Workers' Compensation Part 2
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Questions and Answers

What benefits are survivors entitled to if a worker dies due to a workplace injury?

  • A lump-sum death benefit and educational grants
  • Wage replacement and funeral expenses
  • Lifetime salary continuation
  • Wage replacement, a lump-sum death benefit, and funeral expenses (correct)
  • Under the WSIA, what percentage of earnings payments is set aside for retirement for workers receiving loss of earnings payments for over 12 months?

  • 15%
  • 5% (correct)
  • 10%
  • 3%
  • What must workers under 64 do if they wish to contribute an additional 5% towards their retirement income?

  • Complete a specific form online
  • Contribute at any time during their employment
  • Make a written request (correct)
  • Notify their employer verbally
  • What happens if the total amount set aside for retirement exceeds $3,000?

    <p>It can be converted to an annuity or other payment form (C)</p> Signup and view all the answers

    What type of compensation do workers receive for Non-Economic Loss (NEL)?

    <p>Compensation for loss of enjoyment of life (A)</p> Signup and view all the answers

    How is compensation for Non-Economic Loss (NEL) determined?

    <p>Via a two-step process (B)</p> Signup and view all the answers

    What do WSIB annual statements provide for the workers?

    <p>Contributions, investment income, and other relevant details (A)</p> Signup and view all the answers

    What is the primary purpose of change-over benefits under the WSIA?

    <p>Mitigating loss during return-to-work plans (D)</p> Signup and view all the answers

    What is the NEL amount for a 30-year-old worker who is 80% impaired?

    <p>$63,040.73 (D)</p> Signup and view all the answers

    Which section of the WSIA details the obligations of employers?

    <p>Sections 67 to 87 (C)</p> Signup and view all the answers

    What is the result of calculating the NEL for a worker who is 15% impaired with a base amount of $45,958.16?

    <p>$6,893.72 (C)</p> Signup and view all the answers

    Survivor benefits under WSIA are primarily provided to whom?

    <p>Survivors of a worker who dies from a work-related injury (C)</p> Signup and view all the answers

    How does the WSIA determine premium rates for Schedule 1 employers?

    <p>Based on accident records and safety precautions (D)</p> Signup and view all the answers

    What should all Schedule 1 and Schedule 2 employers do within 10 days of hiring?

    <p>Register with the Board (B)</p> Signup and view all the answers

    What is the lump-sum payment for a surviving spouse intended to cover?

    <p>Immediate financial relief (B)</p> Signup and view all the answers

    Why might Schedule 2 employers need to deposit funds with the Board?

    <p>To cover future claims for accidents (C)</p> Signup and view all the answers

    What does the Appeals Tribunal focus on when hearing appeals of final Board decisions?

    <p>Case merits (D)</p> Signup and view all the answers

    What is the timeframe for filing a written notice of objection if a party believes an error was made by the Board?

    <p>30 days for certain decisions (B)</p> Signup and view all the answers

    What authority does the Board have regarding employers' records?

    <p>Conduct investigations (C)</p> Signup and view all the answers

    What is a possible consequence for directors or officers if a corporation commits an offence?

    <p>They can be charged as individuals (B)</p> Signup and view all the answers

    What must happen to penalties from convictions related to offences under the WSIA?

    <p>They contribute to the insurance fund (B)</p> Signup and view all the answers

    Who appoints the chair and president of the Workers' Compensation Board, now called WSIB?

    <p>Lieutenant Governor (C)</p> Signup and view all the answers

    What is required of the WSIB every five years?

    <p>An annual strategic plan (C)</p> Signup and view all the answers

    What do prosecutions for offences under the WSIA need to occur within?

    <p>Two years of the offence being known (C)</p> Signup and view all the answers

    What is the main purpose of Section 83 within the WSIA framework?

    <p>To incentivize employers to create safer workplaces (A)</p> Signup and view all the answers

    What responsibility does Section 96 impose on the Board regarding the insurance fund?

    <p>To monitor the fund's sufficiency and prevent unfair burdens (C)</p> Signup and view all the answers

    What distinguishes Schedule 2 firms from Schedule 1 firms under the WSIA?

    <p>Schedule 2 firms are self-insured and bear full accident costs (D)</p> Signup and view all the answers

    What is the outcome when deficiencies are identified in the insurance fund?

    <p>Additional premiums may be required from all employers (D)</p> Signup and view all the answers

    What is the nature of the decisions made by the Board as per the WSIA?

    <p>They are not subject to judicial review (B)</p> Signup and view all the answers

    How can parties express disagreement with a decision made by the Board?

    <p>By submitting a written notice of objection (A)</p> Signup and view all the answers

    What does the WSIA state about the type of decisions the Board can make?

    <p>The Board can determine injuries caused by accidents (A)</p> Signup and view all the answers

    What authority does the Lieutenant Governor possess concerning the WSIA insurance fund?

    <p>To direct the Board to increase premiums to meet funding standards (D)</p> Signup and view all the answers

    Flashcards

    Insured Workers' Payments

    Payments for lost wages due to work-related injuries covered by insurance under WSIA.

    Survivor Benefits (Death)

    Wage replacement, lump-sum death benefit, and funeral expenses for workers who die on the job.

    Loss of Retirement Income (WSIA Section 45)

    5% of loss of earnings payments set aside for retirement, starting after 12 consecutive months of payments.

    Non-Economic Loss (NEL)

    Compensation for permanent impairment related to loss of enjoyment of life that is not connected to income.

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    NEL Calculation Steps

    Two-step process for determining non-economic loss payout. First is severity of impairment. Second is the value associated to that impairment based on age.

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    Retirement Pension

    A pension paid to injured workers over 65, based on the total amount saved, plus interest.

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    Conversion of Retirement Amounts

    For retirement funds above $3,000, workers can convert their accumulated amount into an annuity or other payment form. Smaller amounts are paid in a lump sum.

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    Survivor Benefit Limitations

    Survivors may not receive benefits from both section 45 (retirement income) and section 48 (death benefits) simultaneously.

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    Calculating NEL (80% impaired)

    To calculate the Net Earnings Loss (NEL) for a 30 year old worker with 80% impairment, multiply the daily wage ($1,313.71) by the difference in age (15 years less, than usual 45 years). Then add this result to the standard amount for 100% impairment ($59,095.26). The final result will be multiplied by 0.80 (the percentage of impairment).

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    Calculating NEL (15% impaired)

    To calculate the Net Earnings Loss (NEL) for a worker with 15% impairment, multiply the standard amount for 100% impairment ($45,958.16) by 0.15 (impairment percentage).

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    Survivor Benefits (WSIA)

    Benefits paid to the survivors of a worker who dies due to a work-related injury, under the Workplace Safety and Insurance Act (WSIA).

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    Schedule 1 Employer

    Employers required to register with the Board within 10 days of hiring; provide annual wage summaries; and do not pay benefits directly to workers, using the premium amounts calculated for accident records and safety precautions.

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    Schedule 2 Employer

    Employers responsible for their own costs and paying benefits to injured workers; may need to deposit funds with the Board for future claims and obtain insurance coverage for accident costs.

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    WSIA Premium Adjustment

    Premium rates for Schedule 1 employers can be adjusted based on safety practices, accident records, compliance with first-aid requirements, workplace injury costs compared to industry standards.

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    Cost Transfer (employer)

    A mechanism allowing an employer to seek some reimbursement of costs resulting from a work-related injury caused by another employer.

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    WSIA Administration

    The Workplace Safety and Insurance Act's (WSIA) guidelines for administrative procedures, from section 49-66.

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    WSIA's Goal

    The Workers' Safety and Insurance Act (WSIA) aims to promote health and safety in workplaces through various methods, including education, economic sanctions, and financial incentives.

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    Economic Incentive for Safety

    The WSIA uses a system of fluctuating premiums to incentivize employers to improve workplace safety. Companies with poor safety records face higher premiums, encouraging them to adopt safer practices.

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    Self-Insured Firms

    Schedule 2 firms, which are self-insured, don't receive the same economic incentives for safety improvement because they bear the full cost of accidents without the pressure of fluctuating premiums.

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    Insurance Fund

    The WSIA requires the Board to maintain an insurance fund for Schedule 1 employers to ensure adequate resources to pay for benefits and operational costs.

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    Funding Standards

    The Board monitors the insurance fund's sufficiency and adjusts premiums as needed to prevent any individual class from being unfairly burdened by past accident costs.

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    Board's Decision-Making Power

    The Board has exclusive authority to make decisions on matters related to the WSIA, including classification of industries, determining injuries caused by accidents, and assessing compliance with return-to-work programs.

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    Finality and Privative Clauses

    Board decisions under the WSIA are final and cannot be challenged in court, ensuring a quick and efficient system for dispute resolution.

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    Objections and Reconsideration

    Parties disagreeing with a Board decision can file a written notice of objection within specific timeframes, allowing the Board to reconsider its decision or offer mediation.

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    WSIA Board's Decision in Tie

    When evidence for and against a claim is equal, the decision favors the worker.

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    WSIA Appeal Process

    A party can object to a Board decision within six months (or 30 days for certain decisions) and request reconsideration.

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    WSIA Appeals Tribunal Role

    The Tribunal reviews final Board decisions on healthcare, benefits, and classifications based on case merits, not legal precedents.

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    WSIA Enforcement Powers

    The Board can inspect employer records and premises to ensure safety, and enforce premium payments.

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    WSIA Offences and Penalties

    Offences include false statements, failing to report changes, and non-compliance. Fines contribute to the insurance fund.

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    WSIB's Administrative Role

    The WSIB (formerly the Workers' Compensation Board) manages the WSIA, including safety regulations, compensation, and audits.

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    WSIB Governance Structure

    The WSIB Board includes a chair, president, and members representing workers and employers.

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    WSIB Strategic Plan

    Every five years, the WSIB develops a strategic plan with the Ministry of Labour.

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    Study Notes

    Workers' Compensation (Part 2)

    • Workplace Safety and Insurance Act (WSIA) expands coverage in this module
    • This module covers parts VI through XIII of the WSIA
    • Previous module (Module 4) covered foundational concepts like coverage, prevention, insurance, claims, benefits, and return-to-work plans
    • Insured payments are covered, including wage replacement (total or supplemental), non-economic loss (NEL), health care, and return-to-work/Labour Market Re-entry Plan (LMRP)
    • If a worker dies, survivors receive wage replacement, a lump-sum death benefit, and funeral expenses (sections 43-48 of WSIA).
    • Payments start when earnings are lost and continue until the earliest of return to pre-injury work, age 65, two years after the injury (if over 63), and no longer impaired.
    • Wage replacement is 85% of the difference between pre- and post-injury earnings, with a minimum capped at lesser of $22,904.44 or pre-injury earnings
    • Payments depend on cooperation with health care, return to work, and LMRP
    • WSIB payments are not taxable
    • Clarification Points regarding WSIA sections 43-48 (death benefits) and calculation methods for payment amounts

    Insured Payments

    • Workers eligible for compensation covered by the WSIA
    • Include wage replacement (full or supplemental) benefits
    • Non-economic loss (NEL)
    • Health-care costs
    • Return-to-work and/or Labour Market Re-entry Plan (LMRP)

    Payment Details

    • Payments begin when earnings are lost and continue until the earliest of these conditions:
      • Return to pre-injury work
      • Reaching age 65 (or two years after the injury, if over 63)
      • No longer impaired
    • Wage replacement equals 85% of the difference between pre-injury and post-injury net earnings, with a maximum capped at the lesser of $22,904.44 or the worker's pre-injury earnings
    • Payments dependent on cooperating with health care, safe return to work, and LMRP
    • WSIB payments are not taxable

    Loss of Retirement Income (WSIA Section 45)

    • WSIB sets aside 5% of loss of earnings payments for retirement for over 12 consecutive months.
    • Workers under 64 can choose to add 5% more to the contribution to the retirement account
    • The contribution amount is deducted from their payments.
    • At age 65, workers receive a pension based on the total amount set aside, plus interest. Amounts over $3,000 pay out as annuities or other payment forms; smaller sums pay out as lump sums.

    Non-Economic Loss (NEL)

    • Compensation for loss of enjoyment of life unrelated to income
    • Determined through a two-step process.
    • Step 1: Determining impairment using medical assessments and rating schedules
    • Step 2: Calculating compensation based on worker's age and impairment percentage -Compensation ranges between a maximum of $85,359.27 and a minimum of $32,831.21 -Calculated using a formula involving the worker's age and impairment percentage

    Survivor Benefits (WSIA)

    • Benefits paid to survivors of a worker who dies due to a work-related injury.
    • Surviving spouse receives a lump sum payment of $80,673.30, adjusted for age (increases under 40, decreases over 40)
    • Amounts over 13,132.01 paid monthly for life, otherwise paid as a lump sum.
    • Periodic payments based on a percentage of the worker's net average earnings (NAE), with limits and adjustments based on age and the presence of children.

    Additional Provisions

    • Cremation or burial costs of at least $3,025.25 can be paid
    • Other dependents may be eligible, and amounts depend on the presence of a spouse or children

    Administration of the Act Summary

    • The WSIB (formerly WCB) has various powers:
      • Establishing employer premium policies
      • Reviewing and recommending amendments to the Act and regulations
      • Approving annual budgets and investment policies
      • Providing financial assistance to employers for workplace modifications for injured workers or survivors
      • Designating and monitoring return-to-work service providers
    • The WSIB governing board includes workers and employer representatives
    • The WSIB develops an annual strategic plan and mandates a value-for-money audit of one program annually.
    • The Office of the Worker Advisor assists non-unionized workers and their survivors
    • The Office of the Employer Advisor supports employers with fewer than 100 employees

    Decisions and Appeals

    • WSIA establishes the exclusive authority of the Board to make decisions regarding classification of industries, determining work-related accidents, and compliance with return-to-work programs
    • Decisions are final and cannot be challenged in court.
    • Parties can object to decisions or seek mediation if dissatisfied
    • Judicial review enables court review of Board decisions
    • Appeals Tribunal reviews Board decisions on health care, benefits, and classifications

    Enforcement

    • The Board has powers to examine employer records to verify accuracy of statements, payroll, and classification (Schedule 1 or 2).
    • The Board can inspect premises for safety and compliance with regulations
    • Penalties include fines up to $25,000 for individuals, imprisonment up to six months, or both; or up to $500,000 for corporations. All fines contribute to the insurance fund.

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    Description

    This quiz delves into Modules VI through XIII of the Workplace Safety and Insurance Act (WSIA). It explores various aspects of insured payments, including wage replacement, non-economic loss, and benefits for survivors. Test your understanding of the key components related to workplace safety and insurance coverage.

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