Initial Entitlement
Policy adjudicators use to determine whether or not initial entitlement can be allowed in a claim
What is 11-01-01?
This is policy speaks to job suitability.
What is 19-02-07 (RTW Overview and Key Concepts)?
This section of the act outlines the circumstances under which WSIB can pay LOE benefits
Section 43
Three main components of policy 15-02-02, Accident in the Course of Employment.
What are time, place and activity?
The presumption clause applies to these two accident types.
What are chance event and willful and intentional act not being that of the worker?
System used by eligibility adjudicators to determine initial entitlement in a claim
Definition of safe
What is: does not pose a health & safety risk to worker or others, is performed at a workplace covered by OHSA or Canada Labour Code, worker is able to travel to and from the worksite safely?
LOE benefits are calculated at this rate.
What is 85% of NAE
This policy covers travel while on employer business
What is Travelling (15-03-05)?
This is what MMR is short for
What is Maximum Medical Recovery?
These are the five points of the five point check.
What are: Employer, Worker, Personal Work-related injury, proof of accident and compatibility?
Definition of Productive
What is: work that would provide objective benefit to the injury employer's business?
What are: accident employer must have WSIB coverage, injured person must have more than one contract of employment at the time of injury, there must be earnings from each of the employers in any of the four weeks leading up to DOI?
This policy deals with employer parking lots
What is Employers’ Premises, Parking Lots, Roads, Plaza, Malls, Boundaries (Policy 15-03-04)?
These are the three employment patterns
What are: permanent, non-permanent and concurrent?
These are the four immediates (which establish proof of accident)
These documents outlining the injured person's pre-injury job may be provided by the employer
What is a job Physical Demands Analysis (PDA) or job description?
Name 4 things to consider when paying LOE benefits
What are: work-related impairment, clinical evidence to show that the inability to work is due to the work-related injury, current level of function, loss of earnings due to inability to perform pre-injury job, suitable work available to cease the loss of earnings, worker co-operating in health care and RTW?
This policy tells us that the injured person has 6 months to file a claim for benefits with WSIB
What is Worker's Requirement to Claim and Consent (15-01-03)?
These are the three types of personal injuries
What are: damage to the body, damage to an extension of the body and psychotraumatic disability?
This section of the act provides us with the threshold statement.
What is section 13?
According to Policy 19-02-07, Suitable work consists of these three components.
What are: safe, productive and within the injured person's functional abilities?
LOE benefits can be paid to the earliest of:
What are: the day the loss of earnings ceases, the day the worker reaches age 65 if the worker was less than 63 years of age at the time of injury, 2 years from DOI if the worker was 63 years of age or older at the time of injury, the day the worker is no longer impaired as a result of the injury?
This policy outlines reporting obligations for the employer
What is Employers' Initial Accident Reporting Obligations (15-01-02)?
These are the four accident types
What are: Chance event, willful and intentional act not being that of the worker, disablement unexpected result of work duties, disablement gradual onset?