WSIB Claims, Benefits, and Return to Work After a Workplace Injury

Ontario’s Workplace Safety and Insurance Act, 1997 (WSIA) governs what happens after a worker is hurt on the job: how the injury is reported, what the WSIB pays, what care the worker is entitled to, how the worker gets back to work, and how disputes are decided. This page walks through that post-injury lifecycle for both employer and worker, in plain language, and links each rule to the official source.

Most of what follows is a statutory floor. Reporting, benefits, health care, and the duty to cooperate are minimum obligations set by the Act. One part, though, runs the other way: the re-employment duty for employers of 20 or more goes beyond the ordinary common-law duty to accommodate, imposing a hard, time-bound obligation that the common law alone does not create — so on that point the statute is the more demanding standard, not the floor.

How fast must an employer report a workplace injury to the WSIB?

If a workplace accident requires health care or stops the worker from earning full wages, the employer must notify the WSIB within three days of learning about it, on the Board’s prescribed form, and give the worker a copy of that notice at the same time. Miss that deadline and the employer owes the Board a set penalty on top of any court fine.

The worker files their own claim separately, and the worker has more time: as soon as possible, but no later than six months after the accident — or after the worker learns of an occupational disease. The Board can extend that window where it considers doing so fair.

Two obligations continue while the claim is being decided:

• Wages for the day of injury. The employer pays the worker their full wages and benefits for the day they were hurt, as if the accident had not happened. If the employer does not, the Board pays it and bills the employer back.
• Benefit contributions for up to one year. Where the employer was already contributing to health, life insurance, or pension benefits, those contributions continue for the first year of the absence — provided the worker keeps paying their own share. Failing to do so can leave the employer liable for the worker’s losses plus a penalty.

The employer also cannot lean on a hurt worker. It is prohibited to fire, discipline, threaten, or pressure someone to stop them from filing a claim or to make them drop one, and it is prohibited to give the Board false information. Both carry administrative penalties and possible prosecution.

Source: Workplace Safety and Insurance Act, 1997, ss. 21–25.

The statute is the floor, not the ceiling. These are minimum statutory duties under the WSIA. They sit alongside an employer’s other post-injury obligations — for example the separate workplace-accident notice and reporting requirements under the OHSA, and the duty to accommodate disability under the Human Rights Code — none of which the WSIA reporting rule displaces.

How much does the WSIB pay an injured worker in loss-of-earnings benefits?

Loss-of-earnings benefits are generally 85 per cent of the gap between the worker’s net pre-injury earnings — take-home pay after tax, CPP/QPP, and EI — and what the worker now earns or could earn in suitable and available work. Payments begin on the day the income loss starts.

Those payments stop at whichever of these comes first: the earnings gap closes, the worker is no longer impaired by the injury, the worker turns 65 (if injured before age 63), or two years pass from the injury date (if the worker was 63 or older when injured).

Several thresholds and conditions shape the amount:

• Minimums apply. For a full loss of earnings, the floor is the lesser of $22,904.44 a year and the worker’s pre-injury take-home pay, so very low earners are not left with almost nothing. The partial-loss minimum involves a separate two-branch calculation. (This minimum is a figure set under the Act and is indexed; confirm the current amount at the official source before relying on it.)
• Cooperation matters. The Board may reduce or suspend benefits during any period when the worker is not cooperating with health care, with early-and-safe return-to-work efforts, or with a labour-market re-entry assessment or plan.
• Earnings are capped and indexed. Pre-injury average earnings are treated as no more than 175 per cent of Ontario’s average industrial wage for that year, and benefit amounts are adjusted upward each January 1 by an indexing factor tied to the Consumer Price Index.
• Reviews happen. The Board may review payments annually or when a material change occurs, but is generally barred from doing so beyond 72 months after the injury date — subject to several statutory exceptions, including fraud, an incomplete re-entry plan, and significant deterioration.

Two points are easy to miss. The benefit does not replace the full paycheque: it is 85 per cent of net take-home pay, not gross. And any payment or benefit the employer provides relating to the accident is factored in when the Board calculates what it owes.

Source: Workplace Safety and Insurance Act, 1997, ss. 43–56.

The statute is the floor, not the ceiling. Loss-of-earnings benefits are a statutory replacement for the right to sue — the no-fault bargain — and they are deliberately partial: 85 per cent of net, not gross, and subject to the cap, the cutoffs, and the cooperation reduction set out in the Act. The figures here are durable structural constants in the statute, but indexed amounts such as the full-loss minimum change over time, so confirm the current numbers at the source before relying on them.

What health care is an injured worker entitled to, and what must each side do?

A worker injured on the job is entitled to whatever health care is “necessary, appropriate and sufficient” for the injury, paid for by the WSIB, and the worker makes the first choice of health professional. In return, the worker must cooperate with the treatment the Board considers appropriate and attend any required examination, while the employer carries its own duties around first-trip transportation, confidentiality, and damaged assistive devices.

“Health care” is read broadly: practitioner services, hospital and facility care, drugs, an attendant, assistive devices and prostheses, home and vehicle changes for independent living, extraordinary travel to get treatment, and quality-of-life measures for severely impaired workers. The Board decides what is necessary and what gets paid, and it can set fee schedules. A practitioner cannot bill the worker for insured care, and providers who bill late can have their payment docked.

The duty runs both ways. A worker claiming or receiving benefits must cooperate with the health-care measures the Board considers appropriate, and must attend a medical examination if the Board asks — the Board picks and pays for that exam. The employer can also ask the worker to attend an exam, at the employer’s cost, but the worker can object; in that case the employer has 14 days to ask the Board to direct it, and the Board’s call there is final. If a worker will not cooperate, or skips or obstructs an exam without good reason, the Board can reduce or suspend their payments while that continues.

Three employer-side duties sit alongside the worker’s:

• Day-one transportation. At the time of injury, the employer must arrange and pay for transportation to a reasonably nearby hospital or physician, or to the worker’s home, if the worker needs it. Fail to do that and the Board can order the employer to reimburse whatever transportation was arranged instead.
• Functional abilities forms. When a worker or employer asks, the treating professional reports the worker’s functional abilities on the prescribed form. That information is confidential — it can only be shared with someone who is actively helping return the worker to work.
• Damaged assistive devices. If a workplace accident damages a worker’s prosthesis or assistive device, the Board can pay to repair or replace it. If the damage leaves the worker unable to work, they qualify for lost-earnings benefits as though the accident itself had caused the stoppage. The Board can also pay an annual allowance when the device causes clothing to wear out or get damaged.

Source: Workplace Safety and Insurance Act, 1997, ss. 32–39.

The statute is the floor, not the ceiling. The WSIA’s confidential functional-abilities process is the injury-specific channel for medical information. It sits beside the broader duty to accommodate disability under the Human Rights Code and the documented individual-accommodation-plan process under the IASR Employment Standard — meeting the WSIA’s medical-information rules does not discharge those separate obligations.

What does the duty to cooperate in return to work require?

When a worker is injured on the job, the Workplace Safety and Insurance Act makes both the employer and the worker legally responsible for cooperating in an early and safe return to work. The duty runs both ways, and going quiet on an injured worker is itself a failure to cooperate.

For the employer, cooperating in the worker’s early and safe return to work means four things:

• Reach out to the injured worker as soon as possible after the injury, and keep the lines of communication open throughout recovery and any ongoing impairment.
• Try to offer suitable work that is actually available and consistent with the worker’s functional abilities — and, where possible, work that gets the worker back to roughly their pre-injury pay.
• Give the WSIB the information it asks for about the return to work.
• Do anything else the regulations require.

The worker’s side mirrors this: the worker must contact the employer promptly, stay in touch, help identify suitable work within their abilities, and give the Board the information it requests.

A few situations follow different rules. Construction employers and workers follow separate rules set by regulation rather than the general list above, and there are special arrangements for emergency workers and certain volunteer firefighters, ambulance, and auxiliary police members.

If cooperation breaks down, either side must tell the Board. The Board can monitor progress, attempt mediation, and — if that fails — decide the dispute, generally within 60 days. The most common failure point for employers is the communication piece: going silent on an injured worker is, on its own, a breach of the duty.

Source: Workplace Safety and Insurance Act, 1997, s. 40.

The statute is the floor, not the ceiling. The duty to cooperate is the early, shared baseline. It overlaps with — but does not replace — the substantive duty to accommodate disability short of undue hardship under the Human Rights Code, and the documented return-to-work and individual-accommodation-plan process under the IASR Employment Standard. A supportive, well-run return-to-work process generally goes further than the statutory minimum.

Which employers have to offer an injured worker their job back?

An employer who regularly employs 20 or more workers must offer to re-employ a worker who is injured on the job and was employed continuously for at least one year on the date of injury, once that worker is medically able to come back. Employers who regularly employ fewer than 20 workers are exempt, and construction has its own prescribed rules. This is an obligation under the Workplace Safety and Insurance Act, enforced by the WSIB — not a courtesy.

What the employer must offer depends on the worker’s recovery:

• Fit for their old job: offer the position the worker held when injured, or comparable alternative work at comparable pay.
• Fit only for suitable work: give the worker first crack at suitable openings as they come up.

The employer must also accommodate the work or the workplace, short of undue hardship. The WSIB can step in to decide whether someone is medically fit and whether the employer has actually met its duty.

The obligation runs until the earliest of: two years from the injury, one year after the worker can do their pre-injury job, or the day the worker turns 65.

A trap sits at the end of the duty. If an employer re-employs a worker and then lets them go within six months, the law presumes the employer did not fulfil its duty — and the burden shifts to the employer to prove the firing had nothing to do with the injury. Fall short and the WSIB can fine the employer up to a year’s net earnings and order payments to the worker.

Source: Workplace Safety and Insurance Act, 1997, s. 41.

The statute is the floor, not the ceiling. This goes beyond the ordinary common-law duty to accommodate. The WSIA imposes a hard statutory obligation on employers of 20 or more to actually offer re-employment to an injured worker — enforceable for up to two years from the date of injury (or until one year after the worker is medically able to return to their pre-injury role, whichever comes first) — backed by WSIB penalties. Common law alone does not impose this specific, time-bound duty.

Can a WSIB decision be taken to court?

No. The WSIB has exclusive jurisdiction over a workplace-injury claim, and a court will not second-guess its rulings — there is no judicial review to overturn a Board decision. A worker or employer who disagrees objects to the Board first within set deadlines, and only a final Board decision can then be appealed to the Workplace Safety and Insurance Appeals Tribunal (the WSIAT).

The Board’s exclusive jurisdiction covers questions such as whether an injury came from an accident, whether the accident arose out of and in the course of the job, whether there is a loss of earnings or lasting impairment, and whether the employer met its return-to-work duties. Two principles shape how those calls are made: the Board decides on the merits and justice of the case and is not bound by legal precedent, and where the evidence for and against an issue is roughly equal, the tie goes to the person claiming benefits.

The first step in disagreeing is an objection to the Board, in writing, setting out why the decision is wrong. The deadlines are short and they differ by subject:

• 30 days for decisions about return to work or a labour market re-entry plan;
• six months for everything else.

The Board can extend these periods, and it can reconsider any decision on its own at any time. It may also offer mediation on a return-to-work objection; if that mediation does not resolve things, the Board must still wrap up the decision within 60 days of when it first received the notice of objection — not 60 days from the mediation breakdown.

Only a final Board decision can be appealed to the WSIAT. The notice of appeal is in writing, within six months (extendable), and the Tribunal can confirm, vary, or reverse the Board. The Tribunal applies the Board’s own policies and decides the appeal within 120 days of the hearing ending. Ongoing periodic payments keep flowing while an appeal is pending.

The two most common employer errors are blowing the short 30-day window on return-to-work decisions, and treating a non-final decision as if it were ready to appeal.

Source: Workplace Safety and Insurance Act, 1997, ss. 118–130.

The statute is the floor, not the ceiling. The Board’s exclusive jurisdiction and the bar on judicial review mean the WSIA’s own objection-and-appeal route is, for most claim questions, the only route. There is no parallel court action to fall back on, so meeting the short statutory deadlines is essential rather than optional.

---

This page is general information about Ontario workplace-injury law, not legal advice. WSIB duties run on tight clocks and the early steps shape the whole claim, so obtain advice before acting on a specific file.