What are an injured worker’s responsibilities when it comes to health examinations?
Generally, workers who receive workplace safety and insurance benefits must co-operate in their health care and return to work . This may require health examinations for a number of reasons such as determining appropriate health care, assessing permanent impairment for non-economic loss benefits or assessing a worker’s abilities and limitations given the injury.
When are health examinations needed?
The Workplace Safety and Insurance Board or the worker's employer may request a health examination for workers who are receiving workplace insurance benefits if it will help:
- the worker's early and safe return to work
- clarify differences in opinions between health professionals or
- clarify the nature of the injury, the diagnosis, if it was work-related, level of impairment, or the worker's physical precautions.
The WSIB may also request a health examination if it will help the worker:
- re-enter the labour market in a suitable employment or business
- get the most timely access to treatment that is possible.
The employer may also request a health examination if it will help:
- provide significant new information not already available to the employer through claim file access.
Who can perform a health examination?
A health professional must conduct the examination. This includes any member of the College of a health profession as defined in the Regulated Health Professions Act, 1991. This includes, but is not limited to, physicians, chiropractors, physiotherapists, nurses, and psychologists. Only roster doctors may conduct non-economic loss assessments.
If the Workplace Safety and Insurance Board (WSIB) chooses one of its own health professionals to do the examination, the WSIB will provide a chaperone to accompany him/her.
For which claims are these rules in place?
The health examination policies apply to all requests for health examinations that are made on or after January 1, 1998. If your injury was before this date contact your adjudicator to see how the rules differ.
What if the worker refuses an examination requested by the employer?
If a worker objects to having a health examination that is requested by the employer the worker must notify the employer of the objection. If the employer wants the WSIB to give direction to the worker to have the examination, the employer has 14 days to give the WSIB a written request. The WSIB will review the situation to see if the examination is needed and that it relates to the injuries, diseases, or conditions for which the worker is claiming benefits.
What if the worker simply refuses to go, even after the WSIB has determined it appropriate?
The WSIB decides if the worker has reasonable cause or excuse, such as severe weather conditions, a death in the immediate family or serious illness. If there is no reasonable cause or excuse, the adjudicator may reduce or stop the worker's benefits for as long as the worker fails to co-operate.
Who has appeal rights concerning health examinations?
For employer-requested health examinations, either the worker or the employer can appeal the WSIB's direction. An appeals resolution officer will do the review and make the final decision. The appeals resolution officer's decision is final and there is no appeal to the Workplace Safety and Insurance Appeals Tribunal.
Workplace Safety and Insurance Board
Ontario’s Workplace Safety and Insurance Board (WSIB) plays a key role in the province’s occupational health and safety system. The WSIB administers no-fault workplace insurance for employers and their workers and is committed to the prevention of workplace injuries and illnesses. The WSIB provides disability benefits, monitors the quality of healthcare, and assists in early and safe return to work for workers who are injured on the job or contract an occupational disease.
This information is available in several languages by calling our information hotline at 416-344-4999, toll-free 1-800-465-5606 or Telephone Service for the Deaf (TTY): 1-800-387-0050
Pour obtenir un exemplaire en français, composez le 1-800-465-5606.