If you suspect anyone involved in a WSIB case (person, business, representatives, supplier or health-care practitioner) is not dealing honestly with us, you can use our toll-free action line at 1-888-SI-LEADS (1-888-745-3237), Monday to Friday, 7:30 a.m. to 5 p.m. or email us at firstname.lastname@example.org or contact us confidentially through our website.
What happens after I report suspected fraud or abuse of the workplace compensation system?
The details are recorded to track suspected fraud or non-compliant behaviour and may be counted as part of our statistical reporting. All reports are reviewed. We investigate some of the reports and follow up administratively on others.
What steps are taken to protect my identity?
When reporting fraud or wrong-doing, you are not required to provide your name, address, or any other information that may identify you.
Under the Freedom of Information and Protection of Privacy Act and the Workplace Safety and Insurance Act any information you provide (other than information that identifies you) may be released to people including, but not limited to, the person with a workplace injury or illness, their employer as well as both of their representatives.
What are some examples of fraud or abuse of the system?
Some examples include:
- Falsely claiming that an injury is work-related (s. 149(1) Workplace Safety and Insurance Act)
- Misrepresenting your injury or illness to receive WSIB benefits (s. 149(1) Workplace Safety and Insurance Act)
- Failing to report all employment income while receiving WSIB benefits (s. 149(1) and s. 149(2) Workplace Safety and Insurance Act).
- Billing for services not provided (s. 149(4) Workplace Safety and Insurance Act)
Examples for businesses:
- Failing to report an accident, or discouraging an employee to report an accident (s. 152(3) and 155(1) Workplace Safety and Insurance Act)
- Providing inaccurate payroll (s. 152(1.1) Workplace Safety and Insurance Act)
What are the penalties for committing fraud or abuse of the system?
People convicted under the Workplace Safety and Insurance Act can be subject to a fine of up to $100,000 and/or six months in jail for each offence. People who commit fraud exceeding $5,000 can be sentenced to imprisonment for up to 10 years. Penalties may also include fines, probation, and/or an order to pay full restitution.
Corporations convicted under the Act can be fined up to $500,000 for each offence.
The court may also order restitution of the full amount of money received in the commission of the offence.
What is considered an offence for health care providers who deal with WSIB?
It is an offence when a health care provider or supplier intentionally does any of the following:
- bills for services or goods that are not provided
- submitting a false medical report
Would a conviction under the Workplace Safety Insurance Act or the Criminal Code affect a health care provider’s licence to practice?
In cases where a health care practitioner is convicted, we notify the appropriate regulatory body and provide a factual summary of the situation. The regulatory body will take whatever action it deems necessary.