Co-operation: a worker’s obligation
To get disability insurance benefits from the Workplace Safety and Insurance Board, a person must obey certain obligations. Workers who do not co-operate with these obligations may have their benefits reduced or suspended to encourage them to comply.
The WSIB will communicate with claimants to tell them what the rules are, what obligations they have, and what happens if they do not co-operate. The WSIB does not penalize workers for non-co-operation if there is a legitimate reason, such as an unexpected illness or accident, or a death in the family. However, if the worker refuses to co-operate and has no reasonable cause, the WSIB may reduce or suspend the worker's benefits.
If this happens, the WSIB does not restore benefits for any period where they were reduced or suspended due to non-co-operation. If a worker does not meet an obligation, the WSIB will determine whether there was a legitimate reason for the non-co-operation.
What are the activities the injured worker must co-operate with?
- co-operate in the health care and prescribed treatment indicated by the WSIB
- undergo a health examination at the direction of their health professional or the WSIB
- provide information to the WSIB to assist in the adjudication of their claim and
- co-operate in an early and safe return to work or labour market re-entry assessment and plan, as indicated by the WSIB.
While the WSIB does not restore benefits during periods of non-co-operation, benefits will be restored if the WSIB
- did not communicate the co-operation obligations and results of non-co-operation to the worker
- was wrong in finding the worker did not co-operate.
Leaves and Vacations
The WSIB will continue to pay benefits for workers on a short-term leave as long as their leave does not interfere with their ability to fulfill their co-operation obligations. As well, workers can take up to three weeks vacation a year as long as the vacation does not interfere with their ability to fulfill their obligations. The vacation must be taken at a time agreed upon by the worker and the WSIB.
Failure to co-operate - what could happen?
(1) FEL Supplements
Workers who receive future economic loss (FEL) benefits and who do not co-operate in a medical rehabilitation program, early and safe return to work program, or labour market re-entry assessment or plan will have their supplements suspended.
(2) Fraud Offences
If a worker commits a claims-related offence or fraud, the WSIB will reduce or suspend benefits.
Workplace Safety and Insurance Board
Ontario’s Workplace Safety and Insurance Board (WSIB) plays a key role in the province’s occupational health and safety system. The WSIB administers no-fault workplace insurance for employers and their workers and is committed to the prevention of workplace injuries and illnesses. The WSIB provides disability benefits, monitors the quality of healthcare, and assists in early and safe return to work for workers who are injured on the job or contract an occupational disease.
This information is available in several languages by calling our information hotline at 416-344-1000, toll-free 1-800-387-0750 or Telephone Service for the Deaf (TTY): 1-800-387-0050
Pour obtenir un exemplaire en français, composez le 1-800-387-0750416-344-1000.