Determining the Date of Injury

Policy

A worker’s date of injury varies based on the nature of the event(s) that give rise to his or her claim for benefits under the Workplace Safety and Insurance Act, 1997 (WSIA). For all purposes associated with the administration of benefits and services under the WSIA, a worker’s date of injury is the same as his or her date of accident.

Purpose

The purpose of this policy is to establish/calculate

  • the date the worker is first entitled to WSIB benefits/services
  • the start of the 72-month loss of earnings (LOE) review period
  • an employer's re-employment obligation period, and
  • the one year period an employer is required to contribute towards a worker's employment benefits.

Guidelines

Determining the date of injury

The date of injury (also known as the date of accident) varies based on the type of claim and can refer to the date

  • of the actual incident
  • on which an unexpected result of working duties occurs
  • of first medical attention, or
  • of diagnosis.

In a chance event claim, which occurs when an identifiable, unintended event causes an injury, the date of injury is the date of the actual incident. An example of a chance event claim is where a box of supplies falls from a shelf and lands on a worker's foot, causing a fracture.

In an unexpected result disablement claim, the date of injury is the date that the unexpected result of working duties occurs. An example of an unexpected result disablement claim is where a worker bends over to pick up a box of supplies and suffers a back injury.

In a gradual onset disablement claim, the date of injury is established using the date of first medical attention which led to the diagnosis, or the date of diagnosis, whichever is earlier. An example of a gradual onset disablement claim is where a worker gradually develops left wrist and hand symptoms from work-related duties and is diagnosed with carpal tunnel syndrome.

In an occupational disease claim, when a worker’s illness or disease is a result of a specific chance event, the date of injury is the actual date of the incident. An example would be where a worker develops a lung condition after inhalation of toxic fumes from a chemical fire. However, most occupational disease claims do not result from a single event occurring at a specific time. As work-related diseases generally result from the cumulative effect of occupational exposure spanning many months or years, the date of injury is not based on when the exposure to the causal agent(s) occurred, but rather on when the illness or disease first becomes apparent. An example of this type of occupational disease claim is where a worker develops lung cancer after many years of exposure to asbestos dust at work. In these cases, the decision-maker determines the date of injury based on either

  • the date initial medical attention is sought for symptoms consistent with the diagnosis, or
  • if medical continuity of compatible symptoms is unclear, the date a medical specialist conducts a full clinical assessment and determines the diagnosis.

Implications of the date of injury

WSIB decision-makers use the date of injury primarily to

  • establish the date the worker is first entitled to WSIB benefits/services, and
  • calculate the start of the 72-month LOE review period.

In claims with an accident date on or after January 1, 1998, the 72-month lock-in date is important since LOE benefits cannot be reviewed more than 72 months from the date of injury, unless exceptional circumstances exist, see 18-03-06, Final LOE Benefit Review.

The WSIB also uses the date of injury to calculate

  • an employer's re-employment obligation period, and
  • the period during which an employer is required to contribute towards a worker’s employment benefits.

Further information on use of the date of injury in these two contexts, and other general implications of the date of injury, are set out below.

Employers' re-employment obligation

For workers who are medically able to perform suitable work, an employer's re-employment obligation continues until the earliest of

  • the second anniversary of the date of injury, or
  • the date on which the worker reaches 65 years of age, or
  • for employers in the construction industry, the date on which the worker declines an offer from the employer to re-employ the worker in accordance with the applicable Regulation.

For more information on the duration of an employer's obligation to re-employ, see 19-02-02, Responsibilities of the Workplace Parties in Work Reintegration. For more information on re-employment in the construction industry, see 19-05-02, Re-employment Obligation in the Construction Industry—Threshold, Duration and Specific Employer Requirements.

Employers' contribution to workers' employment benefits

An employer's obligation to contribute towards a worker's employment benefits continues until one year from the date of injury. For more information on an employer's obligation to contribute towards a worker's employment benefits, see 18-01-12, Employer Contributions to Worker Benefits.

General implications

The date of injury is used when administering all sections of the WSIA where the terms "date of injury" or "date of accident" appear, as well as all sections of the WSIA which contain terms that have the same meaning, e.g., "at the time of the injury" or "when the injury occurred." Likewise, if any of these terms appear in another Operational Policy Manual document, they have the same meaning as the date of injury, unless specified otherwise.

Recurrences

Periods of impairment resulting from recurrences of work-related injuries/diseases are not new injuries. Therefore, the date of injury for re-employment purposes, and for the purpose of determining compliance with the employer's obligation to contribute towards a worker's employment benefits, is the date of the original injury.

Application date

This policy applies to all decisions made on or after February 15, 2013 for all injuries on or after January 1, 2009.

Document History

This document replaces 11-01-04 dated February 18, 2009.

This document was previously published as:
11-01-04 dated January 5, 2009
11-01-04 dated October 12, 2004
19-04-11 dated June 15, 1999.

References

Legislative Authority

Workplace Safety and Insurance Act, 1997, as amended
Sections 2(1), 25, 30(8)(c), 41, 43, 44, 45(1), 46, 48(24), 53
O. Reg. 35/08

Minute

Administrative
#1, January 28, 2013, Page 502