INJURED WORKERS PAMPHLET. Ottawa District Injured Workers Group

Size: px
Start display at page:

Download "INJURED WORKERS PAMPHLET. Ottawa District Injured Workers Group"

Transcription

1 INJURED WORKERS PAMPHLET Ottawa District Injured Workers Group

2 doctor RIGHT AWAY! Inform So your were employer hurt at work (supervisor or boss) about the incident right away or within the What to do if you have been injured: first 24 hours is eligible? If you can no longer do your job because of an injury or disease that Who is eligible? relates to If your can work, no longer you do your may be entitled job because to of an benefits injury or disease that relates to your that compensate your work, you may be entitled to regular pay benefits by that the compensate Worker s your Safety regular and pay by the Worker s Safety and Insurance Board Insurance WSIB Board (previously WSIB called the (previously Worker s called the Worker s Compensation Board). Your injury accident could at work have (like happened falling off a ladder in or an accident slipping at work in the (like hall), falling or it could off have a ladder), or it may be developed something over time that (like happened carpal tunnel over a syndrome) time (like carpal tunnel syndrome) der to be eligible for WSIB benefits, you t: Get medical attention, first aid, and see a doctor RIGHT AWAY! Tell your employer (supervisor or boss) about the incident RIGHT AWAY or within 24 HOURS Compensation Board). Your injury could have happened in an In order to be eligible for WSIB benefits, you must: Have a worker-employer relationship with an employer covered by the WSIB Have an injury or illness directly related to your work Promptly file a claim with the WSIB Provide all relevant information requested by the WSIB to help us determine your benefits Consent to the release of *functional abilities information* (different from medical information) to your employer by the health care professional treating you: *functional abilities information* comes from the health care professional treating you. It tells your employer what kinds of activities your illness or injury allows you to carry out safely. This helps your employer find safe and suitable work for you during your recovery. Provide information requested b help determine your benefits. Consent to the release of functi information (different from med to your employer by the health c professional treating you. When/ who should make a claim: If you have: received health care, and/or lost time or wages from work beyond the day of accident/illness, or continued to work but on partial hours only had to do different work due to the accident/ illness for more than 7 DAYS and did not see a health professional, you can also make a claim. When/Who should make a claim If you have: Received health care, or Lost time or wages from wo of accident/illness, or Worked on modified duties f two weeks. Then you can make a claim FORM 6 Then you can make a claim using Form 6 BENEFITS Benefit for loss of earnings The most well known kind of benefit is the replacement of earnings you lost while disabled by workplace illness or injury, officially called benefit for loss of earnings If you miss time from work because of your injury or illness, WSIB pays benefits for loss BENEFITS of earnings starting from the working day after your injury occurred Benefits for injuries on or after January 1 The kind of benefits you can ex 1998 are calculated at 85% of your NET (take-home) pay. For how long can I receive this benefit? Loss of earnings benefits continue until you are no longer impaired by your work-related injury or illness, or until you no longer have a loss of earnings, or until you reach age 65. If you are still impaired at age 65, LOE benefits stop, but loss of retirement income benefits may apply. If you are 63 years old or older at the time of injury, you can receive LOE benefits for up to two years as long as you have loss of earnings. Other benefits: Although Benefits for loss of earnings is the most common, you might be eligible for a whole range of benefits: 2

3 Legal Services 1 Nicholas St, Ottawa Phone: (613) Compensation for physical, functional, or psychological loss the impairment causes Compensation for loss of retirement income Benefits for future economic loss South Ottawa Community Legal Services: Suite 406, 1355 Bank St, Ottawa Phone: seriously injured (613) workers Health Care Benefits Health Care Equipment and Supplies Other benefits geared specifically towards Your Ottawa WSIB Office: Workplace Safety and Insurance Board 180 Kent Street, Tower 4, Suite 400 Ottawa, ON West End Legal Services of Ottawa 1299/1301 Richmond Rd, Ottawa Phone: (613) K1P 0B6 Phone: Phone: Fax: / Clinique juridique francophone de l'est d'ottawa 290 rue Dupuis, Ottawa Phone: (613) Assistance with your claim/ appeal: If you need additional help with filing your claim or making an appeal to WSIB, there are many places to get information that may assist you. One of the best resources is the WSIB website: If you still require assistance, you may contact the Ottawa District Injured Workers Group: Forms Overview ODIWG 200J-1511 Merivale Rd, Nepean Phone: (613) You may also be able to obtain assistance from one of the following Ottawa legal clinics Community Legal Services: 1 Nicholas St, Ottawa Phone: (613) South Ottawa Community Legal Services: Suite 406, 1355 Bank St, Ottawa Phone: (613) West End Legal Services of Ottawa 1299/1301 Richmond Rd, Ottawa Phone: (613) Clinique juridique francophone de l'est d'ottawa 290 rue Dupuis, Ottawa Phone: (613) FORMS OVERVIEW If you wish to ma there are 3 forms s FORM 6 Injury/D Th you, the work your injury/di the injury too It is importan accurately an pages provid to complete t If you want to make a claim for WSIB benefits, there are 3 forms form 6, 7, and 8--that need to be filled out and sent to WSIB: FORM 6: Worker s Report of Injury/Disease After a work-related injury or disease, you the injured worker have to fill out a Form 6 to tell the WSIB the details of your injury/disease (when, where, and how the injury happened) if you want to file a claim for WSIB benefits. Remember there is a time limit for your claim! You have to file your claim within 6 MONTHS from the date of the accident or your learning of the disease. Therefore, FORM 7: EMPLOY Injury/Disease make your claim as soon as possible. This pamphlet tells you how to complete Form 6 in the section: How to Fill out Form 6. You can read that section for further information. Once your em they must su 3 days. This job, pay and It is importan about your in is needed in amount of yo FORM 7: Employer s Report of Injury/Disease Tell your employer about the accident or disease as soon as possible. Your employer has to complete Form 7 within 3 DAYS and the WSIB has to receive the completed form within 7 business days after your employer learns of your injury/disease. Form 7 describes details of your job, pay, and accident/illness. 3

4 How long have you been doing this job for employer? FORM 8: Health Professional s Report areful here. See They a doctor are or not health asking professional you how as soon you have worked as possible for after your an injury, employer, on the they same day are ng how long if you it is possible. have been You can doing go to the a community cific job you health were clinic doing or hospital when you if your were family doctor is not available right away. ed or fell ill. For example, if you started out Tell your doctor that you have been injured ipping/receiving at work, and so they then will moved fill out a to Form a 8. This rent department form provides and started information working about your in ication and injury, you got the hurt treatment or sick plan, in and that your new return to ition, you give work the information, date you which includes your ted in fabrication, functional not abilities. ping/receiving. Make sure to request a copy of the completed Form 7 from your employer. Check it to ensure that all information provided by your employee is accurate, including your regular an overtime hours. If you notice any mistake or missing information after Form 7 has been submitted, call or write to the WSIB to inform them. FORM 6: Worker s Report of Injury/Disease One of the most important steps you take in filing your WSIB claim is to fill out Form 6 accurately. This will save you time and improve your chances of having your claim receive speedy consideration. What is Form 6? Form 6 is a WSIB form that you fill out and send to the WSIB after a work-related injury or illness if you want to make a claim. Form 6 provides the WSIB with the information about your claim, so they can process and make decisions about it. You can explain in detail the cause of your injury/illness. You might have filled out other forms for your employer at work, but Form 6 is different from them. You must complete and submit Form 6 to claim benefits for a work-related accident. When to Complete Form 6? You should fill out, sign, and submit Form 6 to the WSIB as soon as possible after a work-related injury or after you become aware of your illness. Do it as early as possible so you can still remember the details of your injury/illness. Section A: Worker Information You have to make your claim within 6 MONTHS from the date of the accident or your learning of the disease. If you missed the deadline, you may still be able to file your claim if you can show there were exceptional circumstances. Please call for further information. How to get Form 6? If the WSIB has established a claim from your employer s or health professional s report, they will mail Form 6 to you. You can download and print a copy of Form 6 from the WSIB website ( Click on Workers and then click on Forms on the side menu bar. You can pick up Form 6 at your union office, from your union representative, or your local WSIB office. eform6 If the WSIB has established a claim from your employer s or doctor s report, they will send you a package with a hard copy of Form 6 along with a claim number. You can use this claim number to file eform6 on line. Go the WSIB website: and click on Workers eform6 on the side menu bar. Then click on File your eform6 to start filing on line. Where to send Form 6? Remember to sign and date Form 6 after completing it. Keep a copy for your own record and give a copy to your employer. Mail a copy to the WSIB: Workplace Safety and Insurance Board 200 Front Street West Toronto ON M5V 3J1 OR 4

5 Fax: Local (416) Toll-Free Section F: Earnin How to Fill out Form 6? Form 6 has 7 sections (Section A-G). Please print in black ink to fill out the form. Section A: Worker Information Make sure that you provide the following information accurately. Incorrect information may delay your claim. Section G: Declarations and Signature Full name Mailing address Phone number Date of Birth Social Insurance Number (SIN) Your name and SIN have to appear on all 3 pages of Form 6. A1: Date you started with employer Write down the date (or the most recent date) that you started working with your employer. A2: How long have you been doing this job for this employer? Write down the length of time (in years, months, weeks, or days) that you have being doing the specific job when you were injured or fell ill. For example, you worked as shipper/receiver for 2 years and then as manufacture manager for 3 years. You got injured or sick while working as a manufacture manager. Put 3 years (the length of time being manufacture manager) in the box. Check yes if you are a union member and you want your union to represent you in this claim. Section G: Declarations and Signature If you do not fill out this last section properly, it could delay your benefits. A5: If yes, do you consent to the disclosure of verbal claim file status information to your union representative? When you sign this form you are telling WSIB that you are Check claiming yes benefits if you agree for to your let the workrelated injury/illness and you are declaring that all WSIB to the information that you have provided is true. communicate orally with your union representative about your claim. If you disagree, check no. For your union representative to gain access to written information of your claim, you need to provide the Also, by signing this form you allow the health WSIB professional with written treating authorization. you to provide you, your employer and the WSIB with information about functional abilities any information that can exchange. be used to get you safely back to work. If your representative is not from your union, you need to give written authorization to the WSIB for Section B: Employer Information For a copy of WSIB s Privacy Statement visit the WSIB website. Write down all the requested information in this section. Check your pay stub for the correct employer information, if you are not so sure about certain information. Appealing a Ruling If you work for a Temporary Employment Agency that sent you to the job, write down the agency s name, not the worksite employer s name. You can provide the information about the location where the injury/illness took place in Section C. Section C: Accident/Illness Dates and Details This is the section where you provide the information of the who, what, when, and where of your claim. C1: Date and hour of accident/awareness of illness It is y decis APP The f APPE Ther so b Step A3: Would an interpreter be helpful? The WSIB provides free translation and interpretation services in several languages to help you communicate with the WSIB staff. Please call for interpretation services. A4: Do you authorize your union to represent you in this claim? If the injury occurred suddenly because of an accident, such as a head injury as a consequence of a heavy box falling on your head, write down the date and time that the accident happened. If your injury occured over a period of time, for example, from repetitive movement, give the approximate date that you started noticing the injury. C2: Date and hour reported to employer 5

6 Write down the date and time when you informed your employer of the accident/illness. Remember to tell your employer as early as possible. C3: Who did you report this accident/illness to? (Name & Position and Telephone) In many cases, you should report the accident/illness to your supervisor, manager, company nurse, or other people specified by your employer. Be sure to provide their full name, position, and telephone number. C4: Area of Injury (Body Part) Check all injured body parts as a consequence of the accident/illness. Make sure to indicate on which side (left or right) of the body the injured body parts are. If the injured body parts are not listed, check other and give specifications. Check the appropriate box for your handedness. This information may be useful for the WSIB to help you to return to work. C5: Did the accident/illness happen on the employer s property or work site? Check the appropriate box to indicate whether the accident/illness happened on or outside the employer s property or work site. Give the specific place on the premises where the accident/illness happened, for example, parking lot, warehouse, or kitchen. If no, provide the information of the location where the injury/illness happened. Examples: You work for a temporary employment agency, and the injury happened at the company where you were placed. Write down the name of the company where you were placed. You work for a cleaning company and you are assigned to work at a department store, where your injury happened. Write down the name of the department store and its location. C6: Did it happen outside the Province of Ontario? Check the appropriate box to indicate whether the injury/illness happened outside Ontario. If you check yes, the WSIB will send you an election form, so you can choose whether to claim your benefits in Ontario or not. If you decide to make your claim in Ontario, you have to indicate that in your election form. You have to submit the election form within 3 months from the date that your election form was issued. C7: Have you hurt this area(s) of your body before? Check the appropriate box for this question. If you checked yes, it does not mean the WSIB will deny your claim. This information will help the WSIB to process your claim and perhaps reduce the claim cost for your employer. C8: Do you have any prior related WSIB/WCB claims? If you have a prior claim in Ontario or somewhere else, check yes. This information will help the WSIB to decide whether your injury is actually a reinjury under the prior claim. C9: If you had a sudden type of accident/illness, describe your injury... Provide full details of how the accident happened and what you were doing when it occurred. Include all the important information about the accident. For example, you can provide the name, size, and weight of the object involved; a description of the machinery, tools, or vehicles used at the time of the accident; environment conditions (temperature, noise, chemicals, gas, other people). For example: I was moving boxes in the canned food aisle of the supermarket. I lifted a 30-lb box from the floor and strained my lower back. OR 6

7 If you had a gradual onset type of injury, describe your injury... Provide a detailed description of your work, if your injury developed over a period of time. Give details about Frequency of performing the task The length of time that you have engaged in the activities The size and weight of objects as well as the tools or products involved Whether there is any recent change to your work, work schedule, or workplace Example: I am a cashier and I continue to scan books for my 4-hour shift with my right hand for 5 years. The books weigh from a few ounces to 3 pounds. Recently I was assigned to an 8-hour shift because the bookstore has extended store hours for the Christmas season. I started experiencing some pain in my right wrist from time to time about 6 months ago, and the pain became very severe about 2 days ago. C10: When did you first start to have problems with this injury/condition? This information will help the WSIB to decide the day of injury/illness, especially if you have a gradual onset of injury. C 11: If you did not report this to your employer right away, please tell us the reason why You should always report your injury/illness to your employer right away. If you did not, please provide the WSIB with the reasons why you did not report it right away. C 12: If there were any witnesses to your accident... The WSIB may need to contact the witnesses for further information. Please provide the names and positions of your supervisors or co-workers who saw the accident, to whom you mentioned the accident, your pain, or problems. C13: The Workplace Safety and Insurance Act requires your employer to give you a copy of the Employer s Report of Injury/Disease (Form 7) Check the appropriate box to indicate whether you received a copy of Form 7 from your employer. Ask your employer for a copy if you have not received it. C14: The Workplace Safety and Insurance Act requires you to give a copy of this report (Worker s Report of Injury/Disease Form 6) to your employer. Just like your employer has to give you a copy of Form 7, you have to provide a copy of Form 6 to your employer. This information might help them to investigate the causes of the accident and to prevent it from happening again. Section D: Health Care Information You provide information about the health care you received concerning your injury/illness in this section. Tell the person treating you that the injury/illness is work-related so the health professional can fill out Form 8 and send it to the WSIB. You also need to tell your employer that you received medical treatment for your injury. Your employer needs to fill out Form 7 and submit it to the WSIB. Make sure to inform the health professional treating you of your claim number once you receive it. Bear in mind that your employer is supposed to pay for the transportation for you to receive heath care on the day when the accident happened. D1: Did you get first aid or care at work? Check yes and write down the name or title of the first-aider if after the work-related injury you received first aid treatment, such as cleaning and dressing wounds, by a trained first-aider. Please also provide the date of the first-aid treatment you received. D2: Where did you go for health care, for your injury, outside of work? 7

8 Check all boxes that apply to you. Nursing Station: it refers to a facility that is outside a hospital and it is usually located in smaller communities. Emergency Department: it can be either part of a hospital or located in a specialized emergency facility that is not part of a hospital. Admitted to Hospital: if you were admitted to a hospital and stayed overnight, check this box. Ambulance: If you received treatment from a paramedic, check this box. Health Professional Office: Health care professionals refer to a: chiropractor physician physiotherapist registered nurse extended practice or dentist. Health professional office refers to an independent office where a health professional practices. Clinic: it refers to a walk-in clinic or a facility where several health professionals practice. If you went to a nursing station, emergency department, or you were admitted to a hospital, please write down the name and the address of the facility and the date that you received health care. You only need to provide the date of visit if you check the box(es) for Ambulance, Health Professional Office, or Clinic. D3: Were you prescribed any medications/drugs? Check the appropriate box for this question. The WSIB may pay for the medications/drugs for treating your injury/illness. D4: Were you referred for any other treatment or test? Check yes if you were referred for any other treatment, for example, massage, or test, like X-ray. D5: Did you talk to your health professional about going back to regular or modified work? If yes, were you given any work limitation? Check the appropriate boxes for these two questions. Talk to your health professionals about return to work. They might complete a return to work note, which provides the information about your work limitations. This information can help you and the employer to make decisions, like accommodation, about your return to work. You have to tell your employer if you have any work limitations. D6: Did you tell your employer you went for medical treatment? Please provide the date when you told your employer you went for medical treatment, and the name as well as the position of the person whom you informed. You have to tell your employer if you received medical treatment for your injury. Your employer needs to complete Form 7 and submit it to the WSIB. If you have not told your employer yet, tell your employer right away. Section E: Lost Time and Return to Work After you completed and submitted Form 6, if there is any change in this section, please inform your adjudicator immediately of the changes. E1: After the day of accident/illness... Check the appropriate box to answer this question. Modified duties refer to any change or accommodation to your work or the workplace. For example, you are given a lighter task or your employer gives you a stool, so you can sit down to perform your task. The lost time refers to any amount of time that you lost for performing your work. It can be a partial day or more. This includes time you take to receive health care treatment. E2: If you lost time, have you returned to work? Check the appropriate box to answer this question. If your answer is yes, provide the date of your 8

9 return to work and whether you are doing regular or modified work. E3: Did you discuss return to work with your employer? Check the appropriate box for this question. You need to take initiatives to discuss with your employer about your safe return to work. E4: Does your employer have modified work? Check the appropriate box to answer this question. You have to discuss with your employer to find out if there is any modified work for you. Section F: Earnings (Do not include overtime) F1: Rate of Pay Provide your hourly or weekly pay, if you get paid hourly or weekly. Check other if your pay is based on salary or other forms of payment, such as commission. Please provide specific information. Check the appropriate box to answer this question. This information affects the amount of money you may receive from the WSIB. Section G: Declaration and Signature Make sure that you sign and fill out this section properly. Otherwise, your benefits may be delayed. By signing Form 6, you declare that all the information you provided is true. Also, it allows the health professionals treating you to provide information about your functional abilities to you, your employer, and the WSIB, and this information will help you to safely return to work. APPEALING A RULING It is your right to ask WSIB to reconsider their decision to deny your claim. This is called an APPEAL or an OBJECTION of WSIB s decision. The following steps outline the process for APPEALING WSIB s decision: What can I do if WSIB has denied my claim? F2: Usual number of pay hours : Give the number of hours you work weekly. If you check other, please specifiy. F3: If you lost time from work after the day of accident/illness, did your employer continue to pay you? Check the appropriate box to answer this question. Check yes if your employer kept paying you while you were not working after your accident/illness. F4: Have you applied for, or did you receive, any other benefits (money) while off work? Check yes if you have applied or received other benefits, like EI, while you were off work. F5: At the time of the accident/illness did you work for more than one employer? Step 1: Call the WSIB! Get in touch with the representative who made the decision. Their contact information (probably a phone number) will be on the letter explaining the decision that was made. At the very least, this conversation will clear up any misunderstandings of why your claim was denied. Ask the decision-maker to reconsider! If the decision-maker confirms the original decision.. 9

10 Step 2: Official Objection Intent to Object Form: Section C: Accident/Illness Dates and Details What is it the Intent to Object Form? In this form you are to provide any/ all new information that might alter a decision by the frontline decision maker. This form is also where you are going to bookmark your objection and provide your reasons as to why you believe the decision is wrong. Where do I get the Intent to object form? : From the WSIB website ( or through the mail, upon request, by calling the WSIB at or Information to be provided on the Intent to Object form: Your name Your claim number Identification of the objecting party General information about the objecting party Representative contact information (if you have representation) Date of decision(s) being objected to and the issues in dispute contained in the decision letters Any new information or additional explanation Signature and date. The form is structured so that only the first page must be returned; page 2 should only be used to express new information or if you would like to provide reasons for the objection. The completed Intent to Object Form must be mailed/faxed to the WSIB within the time limit. Time Limit The time limit will be indicated on the letter expressing the representative s decision: You have up to 30 DAYS to object to a WSIB decision about Return to Work or Work Transition issues, including reemployment decisions. This is where you provide the what, where and when of your claim. OR You have up to 6 MONTHS to object to If you work for a Temporary any other WSIB decision. Employment Agency, make sure to fill out th name of the worksite employer here, not the OR name of the If agency you are objecting under to multiple section decisions 4. associated with different time limits, the time limit is set at 6 MONTHS. What happens after I send in my form? The decision maker will review your form and their decision. You should get an answer within about 2 WEEKS. If the decision-maker does not change the outcome of the claim. Step 3: Appeal the decision with the A: Date WSIB and hour of accident/awarenes illness. Appeal Readiness Form: This is your chance to make your argument(s) about If the injury their decision occurred made in your suddenly case and indicate because your of o opinion on how your appeal should be resolved (by event, such oral or written as a hearing fall or even impact, by such a provide the d and time mechanism that the as mediation). event You occurred. will be assigned an Appeals Resolution Officer (ARO) who will be reviewing your appeal and making the final If the injury decision. did not occur suddenly, but over period of time, from repetitive motion for The Appeal Readiness form must be mailed/faxed example, to the give WSIB. the approximate date that yo started to notice the injury. Information to be provided on the Appeal Readiness form Any new information or evidence that may influence your appeal All evidence (doctor reports, for example) 10

11 Your substantive arguments as to why the decision is wrong. How you would like this appeal to be resolved (while the WSIB will not necessarily abide by your choice, you should indicate what you prefer anyways). If you need an interpreter at the oral hearing if that is what you requested. Information of any witnesses (name, reason for summons, address) you plan on calling to the oral hearing if you requested it. Whether you would prefer an oral hearing by teleconference. Time Limit: Good News! There is no time limit to submitting this form! The whole idea behind this form is that you only fill it out WHEN YOU ARE COMPLETELY READY FOR THE APPEAL. So make sure you have everything you need before sending this in! The only time limit related to this form is that you need to make sure that you will be available to attend an oral hearing (if that was requested) within 90 DAYS. conflict (like mediation, for example). These are only used in this process within Special projects and usually when the dispute involves a larger employer. This is rarely used to resolve an appeal. If the disputed decision is upheld by the ARO Step 4: Appealing WSIB s final decision If your ARO does not change their decision, you have the option to appeal to the Workplace Safety and Insurance Appeals Tribunal (WSAIT) this is the final stage of appeal. You have 6 MONTHS from the date of the final WSIB decision to send your appeal to WSAIT. You will need to fill out the WSIAT Notice of Appeal form, and a WSAIT hearing will be scheduled. WSAIT may order WSIB to reconsider its decision based on the information you provide in the hearing. What methods are available to resolve this matter? Hearing in Writing (HIW) - an Appeals Resolution Officer (ARO) will generally make a decision within 30 DAYS after reviewing the information in your claim file and any additional information you submit on the Appeal Readiness Form (or on the Respondent Form if you are not the party who is objecting to a decision but you are a party who is participating in the appeal). You can attach additional information/argument to the Appeal Readiness Form or Respondent Form. An Oral Hearing (OH) can be held in person or by teleconference. If the WSIB decides an oral hearing is necessary, they will schedule one to be held within 90 calendar days after the WSIB confirms an oral hearing is required. Alternative Dispute Resolution: This includes all other ways to resolve the You have the right to be treated fairly and with respect throughout the entire appeal process AND REMEMBER TO KEEP COPIES OF ALL DOCUMENTS AND COMMUNICATIONS DURING THIS PROCESS!!!! This document does not contain legal advice. Pro Bono students Canada is a student organization. This document was prepared with the assistance of PBSC law student volunteers. PBSC students are not lawyers and they are not authorized to provide legal advice. This document contains general discussion of certain legal and related issues only. If you require legal advice, please consult with a lawyer. 11

12 Sources: Form 6 Reference Guide for Workers able%20fileform%206%20guidelines/1906a. pdf Making a Claim 0/ArticleDetail/24338?vgnextoid=e78fe35c819 d7210vgnvcm c710arcrd Benefits rticledetail/24338?vgnextoid=84494c23529d7210v gnvcm c710arcrd&vgnextchannel=0 9f55087bbeaf110VgnVCM e18120aRCRD Appeals rticledetail/24338?vgnextoid=a457a5596b8d7210v gnvcm c710arcrd&vgnextchannel=bf 28aeb5067e6210VgnVCM e18120aRCRD Appeals Services Division Practice and Procedures spp/appealsp&p.pdf WSIAT: Apeeals Process Workplace Safety and Insurance Act, 1997, S.O. 1997, CHAPTER 16 _97w16_e.htm 12

How To Claim Benefits From The Work Safety And Insurance Board

How To Claim Benefits From The Work Safety And Insurance Board F O R M 6 W O R K E R s r e p o r t o f i n j u r y / d i s e a s e R e f e r e n c e G u i d e f o r W O R K E R s PRINT GUIDE ENTER GUIDE Table of Contents What To Do If You have An Accident at Work...........

More information

Workers Compensation: Making a claim

Workers Compensation: Making a claim Workers Compensation: Making a claim What are workers compensation benefits? Workers compensation benefits are payments for injuries or diseases that are related to the work you were doing. Workers compensation

More information

Migrant Workers and Workers Compensation. What You Should Know. What are workers compensation benefits?

Migrant Workers and Workers Compensation. What You Should Know. What are workers compensation benefits? Migrant Workers and Workers Compensation What You Should Know What are workers compensation benefits? Workers compensation benefits are available to people who are hurt at work in Ontario, including migrant

More information

GENERAL INFORMATION. What should I do if I m injured at work?

GENERAL INFORMATION. What should I do if I m injured at work? GENERL INFORMTION What should I do if I m injured at work? Ensure you report the accident immediately to your supervisor. Describe the event in detail, provide the names of any witnesses to the incident,

More information

Information about workers' compensation. Information for newcomers to Ontario

Information about workers' compensation. Information for newcomers to Ontario Information about workers' compensation Information for newcomers to Ontario What is the Workplace Safety and Insurance Board? The Workplace Safety and Insurance Board (WSIB) is Ontario's no-fault insurance

More information

WHAT CAN I DO WHEN I HURT MYSELF AT WORK?

WHAT CAN I DO WHEN I HURT MYSELF AT WORK? WHAT CAN I DO WHEN I HURT MYSELF AT WORK? This booklet is to help you when you are injured on the job 1 Name of WSIB Representative: Date of Injury: Supervisor: Witnesses: What happened (date and time,

More information

www.workershealthcentre.ca

www.workershealthcentre.ca Alberta Workers Health Centre Work Plays Schools Program Resource Package Injured at Work? You have the right to report a work-related injury or illness to the Workers Compensation Board (WCB). Workers

More information

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 975/06

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 975/06 WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 975/06 BEFORE: M. Crystal: Vice-Chair HEARING: February 28, 2007 at Toronto Written case DATE OF DECISION: March 1, 2007 NEUTRAL CITATION: 2007

More information

Did you know that you can securely file Form 7 online with our eservices?

Did you know that you can securely file Form 7 online with our eservices? Did you kw that you can securely file Form online with our eservices? eform offers a fast, effective solution for managing your Form reports with the WSIB. To submit an eform, visit our eservices site.

More information

WORKERS' COMPENSATION CLAIMANT INFORMATION PACKET

WORKERS' COMPENSATION CLAIMANT INFORMATION PACKET WORKERS' COMPENSATION CLAIMANT INFORMATION PACKET Instructions Statement of Rights Prescription ID and Pharmacy Information The New York State Insurance Fund TLC EMERGENCY MEDICAL SERVICES Inc. TLC MEDICAL

More information

Injured at work? We re here to help. A guide to the Workplace Safety and Insurance Board

Injured at work? We re here to help. A guide to the Workplace Safety and Insurance Board Injured at work? A guide to the Workplace Safety and Insurance Board This handbook will show you, step by step, how the Workplace Safety and Insurance Board (WSIB) helps to prevent workplace injuries and

More information

Public Sector Injury Benefit Scheme 2015

Public Sector Injury Benefit Scheme 2015 Public Sector Injury Benefit Scheme 2015 Application for Injury Benefit - Notes for Guidance Purpose of this Guidance Isle of Man Government employers and Injury benefit applicants must read the guidance

More information

Administrative Procedures Memorandum A4002

Administrative Procedures Memorandum A4002 Page 1 of 8 Date of Issue May 2015 Original Date of Issue September 1985 Subject References Links Contact REPORTING OF WORKPLACE INJURY/ILLNESS Workplace Safety & Insurance Act Occupational Health & Safety

More information

FILING WORKERS COMPENSATION CLAIMS IN IDAHO

FILING WORKERS COMPENSATION CLAIMS IN IDAHO Claims contact information First Report of Injury forms ReportClaim@IdahoSIF.org General e-mail ClaimsIM@IdahoSIF.org FILING WORKERS COMPENSATION CLAIMS IN IDAHO Provider inquiries 208-332-2169 or 800-334-2370

More information

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 2289/08

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 2289/08 WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 2289/08 BEFORE: M. Crystal: Vice-Chair HEARING: October 31, 2008 at Toronto Written case DATE OF DECISION: October 31, 2008 NEUTRAL CITATION:

More information

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 2115/14

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 2115/14 WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 2115/14 BEFORE: C. M. MacAdam : Vice-Chair S. T. Sahay : Member Representative of Employers K. Hoskin : Member Representative of Workers HEARING:

More information

Guide to. For Connecticut Private Sector Employees

Guide to. For Connecticut Private Sector Employees Guide to Workers Compensation For Connecticut Private Sector Employees NEW ENGLAND HEALTH CARE EMPLOYEES UNION DISTRICT 1199, SEIU 77 Huyshope Avenue, Hartford, CT 06106 860-549-1199 September 2009 Workers

More information

Injury Report Instructions

Injury Report Instructions Injury Report Instructions The numbers refer to question numbers on the form that may require additional explanation. Worker Details 1 Have your work duties been modified? Your duties have been modified

More information

Administrative Procedures Memorandum A4007

Administrative Procedures Memorandum A4007 Page 1 of 9 Date of Issue May 2015 Original Date of Issue March 2011 Subject WORKPLACE SAFETY AND INSURANCE BOARD (WSIB) CLAIMS References Links Contact Workplace Safety & Insurance Act (Ontario) Human

More information

PROCEDURES TO CLAIM SHORT TERM DISABILITY BENEFITS

PROCEDURES TO CLAIM SHORT TERM DISABILITY BENEFITS PROCEDURES TO CLAIM SHORT TERM DISABILITY BENEFITS The Short Term Disability (STD) benefits help you through periods when you are off work due to disability caused by illness or accidental injury outside

More information

How To Get A Wsib Award

How To Get A Wsib Award A Member s Guide to the Workplace Safety and Insurance Board w s i b Elementary Teachers Federation of Ontario Revised January 2012 Workplace Safety and Insurance Board (WSIB) Applying for WSIB benefits

More information

How To File A Worker S Compensation Claim In Azoria

How To File A Worker S Compensation Claim In Azoria Workers Compensation Instructions for Filing a Claim Please complete following steps within 24 48 hours of the incident: Report the incident to your supervisor immediately or, if a medical emergency, dial

More information

REVIEWS AND APPEALS OF WorkSafeBC DECISIONS

REVIEWS AND APPEALS OF WorkSafeBC DECISIONS REVIEWS AND APPEALS OF WorkSafeBC DECISIONS A Worker s Information Kit Ministry of Jobs, Tourism and Skills Training and Minister Responsible for Labour www.labour.gov.bc.ca/wab REVIEWS AND APPEALS OF

More information

VISION MISSION VALUES WORKERS RIGHTS. Eliminate workplace diseases and injuries.

VISION MISSION VALUES WORKERS RIGHTS. Eliminate workplace diseases and injuries. Worker s Handbook VISION Eliminate workplace diseases and injuries. MISSION In partnership with stakeholders, we ensure workplace safety, and care for workers. VALUES Respect We demonstrate care, compassion,

More information

NHS INJURY BENEFITS SCHEME - Notes for Guidance

NHS INJURY BENEFITS SCHEME - Notes for Guidance NHS INJURY BENEFITS SCHEME - Notes for Guidance Purpose of this Guidance This leaflet provides both general and detailed information and guidance for NHS employers, applicants and reporting doctors for

More information

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 2395/13

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 2395/13 WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 2395/13 BEFORE: A.G. Baker: Vice-Chair HEARING: December 27, 2013 at Toronto Written DATE OF DECISION: May 9, 2014 NEUTRAL CITATION: 2014 ONWSIAT

More information

WCB claims. WCB claim process. Worker suffers an injury/occupational disease. Report to first aid/supervisor.

WCB claims. WCB claim process. Worker suffers an injury/occupational disease. Report to first aid/supervisor. Section 4 WCB claims WCB claim process Worker suffers an injury/occupational disease. Worker reports to doctor. Physician s first report is sent to WCB. (Form 8). Report to first aid/supervisor. Injured

More information

NHS INJURY BENEFITS SCHEME - Notes for Guidance

NHS INJURY BENEFITS SCHEME - Notes for Guidance NHS INJURY BENEFITS SCHEME - Notes for Guidance Purpose of this leaflet This leaflet provides both general and detailed information and guidance for NHS employers, applicants and reporting doctors for

More information

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1617/14

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1617/14 WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1617/14 BEFORE: T. Mitchinson: Vice-Chair HEARING: August 29, 2014 at Sudbury Oral DATE OF DECISION: September 4, 2014 NEUTRAL CITATION: 2014

More information

Workers Compensation

Workers Compensation Overview: Details vary from state to state, but the general underlying principles of the workers compensation system include: Workers have relinquished recourse to liability suits in exchange for a no-fault

More information

WORKERS COMPENSATION/PRIVATE INSURANCE COVERAGE FOR LEARNERS ON UNPAID TRAINING PLACEMENT

WORKERS COMPENSATION/PRIVATE INSURANCE COVERAGE FOR LEARNERS ON UNPAID TRAINING PLACEMENT WORKERS COMPENSATION/PRIVATE INSURANCE COVERAGE FOR LEARNERS ON UNPAID TRAINING PLACEMENT OVERVIEW Effective July 1, 1993, all students (learners) in unpaid training placements who are placed in agencies

More information

Frequently Asked Questions About Georgia Workers Compensation Ty Wilson Attorney At Law 1-866-937-5454 www.tywilsonlaw.

Frequently Asked Questions About Georgia Workers Compensation Ty Wilson Attorney At Law 1-866-937-5454 www.tywilsonlaw. Frequently Asked Questions About Georgia Workers Compensation Ty Wilson Attorney At Law 1-866-937-5454 www.tywilsonlaw.com Special Report Frequently Asked Questions About Claims Special Report Ty Wilson

More information

Raising Concerns or Complaints about NHS services

Raising Concerns or Complaints about NHS services Raising Concerns or Complaints about NHS services Raising concerns and complaints A step by step guide Raising concerns and complaints Questions to ask yourself: 1. What am I concerned or dissatisfied

More information

NT WORKERS COMPENSATION CLAIM FORM

NT WORKERS COMPENSATION CLAIM FORM Information for Workers Guidance to PART 1 of the Claim Form Notify your employer of your injury, verbally or in writing, as soon as practicable. Fully complete PART 1 (questions 1 to 8) of the following

More information

THE EMPLOYEE S ROLE: When an Employee is Injured on the Job. Human Resources Management Workers Compensation Program

THE EMPLOYEE S ROLE: When an Employee is Injured on the Job. Human Resources Management Workers Compensation Program THE EMPLOYEE S ROLE: When an Employee is Injured on the Job Human Resources Management Workers Compensation Program August 16, 2010 This guidebook gives an overview of the California workers compensation

More information

Facts & Tips about Long-term Disability (LTD)

Facts & Tips about Long-term Disability (LTD) Facts & Tips about Long-term Disability (LTD) Revised June 2008 Please keep this document handy for reference It offers general information about LTD benefits under an insurance policy or contract. It

More information

Injured on-the-job? Know Your Workers' Compensation Rights in New Jersey

Injured on-the-job? Know Your Workers' Compensation Rights in New Jersey Page1 Injured on-the-job? Know Your Workers' Compensation Rights in New Jersey HPAE members who are injured or made ill on-the-job may be entitled to cash benefits, medical care, and other benefits under

More information

Work Injury Reporting Hotline 877 682-7778

Work Injury Reporting Hotline 877 682-7778 FACTS ABOUT WORKERS COMPENSATION The content of this pamphlet has been approved by the Administrative Director of the Division of Workers Compensation. The information in this pamphlet is available in

More information

What injuries should you report to WCB?

What injuries should you report to WCB? Employer Report of Injury Important Information How soon should you report injuries to WCB? As soon as possible. Research shows the longer the delay in reporting and managing an injury, the higher the

More information

A Guide to Appealing Disability Benefits in the Broader Public Service (BPS)

A Guide to Appealing Disability Benefits in the Broader Public Service (BPS) A Guide to Appealing Disability Benefits in the Broader Public Service (BPS) OPSEU Pensions and Benefits Unit April 2013 Table of Contents Introduction... 3 Overview... 3 Know and Meet the Deadline(s)

More information

Application for Victim

Application for Victim Compensation for Victims of Crime Program Application for Victim The Compensation for Victims of Crime Program is part of Manitoba Justice, Victim Services Branch and gives compensation to eligible victims

More information

Information for Workers. Information for Workers

Information for Workers. Information for Workers Information for Workers Information for Workers Revised March 2015 Contents Overview... 2 Workplace Injuries... 2 Worker Responsibilities... 2 Employer Responsibilities... 4 WCB Responsibilities... 4 Returning

More information

How To Get Workers Compensation Benefits In Massachusetts

How To Get Workers Compensation Benefits In Massachusetts If you are having health problems because of your job, you have a right to benefits. Here s what you need to know about: Workers Compensation in Massachusetts If you are injured or become ill because of

More information

A GUIDE TO INDIANA WORKER S COMPENSATION

A GUIDE TO INDIANA WORKER S COMPENSATION A GUIDE TO INDIANA WORKER S COMPENSATION 2004 EDITION MACEY SWANSON AND ALLMAN 445 North Pennsylvania Street Suite 401 Indianapolis, IN 46204-1800 Phone: (317) 637-2345 Fax: (317) 637-2369 A GUIDE TO INDIANA

More information

Who Administers the Workers Compensation Program and Related Responsibilities?

Who Administers the Workers Compensation Program and Related Responsibilities? What is Workers Compensation? Who Administers the Workers Compensation Program and Related Responsibilities? Who is Eligible for Workers Compensation? What Coverage is Provided? What is a Compensable Injury?

More information

WORKERS COMPENSATION CASE EVALUATION & SETTLEMENT VALUATION REQUEST & WORKSHEET

WORKERS COMPENSATION CASE EVALUATION & SETTLEMENT VALUATION REQUEST & WORKSHEET WORKERS COMPENSATION CASE EVALUATION & SETTLEMENT VALUATION REQUEST & WORKSHEET Note: This worksheet requests important information necessary in order to provide an opinion as to the settlement value range

More information

Worker s Handbook. A guide to your workers compensation insurance. Nova Scotians safe and secure from workplace injury

Worker s Handbook. A guide to your workers compensation insurance. Nova Scotians safe and secure from workplace injury Worker s Handbook A guide to your workers compensation insurance Nova Scotians safe and secure from workplace injury Your Worker s Handbook at a glance Your care comes first: health care benefits.... 2

More information

Return to Work Plan Package

Return to Work Plan Package Return to Work Plan Package Working collaboratively to facilitate Work Reintegration This package includes the following templates/samples: Return to Work Plan Discussion Guide Contact Log Return to Work

More information

General Information on Representing Yourself in a Workers Compensation Case

General Information on Representing Yourself in a Workers Compensation Case General Information on Representing Yourself in a Workers Compensation Case Idaho Industrial Commission PO Box 83720 Boise, ID 83720-0041 Telephone: (208) 334-6000 Fax: (208) 332-7558 www.iic.idaho.gov

More information

A GUIDE TO THE BENEFITS PROVIDED BY THE ILLINOIS WORKERS COMPENSATION ACT

A GUIDE TO THE BENEFITS PROVIDED BY THE ILLINOIS WORKERS COMPENSATION ACT A GUIDE TO THE BENEFITS PROVIDED BY THE ILLINOIS WORKERS COMPENSATION ACT INTRODUCTION The information contained in this booklet is an overview of benefits provided by the Illinois Workers Compensation

More information

How To Get Paid For An Accident On The Job In South Carolina

How To Get Paid For An Accident On The Job In South Carolina SOUTH CAROLINA BAR Workers Compensation and the Law WORKERS COMPENSATION The South Carolina Workers Compensation Act provides a system for workers injured on the on the job to receive medical care and

More information

Guidelines for Workplace Insurance for Postsecondary Students of Publicly Assisted Institutions on Unpaid Work Placements

Guidelines for Workplace Insurance for Postsecondary Students of Publicly Assisted Institutions on Unpaid Work Placements Guidelines for Workplace Insurance for Postsecondary Students of Publicly Assisted Institutions on Unpaid Work Placements Revised: June 2014 Table of Contents 1. Definitions :... 3 2. Relevant Statutory

More information

Understanding Workers Compensation Rights and How to Protect Them

Understanding Workers Compensation Rights and How to Protect Them Understanding Workers Compensation Rights and How to Protect Them Jennifer M. Zupp Norelius, Nelson, Zupp, Zupp, P.C. 1317 Broadway POB 278 Denison, IA 51442 Ph. 1-712-263-4245 Fax. 1-712-263-8773 e-mail:

More information

Important Information

Important Information 16 An Employee s Guide to the South Dakota Workers Compensation System Division of Labor and Management Phone: (605) 773-3681 www.sdjobs.org Department of Labor and Regulation 700 Governors Drive Pierre,

More information

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 376/08

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 376/08 WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 376/08 BEFORE: A. Morris: Vice-Chair HEARING: February 7, 2008 at Toronto Oral DATE OF DECISION: June 9, 2008 NEUTRAL CITATION: 2008 ONWSIAT

More information

A GUIDE TO THE LAW IN ALBERTA REGARDING EMPLOYMENT LAW

A GUIDE TO THE LAW IN ALBERTA REGARDING EMPLOYMENT LAW A GUIDE TO THE LAW IN ALBERTA REGARDING version: 2014 COPYRIGHT & DISCLAIMER GENERAL All information is provided for general knowledge purposes only and is not meant as a replacement for professional legal

More information

SUMMARY DECISION NO. 1007/99. Accident (occurrence).

SUMMARY DECISION NO. 1007/99. Accident (occurrence). SUMMARY DECISION NO. 1007/99 Accident (occurrence). The worker appealed a decision of the Appeals Resolution Officer denying entitlement for low back disability. The worker experienced the onset of back

More information

Getting help and what to know if you ve been injured at work

Getting help and what to know if you ve been injured at work Getting help and what to know if you ve been injured at work Introduction If you ve been injured at work, this guide provides you with useful information to help you recover from your injury. Once you

More information

First. Aid. Regulation 1101 REQUIREMENTS

First. Aid. Regulation 1101 REQUIREMENTS First Aid REQUIREMENTS Regulation 1101 Introduction This brochure is about the first aid requirements of the Workplace Safety and Insurance Board (WSIB). It contains the law (Regulation 1101) and the policy

More information

F O R M 7 E M P L O Y E R S R E P O R T O F I N J U R Y / D I S E A S E. Table of Contents

F O R M 7 E M P L O Y E R S R E P O R T O F I N J U R Y / D I S E A S E. Table of Contents F O R M 7 E M P L O Y E R S R E P O R T O F I N J U R Y / D I S E A S E R E F E R E N C E G U I D E F O R E M P L O Y E R S PRINT GUIDE ENTER GUIDE Table of Contents Overview of Employer Reporting Obligations............

More information

For the purpose of this Procedure the following definitions will apply:

For the purpose of this Procedure the following definitions will apply: Procedure 6.5: Workplace Safety and Injury Reporting Volume 6 Managing Office: Office of Human Resources Effective Date: March 15, 2011 Revised: June 2014 I. GENERAL POLICY Alabama A&M University ( AAMU

More information

What Happens After I Report the Injury?

What Happens After I Report the Injury? Introduction The Iowa Workers Compensation Act provides the only legal remedy against their employer for workers who are injured on the job. Workers Compensation law can be very technical. The law is administered

More information

WORKERS COMPENSATION FORMS CENTRAL STORES COMMODITY CODES

WORKERS COMPENSATION FORMS CENTRAL STORES COMMODITY CODES WORKERS COMPENSATION FORMS CENTRAL STORES COMMODITY CODES Employer s Report of Occupational Injury/ Illness (5020) 7673 Authorization to Release Records (WC10) 7697 Workers Compensation Benefit Election

More information

Facts About Maine s. Compensation Laws

Facts About Maine s. Compensation Laws Facts About Maine s Workers Compensation Laws Revised December, 2015 The Maine Workers Compensation Board prepared this guide to help you understand Maine s workers compensation system. This guide attempts

More information

Table of Contents. A Message From Attorney Edgar Snyder 1. Eligibility for Workers Compensation 3. Types of Workers Compensation Claims 5

Table of Contents. A Message From Attorney Edgar Snyder 1. Eligibility for Workers Compensation 3. Types of Workers Compensation Claims 5 Table of Contents A Message From Attorney Edgar Snyder 1 Eligibility for Workers Compensation 3 Types of Workers Compensation Claims 5 Workers Compensation Benefits Payments 9 The Hearing Process 13 The

More information

OPSEU Guide to the Hospitals of Ontario Disability Income Plan (HOODIP)

OPSEU Guide to the Hospitals of Ontario Disability Income Plan (HOODIP) OPSEU Guide to the Hospitals of Ontario Disability Income Plan (HOODIP) OPSEU Membership Benefits Department April 2010 Page 2 of 28 Table of Contents 1. INTRODUCTION... 5 2. HOODIP AND YOUR COLLECTIVE

More information

University Students Council of the University of Western Ontario EARLY AND SAFE RETURN TO WORK POLICY

University Students Council of the University of Western Ontario EARLY AND SAFE RETURN TO WORK POLICY EFFECTIVE: 30 th October 2012 SUPERSEDES: 15 th November 2011 AUTHORITY: General Manager RATIFIED BY: Executive Council 30 th OCTOBER 2012 RELATED DOCUMENTS: PAGE 1 of 8 PURPOSE: This Policy is created

More information

Workers Compensation Claim Form

Workers Compensation Claim Form Workers Compensation Claim Form Workers tear off and keep this section for your information Who can make a claim? You are entitled to make a claim if you sustain an injury in the course of your employment

More information

Workers Compensation Informational Materials and Filing Overview

Workers Compensation Informational Materials and Filing Overview Workers Compensation Informational Materials and Filing Overview Call 911, as applicable, and/or seek medical attention as necessary. Report the incident to the supervisor/department. The supervisor/department

More information

Application for Subsidized Housing in Toronto

Application for Subsidized Housing in Toronto Application for Subsidized Housing in Toronto Large print applications are available upon request. Disponible en français 176 Elm Street If you do not speak English or French, choose someone you trust

More information

Workplace Accident, Illness and Disability Management System Policy and Supporting Program

Workplace Accident, Illness and Disability Management System Policy and Supporting Program Ryerson University POLICY-PROCEDURE Workplace Accident, Illness and Disability Management System Policy and Supporting Program 1. Introduction Provisions within the Ontario Workplace Safety and Insurance

More information

How to Ensure Your Healthcare Gets Paid For - Kentucky

How to Ensure Your Healthcare Gets Paid For - Kentucky Cancer Legal Resource Center 919 Albany Street Los Angeles, CA 90015 Toll Free: 866.THE.CLRC (866.843.2572) Phone: 213.736.1455 TDD: 213.736.8310 Fax: 213.736.1428 Email: CLRC@LLS.edu Web: www.disabilityrightslegalcenter.org

More information

WORKPLACE INJURY INSURANCE: Worker s Handbook

WORKPLACE INJURY INSURANCE: Worker s Handbook WORKPLACE INJURY INSURANCE: Worker s Handbook A GUIDE TO YOUR WORKERS COMPENSATION INSURANCE The following information is provided as a basic guide to your Workers Compensation Insurance. For more complete

More information

Yes. City: Province: Postal Code: Phone:

Yes. City: Province: Postal Code: Phone: PO BOX 2415 EDMONTON AB T5J 2S5 780-498-3999 (in Edmonton) 1-866-922-9221 (toll free in Alberta) Fax: 780-427-5863 1-800-661-1993 March 2008 WORKER S REPORT of Injury Occupational Disease C060 Seven Digit

More information

Your Social Security. Disability Benefits. What You Need to Know to Collect What s Rightfully Yours

Your Social Security. Disability Benefits. What You Need to Know to Collect What s Rightfully Yours Your Social Security Disability Benefits What You Need to Know to Collect What s Rightfully Yours This guide is provided by Berger and Green Attorneys At Law 5850 Ellsworth Avenue Suite 200 Pittsburgh,

More information

February Safety Subject

February Safety Subject February Safety Subject Injury / Incident Reporting You can report hazards or make safety suggestions on the Wood County web site at www.co.wood.oh.us/employee/. Click on the Safety tab. All injuries,

More information

Health & Safety The Compensation Fund 2013

Health & Safety The Compensation Fund 2013 The Compensation Fund provides compensation for workers who get hurt at work, or sick from diseases contracted at work, or for death as a result of these injuries or diseases. The Compensation Fund is

More information

Date of Birth: / / Male Female Martial Status: Language: English Spanish Other: E-mail: Occupation: Date Hired: / /

Date of Birth: / / Male Female Martial Status: Language: English Spanish Other: E-mail: Occupation: Date Hired: / / Early reporting can save you money. Report all injuries immediately! The information below allows Pinnacol Assurance s customer service representatives to quickly and accurately process your claim. Use

More information

Employer s Report of Injury or Occupational Disease form attached

Employer s Report of Injury or Occupational Disease form attached Employer s Report of Injury or Occupational Disease Important Information How soon should you report injuries to WCB? As soon as possible. Research shows the longer the delay in reporting and managing

More information

Migrant Workers and WSIB Benefits

Migrant Workers and WSIB Benefits Migrant Workers and WSIB Benefits CLEO Webinar September 21, 2015 Jessica Ponting OVERVIEW The basics of WSIB in Ontario Why differences in migration programs are relevant for WSIB How to best protect

More information

THE CUPE ONTARIO INJURED WORKERS ADVOCATE AWARD

THE CUPE ONTARIO INJURED WORKERS ADVOCATE AWARD THE CUPE ONTARIO INJURED WORKERS ADVOCATE AWARD Closing date for nominations is April 24 Do you know a member who has made a significant contribution on behalf of injured workers? CUPE Ontario s Injured

More information

Coping with Cancer: Know how to get financial help

Coping with Cancer: Know how to get financial help Coping with Cancer: Know how to get financial help For patients living with cancer UHN Read this booklet to learn about: What programs are available to you How to apply for and use the programs Programs

More information

FACTS ABOUT WORKERS COMPENSATION

FACTS ABOUT WORKERS COMPENSATION FACTS ABOUT WORKERS COMPENSATION What Is It Since 1913, California Workers' Compensation law has guaranteed prompt, automatic benefits to workers who become injured or ill because of their jobs. It is

More information

A guide for injured workers. Introducing WorkSafe

A guide for injured workers. Introducing WorkSafe A guide for injured workers Introducing WorkSafe September July 2013 2011 Contents 1. About us 1 2. Weekly payments (income entitlements) 2 3. Services to help you get better 4 4. Getting back to work

More information

Workers Compensation Overview

Workers Compensation Overview Workers Compensation Overview YOUR LEGAL RIGHTS Workers compensation provides benefits to workers who are injured on the job or who have an illness, disease, or disability caused or made worse by workplace

More information

Application for Subsidized Housing

Application for Subsidized Housing Peel Region Upon completion, please return to: Peel Access to Housing Region of Peel - Human Services Large print applications are available upon request Disponible en français Application for Subsidized

More information

Wesley Mission Income Protection Claim Form

Wesley Mission Income Protection Claim Form Wesley Mission Income Protection Claim Form INCOME PROTECTION CLAIMS In order to alleviate any delay in the processing time of your claim, please ensure the following: The claim form is returned with all

More information

We thank you for your business, and look forward to providing you with the necessary protection and care for your business and employees.

We thank you for your business, and look forward to providing you with the necessary protection and care for your business and employees. RE: Workers Compensation Claims Kit Dear Policyholder: Welcome to the Workers Compensation Insurance Program offered through Tower Group Companies. While we hope that your company never experiences a workers

More information

UNDERSTANDING WORKERS COMPENSATION

UNDERSTANDING WORKERS COMPENSATION This brochure was prepared by the Washington State Association for Justice (WSAJ) as a guide to help the citizens of Washington State understand their rights. Established in 1953, WSAJ represents attorneys

More information

Personal Injury Workbook. To assist you in recording relevant information

Personal Injury Workbook. To assist you in recording relevant information Personal Injury Workbook To assist you in recording relevant information PERSONAL INJURY WORKBOOK This workbook will help you keep track of important information about your accident and injuries. As you

More information

Your Rights at Work in Australia Prepared by Labor Council of NSW For more information call our hotline1800 688 919

Your Rights at Work in Australia Prepared by Labor Council of NSW  For more information call our hotline1800 688 919 Your Rights at Work in Australia Prepared by Labor Council of NSW www.labor.net.au For more information call our hotline1800 688 919 HOW PAY AND CONDITIONS ARE SET IN AUSTRALIA ACTS OF PARLIAMENT Legislation

More information

Office of Human Resources Standard Operating Procedure HR SOP #021

Office of Human Resources Standard Operating Procedure HR SOP #021 Office of Human Resources Standard Operating Procedure HR SOP #021 Subject: Workers Compensation Effective Date: April 1, 2014 Policy Statement: The Department of Natural Resources (DNR) will coordinate

More information

INDUSTRIAL COMMISSION OF ARIZONA

INDUSTRIAL COMMISSION OF ARIZONA INDUSTRIAL COMMISSION OF ARIZONA WORKERS COMPENSATION INFORMATION FOR THE INJURED WORKER Phoenix Office: Industrial Commission of Arizona 800 W. Washington Street Phoenix, Arizona 85007-2922 Claims Phone:

More information

MEMBERS BENEFIT FUND Hourly Construction Division. APPLICATION for SHORT TERM DISABILITY BENEFITS

MEMBERS BENEFIT FUND Hourly Construction Division. APPLICATION for SHORT TERM DISABILITY BENEFITS MEMBERS BENEFIT FUND Hourly Construction Division APPLICATION for SHORT TERM DISABILITY BENEFITS L. I. U. N. A. L o c a l 1 8 3 IMPORTANT INFORMATION If you become disabled, while covered, because of either

More information

Workers Compensation. Your Guide to Handling Worker s Compensation Reporting and Filing

Workers Compensation. Your Guide to Handling Worker s Compensation Reporting and Filing Workers Compensation Your Guide to Handling Worker s Compensation Reporting and Filing Filing Worker s Compensation Claims Compensation Claims When the department is notified of an employee s work-related

More information

Contact information. Dr. Agnieszka Kosny, Scientist Institute for Work & Health 416.927.2027, ext. 2167 akosny@iwh.on.ca or akosny@gmail.

Contact information. Dr. Agnieszka Kosny, Scientist Institute for Work & Health 416.927.2027, ext. 2167 akosny@iwh.on.ca or akosny@gmail. Contact information Additional copies of this report and the full study report on which it is based are available at: www.iwh.on.ca/immigrant-workers-experiences If you have any questions or comments,

More information

ELGIN LOCAL SCHOOLS. WORKERS COMPENSATION MANUALS AND FORMS For Elgin Administration

ELGIN LOCAL SCHOOLS. WORKERS COMPENSATION MANUALS AND FORMS For Elgin Administration ELGIN LOCAL SCHOOLS WORKERS COMPENSATION MANUALS AND FORMS For Elgin Administration Revised May 2014 1 ELGIN LOCAL SCHOOLS BUREAU OF WORKER S COMPENSATION CLAIM INSTRUCTIONS The Following steps must be

More information