Tips and Hints About Prior Injuries and Prior Medical Records Relevancy in Canada Workers Compensation

In Ontario, Canada the Workplace Safety and Insurance Board (WSIB) considers prior injuries and prior medical records for several reasons, according to Ontario, Canada workers’ compensation attorney David Brady of Hicks Morley. If the current injury is a recurrence of a prior work-related injury, the WSIB claim number remains the same. If the current work-related injury is new, it will be given a new WSIB claims number. Use medical records to establish date of injury. This is significant for Schedule 1 employers. Schedule 1 employers comprise most of the private sector employers and some public sector employers who have opted for coverage under Schedule 1. Except for very small employers and construction employers, Schedule 1 employers are experience rated under a New Experimental Experience Rating program (NEER). NEER is based on actual and expected claims costs for each claim within specified claims costs maximums. In its very simplest form, employers are classified by business activity and pay annual premiums based on the risk assessment associated with their industry rate group. Employers in the NEER program receive annual surcharges and rebates depending upon how their experience relates to the experience of their rate group. The experience rating model works (workersxzcompxzkit) on a moving three-year claims experience wheel. If there is a recurrence and the original claim is outside of the moving three-year period, it will not count in the annual surcharge/rebate calculation. If the current compensation claim is new and not connected to a prior claim, it counts in the annual surcharge/rebate calculation. Bottom line, accident claim dates matter with respect to an employer’s annual experience rating results. Prior injuries and prior medical information are, therefore, important in establishing whether accidents and claims costs are new or connected with earlier workplace events. Of course, all relevant medical information must be brought forth (voluntarily or by subpoena or by order of the WSIB/WSI Appeals Tribunal) to establish entitlement under the legislation. The worker must show, on a balance of probabilities, that the workplace was a significant contributing factor of the worker’s medical condition(s). Author: Attorney Brady can be reached at 416-864-7310 or [email protected] www.hicksmorley.com of Toronto, Canada. Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs. ©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact I[email protected]