outcomes for your injured workers
  • Financial savings for your company
  • Quick resolution to disability claims
  • Workers who understand your company’s policies and are committed to supporting your RTW programs


Want to learn more about WSIB claims management?

Register for one of our upcoming workshops (click to learn more):
  • Introduction to Claims Management
  • Introduction to the WSIB's NEER Program
  • Advanced NEER Strategies
Register today to take advantage of early bird pricing!

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