Policy
All claim file information is considered personal information under The Freedom of Information and Protection of Privacy Act (FIPPA) and may be disclosed in limited circumstances in accordance with various exceptions listed in FIPPA. FIPPA and the Workplace Safety and Insurance Act, 1997 (WSIA) permit disclosure of personal information to worker or employer representatives where the authorization or permission of the worker or the employer, as the case may be, has been obtained.
When authorization has been obtained, and when the authenticity of the representative is not in doubt, disclosure to the representative is allowed in the same manner as it would be to the worker or the employer.
In all cases, therefore, WSIB staff must take reasonable steps to verify the authenticity of the person requesting information, and the authorization of the worker or the employer, before any information is disclosed. Such steps may include
- calling the worker, employer, or representative, and
- requesting a claim number, account number, or other verification information.
Purpose
The purpose of this policy is to outline who can be a worker or employer representative, what the WSIB requires to confirm representation, and what claim file information can be disclosed to a particular type of representative.
Guidelines
This document should be read in conjunction with 21-02-01, Disclosure of Claim File Information - General.
The information in this document dealing with employer representatives only applies to employer representatives seeking access to claim file information. For information on employer representatives and disclosure of employer account information, see 21-01-01, Access to Employer Information.
Definitions
Authorized representative means a person, firm or organization that has been licensed under the Law Society Act and the license is in good standing, or is exempt from the Law Society Act licensing requirements. Such representatives must have the worker's or employer's written consent (authorization) to represent the workplace party in relation to a WSIB claim file. These representatives include, but are not limited to
- lawyers
- paralegals
- union or bargaining agent representatives
- licensed representatives from the Office of the Worker Adviser (OWA) or the Office of the Employer Adviser (OEA)
- unlicensed representatives from the OWA or OEA who have provided legal services for workplace parties through the OWA or OEA any time between the period of May 1, 2007 and December 31, 2021 and who continue to provide such services through the OWA or OEA
- Constituency Assistants working in Members of Provincial Parliament (MPPs) offices
- Indigenous Court Workers providing services as part of the Indigenous Court Program, and
- Ontario Federation of Labour staff and consultants representing union members in workers' compensation matters (under the Occupational Disability Response Team), including their work in representing families of deceased workers.
Informal representative means a friend or family member who helps the workplace party gain information about a claim, but does not charge a fee for this service.
Personal representative means anyone with the legal authority to administer the estate of a deceased worker, including executors and administrators.
Authorized representatives
The WSIB must be notified in writing of the authorization of representatives before such representatives are given verbal information about the claim, copies of the claim file documents (including WSIB decision letters), or written status information. Such authorizations must be signed by the worker or the employer, as the case may be.
Authorized worker and employer representatives are entitled to be copied when the WSIB issues a decision letter in a claim to which the authorization applies.
Unless notified otherwise, the WSIB assumes the continuing validity of a worker or employer representative's authorization. Therefore, the onus is on the worker or employer to notify the WSIB for each claim if the authorization is cancelled or a new representative is selected.
Special guidelines apply, as noted below, when the authorized representative is from a union, a MPPs office, the OWA, or the OEA.
Representatives on more than one claim
Workers and employers who want a specific representative to represent them on all their claims must ensure that separate, written and signed authorizations are on file in each claim. This is true even if the same individual or firm represents them on all claims.
Claim information (verbal or written) can only be disclosed to the representative if a written and signed authorization is on file in the claim under which the request is made.
Union representatives
Unions and their staff must submit written and signed authorizations only when requesting actual copies of claim file documents (including WSIB decision letters) or written status information about the claim. Separate authorizations must be received for each claim file in which such disclosure is sought.
When requesting verbal information, union representatives need only provide
- verbal assurance of authorization, and
- the worker's claim number.
A worker’s check mark(s) in the relevant section of the Form 6 (Worker’s Report of Injury/Disease) provides (1) authorization for a union to represent the worker in matters before the WSIB, and (2) consent for the disclosure of verbal claim file status information to the union representative. Before actual copies of claim file documents can be disclosed, however, a signed, written authorization from the worker must be received.
MPPs and the Offices of the Worker/Employer Adviser
MPPs and their staff, as well as eligible staff members from the OWA or the OEA, must submit written and signed authorizations only when requesting actual copies of claim file documents (including WSIB decision letters) or written status information about the claim. Separate authorizations must be received for each claim file in which such disclosure is sought.
When requesting verbal information, MPPs and their staff, as well as eligible staff members from the OWA or the OEA, need only provide
- verbal assurance of authorization, and
- the worker's claim number.
Informal representatives
Friends or family members who are assisting a worker or employer with a claim, without charging a fee, must have the authorization or permission of the worker or employer before any claim file information can be disclosed.
Evidence of permission is generally provided when the informal representative can cite the relevant claim number and/or answer other verification questions about the claim.
Where permission is clear, informal representatives may only obtain verbal information about the status of a claim. They are not entitled to copies of claim file documents.
Where permission is not clear, written authorization is required.
Importantly, in all discussions with informal representatives, disclosure of claim file information is limited to the information that is necessary to assist the representative in resolving the issue(s) that gave rise to the request.
Personal representatives
A deceased worker's personal representative has a right of access to claim file information, in the same manner that the worker would have had, if disclosure of the information
- is related to the administration of the worker's estate, or
- fulfills a purpose of the WSIA, such as determining entitlement to survivor's benefits.
Any personal representative seeking access to a deceased worker's claim file must establish their legal authority by providing
- a copy of the will
- a letter from the lawyer handling the estate, or
- an equivalent official document.
If decision-makers are unsure of a personal representative's legal authority, the WSIB's Legal Services Branch should be contacted.
For specific limitations on a personal representative's right of access where there is an issue in dispute, see 21-02-02, Disclosure of Claim File Information (Issue in Dispute).
Application date
This policy applies to all decisions relating to the disclosure of claim file information made on or after June 1, 2023, for all accidents.
Document History
This document replaces 21-02-04 dated October 14, 2009.
This document was previously published as:
21-02-04 dated February 20, 2006
21-02-04 dated January 3, 2006
21-02-04 dated October 12, 2004.
References
Legislative Authority
Workplace Safety and Insurance Act, 1997, as amended
Sections 57, 58, 181
Workers’ Compensation Act, R.S.O. 1990, as amended
Sections 71, 114
Freedom of Information and Protection of Privacy Act, R.S.O. 1990, as amended
Sections 10, 42, 43, 66(a)
Law Society Act, R.S.O. 1990, as amended
Section 27
By-Law 4 Licensing
Minute
Administrative
#1, May 24, 2023, page 613