Policy
All claim file information is considered personal information under the Freedom of Information and Protection of Privacy Act (FIPPA) and may be disclosed in limited circumstances in accordance with various exceptions listed in FIPPA. These exceptions permit disclosure of personal information to health care providers, labour market re-entry (LMR) service providers, secondary service providers, subcontractors and research entities, (for the purposes of this policy collectively known as “WSIB service providers,”) where
- the consent of the person to whom the information relates has been obtained
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such disclosure is consistent with the purpose for which the information was collected, or
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disclosure is to a research entity following a formal written Freedom of Information request.
If disclosure of personal information is allowed, the responsible WSIB employee takes steps to limit the disclosure to the information that is necessary to meet the requirements of FIPPA and the Workplace Safety and Insurance Act (WSIA).
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Guidelines
This document should be read in conjunction with 21-02-01, Disclosure of Claim File Information – General.
Definitions
Health care providers for the purpose of this policy include, but are not limited to
- treating health care practitioner
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regional evaluation centre
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community clinic
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specialty clinic
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physiotherapist
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occupational therapist
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psychiatrist/psychologist, and
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non-economic loss (NEL) assessment physician.
LMR service provider means a person, group of persons or firm that provides a range of LMR services including, but not limited to
- LMR assessment
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LMR plan design
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LMR plan implementation, and
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LMR plan monitoring.
Secondary service provider means a person, group of persons, or firm that provides services to injured workers at the request of an LMR service provider. Such secondary service providers include, but are not limited to
- vocational training agencies
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educational institutions, and
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providers of English as a second language courses, academic upgrading, computer skills, or job search training programs.
Subcontractor means a person, group of persons, or firm that has a contract with an LMR service provider for the performance of LMR assessment services. Such assessment services include but are not limited to
- aptitude testing
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vocational testing (including psycho-vocational evaluations)
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ergonomic and other occupational therapy assessments, and
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cognitive and/or physical demands analyses.
Research entity means a person, group of persons, or firm that does research in the fields of occupational health and safety/workplace insurance, as well as conducts satisfaction surveys and focus groups. Generally, such research entities are incorporated as not-for-profit organizations and are overseen by a Research Ethics Board. An example would be the Institute for Work and Health.
Disclosure of claim file information—regular WSIB business
The relevant FIPPA exceptions allowing the WSIB to disclose personal information contained in claim files, to WSIB service providers during the conduct of its day-to-day business, can be summarized as follows:
Consent
Disclosure to WSIB service providers is allowed if the individual about whom the information relates consents to the disclosure. Where consent is received, the responsible WSIB employee ensures that such consent is
- valid, i.e., actually provided by or on behalf of the individual, and
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provided verbally or in writing.
No consent required
Purpose of collection and consistent purpose
A specific FIPPA exception allows for the disclosure of personal information that has been obtained indirectly, (i.e., from someone other than the worker), where such disclosure is for
- the purpose for which the information was collected, or
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a purpose consistent with (reasonably compatible with) this purpose.
Where personal information has been obtained directly from the worker, disclosure is generally allowed if it is
- for the purpose for which the information was collected, or
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for a consistent purpose, and
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the worker might reasonably have expected such disclosure.
For more information on collection purposes, consistent purposes, and workers’ reasonable expectations see 21-02-01, Disclosure of Claim File Information – General.
Disclosure to LMR service providers
Examples of appropriate disclosure to an LMR service provider for a collection purpose or a consistent purpose are where personal information is disclosed to the LMR service provider for the purpose of allowing the LMR service provider to perform an LMR assessment and/or complete an LMR plan. The personal information disclosed in such circumstances would normally include the worker's
- name, address, telephone number and date of birth
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functional abilities information
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pre-injury job description, and
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pre-injury wage information.
Disclosure to health care providers
Examples of appropriate disclosure to health care providers for a collection purpose or a consistent purpose are where personal information is disclosed to
- a NEL assessment physician for the purpose of allowing the physician to perform a NEL assessment, or
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a regional evaluation centre (REC) for the purpose of allowing the REC to perform a clinical evaluation and to provide the WSIB with recommendations to assist it in planning appropriate health care interventions and supporting a worker's early and safe return to work.
NOTE
How much information should be disclosed in any given case will depend largely on who is receiving the disclosure, and the purpose for which it is being disclosed. For example, disclosure to a treating health care provider may include entire health care reports, while disclosure to a NEL assessment physician would only include relevant portions of the health care information.
Disclosure by LMR service providers
All of the contractual agreements that the WSIB has entered into with its LMR service providers contain terms that require all LMR service providers to
- honour the confidentiality of all information they receive related to a worker's claim, and
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disclose a worker's personal information only to those persons who require access to it to perform the LMR provider's obligations and who have agreed to comply with the privacy requirements in the WSIB's agreement with the LMR service provider.
Upon the request of the worker, LMR service providers are authorized to provide the worker with direct access to all of the information contained in the service provider's file for the worker, including direct access to his/her Vocational Evaluation report or Psycho-vocational Evaluation report. The LMR service provider must then notify the WSIB that access to such information has been provided and, if requested to do so by the WSIB, provide the WSIB with a copy of the information.
If an LMR service provider receives a request for information concerning a worker from an employer or any other person, such request must be directed to the WSIB. The WSIB then discloses or withholds the information based on who is making the request, and the purpose for which the information is being requested.
Disclosure by secondary service providers, subcontractors and health care providers
Secondary service providers, subcontractors and health care providers that provide reports to the WSIB and/or to LMR service providers are required to follow the disclosure rules that apply to them. If a worker requests a copy of his or her reports(s) directly from any of these persons or entities, in most cases such disclosure rules do allow the person or entity to disclose his, her or its report(s) to the worker, upon the worker's request.
Disclosure to research entities—formal Freedom of Information requests
Entities requesting personal information for research purposes must make a formal Freedom of Information request to the WSIB under the authority of FIPPA. All such requests should be in writing and directed to the WSIB Privacy Office.
Before disclosing any personal information to a research entity, the WSIB Privacy Office ensures that
- the research project has been submitted for ethics review
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the researcher will not use the personal information for any purpose other than the designated research purpose
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the researcher keeps the information in a physically secure location to which access is given only to authorized persons
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the researcher will destroy all personal information by a specified date
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the researcher will not contact any individual to whom personal information relates, directly or indirectly, without the prior written authority of the WSIB
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the researcher will ensure that, in the absence of written authority from the WSIB, no personal information will be used or disclosed in a form in which the individual to whom it relates can be identified, and
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the researcher will provide the WSIB Privacy Office with a copy of the research prior to publication.
Application date
This policy applies to all decisions relating to the disclosure of claim file information made on or after October 14, 2009, for all accidents.
Document history
This document replaces 21-02-06 dated February 20, 2006.
This document was previously published as:
21-02-06 dated January 3, 2006
21-02-05 dated October 12, 2004.
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References
Legislative Authority
Workplace Safety and Insurance Act, 1997, as amended
Sections 181(1), 181(2)
Workers’ Compensation Act, R.S.O. 1990, as amended
Section 114
Freedom of Information and Protection of Privacy Act, R.S.O. 1990, as amended
Sections 20, 21, 42, 43
Minute
Administrative
#7, September 18, 2009, Page 476
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