What WSIB Claims Management Means
When a worker is hurt or becomes ill because of work, the Workplace Safety and Insurance Board (WSIB) gets involved. Claims management is how you, as the employer, report the incident, support a safe return to work, control claim costs, and close the file properly.
In Ontario, whether you run a tool-and-die shop, an auto parts facility, a long-term care home, or a construction crew, a well-run claim protects your people and your bottom line.
Why It Matters to Your Business
Every claim affects your premium rate for years. Delays, poor communication, or missed steps can turn a simple incident into a costly, long-running file.
Handled well, most claims resolve faster, benefits are right-sized, and your premiums stay in check. Handled poorly, you face higher rates, penalties, and potential disputes.
Step-by-Step: From Incident To Closure
1) Ensure safety and care
- Provide first aid.
- Arrange and pay for immediate transportation to healthcare if needed.
- Pay the injured worker for the day of injury.
2) Investigate and document
- Record what happened, where, and who saw it.
- Save photos, equipment tags, and maintenance logs.
- Do not speculate on cause or blame in your report. Stick to facts.
3) File the Employer’s Report (Form 7)
- File within 3 days of learning the injury required healthcare or caused lost time or modified work.
- Give a copy to the worker.
- Report wages accurately.
- Failure to file on time with accurate information can result in administrative penalties, non-compliance charges and other charges under the WSIA.
4) Start the return-to-work plan
- Ask the worker to obtain a Functional Abilities Form from their provider.
- Identify safe, suitable modified duties within those abilities. Example: A press operator might move to visual inspection, light packaging, or training tasks.
- Make the offer in writing with hours, pay, duties, and start date. Aim for comparable wages where possible.
- Involve the WSIB Return to Work Specialist in the return to work planning.
5) Communicate with WSIB and the worker
- Respond promptly to WSIB calls and letters.
- Keep discussions with the worker focused on abilities, not diagnoses.
- Document all contacts and keep claim details confidential.
6) Monitor benefits and decisions
- Review WSIB decision letters for accuracy (earnings, accident date, job details).
- If you disagree, note the objection deadline on the letter.
7) Object when needed
- Return-to-work and work reintegration decisions usually have a 30-day objection deadline.
- Most other decisions have a 6-month deadline.
- File a clear, factual objection with supporting documents (duty descriptions, offers of work, attendance records).
8) Manage costs
- Keep suitable work available and check in regularly.
- Track whether absences are medically supported and within restrictions.
- Assess if cost relief or cost transfer may apply under WSIB policy (for example, where non-work factors are predominant or another party is responsible).
9) Close the claim
- Claims close when the worker recovers or reaches maximum medical recovery and suitable work is in place.
- Confirm WSIB has updated the file if the worker returns to regular work.
- Review your premium statement to confirm the claim’s impact.
Common Pitfalls To Avoid
1) Late Form 7. Filing late triggers penalties and invites scrutiny.
2) Vague or unsafe modified duties. Offers must be specific, safe, and within restrictions—or WSIB will disregard them.
3) Over-sharing medical details. You are entitled to functional abilities, not diagnoses.
4) Missing objection deadlines. A day late can mean a permanent cost to you.
5) Poor wage reporting. Understating or overstating earnings leads to wrong benefit rates and future disputes.
6) “Set and forget” return-to-work. You must monitor, adjust duties, and communicate. Silence looks like non-compliance.
7) Assuming termination ends obligations. Re-employment and cooperation duties continue, and missteps can trigger penalties.
8) Failure to proper document the initial injury and the severity (weights, measures, pictures). This information is crucial and the lack of it can result in assumptions that lead to increased claim costs.
Your Legal Obligations In Plain Terms
- Report injuries promptly.
- Pay the day of injury and cooperate with WSIB.
- Offer safe, suitable work that matches functional abilities.
- If you have 20+ workers and the injured worker has 1+ year of service, you likely have a re-employment obligation. This can last up to two years after injury or one year after the worker is medically able to perform essential duties, whichever is longer.
- Keep information confidential and accurate.
How We Help
We help employers manage Workplace Safety and Insurance Board (WSIB) claims from start to finish. Our team handles accident reporting, objections, benefits disputes, cost relief strategies, and return-to-work compliance to reduce premiums and protect your bottom line.
In practice, that means:
- Review the Form 7 with you prior to submissions, communicate with the WSIB, and assist with managing timelines from day one.
- Practical return-to-work. We build workable modified duties that fit your Ontario operation and document them properly.
- Strategic objections. We challenge decisions that drive unnecessary costs, on time and with evidence.
- Cost control. We analyze whether relief or cost transfer is available and pursue it.
- Clean closure. We confirm benefit end dates, status, and premium effects so the file truly closes.
What To Do Now
If you have a new claim, an uncooperative return-to-work, or a rising premium, act before deadlines pass. We can step in today, steady the file, and push it to closure while controlling costs.
Call Pearsall Marshall LLP to set up a quick, no-obligation assessment of your WSIB claims portfolio and next steps.