Lecture 4 Flashcards

1
Q

What are the incident reporting steps?

A
  1. Get medical help
  2. Document
  3. Report to the workplace safety and insurance board.
  4. Work together.
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2
Q

What is first aid?

A

What time, treatment or care in any follow up visits for observation purposes only
Includes cleaning, cuts, treating burns, applying bandages and dressings, plain, cold compress, applying splint, changing bandage

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3
Q

What do we do for documentation for accident investigation?

A

Tell employer about injury and medical treatment you received
Provide a lot of detail regarding replace injury, including who, when, what, where, how
Complete incident form

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4
Q

When do we report to the workplace safety and insurance board when accident happened?

A

Needed treatment from professional help
Not able to go to work
Being paid less or receiving fewer hours of work due to injury

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5
Q

What scenarios do we not report the injury to the workplace safety, and insurance board?

A

When first aid treatment was not needed
Did not take any time off work
Payment was not affected

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6
Q

Can you still claim benefits if property damage happened?

A

Yes, eligible to claim benefits for repairing or replacing devices even if you have no other injuries

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7
Q

How long should it take to hand in the workplace safety and insurance board form 6?

A

Six months from date of injury

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8
Q

Required information on form 6?

A

Worker information (name, date of birth, address)
Employer information
Accident illness details
Healthcare information
Employment information
Return to work information

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9
Q

When applying for workplace safety insurance benefit, can a doctor looked through our personal information?

A

You must agree to allow doctor to look through and release information about functional abilities to your employer

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10
Q

What does functional ability mean?

A

Describes what you can, and cannot do at work because of your work related injury
Does not include details about your medical condition

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11
Q

What are some workplace safety and insurance benefit claims?

A

Accidents
Disablement
Psychological conditions
Occupational diseases —> cancer
Hearing loss
Survivors benefit

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12
Q

What is the no-fault system?

A

Do not need to show evidence that it was your fault or the employers fault to get benefits
Even if employer thinks accident at work was your fault, you are still entitled to benefits and services from the WSIB

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13
Q

What happens after filling out a form 6?

A

Receive letter from WSIB providing claim number
Claim number does not represent approval
If never received, call, WSIB

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14
Q

What are the extensions to filing a claim after the six months?

A

WSIB policy has changed, and first approval was denied
File claimed in another province
Employer failed to report to the WSIB, or employer made you afraid to report
Only needed healthcare benefits file claimed, however later experience loss of earnings
Exceptional circumstances —> personal reasons

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15
Q

How many days after do you have when you have any changing and health?

A

10 calendar days

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16
Q

What are some material changes in circumstances?

A

Change the medical status
Changes in earnings are income
Changes in work status
Changes in availability for cooperation in healthcare, early and safe return to work activities, reentry into workspace

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17
Q

What is the employers obligation?

A

Report a work related accident to the WSIB if a worker requires healthcare, absent from regular work, or less than regular pay, requires modified work
Complete form 7 within 3 calendar days after learning that incident occurred
Worker and health professional needs a copy of form 7

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18
Q

What form does health professionals report?

A

Form 8

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19
Q

What is the rationale behind Worker’s Compensation?

A

Fairness to injured employees
Reduction of cost to employers associated with workplace injuries
Essentially a compromise between the needs of an employer, and the needs of an employee

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20
Q

What are the underlying philosophy when injured at the workplace?

A

Collective liability —> financial burden of workers compensation is shared by all companies
No fault
Security of payment —> job is still there even if hurt
Exclusive jurisdiction —> handled by WSIB, not the government
Independent boards —> not handled by governing party

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21
Q

What is loss of earnings Benefits?

A

WSIB can pay you 85% of your net earnings loss from the day after your injury, until you are no longer impaired, you no longer suffer wage loss, or WSIB believes you should no longer be suffering a wage loss
Receive LOE benefits until age 65, unless 63 year old at time of injury

22
Q

What is the non-economic loss?

A

Recognizes the permanent effects of your workplace injury on your life outside of work
Based on degree of permanent impairment

23
Q

What happens with healthcare benefits after accident?

A

Paid by WSIB
Includes treatment by medical professional and gives prescription medication
Serious injuries include services of an attendant , changes to home, measures to improve quality of life

24
Q

What happens to the employee benefits after an accident?

A

If continuing with contributions to your regular employment benefits, employer must also continue to make contribution to these benefits for the first year that you were off work

25
Q

What happened to the retirement benefits after an accident?

A

Under 64 a time of injury, LOE benefits for more than 12 consecutive months will receive retirement benefit at age of 65
WSIB pays this benefit

26
Q

What happens to medical rehabilitation after an accident?

A

Treatment is paid for until worker restores any loss ability to function until the workers deem fit to return to work

27
Q

What happens to vocational rehabilitation after an accident occurs?

A

Involves providing education and training, needed to prepare the worker for new occupational job

28
Q

What is an incentive for companies to have accident prevention?

A

Employers will usually invest an accident prevention programs, in order to keep compensation cost down
Premium reduction for organizations to perform better than average, while surcharges for those that perform poorly

29
Q

What is cost allocation?

A

Spreading the cost of Worker’s Compensation across the industry, so that no individual companies overly burdened
Cost includes cost of insurance premiums , benefits, and administration
Based on experience rating of the industry
Lower premium charge of less number of accidents occur

30
Q

What are the four categories for compensable injuries?

A

Temporal partial disability
Temporal total disability
Permanent partial disability
Permanent total disability

31
Q

What is temporal disability?

A

Probability that an injured worker who is currently unable to work, will be able to resume gainful employment with no or only partial disability
Assumes employees condition will substantially improve

32
Q

What is temporal total disability?

A

Worker in capable of work for a period of time, but will recover fully

33
Q

What is temporal partial disability?

A

Injured worker is capable of light or part-time duties

34
Q

What is permanent partial disability?

A

Injured employee is not expected to fully recover,
might work again, but not a full capacity
Likely needed to be retrained for another occupation
Classified as either a schedule, or non-schedule disability

35
Q

What is a scheduled disability?

A

Unambiguous
Compensation based on standard schedule

36
Q

What is non-schedule disability?

A

Less straightforward
amount of compensation must be determined

37
Q

What is permanent total disability?

A

Employees disability is that he or she cannot compete in the job market
Not helpless, just inability to complete reasonably
Employers must adhere to Canadian human rights act
Employers have a duty to accommodate , up to point of undue hardship —> unreasonable difficulties for the organization

38
Q

What determines undue hardship?

A

Cost
Health and safety
Conflicting rights

39
Q

What are the duties to accommodate?

A

Adjust the work environment to the workers accommodation needs
Based on functional abilities
Take into consideration force , posture, and time
Should be mutually agreed-upon and in writing

40
Q

What is an accommodation?

A

Anything that helps remove barriers to working
Is available in all stages of work reintegration

41
Q

When can an employer not accommodate?

A

When employer shows that it would result in undue hardship
Usually seen in smaller companies

42
Q

What happens when accommodation is not possible?

A

WSIB will assign a work transition specialist to your case to develop a plan for long-term return to work
WT specialists can arrange work transition assessment in order to find a suitable occupation for you

43
Q

What is the work transition assessment?

A

Assessment that tests the skills, abilities, and aptitudes to identify long-term job goal
Starts with transferrable skills assessment , test to see if you have the skills to do other jobs without retraining
If if you cooperate, LOE benefits will still occur
If no cooperation , reduce or take away benefits

44
Q

What are the WSIB work reintegration principles?

A

Maintain employment relationship between injured worker an employer
Reintegrate workers into safe and sustainable work
Provide effective and meaningful input and choice on the part of the worker
Maintain high standards for services provided by WSIB staff and parties involved to achieve a desired employment outcomes
Manage cost of the program
Ensure workers are fairly compensated for wage loss , recognize difference between pre-injury earning and post- injury earning ability

45
Q

What are the WSIB reintegration rolls?

A

Case manager
Return to work specialist
Work transition specialist

46
Q

What does the case manager do?

A

Set return to work and recovery goals, make appropriate decisions based upon legislation, policy, and good practises

47
Q

What does the return to work specialist do?

A

Coordinate return to work by facilitating the return to work process and educating the workplace parties on principles and best practises, benefits of RTW, and services available

48
Q

What does the work transition specialist do?

A

Provide expert advice, vocational rehabilitation, planning, and support workers and employers to coordinate work integration, which may include accommodation and transition to a different job if necessary

49
Q

What is an appeal?

A

If you disagree on the outcome, ask for a different decision maker to review the decision and decide if it’s correct

50
Q

What two organizations make appeal decisions?

A

Workplace, safety, and insurance board (WSIB)
Workplace safety, and insurance appeals tribunal (WSIAT)

51
Q

Which organization make the final call on an appeal?

A

The workplace safety insurance appeals tribunal (WSIAT)

52
Q

What is the time limit for appeals?

A

Strict time limits
Appeal within 6 months
30 days for decision about return to work, labour market reentry , or work transition
6 months to appeal to WSIAT