Engaging with the WSIB/insurance systems 1

Session details

Date:

Time:

Location:

Zoom videoconferencing

Didactic presentation by:

Aaron Thompson

Session objectives

At the end of this session, participants should be able to:

  1. Explain what the WSIB is and how it functions  
  2. Describe the role of health-care providers in the workers’ compensation system 
  3. Effectively complete Form 8s for your patients 

Session resources

Appeals: Objecting to a WSIB decision
You will receive a letter from the WSIB informing you of a decision in your claim or the claim of your employee. If you disagree with the WSIB’s decision, respond to the letter as soon as possible and explain why you disagree; point out any facts you think were overlooked and ask the decision maker to reconsider the decision. Source: Workplace Safety and Insurance Board
Didactic presentation: Engaging with the WSIB/insurance systems 1
In this presentation, Dr. Aaron Thompson explains what the WSIB is and how it functions, describes the role of health-care providers in the workers’ compensation system, and how to effectively complete Form 8s for your patients.
Download the PDF(515.55 KB)
Workplace Safety and Insurance Appeals Tribunal: Appeals Process
If you disagree with a final decision of the Workplace Safety and Insurance Board (WSIB), you can start an appeal at the Workplace Safety and Insurance Appeals Tribunal (WSIAT). The WSIB and the WSIAT are separate, independent organizations that play different roles in Ontario’s workplace safety and insurance system. Source: Workplace Safety and Insurance Appeals Tribunal
WSIB Operational Policy: Decision-Making
Under the WSIA and WCA, workers, employers, and health care practitioners must provide the WSIB with information for the purpose of determining entitlement to benefits. Source: Workplace Safety and Insurance Board
WSIB Operational Policy: Entitlement to Health Care
The Workplace Safety and Insurance Act provides: a worker entitled to benefits under the insurance plan is entitled to such health care as may be necessary, appropriate, and sufficient as a result of the injury. Source: Workplace Safety and Insurance Board
WSIB Operational Policy: Psychotraumatic Disability
The purpose of this policy is to provide entitlement guidelines for claims for psychotraumatic injuries. Source: Workplace Safety and Insurance Board
WSIB Operational Policy: Reconsiderations of Decisions
The WSIB may reconsider any decision, and confirm, amend, or reverse it. The individual making the reconsideration decision is responsible for advising the worker and the employer of the decision. Source: Workplace Safety and Insurance Board
WSIB Specialty Programs
WSIB Specialty Programs provide timely access to expert specialists for people with work-related injuries or illnesses. These programs specialize in recovery and achieving a healthy and safe return to work by conducting an assessment and providing interdisciplinary treatment for more complex injuries and illnesses. Source: Workplace Safety and Insurance Board

About presenter

Dr. Aaron Thompson, an occupational medicine specialist, is the chief medical officer of the Ontario Workplace Safety and Insurance Board (WSIB). He is also an assistant professor in the Faculty of Medicine with a cross-appointment to the Dalla Lana School of Public Health, and a former director of the Occupational Medicine Residency Training Program at the University of Toronto. His clinical practice is based at St. Michael’s Hospital, where he is a staff physician in the Department of Occupational and Environmental Health.

Thompson conducts research in both clinical occupational medicine and disability management, with a focus on improving return-to-work (RTW) programs. He brings specialized expertise by providing a clinical perspective on the needs/gaps in existing communication and accommodation tools, and by providing input on how to optimize tools to facilitate effective and sustained work/RTW through effective accommodations that minimize and prevent disability.

Case presentations

Most of the learning in ECHO happens through presenting and discussing case presentations. If you have a case you would like to present, please submit a completed case presentation form to the ECHO OEM project coordinator.

Physicians presenting a case may bill OHIP for case conferences (billing codes K707 or K701).