Policy
Health care practitioners, who provide health care to a worker or are consulted with respect to a worker's health care, must provide the WSIB with information regarding the work-related injury/disease, when requested.
Purpose
The purpose of this policy is to outline the obligation of health care practitioners to provide the WSIB with information related to a worker's work-related injury/disease.
Guidelines
For definitions of health care, health care practitioner, and health professional, see 17-01-02, Entitlement to Health Care.
The WSIB supplies health professionals with the initial reporting forms decision-makers need to determine a worker's entitlement to benefits. The WSIB depends on health professionals to report and return these required forms within 48 hours of treating injured workers. If a report is incomplete or if a case is complex, WSIB staff may contact the health professional directly.
First reports from health professionals
Health Professional's Report (Form 8)
The WSIB supplies these forms. Health professionals who first treat the worker complete this form. For information regarding the health professionals who can complete the initial reporting form, see 17-01-03, Choice and Change of Health Professional. The Health Professional's Report is available on the WSIB's website at www.wsib.on.ca.
Dental Report - Form 0278A
See 17-03-03, Dental Entitlement.
Recurrences
Health professionals treating the worker also use the Health Professional's Report (Form 8) to report a recurrence to the WSIB. For more information, see 15-02-05, Recurrences.
Follow-up reports
The WSIB periodically requires current information to confirm ongoing entitlement to benefits in an allowed claim. To obtain this information, the decision-maker sends out follow-up forms to be completed and returned to the WSIB by the worker's health professional. Without the information provided in these completed reports, payments of benefits to the worker may be delayed. To avoid payment delays, it is important that current clinical information is regularly provided to the decision-maker. The WSIB provides the worker with follow-up reports to take to health professionals to be completed and returned to the WSIB. (If reports are incomplete, or if the case is complex, the WSIB may contact health professionals directly.)
Other reports
Medical specialists provide reports in the form of consultation notes. The WSIB contacts other health care practitioners if and when information is required.
Health Care Fees
For details about health care fees, see 17-02-03, Payment of Clinical Assessment/Reports Requested for Adjudication and 17-03-01, Health Care Fees.
Application date
This policy applies to all decisions made on or after January 1, 2015, for all accidents.
Document History
This document replaces 17-02-02 dated October 12, 2004.
This document was previously published as:
17-02-02* dated June 15, 1999,
17-02-04* dated June 15, 1999
*documents were replaced by 17-02-02 dated October 12, 2004.
References
Legislative Authority
Workplace Safety and Insurance Act, 1997, as amended
Sections 37(1), (2)
Workers' Compensation Act, R.S.O. 1990, as amended
Section 51(1)
Minute
Administrative
#6, December 12, 2014, Page 521