Employee incident report
What do you do immediately after you have hurt yourself at work.
Report to the supervisor
What is the first thing you do as the supervisor when you learn someone has hurt themselves?
Speak with the person to ensure that they do not need first aide or medical attention
The information may be used for submission to the Labour board. It is important to have the Social Insurance number and the date of hire on these forms
Why are modified duties offered to an injured staff?
The Home is responsible to find appropriate work for an injured individual.
What forms do you need to fill out when you have injured yourself?
Incident report
What paperwork needs to be filled out when someone has hurt themselves at work?
The incident report
Initial offer of modified duties
Who needs to be informed of every injury that happens in the work place?
The manager in the Home at the time of the injury or the manager on call after the incident.
What happens if you do not accept modified duties?
WSIB will make a judgement call and if they feel you were able to complete modified duties you will NOT be paid for the time you have taken off.
What are modified duties?
The employer will work with you to determine what you are able to do while working within your restrictions.
How do you know what modified duties to offer an employee?
The offer of modified work has appropriate duties depending on the injury.
What is a form 7?
This is the form that Middlesex Terrace completes and submits to WSIB on your behalf after an injury if you have required medical treatment.
What if my doctor tells me to stay off work for a few days?
WSIB believes that unless you are on complete bedrest you can come to work and do modified duties.
You will not be paid for time missed unless totally incapacitated.
Who establishes what your modified duties will be?
You and your supervisor work together to determine the job routine for you while injured.
What do you do with the package once it is completed?
Leave it for your supervisor or for the Executive Director. Do NOT leave it at the nursing station.
What is a form 8?
This is the form that the physician that treats you fills out and that you MUST return to Middlesex Terrace Executive Director immediately.
How often do you need to get an Functional Abilities form filled out by your physician or Physiotherapist once on WSIB?
Every 2 weeks
What are your responsibilities when injured.
To keep the employer informed as to how you are progressing.
The charge nurse will leave the paperwork and also send an EMAIL to the managers informing them of the situation.
Is it ok to wait until your next shift to return the form 8 to the Executive Director?
No. There is a strict timeline for the Home to submit this information. You need to either bring the form 8 to the Home or email a copy to the manager who will get it to the ED.
How often do you need to meet with your supervisor if on modified duties?
Every 2 weeks when you have a new FAF completed.