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Policy updates/clarifications

Need more information on the latest word on a policy? Find it here. Learn about Policy development at the WSIB.

For copies of past policies, please email km@wsib.on.ca or phone 416-344-4355 or 1-800-387-0750, ext. 416-344-4355.

Note: As part of the WSIB’s commitment to policy renewal, the policies below have also been revised for accuracy and relevance, and have been formatted into the new OPM template (PDF).

Policy Agenda 2017

The annual Policy Agenda outlines the WSIB’s policy priorities for the coming year. For the 2017 Policy Agenda (PDF), the Rate Framework Modernization initiative will continue. The WSIB will also continue to review any policy implications related to the claim suppression amendments which have been made to the Workplace Safety and Insurance Act, 1997 (WSIA) and the General Regulation.

The WSIB is also working towards operationalizing the indexation changes that will come into effect on January 1, 2018 as a result of recent amendments to the WSIA. To align with the provincial and federal government’s medical assistance in dying legislation, the WSIB will determine whether any policy changes may be required to clarify the treatment of cases where medical assistance in dying is chosen in connection with work-related injuries/diseases. In addition, the WSIB will consider whether any policy changes are required as a result of a systematic review of occupational aluminum exposure and adverse health conditions.

In 2017, the WSIB will also commence the cyclical reviews of the Pre-existing Conditions policy and the suite of Work Reintegration policies.

See our past policy agendas.

Policy revisions related to Access to Employer Information

*Effective October 10, 2017*

Operational Policy Manual document 21-01-01, Access to Employer Information required a variety of revisions to more clearly reflect the Freedom of Information and Protection of Privacy Act and to support compliance with the Government of Ontario’s Open Data Directive

Previous policy

Below is the policy that was in place and effective prior to October 10, 2017:

Below is an annotated version of the revised policy which explains changes from the prior version:

New policy related to chronic mental stress and policy revisions related to traumatic mental stress

*Effective January 1, 2018*

On May 17, 2017, the provincial government passed Bill 127, Stronger, Healthier Ontario Act (Budget Measures), 2017. Bill 127 amended section 13 of the Workplace Safety and Insurance Act, 1997 (WSIA) to provide that workers are entitled to benefits under the insurance plan for chronic and traumatic mental stress arising out of and in the course of employment.  A worker is not entitled to benefits for mental stress caused by decisions or actions of the worker’s employer relating to the worker’s employment, including a decision to change the work to be performed or the working conditions, to discipline the worker or to terminate the employment. These amendments take effect on January 1, 2018. For more information, see the Work Related Chronic Mental Stress Policy Consultation webpage.

Policy 15-03-14, Chronic Mental Stress (Accidents on or After January 1, 2018)

Entitlement guidelines for chronic mental stress can be found in the new WSIB Operational Policy Manual (OPM) document 15-03-14, Chronic Mental Stress (Accidents on or After January 1, 2018). The new Chronic Mental Stress policy applies to all claims for chronic mental stress with accident dates on or after January 1, 2018. The new policy has been approved by the WSIB’s Board of Directors.

Policy 15-03-02, Traumatic Mental Stress (Accidents on or After January 1, 2018)

For entitlement to traumatic mental stress, Bill 127 removed the requirement that the traumatic event be “sudden and unexpected”.  OPM document 15-03-02, Traumatic Mental Stress, which has been renamed 15-03-02, Traumatic Mental Stress (Accidents on or After January 1, 2018), has been revised to reflect this amendment and to provide additional clarity around the two types of work-related mental stress. The policy changes apply to all claims for traumatic mental stress with accident dates on or after January 1, 2018. The revised policy has been approved.

Previous policy

Below is the policy which remains effective for claims for traumatic mental stress with accident dates prior to January 1, 2018:

Annotated document

Below is an annotated document of the new and prior versions:

Policy changes related to Occupational Aluminum Exposure

The Occupational Aluminum Exposure policy (Policy 16-01-10 “Occupational Aluminum Exposure, Dementia, Alzheimer’s Disease and Other Neurologic Effects”) has been rescinded and removed from the Operational Policy Manual (OPM).

Read more about the WSIB’s ongoing work regarding Occupational Aluminum Exposure.

Previous policy

Below is the policy that was in place and effective prior to June 16, 2017

Schedule 2 Administration Rate

*Effective June 1, 2017*

The WSIB has recently reviewed how the administration rate for Schedule 2 employers is determined. As a result, the WSIB will be providing more than one administration rate reflecting a change in how future liabilities are determined. Operational Policy Manual document 12-01-04, Schedules 1 & 2, has been amended to accommodate this change.

Previous policy

Below is the policy that was in place and effective prior to June 1, 2017:

 

Comparison document

Below is a comparison document of the new and prior versions:

Policy changes related to Cancers in Firefighters and Fire Investigators

*Effective January 1, 2017*

On May 1, 2014, the provincial government added six new cancers to the existing Firefighters regulation (Ontario Regulation 253/07, as amended) under the Workplace Safety and Insurance Act, 1997 (WSIA).

Presumptive coverage for skin cancer will take effect January 1, 2017, and Policy 23-02-01,Cancers in Firefighters and Fire Investigators has been updated accordingly. Presumptive coverage for the other five cancers has already taken effect.

Previous policy

Below is the policy that was in place and effective prior to January 1, 2017:

Below is a comparison document of the new and prior versions:

2017 Benefit Rates

*Effective January 1, 2017*

Each year a Benefit Rate Review is performed to maintain appropriate rate levels year over year.

This is done to ensure worker benefit rates keep pace with the economic times, while balancing fairness and financial sustainability of Ontario’s workplace safety and insurance system.

The annual benefit rate changes for 2017 are effective January 1, 2017 until December 31, 2017.

For 2017, benefit rates that will be increasing are:

  • Independent Living Allowance
  • Non-professional Escort Fee
  • Personal Care Allowance – General Rate
  • Personal Care Allowance – Personal Rate
  • Personal Care Allowance – Skilled Rate
  • Minimum Burial Rate
Benefit Legislative Authority 2016 Rate 2017 Rate
Independent Living Allowance s.32,33 $3,950.50 annually $4,005.81 annually
Non-professional escort fee s.32 $90.00/day $91.20/day

Personal Care Allowance (PCA):

General Attendant Rate

Personal Attendant Rate

Skilled Attendant Rate

s.32,33

 

$11.25/hour

$14.90/hour

$21.11/hour

 

$11.40/hour

$15.09/hour

$21.38/hour

Minimum Burial Rate

s.48(22)

(1998 legislative minimum was $2,083.32)

Minimum amount $2,983.48 Minimum amount $3,025.25

Hearing Devices

See Policy 17-07-04, Hearing Devices (PDF), for rates up to and including January 8, 2017.

For the criteria for allowance and payment of hearing devices effective on or after January 9, 2017, see Policy 17-07-04, Hearing Devices (revised).

Previous policy

Below is the policy that was in place and effective prior to January 1, 2017:

Below is a comparison document of the new and prior versions:

Hearing Devices

*Effective January 9, 2017*

The Hearing Devices policy has been amended to reflect the relevant changes to support the WSIB revised hearing aid program.

The WSIB will now be considering specific hearing aid models for workers with work-related hearing loss entitlement.

Once a worker has entitlement to a hearing aid, the WSIB considers specific hearing aids available from two categories; the primary category and the alternate category. The primary category includes a range of hearing aids models that meet the needs of most hearing aid users. For those workers with specific clinical requirements that cannot be met by a hearing aid model from the primary category, the WSIB may consider offering a suitable hearing aid model from the alternate category.

The Hearing Devices policy refers readers to a “Hearing Devices” landing page accessible via the WSIB website which outlines the hearing aid models available.

For the criteria for allowance and payment of hearing devices effective on or after January 9, 2017, see Policy 17-07-04, Hearing Devices.

Previous policy

Below is the policy that was in place and effective prior to January 9, 2017:

Below is a comparison document of the new and prior versions:


Schedule 2 Security Requirement Policy

The WSIB has recently reviewed the financial instruments it allows Schedule 2 employers to use to secure their liabilities under the Workplace Safety and Insurance Act, 1997.

As a result, the WSIB will be providing Schedule 2 employers with the option of securing their liabilities using a surety bond, subject to certain conditions and approval by the WSIB. Operational Policy Manual document 12-01-05, Schedule 2 Security Requirement, has been amended to accommodate this change.

The policy change comes into effect on July 4, 2016.

Previous policy
Below is the policy that was in place and effective prior to July 4, 2016:

New policy related to posttraumatic stress disorder in first responders and other designated workers

On April 5, 2016, the provincial government passed Bill 163, Supporting Ontario's First Responders Act (Posttraumatic Stress Disorder), 2016. Bill 163 amends the Workplace Safety and Insurance Act, 1997 (WSIA) to add a presumption of work-relatedness for first responders and workers in other designated occupations diagnosed with posttraumatic stress disorder (PTSD). Bill 163 is effective as of April 6, 2016.

Under Bill 163, in most cases a first responder or other designated worker will have presumptive entitlement for PTSD if he or she was

  • employed as a first responder for at least one day on or after April 6, 2014
  • diagnosed with PTSD by a psychologist or psychiatrist on or after April 6, 2014, and
  • diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association.

The legislation also provides presumptive coverage for claims that are in process, provided they meet certain diagnostic and employment criteria. Specifically, qualifying claims that are pending with the WSIB or the Workplace Safety & Insurance Appeals Tribunal (WSIAT) on April 6, 2016, and qualifying claims in which the first responder stopped working as a first responder in the two year period before April 6, 2016 are included.

Further details and guidelines about presumptive entitlement for PTSD can be found in the new WSIB Operational Policy Manual (OPM) document 15-03-13, Posttraumatic Stress Disorder in First Responders and Other Designated Workers.

Bill 163 also stipulates that the current provisions of the WSIA dealing with traumatic mental stress continue to apply to claims for PTSD if the requirements of those provisions are met. As a result, entitlement under the existing OPM document 15-03-02, Traumatic Mental Stress, continues to be available for PTSD claims which do not qualify for presumptive entitlement under the new policy.

A link to the new policy has been added to OPM document 15-03-02, Traumatic Mental Stress. In addition, minor housekeeping changes have been made to this policy to reflect updated terminology.

Previous policy
Below is the policy that was in place and effective prior to April 6, 2016:


For more information related to PTSD in first responders and other designated workers, see Presumptive legislation – First responders and PTSD.

If you have questions about filing a claim under the PTSD presumption, please call 1-800-387-0750.

Policy Revisions Related to Periodic Payments for Survivors

On December 10, 2015, Bill 109, Employment and Labour Statute Law Amendment Act, 2015 came into effect. Bill 109 amended the Workplace Safety and Insurance Act, 1997 (WSIA) to expand which earnings can be used to determine periodic payments for the survivors of a worker who has died as a result of a work-related injury/disease. More specifically, in such circumstances as it considers appropriate, the WSIB may also now determine the amount of a deceased worker’s average earnings taking into account the average earnings (at the time of the worker’s injury) of a person engaged in the same trade, occupation, profession or calling as the worker was engaged in and out of which the worker’s injury arose.

Policy 18-02-09, Determining Average Earnings - Periodic Payments for Survivors

Guidelines regarding the determination of average earnings for the purpose of calculating periodic payments for survivors (previously found in policy 18-02-02, Determining Short-term Average Earnings) have been moved to a stand-alone policy (policy 18-02-09, Determining Average Earnings – Periodic Payments for Survivors) and revised to align with the WSIA as amended by Bill 109.

Policy 18-02-02, Determining Short-term Average Earnings

In addition to removing the guidelines pertaining to periodic payments for survivors, the occupational disease section of policy 18-02-02, Determining Short-term Average Earnings has been revised to clarify that average earnings in occupational disease claims are determined in the same manner as average earnings in non-occupational disease claims (i.e., in accordance with the provisions of the average earnings policy suite).

Previous policy

Below is the policy that was in place and effective prior to April 1, 2016:

Please review the Explanatory Note (PDF) for more details about policy revisions related to periodic payments for survivors.

Policy revisions related to Mandatory Coverage in Construction

*Effective April 1, 2016*

On January 1, 2013, the Ontario Government made WSIB coverage mandatory for most individuals engaged in construction activities, and the WSIB released new policies to support these legislative changes. In accordance with the 2014 WSIB Policy Agenda, and the mandatory coverage in construction policies’ two-year review cycle, the WSIB undertook a review of these policies. As a result, five policy changes are being introduced.
All changes are minor in scope, and no significant change has been made to coverage requirements for individuals who fall under expanded compulsory coverage.

Proof of Executive Officer status: policies have been revised to indicate that when an individual’s title conflicts with duties, the WSIB determines Executive Officer status based on the roles and responsibilities of the individual.

Liability for unpaid premiums: policy has been revised to indicate that if an individual (i.e., independent operator, sole proprietor, partner) is entitled to benefits due to a work-related injury and also has amounts owing on his/her account, the WSIB may deduct the amount owing from any benefits payable to that individual [as per s. 138(1) of the Workplace Safety and Insurance Act, 1997].

Minimum Period of Coverage: policy has been revised to indicate when an Executive Officer/Partner who currently has WSIB coverage requests to be exempt from coverage because he/she is no longer performing any construction work, the WSIB requires coverage to have been in place for a minimum of three months before the exemption can be granted.

Executive Officer or Partner exemption: policy has been revised to clarify that the declaration form is no longer valid and the Executive Officer/Partner is subject to compulsory coverage, as of the date the Executive Officer/Partner begins to perform construction work.

Executive Officers and Partners with concurrent employment: policy has been revised to indicate that when a concurrently employed Executive Officer/Partner elects to be exempt from coverage in one or more employment situations, the earnings from the exempt employment are not factored into the average earnings calculation for payment of loss of earnings benefits for any covered employment.

In addition to the above-noted changes, OPM 14-02-19, Clearance Certificate in Construction was revised to align with WSIB corporate objectives and stakeholder feedback, but no significant changes have been made to the policy content.

Previous policies

Housekeeping policy changes related to Mandatory Coverage in Construction

As a result of changes to expanded compulsory coverage in construction policies, the Operational Policy Manual documents listed below required a variety of housekeeping revisions, such as updates to policy cross-references and terminology.

Previous policies
Below are the policies that were in place prior to April 1, 2016

Policy Agenda 2016

The annual Policy Agenda outlines the WSIB’s policy priorities for the coming year. For the Policy Agenda 2016 (PDF), the WSIB will make the policy changes necessary to implement recent amendments to the Workplace Safety and Insurance Act, 1997 (WSIA) that introduced an additional earnings basis that may be used for survivor benefits where appropriate, added provisions to prohibit claim suppression and increased the maximum corporate penalty for offences under the WSIA.

Also, as the WSIB moves toward the finalization of a new Rate Framework and a related regulatory framework, a number of policies are being reviewed for potential amendment and removal,  and new policies may be required.

Finally, the two Loss of Retirement Income (LRI) policies are due for cyclical review in 2016 as they were last revised to reflect amendments to the WSIA under the Good Government Act, 2011. These amendments contained a number of changes to the method of payment for loss of retirement income (LRI) benefits, and non-economic loss (NEL) benefits (paid for permanent impairments).

See our past policy agendas.

Updated Framework for Policy Development and Renewal

In 2012, the WSIB introduced the Framework for Policy Development and Renewal  (Framework), which describes the WSIB’s commitment to ensuring operational policies are clear, up-to-date and provide appropriate guidance to those that use them.

Since that time, a number of opportunities to improve the Framework have been identified. In particular, the updated Framework for Operational Policy Development and Renewal includes:

  • a more detailed description of the WSIB’s approach to consultation that is scaled to the intended impact and scope of the policy issue,
  • updated WSIB terminology and organizational structures.

Policy changes related to Cancers in Firefighters and Fire Investigators

*Effective January 1, 2016*

On May 1, 2014, the provincial government added six new cancers to the existing Firefighters regulation (Ontario Regulation 253/07, as amended) under the Workplace Safety and Insurance Act, 1997 (WSIA).

Presumptive coverage for lung cancer will take effect January 1, 2016, and Operational Policy Cancers in Firefighters and Fire Investigators (23-02-01) has been updated accordingly. Presumptive coverage for four of the cancers has already taken effect, with coverage for the remaining cancer taking effect in 2017.

Previous policy

Below is the policy that was in place and effective prior to January 1, 2016

2016 Benefits Rates

*Effective January 1, 2016*

Each year a Benefit Rate Review is performed to maintain appropriate rate levels year over year.

This is done to ensure worker benefit rates keep pace with the economic times, while balancing fairness and financial sustainability of Ontario’s workplace safety and insurance system.

The annual benefit rate changes for 2016 are effective January 1, 2016 until December 31, 2016.

For 2016, benefit rates that will be increasing are:

  • Independent Living Allowance
  • Non-professional Escort Fee
  • Personal Care Allowance – General Rate
  • Personal Care Allowance – Skilled Rate
  • Guide & Support Dog Allowance
  • Meal Allowance
  • Minimum Burial Rate
Benefit Legislative Authority 2015 Rate 2016 Rate
Independent Living Allowance s.32,33 $3,899.80 annually $3,950.50 annually
Non-professional escort fee s.32 $88.00/day $90.00/day

Personal Care Allowance (PCA):
 

General Attendant Rate

Personal Attendant Rate

s.32,33

 

$11.01/hour

$14.40/hour

 

$11.25/hour

$14.90/hour

Guide and Support Dog Allowance s.32,33 $968.24/year $1,100/year
Meal Allowance s.33 $49/diem
Breakfast $10.00
Lunch $16.00
Dinner $23.00
$51/diem
Breakfast $12.00
Lunch $16.00
Dinner $23.00
 
Minimum Burial Rate

s.48(22)

(1998 legislative minimum was $2,083.32)

Minimum amount $2,948.10 Minimum amount $2,983.48

Previous policy

Below is the policy that was published prior to January 4, 2016:

Housekeeping policy changes related to Motor Vehicle Accidents

Operational Policy 15-01-06, Third Party Motor Vehicle Accident Claim Costs has been revised to clarify that the policy only applies to motor vehicle accidents that occur in Ontario.

Previous policy
Below is the policy that was in place prior to January 2, 2015:

Housekeeping policy changes related to Volunteer Forces

Operational Policy 12-04-02, Volunteer Forces has been revised to clarify that the provisions contained in policy 15-02-02, ‘Accident in the Course of Employment’ are considered when determining whether a volunteer’s injury is work-related.

Previous policy
Below is the policy that was in place prior to January 2, 2015:

Housekeeping policy changes related to Benefits Policy Review

*Effective January 1, 2015*

The WSIB developed new and revised policies as part of its Benefits Policy Review. These policies came into effect on November 1, 2014. As a result, the Operational Policy Manual documents listed below required a variety of housekeeping revisions, such as updates to policy cross-references and terminology.
 


Previous policies
Below are the policies that were in place prior to January 2, 2015:

Housekeeping policy changes related to the Interjurisdictional Agreement (IJA)

*Effective January 1, 2015*

Revisions to the Interjurisdictional Agreement on Workers' Compensation (IJA) are effective January 1, 2015. As a result, the following Operational Policy Manual documents required minor revisions, including a revision confirming the inclusion of the bus industry in the Alternative Assessment Procedure.

Previous policies
Below are the policies that were in place prior to January 2, 2015:

Housekeeping changes to ECM documents

H-875-09, Optometrists’ Offices was revised to update the description for Optometrists’ Offices to reflect a legislative change authorizing Optometrists to prescribe medication.

In addition, to reflect changes in terminology, the title of the Classification Unit in F-638-03 was changed from ‘Opticians’ Shops’ to ‘Ophthalmic Retailing’.

Previous policies
Below are the ECM documents that were in place prior to January 2, 2015:

Benefits Policy Review: New and revised policies

* Effective November 1, 2014*

Following extensive stakeholder consultation, the WSIB developed new and revised policies as part of its Benefits Policy Review. Specifically, we developed a new Pre-existing Conditions policy.

The WSIB undertook an open and transparent consultation over the past two years as part of developing these policies. Stakeholder input was carefully considered and informed significant changes to the final Pre-existing Conditions policy and in many cases was incorporated into the other policies under review.

The final policies ensure clarity, transparency and fairness - and give decision-makers the tools to make more consistent decisions.

Pre-existing Conditions: The new Pre-existing Conditions policy provides guidance to decision-makers and participants in the system about how to draw the work-related/non-work related line with claims that involve pre-existing conditions. It is intended to protect workers by setting a fair threshold for when benefits may end.

Permanent Impairments: A new Determining Permanent Impairment policy outlines the criteria that must be met in order to establish that a work-related permanent impairment exists. This new policy replaces and incorporates many of the concepts from the Determining Maximum Medical Recovery policy. The revised Determining the Degree of Permanent Impairment policy explains when and how non-work-related factors that impact the area of work-related impairment are factored out of the permanent impairment rating. This revised policy replaces and incorporates many of the concepts from the Effect of a Pre-existing Impairment policy.

Previous policies

Below are the policies that were in place and effective prior to November 1, 2014:

Recurrences: The revised Recurrences policy outlines how entitlement to benefits is determined when a worker experiences a recurrence of a work-related injury/disease. It identifies clinical compatibility of the current condition with the original work-related injury/disease as the primary consideration in making this determination.

Previous policy

Below is the policy that was in place and effective prior to November 1, 2014:


Aggravation Basis: The revised Aggravation Basis policy outlines that entitlement is considered for the acute phase of an injury when a minor work-related accident aggravates a significant pre-accident impairment. While process information and duplication were removed, no substantive changes were made to this policy.

Previous policy

Below is the policy that was in place and effective prior to November 1, 2014:

Work Disruptions: The five existing Work Disruption policies were consolidated into two policies, one addressing temporary work disruptions and one addressing permanent work disruptions. The revised policies set out clear principles and guidance for decision-makers when determining whether a worker’s additional loss of earnings during a work disruption results from the work-related injury/disease.

Previous policies

Below are the policies that were in place and effective prior to November 1, 2014:
Please review the Explanatory Note (PDF) for more details.

Note: The Aggravation Basis and Recurrences policies have been moved within the OPM to the Claims – Work-relatedness chapter and as a result, we have changed their policy numbers.

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