WSIB 's Non Economic Loss Awards: Is it adequate compensation?

A non economic loss award is suppose to compensate an Ontario injured worker for the pain, suffering and loss of quality of life caused by a permanent impairment. In order to receive a non economic loss award an injured worker in Ontario must suffer a permanent impairment which has a specific definition in the Workplace Safety and Insurance Act. A permanent impairment includes any physical abnormality, functional abnormality, disfigurement or psychological damage arising from the abnormality.

A physical abnormality could include the amputation of a limb. A functional abnormality deals with the loss of mobility or the inability to do things such as lifting, sitting, standing, twisting, bending etc. A disfigurement includes damage which causes significant scarring or alters the shape of a person’s face. It could damage caused by burns. Psychological damage includes depression or phobias that result from an injury.

The non- economic loss process is quite simple. Once the Workplace Safety and Insurance Board determines that you have reached Medical Maximal Recovery, that is, your condition has stabilized and not expected to get any better, the Workplace Safety and Insurance Board will determine whether or not you suffer from a permanent impairment. If the answer is yes the WSIB will send you a roster of doctors who have agreed to assess your type of condition. You must choose a doctor from this list within 30 days. You cannot choose a doctor who has previously treated you or a member of your family. If you do not choose a doctor within 30 days the WSIB will pick one for you.

Once a doctor is chosen the Workplace Safety and Insurance Board then arranges an appointment and sends you a letter telling you the date time and place of the appointment. At the appointment the doctor performs an examination. If you suffer from a physical or functional abnormality, the assessment involves measuring various angles using a special ruler. Once the WSIB receives the doctor’s report these measurements are inserted into various charts to determine the percentage of your impairment to the entire body. For example if a person amputates their entire arm the maximum percentage awarded is 27%.

The amount of your cheque is calculated as follows:
Start with the base figure of $52,156.66 for 2004. To this amount either add $1159.43 for every year you were under age 45 at the time you were injured or deduct this amount for every year you were over the age of 45 to a maximum of $75,336.07. Multiply this figure by the percentage granted by the Board.

The entire process takes approximately 6 months. If, after the assessment, you disagree with the percentage granted you can appeal the decision. If your condition worsens in the future you can ask for a re-determination. However you must wait 12 months from the original assessment and provide medical evidence that your condition has worsened.

Does the system properly compensate Ontario injured workers? No, not at all. The system is based an outdated "meat chart" created by the American Medical Association in 1990. It does not take into account the impact that an injury has on a worker - the loss of enjoyment of activities, relationships and day to day activities let alone the level of pain a worker may experience. Can something be done about it? Voice your concerns to your Members of Provincial Parliament.