Health care practitioners & the WSIA

We want to help health care practitioners better understand and interact with our workplace safety and insurance system. We also hope to create effective working relationships that assist you in achieving the best possible outcomes for your patients after a workplace injury or illness.

Health care practitioners & the Workplace Safety and Insurance Act brochure. (246.5kb, PDF). 

The WSIA may be viewed in its entirety online

Purpose

Definitions

Obligation to report information

The obligation to report an injury or illness rests with the employer and worker. The obligation of the health care professional is to provide information relating to the worker’s health care, according to section 37. (1) of the WSIA.

Notice of accident and claim for benefits

21. (1)

Claim for benefits, worker

22. (1) 

Entitlement to Health Care

The WSIA outlines the health care that workers may receive for an accepted claim. Coverage is directed at those services and treatments facilitating recovery, return to work, and improved quality of life. Authorization of benefits and access to care may depend on information you provide; prompt submission is in the best interest of your patient.

Definition

Entitlement to health care

33. (1)

Questions regarding health care

33. (7)

Arrangements for health care

33. (2)

Worker’s duty to co-operate

34. (1)

Board request for health examination

35. (1)

Employer request for health examination

36. (1)
36. (2) 
36. (3) 

Reports regarding health care

37. (1)
37. (2)

 Regarding patients with Permanent Impairment

Patients determined to have a permanent impairment may be assessed by a physician from a roster of physicians trained in Non Economic Loss (NEL) assessments. Permanent impairments will be calculated via the prescribed rating schedule.

Ontario Regulation 175/98 - Rating Schedule

18. (1)The American Medical Association Guides to the Evaluation of Permanent Impairment (third edition revised) as it read on January 14, 1991 is prescribed as the rating schedule for the purposes of subsection 47(2) of the Act.

18. (2) The criteria prescribed for the purposes of subsection 47(2), for impairments not provided for in the rating schedule, are the criteria in the listings in the rating schedule for those body parts, systems or functions which are most analogous to the conditions of the worker.

Degree of permanent impairment

47. (1)
47. (2)
47. (3)

Selection of physician

47. (4)
47. (5)

Report

 47. (6)

Planning for return to work

Please see information on our new Work Reintegration Program as it relates to Return to Work (RTW).

Absence from the workplace is detrimental to the physical, mental and social well-being of your patients.Timely return to work is therapeutic.The WSIA requires employers and workers to cooperate in return to work efforts.The health professional assists this process by providing medical restrictions, return to work precautions and functional limitations as may be applicable.

Report regarding functional abilities

37. (3)

Ontario Regulation 456/97 - Functional Abilities Form

 

Duty to co-operate in return to work

40. (1) 
41. (1)

Determinations regarding return to work

41. (3)

Health professional payment

Health Professionals are paid for clinical services they provide. Treatment services provided by physicians are processed by the MOH&LTC on behalf of the WSIB according to the Schedule of Benefits for Physician Services. Pre-approved services that are not listed in the Schedule of Benefits  for Physician Services are paid by the WSIB directly. For further information regarding billing of these services, please see Health practitioner fees or contact the Health Professional Access line at 1-800-569-7919.

Fee Schedules

33. (3)

Penalty for late billing

33. (4)

Prohibition

33. (5)

No right of action

33. (6)

Protection and release of information

The WSIA requires health practitioners and injured workers to disclose information necessary to the WSIB.

Worker’s consent to disclosure

22. (5)
37. (3)
37. (1)

Worker’s access to records

57. (4)

Legal rights for health care practitioners

179. (4)

WSIB is committed to protecting your patient’s privacy and the confidentiality of their information. Personal information is protected under the Workplace Safety and Insurance Act (WSIA) and the Freedom of Information & Protection of Privacy Act.