Adjudication Support Documents

Introduction

The Adjudication Branch was developed to provide strategic direction for the Adjudication Program, with a direct line of sight to workers and employers in order to improve the consistency and timeliness of decisions and service.

We regularly collaborate with internal business partners to identify adjudication issues that need additional clarification. 

We also provide measurement, analysis, and business intelligence that enable continuous program development. Together with stakeholder consultations, this information is used to develop supplemental resource materials to assist WSIB decision-makers in effective case management.

In order to ensure transparency in decision-making, the Adjudication Branch documents are readily available for download in the categories listed below.

Adjudicative advice

The Adjudicative Advice documents provide WSIB decision-makers with assistance and direction when dealing with issues of ambiguity in which no resource materials are available.

Skills Development Support

Skills Development Support documents provide WSIB decision-makers with support for consistent application of policies, practices, procedures and/or key business issues. 

Best Approaches Guides

A Best Practices Working Group and the Fair Practices Commission have identified adjudication issues that would benefit from more clarity and consistency. The Adjudication Branch develops Best Approaches Guides to assist decision-makers in applying key adjudication principles, processes and practices.

Health care advice

The Health Care Advice documents provide WSIB staff members with clinical and adjudicative decision support information when dealing with questions related to the purchase of health care.

Training in Policy Summary (TIPS) newsletters

The TIPS newsletters were prepared by the Learning and Development Branch in order to provide adjudication staff with practical examples of the application of specific policies.

We write these documents carefully to ensure they support correct and consistent application of policy contained in the Operation Policy Manual.

Adjudicative advice documents

• A Code of Conduct for Representatives Dealing with WSIB Situations (167.1kb, PDF)
• A Worker is a Worker (306.1kb, PDF)
• Calculating Loss of Earnings/Future Economic Loss (LOE/FEL) - Minimum Wage (365.2kb, PDF) [For decisions prior to July 1, 2007]
• Commutations and FEL/LOE Benefits over 10% (111.1kb, PDF)
• Coverage and Entitlement for Workers Hired Under the Commonwealth Caribbean and Mexican Seasonal Agricultural Workers Program (141.0kb, PDF)
• Dependent Contractors - Determining Average Earnings (169.1kb, PDF)
• Determining Maximum Medical Recovery (MMR) Time (172.1kb, PDF)
• Employers’ Initial Accident Reporting Obligations - Clarification (170.3kb, PDF)
• Escalation Protocol for Obtaining Outstanding Medical Information (174.9kb, PDF)
• FEL Benefit and Additional Wage Loss Relating to Health Care Appointments (172.9kb, PDF)
• Initial Entitlement (Disablement) (172.9kb, PDF)
• Non Economic Loss (NEL) Reconsideration vs. Redetermination (103.6kb, PDF)
• Operating Area - Requests for Reconsiderations of Appeals Branch Decisions (103.0kb, PDF)
• Permanent Impairment (NEL) Rating Guideline for Acromioplasty (170.6kb, PDF)
• Permanent Impairment (NEL) Rating Guideline for Splenectomy (181.8kb, PDF)
• Permanent Impairment (NEL) Rating Guideline for Upper and Lower Extremity Repetitive Strain Injuries (RSI) (191.8kb, PDF)
• Practice Guidelines for Ordering Loss of Earnings (LOE) Benefits Arrears Under WSIA (165.7kb, PDF)
• Pre-bill 99 Vocational Rehabilitation(VR) Plans and Commitments - Clarification (244.0kb, PDF)
• Students, Apprentices and Learners - Questions and Answers (409.2kb, PDF)
• Requesting Functional Capacity Evaluations (108.4kb, PDF)
• Retrospective Return to Work (RTW) Situations (166.7kb, PDF)
• Understanding the National Occupational Classification (NOC) System (241.1kb, PDF)
• Using the Physical Demands Information Form (PDIF) (105.4kb, PDF)
• Determining Maximum Medical Recovery (MMR) Time (172.1kb, PDF)

Skills Development Support

• How LOE Benefits Impact Older Workers (118.9kb, PDF)

Best Approaches Guides

• Decision Writing (503.5kb, PDF)
• Loss of Earnings (LOE) Reviews - Practice Guidelines
• Traumatic Mental Stress
• Recognizing Time to Heal -- Assessing Timely and Safe Return to Work (112.6kb, PDF)
• Return to Work Considerations - Workers with Psychological Entitlement and Chronic Pain Disability (104.9kb, PDF)
• Maintenance Treatment (102.9kb, PDF)
• Weighing of Medical Evidence (534.5kb, PDF)

Health care advice

• Assistive Devices and Equipment: Adjustable Beds (169.6kb, PDF)
• Assistive Devices and Equipment: Bathroom Equipment (103.4kb, PDF)
• Assistive Devices and Equipment: Easy Lift Chairs (167.3kb, PDF)
• Assistive Devices and Equipment: Power-Assist Wheels (171.1kb, PDF)
• Assistive Devices and Equipment: Wheelchairs - Manual and Power (174.4kb, PDF)
• Assistive Devices and Equipment: Scooters (234.2kb, PDF)
• Assistive Devices and Equipment: Standers (107.6kb, PDF)
• Assistive Devices and Equipment: Support Surfaces (171.9kb, PDF)
• Assistive Devices and Equipment: Therapeutic Tubs (174.0kb, PDF)

TIPS newsletters

• Impact On Benefits of Bill 179 and New Entitlement Following Work Disruptions Policies (514.5kb, PDF)
• Impact of the WSI Act on Re-employment Obligations (245.3kb, PDF)
• Late Filing - Procedures and Penalties (248.5kb, PDF)
• New Reporting Obligations (378.7kb, PDF)
• Work Reintegration Policies (260.8kb, PDF)