Almost all employers have been faced with at least one WSIB claim that leaves them questioning if there is something more that they could do. Their concerns often surround the level of impairment/disability, confusion as to the nature of the injury, or in some circumstances even questioning the overall work-relatedness of the injury.

Many employers don’t realize that there is a WSIB policy that can be utilized to provide support and direction in such circumstances.

The WSIB policy entitled Employer-Requested Health Examinations, 17-04-02 outlines an employer’s right to request that a worker undergo a private independent health examination at the employer’s expense to address their concerns.

How does this work?

• The employer requests that a worker attends an Independent Medical Examination (IME) during work time and offers to pay them for the attendance.
• If the worker agrees to go, the employer needs to send the report to the WSIB once received.
• If they do not agree to go, the employer has 14 calendar days to ask the WSIB for direction and outline why it would be helpful as per policy.
• If the WSIB agrees, they can compel a worker to go. If a worker does not go without reasonable cause, WSIB can reduce/suspend their benefits until the worker attends the IME.
• If the WSIB disagrees, the employer can appeal the decision to the ARO. The decision of the ARO is the final decision.

When is an IME beneficial?

• In order to provide detailed restrictions to facilitate an expedited return to work.
• Dealing with a GP/family doctor that unreasonably insists on a worker being totally disabled.
• There is no objective medical documentation to support continued total disability.
• A diagnosis is needed and a GP/family doctor is unable to provide one.
• The worker is not progressing or is progressing very slowly.
• There are concerns over the work-relatedness of the injury.
• Obtaining Cost Relief where a minor injury may be superimposed over a pre-existing condition or pre-accident impairment.

How much weight will WSIB place on the IME?

The weight that WSIB will place on the IME reports is situationally dependent. The WSIB will apply less weight to an IME if there are other specialist reports on file, where the worker has seen the same specialist over a period of time. The WSIB will apply more weight to an IME if the issues surround a family doctor’s opinion in comparison to the IME specialist’s opinion. 

How can TeksMed help?

TeksMed’s paralegal team can manage claims of this nature from start to finish and challenge WSIB on an employer’s behalf where appropriate.

TeksMed has now incorporated Functional Abilities Evaluations (FAE) at no additional cost to their clients, within their disability management programs that contain QuikCare expedited healthcare. An FAE is a form of IME that provides important and objective information about a worker’s ability or inability to return to work or daily activities.

Whether your business needs help with a return to work plan for a disabled employee or you simply want to put a disability management program in place, TeksMed can help. Contact us today for a consultation.