What if a client says they were hurt at work?

General Rule: In most cases, if someone is injured at work or because of work, they should be able to make a claim for payments from the Workplace Safety and Insurance Board (WSIB). These payments can help support them financially if they aren’t able to work, but they can also help with other things. For example, even if your client hasn’t stopped working or lost wages, they might still be able to get help with their medical bills or other related expenses from the injury.

TYPES OF INJURIES

Injuries can be organic (e.g., a broken arm) or non-organic (e.g., PTSD from being in a fire at work). Injuries can also create secondary conditions (e.g., someone injures their back, and then following a prolonged period of disability, becomes depressed). Sometimes it won’t be clear to your client if their injury is covered by WSIB or not, but there are some things you can help them keep in mind:

• Just because an injury does not require an emergency room visit, doesn’t mean it doesn’t fall under the scope of injuries covered by WSIB. 
• Just because your client might have a pre-existing condition doesn’t mean they are disqualified from making a claim to WSIB.
• Just because your client is in custody doesn’t mean they don’t qualify for benefits from WSIB, however, incarceration can affect the amount of benefits they receive.
• Sometimes the extent of the injury isn’t always clear when it happens. Things can progress, change or become worse over time, so documenting the injury from the beginning is important.
• Some conditions might emerge gradually over time (e.g., carpal tunnel syndrome from typing on a keyboard) and some conditions might happen unexpectedly from their work duties (e.g., putting something in a filing cabinet and hearing a snap in the shoulder). 
• If your client was injured at work by someone else (e.g., assaulted by a co-worker), they might only see it as a criminal issue, but your client could also be eligible for WSIB because of the injuries caused.
• Depending on the circumstances, if the injury occurred outside of the place of employment (e.g., parking lot), while travelling to work, while on a break, while away from their place of employment (e.g., on a delivery), or when working from home, they might still be able to get WSIB.
• Some injuries at work can also be connected to human rights issues, including discrimination based on disability. For more information on discrimination at work, see “What if a client is being discriminated against at work?”

WSIB works through a no-fault system, so even if your client was injured doing something they were told not to do, they can still make a claim. The role they played in their injury might impact that claim, but they can still be eligible for WSIB.

Warning: There are some employers who may not be covered by WSIB, but these are limited to certain industries, including trade unions. However, if your client is part of a union, their employer could still be covered by WSIB in some cases. They should speak with their union representative to find out. 

How You Can Help:

• Step 1: If your client tells you they were injured at work, you should ask them whether they have reported the injury to their employer or union representative (if applicable). If they haven’t, you should remind them to do so as soon as possible.
  • Note: If your client is being paid in cash, they should seek legal advice immediately. Making a report to WSIB can have other consequences, and they should speak with a legal service provider before taking any steps. Some places you can help your client call include the Workers’ Health and Safety Clinic at 1-877-832-6090, the Injured Workers Community Legal Clinic at 1-833-461-2411, or the IAVGO Community Legal Clinic at 1-877-230-6311 (or 1-866-521-8535 for migrant workers). You can also help them contact their local legal clinic if the clinic provides services related to employment issues.
• Step 2: If they haven’t already done so, help your client get medical care as soon as possible. Medical evidence is critical for most claims, so you should remind your client to tell the medical professional that it is a workplace injury and make sure that they note what happened. Your client should also be careful to follow the treatment prescribed by the medical professional.
  • The medical professional should fill out a Health Professional’s Report (Form 8) which they will submit to WSIB. Your client should ask for a copy of this, if possible. 
• Step 3: Help your client get legal advice to better understand their options. Some places you can help your client call include the Workers’ Health and Safety Clinic at 1-877-832-6090, the Injured Workers Community Legal Clinic at 1-833-461-2411, or the IAVGO Community Legal Clinic at 1-877-230-6311 (or 1-866-521-8535 for migrant workers). You can also help them contact their local legal clinic if the clinic provides services related to employment issues.
• Step 4: Tell your client to keep records/documents related to their injury. Suggest they make their own notes of the accident, including what happened, when it happened and who was there. If they spoke to their supervisor or a union representative after the incident, make sure they make notes about those conversations too. You can help them by writing down the things they say. They should also keep any receipts and records from any medical appointments or expenses. This documentation will be important later on, and your client should keep it in a safe place.
  • Note: Remind your client to keep in contact with their employer throughout the process and provide them with updates, as this can be helpful later on in a claim. Ideally, these updates should be in writing. 
• Step 5: 
  • If the employer tells your client that they are covered by WSIB, they can report the injury to WSIB online, but they need to do this within 6 months of the injury or date of diagnosis. For more information, help them contact the Office of the Worker Adviser (if they aren’t a union member) or refer them to resources on how to make a claim to WSIB.
    • Even though your client has 6 months to make their report, they should ideally file it as soon as possible while the facts are fresh in their mind. 
  • If your client isn’t sure if their employer is covered by WSIB or if their employer tells them that they don’t have coverage, help them complete WSIB’s Form 6: Worker’s Report of Injury/Disease. Once they file it, WSIB will give them a decision in writing about whether their employer has or should have coverage. Your client should also give their employer a copy of this form once they file it.
    • When filing out the form, remind your client to review it a few times before submitting it to WSIB. All the information on it must be clear and correct.
    • Note: Some employers will say they don’t have coverage even though they do or they should. Some employers may also tell your client that they are an independent contractor and would not fall under their coverage. Their employer cannot make that determination. WSIB will be able to tell your client whether their employer does or should have coverage. WSIB will also decide whether your client is an independent contractor or not. 
• Step 6: If your client’s employer isn’t covered by WSIB, there might be other kinds of benefits that they can apply for, either from their employer, or from the government. They might also be able to go to court to get money for lost wages or expenses related to their injury, but they should get legal advice about their options. When referring your client for legal advice, remind them that there are time limits on these processes, so they should get advice as soon as possible. Help them set up a free 30-minute call through the Law Society Referral Service or through the Pro Bono Ontario hotline, or check if their local legal clinic provides services related to employment issues and refer them there. You can also help your client call the Workers’ Health and Safety Clinic at 1-877-832-6090, the Injured Workers Community Legal Clinic at 1-833-461-2411, or the IAVGO Community Legal Clinic at 1-877-230-6311 (or 1-866-521-8535 for migrant workers).
• Step 7: If your client has filed a claim with WSIB, refer them to additional information on what happens next.
• Step 8: Warn your client that if they get money for loss of earnings from other benefit programs (e.g., Ontario Works, EI, etc.) while waiting for a decision from WSIB, they might need to pay back some of those benefits if they are approved for WSIB.