Policy
If requested by the WSIB, a worker must undergo an examination by a health professional selected and paid for by the WSIB.
Purpose
The purpose of this policy is to outline when the WSIB may request a worker undergo a health examination, the worker's right to object, and how benefits may be impacted in the absence of reasonable cause.
Guidelines
Need for examination
The WSIB determines that an examination is needed and may arrange one if it will help:
- in the worker's return-to-work (RTW) activities
- the worker re-enter the labour market in a suitable occupation
- the worker get the most timely access to treatment possible
- clarify discrepancies in opinions between health professionals, or
- clarify the nature of the injury, work relatedness, the level of disability/impairment, or the worker's physical precautions.
The WSIB pays for both the examination and the report.
Nature and extent of examination
When arranging an examination, the WSIB considers its appropriateness. The examination must relate directly or indirectly 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. If the WSIB selects one of its own health professionals, the policy on chaperones applies, see 17-04-04, Chaperones.
Compliance
If the worker refuses or obstructs the examination, 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 Obligations.
Application date
This policy applies to all health examinations requested by the WSIB on or after March 1, 2021, for all accidents.
Document history
This document replaces 17-04-03 dated February 15, 2013.
This document was previously published as:
17-04-03 dated October 3, 2007
17-04-03 dated October 12, 2004
17-04-03 dated June 15, 1999
16.1 dated January 1, 1998.
References
Legislative authority
Workplace Safety and Insurance Act, 1997, as amended
Section 35
Workers' Compensation Act, R.S.O. 1990, as amended
Section 69(3), (4)
Minute
Administrative
#18, March 24, 2021, Page 587