WSIB New Year Housekeeping

There have been a number of initiatives and changes at the WSIB in recent months.


WSIB has started to publish a few select decisions from the Appeals Branch on the publicly accessible website Canadian Legal Information Institute (CanLII).  Although the Board makes its decisions on a case by case basis and are very fact driven, it will be interesting to see if there is any value in using these decisions for policy interpretation purposes.  The decisions can be found at:  www.canlii.org/en/on/onwsib


The WSIB has introduced two Recurrence teams as part of its new service delivery model.  One is located in Toronto the other in Hamilton.  The teams are responsible for making decisions concerning all recurrences adn secondary injuries where the file has not be active for more than 30 days.  As well, all decisions concerning work disruptions which include short term, long term layoffs, strikes and plant closures are handled by the Recurrence team.  EI Work share and Work reductio programss would fall under this team's purview as well.


WSIB has announced a consultaiton regarding the joint health and safety committee certification program.  For details go to:  www.wsib.on.ca/wsib/wsibsite.nsf/public/PreventionJHSCConsultation


The Board also started a SIEF (Secondary Injury Enhancement Fund) pilot project in Hamilton.  All SIEF requests are to be handled by a special team who will adjudicate all SIEF decisions rather than the adjudicator. SIEF is a program that basically provides demployers with cost relief that translates into reduced premiums with the amount of relief being dependent the severity of the workplace accident and severity of the preexisting conditions or injuries.


Finally, the Board updated severally Policies in October and November, 2009.  These include:


Disclosure of Claim File Information to Worker or Employer Representatives
Disclosure of Claim File Information to Health Care Providers, LMR Providers and Research Entities
Hearing Devices
Independent Living Devices


The new policies can be found at www.wsib.on.ca/wsib/wopm.nsf/home/opmhome


Happy New Year!

Return to Work - Who's Right my Doctor or the Board?

Workers are often faced with the difficult task of deciding what to do when the Board threatens to cut off benefits if they do not return to work or school and yet their doctor writes a note to stay off work. This is a common situation. The answer it not always easy and depends on the facts of each individual case. What worked for your friends may not work for you. But here are some things to keep in mind.

• 
  
  The Board uses the Functional Abilities Form to assist in determining whether you can return to work or school. They will not accept a doctor’s note that states: Mr. X is to remain off work. Pain is expected to be controlled through pain management methods and doctor-prescribed medications. The Board's view is that it may hurt because you are not used to the work but if it isn't harming you it is suitable. Hence, if the work appears to be within your functional abilities it is suitable.

• Your functional abilities must be assessed by a trained professional and accurately reported on a Functional Abilities Form. When you bring it to your health care provider for completion, fully discuss your problems and how the injury limits your activities around the house including any lifting, reaching, bending, standing, walking, sitting, twisting, crouching, sleeping, and driving. Discuss with your health care provider any changes you have had to make to make things easier for yourself like rearranging where things are stored to make it easier to reach them or modifications to your home to assist you in moving around safely. The form can be completed by your family doctor, chiropractor or physiotherapist. Do not over medicate yourself for your assessment as this will not provide an accurate assessment of your functional abilities.

• Try the work. If you don't try, you will not know if the work is suitable or not. This is the first question usually asked by an appeals resolution officer at an appeal hearing. Furthermore, absence of an honest effort can easily be perceived the Board as non-cooperation.

• If you try the job and you cannot perform the work without and increase in pain or other symptoms then report the problems to your employer. Ask if there is other work available. Make suggestions about changes that could help you perform the work with less pain. Keep track of who you spoke to what was discussed and when.

• Report any problems to your health care provider. Bring the job description with you or accurately describe the job so there is no confusion about what the job entails when discussing it with your health care provider. Discuss possible modifications to the work. If your health care provider decides that the job is not suitable, obtain written reasons why they are of this opinion. Objective medical evidence should be provided to show how you are worse and how the job is not safe and exposes you to further injury. Remember it is not your opinion but the health care professional's opinion that should be documented.

• Request a return to work mediation to try to resolve the problem with your employer using this process. Think of other jobs that may be lighter and therefore not as taxing on your injury. Offer to work on a graduated basis, starting at a few hours per day and gradually increasing your duties so that you can build up your strength. Anyone who has not been to work for several months would find it tiring to work an 8 hour day. Ask to begin working a few half-days a week, gradually building up to an 8 hour day.

• Request an ergonomist come out to assess the workstation and job duties. They can often offer suggestions on how to make the job safer and recommend you be taken out of a job that is not suitable for your injury.

• 
  
  If pain or depression/anxiety is a serious barrier then ask the nurse case manager for pain management or a referral to a psychologist to help you cope and eventually return to work.

• Be realistic with a return to work program. You do not want to become re-injured, but unless you are totally disabled, you have abilities.
  

There are many factors that determine what you should do if faced with a return-to-work situation that you do not feel that you are ready for. If you are having difficulties obtain legal advice before making a decision. If the Board determines that you are non-cooperative, not only will your benefits be cut off, but the strength of your appeal may be negatively impacted.