It seems that every employer I have contact with these days is concerned about a claim form an employee that is no longer in service with them. These claims often leave the employers exposed to not only a lost time claim but significant expense.  When I question the employers about the claim and disputing the legitimacy of the claim often what is determined is that the ex-employee has reported the injury to a supervisor, the employee often did not seek medical at the time that the injury was reported and the employer took no action at the time of the report. What happens next is that the employer becomes responsible for the medical expenses and recover of an employee that is no longer in their employment and we have to attempt to get an ex-employee back to being able to do a job that no longer exists for them.  We might as well be making gold out of straw, we would have a significantly better chance at success.

In my discussions with employers I have noted several best practices that need to be considered to reduce exposure for future claim costs. These include:

1. 1.       Report all Work related claims to WSIB
2. 2.       Start a file on all reported injuries
3. 3.       Insist on medical for persistent medical problems
4. 4.       Modify work with the understanding that the employee will be returning to full duties
5. Close the claims

To further explain we must understand several aspects of WSIB claims, the WSIB have a no-fault approach which often means that if anything happens in your building it is your responsibility. WSIB also expects companies to treat all claims of injury the same and manage all claims under the internal responsibility system.  Lastly if an injury is reported until the employee reaches either full recovery or maximum medical recovery it is the employer of injuries responsibility.  As employers we cannot ignore the problem and hope it will go away.

1. Report all injuries to WSIB: Employers will often not report injuries that do not result in immediate medical or modified duties. They will make note of the injury and often the claims management stops at that point. I am not suggesting that you as employers report all paper cuts and blisters to the WSIB, but anything such as Repetitive Stress Injuries, back injuries, ergonomic injuries should be reported. Sending off a Form 7 with any modifications to the workers schedule costs you a bit of time and then places responsibility in the hands of the employee to seek medical. This also cues up your claims management that you have a potential risk that needs to be monitored. If the employee does not seek medical then the claim will be closed as a no action. If the employee reports the injury 6 months down the line and then seeks medical you have already done your part for filing, as employers you are not at risk for failure to report fines.
2. 2.       Start a file on all reported injuries: When you are aware of a potential medical situation start a file and document all actions. It is important you look at the injury, do an investigation, correct major contributory risk factors and document outcomes. If an employee is reporting a RSI or ergonomic related injury and through your investigation you determine that the job was poorly designed and you are able to eliminate the risk this needs to be documented. Often you can eliminate the problem not only for the at risk employee but others as well. Other information to be documented includes additional medical information, any contributory factors that are not work related and how the employee is performing at the job through recovery.
3. 3.       Insist on medical for persistent problems: if you are working with an employee and the employee is insisting that the problem is not improving insist that they follow up with medical and seek appropriate treatment. It is not good enough that the employee goes to the emergency room and has the functional Abilities form completed. They need to be working towards recovery. The recovery process may include physiotherapy, chiropractor or other modalities, but sitting at home waiting to get better or coming to work and complaining is not working to recovery. If the problem is ongoing work with the employee to ensure that they are taking their recovery seriously and the treatment they are getting is working. If the employee refuses to work with you work with the WSIB and ensure the lack of cooperation is noted.
4. 4.       Modify work and work towards normal duties: There is a difference between fixing a poorly designed process and modifying work. If you do an investigation and a better means of doing the task is determined, implement that and all employees will now work in the new normal. If an employee needs modified duties, employers need to accommodate. The accommodation process includes:

• looking at the functional abilities form,
• determining restrictions
• then comparing job duties to restrictions
• offering modified duties in writing
• having the employee sign and either accept or decline  

1. 5.       Close the claim when employee recovers: When your employee reports that they have fully recovered document the report, send a note to WSIB have the employee sign off a return to full duties form, indicating they are fully recovered with no restrictions. Have the employee get a full release from the main treating physician. Forward all information to WSIB.  A form 42 is available on the WSIB web page under the employer's forms in which you can indicate return to normal duties. As well the Employers Subsequent report gives you the opportunity to file updates with the WSIB when the claim progresses to completion. It is critical to have a claim closed to limit the ability of an employee to claim no recovery.

When a claim has been handled properly, documented fully and closed it makes it difficult for employees/ex-employees to claim that the injury has never healed and is as a direct result of work that he/she was doing under your employment.  If companies do not have the documentation to support the management and closure of a claim it becomes a he said she said and often the WSIB will side with the employee especially if you have documented that an injury did occur.