Employer-Requested Health Examinations

Policy

If requested by the accident employer, the worker must undergo an examination by a health professional selected and paid for by the employer.

Purpose

The purpose of this policy is to outline the employer's right to request a worker undergo a health examination, the worker's right to object, and the WSIB's responsibility to provide direction.

Guidelines

For accidents prior to January 1, 1998

The worker may object to undergoing the examination, or to its nature and extent. If the worker objects, the worker or employer may apply to the Workplace Safety and Insurance Appeals Tribunal (WSIAT) to make a decision in the matter. The worker or employer has up to 14 calendar days, from the date of objection, to apply to WSIAT.

For accidents on or after January 1, 1998, the following guidelines apply:

The worker may object to undergoing the examination, or to its nature and extent. If the worker objects, the employer has up to 14 calendar days to ask for direction from the WSIB.

Criteria for WSIB involvement

The WSIB does not get involved unless

  • the worker has made a claim for, or is receiving, benefits
  • the worker refuses the examination or objects to its nature and extent, and
  • the employer has asked, in writing, for WSIB involvement. The WSIB must receive the letter within 14 calendar days of the employer learning of the worker's objection.

Once these criteria for WSIB involvement are met, the WSIB gathers information from the worker and the employer and then determines

  • whether the worker must undergo the examination, and
  • the nature and extent of the examination.

Need for examination

The WSIB determines that an examination is needed if it will help

  • in the worker's work reintegration activities
  • provide significant new information not already available to the employer through claim file access
  • clarify discrepancies in opinions between health professionals, or
  • clarify the nature of the injury, work-relatedness, the level of impairment/disability, or the worker's physical precautions.

Nature and extent of examination

The examination must relate to the injuries, diseases, or conditions for which the worker is claiming benefits.

A health professional, as defined in s.2(1) of the Workplace Safety and Insurance Act, 1997 (WSIA), must conduct the examination.

WSIB direction

If the WSIB does not establish a need for the examination, both parties are informed that it is not required.

If the WSIB establishes a need for the examination, but disagrees with its nature and extent, the WSIB directs the employer to arrange an appropriate examination.

If the WSIB establishes a need for the examination, and that its nature and extent are appropriate, the WSIB directs the worker to undergo the examination.

Compliance

If the worker refuses or obstructs the WSIB's direction, the WSIB determines whether the worker has reasonable cause or excuse, such as severe weather conditions, death in the immediate family, or serious illness.

The WSIB reduces or suspends benefits for as long as the worker fails to comply without reasonable cause, see 22-01-03, Workers' Co-operation Obligation.

Access to health examination report

The examining health professional or the employer is required to provide a copy of the health examination to the WSIB. The employer is responsible for the costs of the report.

Objection to the WSIB's direction

The worker or the employer can appeal the WSIB's direction. The WSIB's Appeals Services reviews the appeal and provides the WSIB's final decision. This decision cannot be appealed to the WSIAT.

Application date

This policy applies to all health examinations requested by the employer on or after February 15, 2013, for all accidents.

Document History

This document replaces 17-04-02 dated January 3, 2007.

This document was previously published as:
17-04-02 dated October 12, 2004
17-04-02 dated June 15, 1999
16.2 dated January 1, 1998.

References

Legislative Authority

Workplace Safety and Insurance Act, 1997, as amended
Section 36

Workers' Compensation Act, R.S.O. 1990, as amended
Section 23

Minute

Administrative
#13, January 28, 2013, Page 504