Benefits under the Workplace Safety & Insurance Act
This page is intended to provide a basic outline of workplace safety and insurance benefits as they pertain to the employees of the University of Toronto (U of T). Should you sustain a work-related injury or occupational disease, your health costs and loss of earnings due to lost time from work may be covered as specified.
All work-related accidents, injuries or occupational diseases must be reported to the Health & Well-being Programs & Services (HWB) within 24 hours. HWB is responsible for reporting to the Workplace Safety & Insurance Board and for the ongoing follow-up of claims.
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Definition of a worker
A worker includes a person who has entered into or is employed under a contract of service or apprenticeship, written or oral, express or implied, manual labour or otherwise. Employees who are eligible for Workplace Safety & Insurance benefits include:
- Permanent full-time staff
- Part-time staff
- Temporary staff
Definition of an accident
- A willful and intentional act, not being the act of the worker
- A chance event occasioned by a physical or natural cause
- Disablement arising out of and in the course of employment
Incidents involving no injury or illness
Supervisors are also required to report all incidents, that may have had a potential for injury or illness although no injury or illness occurred.
A near miss incident is an event, that does not result in injury, or damage but had the potential to do so. Although the outcome is different, the causes that lead to a near miss incident are the same as those that result in injury or damage. As a result, supervisors are required to report and investigate near miss incidents in the same manner as those that cause injury or damage.
Definition of an occupational disease
An occupational disease is an illness or disease brought on, or caused by exposure in the workplace, to a physical, chemical, or biological agent to the extent that the health of a staff member is impaired.
First-aid injuries occur when an employee sustains a work-related injury requiring only first aid.
Health-care injuries arise when an employee sustains a work-related injury when there is no lost time from work, other than on the day of the accident, but medical attention from a chiropractor, physician, physiotherapist, registered nurse (extended class). The Workplace Safety & Insurance Board (WSIB) covers the health-care costs resulting from the injury.
Lost time injuries:
Lost time injuries occur when an employee sustains a work-related injury, which results in lost time from work after the day of the accident.
Choice and change of doctor
Every employee who sustains a work-related injury or occupational disease is entitled to make the initial choice of doctor or other qualified practitioner for the purpose of receiving medical treatment.
To assist workers and employers in early and safe return to work, the WSIB policy allows workers to make their initial choice of health professional from among the following groups of health professionals:
- Registered nurses (extended class)
The WSIB also allows workers to seek initial treatment from two health professionals without the need for a referral or WSIB authorization. Change to a further health-care professional will require approval of the WSIB.
Medical assessment requests by employer
While a worker who claims or is receiving benefits under the insurance plan, may be requested by the University of Toronto to submit to a health examination by a health professional selected and paid for by the University. (Workplace Safety and Insurance Act, 1997, Section 36)
You do have the right to refuse to see the medical practitioner as assigned by your employer. However, your employer has the right to request that the board direct the worker to submit to an examination and, if necessary that the board determine the nature and extent of the examination. A decision of the board under this section is final. You cannot appeal to the tribunal.
Employees’ responsibilities when you have an accident
- Promptly receive first aid
- Notify your supervisor immediately of any injury, including injuries that do not require medical attention or lost time
- Choose a doctor or other qualified practitioner
- Complete and promptly return all report forms received from the WSIB
- In the case of a lost time injury, keep your supervisor updated as to your progress and advise them as soon as possible when you are medically fit to return to regular or modified work
Supervisors’ responsibilities when employees have an accident
- Ensure that first aid is received
- Arrange and pay for transportation to medical care, if needed
- Promptly investigate the accident or near-miss incident to determine the causes
- Send a completed accident report to the office of Health & Well-being Programs & Services within 24 hours
- Take appropriate corrective action to prevent a recurrence
Benefits while absent from work
The University of Toronto pays 15 weeks full salary to most staff members when a claim has been filed with the WSIB. After 15 weeks, the WSIB will receive cheques directly to you at the rate of pay of 85% of net average earnings (gross salary less employment insurance, Canadian Pension Plan, and tax).
After the 15-week period of full salary, you are also responsible for paying the portion of the benefit premiums you wish to maintain when absent from work. Arrangements to submit monthly premiums are to be made through an HWB benefits advisor.
While you are absent from work, the University will continue to pay the employer’s portion of each benefit you are maintaining as per the WSIB Act.
Should your lost time claim be denied by the WSIB, the loss-time will be recorded as sick leave. If it is anticipated that you will be off for more than 15 weeks, a long-term disability kit will be forwarded to you.
If you are injured while out of the province
Staff members injured while outside of the province of Ontario may, under certain conditions, claim benefits under the Workplace Safety & Insurance Act of Ontario.
If you are an Ontario resident, you are automatically covered for up to six months while temporarily working outside of Ontario. If longer than six months, the WSIB must approve an extension of coverage. Your department must contact the WSIB consultant with the details of your destination, reason for going, and length of stay.
The WSIB administrator will seek approval for your extension of coverage and will notify your department of approval.
On or off the University of Toronto premises
You are considered to be in the course of your employment upon entering the University of Toronto’s property within normal working hours. This ends on leaving the premises, unless you leave for the purpose of your employment.
However, should you leave the premises for personal reasons, such as appointments or lunch, you would have removed yourself from the course of your employment and you would not be covered.
The University premises would include buildings, plants, entrances, exits, stairs, elevators, lobbies, parking lots, passage ways, and roads that it controls.
Traveling on business
When the conditions of your employment require that you travel away from the University of Toronto, you are considered to be in the course of employment continuously unless a distinct departure on a personal errand is shown. Therefore, if you must attend a conference, which is out of town for a few days, you would be continuously covered during the conference, as well as during any required traveling. Note, however, the six-month time limit under out-of province travel.