Your Guide to Independent Living · Your Guide to Independent Living Introduction About Your Guide...

Your Guide to

Independent Living

We’re with you al

Allowances Benefits Health Care Services

l the way…

December 2003 2264A (12/03)

Your Guide to Independent Living Copyright

This guide is for you, the worker in the Serious Injury Program. It does not apply to any individual claim unless the Serious Injury Adjudicator responsible for that claim has made a decision that it applies to the claim.

Sharing this document with workers may therefore cause confusion. Please do not share this document with other workers.

COPYRIGHT ©2003 –The Workplace Safety and Insurance Board

December 2003 2264A (12/03) Introduction –1

Your Guide to Independent Living Introduction

About Your Guide to Independent Living Your guide tells you

• how to apply for a benefit or service • how the benefit or service will be paid for • when reviews of your benefit or service will take place.

The guide has six parts Part 1: Allowances Pink pages

Part 2: Benefits Blue pages

Part 3: Health Care Green pages

Part 4: Services Yellow pages

Part 5: Community Contacts White pages

Part 6: Sample Forms White pages

The list of Community Contacts is a source of helpful information. Look for groups in your community that can offer support to you and your family. In Part 6, we have included samples of three forms you are most likely to use to claim expenses.

For more information about the WSIB benefits and services described in your guide, or to get this guide in French or on audiotape, please call your Serious Injury Adjudicator.

A definition of who is a seriously injured/severely impaired worker is on the next page.

There is also information on your support team and how to contact us.



Benefits for Seriously Injured Workers Workers are generally seriously injured/severely impaired if their degree of impairment:

• is permanent and is recognized by a 60% non-economic loss (NEL) benefit in one or more files

• is permanent and is recognized, in one or more claims, by permanent disability (PD) benefits totaling 100%; or

• is likely, in the opinion of a WSIB health care professional, to be permanent, and at the above level (60% NEL or 100% PD)

Your Serious Injury Program (SIP) Team Your support team Each seriously injured worker has a support team from the Serious Injury Program. Your support team meets together to learn about your case and find the best solutions for you. Your team will have:

• a Serious Injury Adjudicator • an Occupational Therapist/Independent Living Consultant • an Advanced Practice Nurse Case Manager • a Nurse Case Manager; and • a Healthcare/LMR Payment Representative

Your team is part of a larger group, either Team A or Team B.

The managers of Teams A and B report to Eliana Iannucci, the Acting Director.

Everyone on the team plays an important part in giving you the best customer service when handling your claim. The next section tells you who can best answer questions you have about SIP.



How to call the Serious Injury Program The WSIB Serious Injury Program is open from Monday to Friday between 8:00 a.m. and 4:30 p.m. You can get service in English, French and other languages.

If you live in the Greater Toronto Area, call the Serious Injury Program at (416) 344-1000. You can also call your Serious Injury Adjudicator directly at one of the telephone numbers listed on the next pages.

If you are calling from outside the Greater Toronto Area Step 1: Call the toll-free number 1-800-387-0750.

Step 2: Tell the receptionist the last 4 numbers of the phone number you want to reach.

TTY (telephone device for the deaf) 1-800-387-0050.

Fax and e-mail You can fax us at (416) 344-4684

Toll-free fax at 1-888-313-7373

You may e-mail staff directly. Please see the telephone and e-mail addresses on the next page.



SERIOUS INJURY PROGRAM Team A General number: 416-344-1000 Toll-free number: 1-800-387-0750

Name Title Phone Number e-mail

Del Bel Belluz, Luisa Manager 416-344-2846 Luisa Del Bel [email protected]

Blanchard, Randy Serious Injury Adjudicator 416-344-2814 [email protected]

Cacciacarro, Toni Serious Injury Adjudicator 416-344-2818 [email protected]

DeGiorgio, Nick Serious Injury Adjudicator 416-344-2819 [email protected]

Godovitz, Steve Serious Injury Adjudicator 416-344-2835 [email protected]

Lepore, Rose Serious Injury Adjudicator 416-344-2849 [email protected]

Panzarella, Rosa Administrative Assistant 416-344-2878 [email protected]

Pearce, Jacklyn Occupational Therapist 416-344-2825 [email protected]

Hirji, Farrah Occupational Therapist 416-344-2847 [email protected]

Gordon, Sharon Occupational Therapist 416-344-2879 [email protected]

Sinclair, Norm Independent Living Consultant 416-344-2891 [email protected]

Edmonds, Virginia AP Nurse Case Manager 416-344-2826 [email protected]

Haley, Margaret AP Nurse Case Manager 416-344-2843 [email protected]

Styan, Ginny AP Nurse Case Manager 416-344-2924 [email protected]

Browning, Carol Anne Nurse Case Manager 416-344-2817 Carol [email protected]

Vanderoude, Pamela Nurse Case Manager 416-344-2892 [email protected]

Zaver, Amira Nurse Case Manager 416-344-2947 [email protected]

Williams, Sharon Healthcare/LMR Payment Rep. 416-344-2805 [email protected]

Widdis, Pat Healthcare/LMR Payment Rep. 416- 344-2894 [email protected]

Ibrahim, Nabil Records Control Clerk 416-344-2864 [email protected]

Iannucci, Eliana Acting Director 416-344-6627 [email protected]

mailto:[email protected]




SERIOUS INJURY PROGRAM Team B General number: 416-344-1000

Toll-free number: 1-800-387-0750 Name Title Phone Number E-mail

March, Brenda Manager 416-344-3121 [email protected]

Carbone, Dave Serious Injury Adjudicator 416-344-2954 [email protected]

Froebel, Louise Serious Injury Adjudicator 416-344-2982 [email protected]

Gatta, Marisa Serious Injury Adjudicator 416-344-2985 [email protected]

Morris, Sheila Serious Injury Adjudicator 416-344-2126 [email protected]

Simonetta, Joe Serious Injury Adjudicator 416-344-3195 [email protected]

Cartaginese, Cathy Administrative Assistant 416-344-2958 [email protected]

Ebrahim, Zarfeen Occupational Therapist 416-344-3059 [email protected]

Carmichael, Deborah Occupational Therapist 416-344-3171 [email protected]

Jamieson, Melissa Occupational Therapist 416-344-3194 [email protected]

Hirji, Shaheeza Occupational Therapist 416-344-3208 [email protected]

Hopwood-Jones, Laurel AP Nurse Case Manager 416-344-3115 “LaurelHopwood_Jones”@wsib.on.ca

Oates, Susan AP Nurse Case Manager 416-344-3168 [email protected]

Hart, Marlene Nurse Case Manager 416-344-3097 [email protected]

Stonehouse, Janet Nurse Case Manager 416-344-3204 [email protected]

Dimech, Joyce Program Support Clerk 416-344-3185 [email protected]

Khan, Yasmein Acting Secretary 416-344-2886 [email protected]

Hopkinson, Eliana Healthcare/LMR Payment Rep. 416-344-3117 [email protected]

Iannucci, Eliana Acting Director 416-344-6627 [email protected]



December 2003 2264A (12/03)


MORE QUESTIONS? This table lists some kinds of questions that you may have and the person on your team that can best help you. If you are not sure who to call, please contact your Program Support Clerk. She will direct your call to the right person.

If you have questions or need to talk about your

contact your

• entitlement to benefits • treatment, • equipment needs

such as a wheelchair or special bed)

Serious Injury Adjudicator

• home and vehicle modifications • attendant’s allowance/personal care allowance • labour market re-entry • assistive devices • quality of life issues

Occupational Therapist/Independent Living Consultant

• home visit or • health care needs

Advanced Practice Nurse Case Manager/ Nurse Case Manager

benefits or allowances and their payment, such as • attendant’s allowance • vocational rehabilitation /personal care allowance • health care payments • repairs, or • clothing allowance

Healthcare/LMR Payment Representative

anything else about SIP

Program Support Clerk

See the WSIB Web Site for other information and links to related Web Sites

Introduction –6

December 2003 2264A (12/03)


Finding Your Guide on the WSIB Web site. A new, user-friendly version of Your Guide to Independent Living is now available on our Web site. The new version allows you to access and print copies of the WSIB forms you may need. To find Your Guide to Independent Living:

• Visit the WSIB Web site at www.wsib.on.ca

• Select your language preference of either English or French

• Click on the icon which reads For Workers

• Scroll down and then click on WSIB Benefits

• Scroll down to the heading which reads What Benefits Can I Receive?

• Scroll down and click on the link that reads Benefits for Seriously Injured Workers (new)

• Scroll down to the heading that reads Learn more about WSIB Benefits and Services.

• Then click on the link that reads Your Guide to Independent Living

Introduction –7

December 2003 Table of Contents –1 2264A (12/03)

Your Guide to Independent Living Table of Contents

Introduction About Your Guide to Independent Living .......... Introduction - 1 Benefits for Seriously Injured Workers............... Introduction - 2 Your Serious Injury Program (SIP) Team .......... Introduction - 2 How to Call the Serious Injury Program............. Introduction - 3 SIP Team A............................................................. Introduction - 4 SIP Team B ............................................................. Introduction - 5 More Questions? .................................................... Introduction - 6 Finding Your Guide on the WSIB web site ......... Introduction - 7

Part 1: Allowances Attendant’s Allowance/Personal Care Allowance Kinds of attendants .................................................................... 1 - 1 How you get this allowance....................................................... 1 - 1 Hiring and paying an attendant .................................................. 1 - 3 Your responsibilities as your attendant’s employer................... 1 - 4 Hiring a bookkeeper to help you................................................ 1 - 5 Clothing Allowance Who can receive a Clothing Allowance?................................... 1 - 7 How you get a Clothing Allowance........................................... 1 - 7 Independent Living Allowance Who can receive an Independent Living Allowance? ............... 1 - 8 How you get an Independent Living Allowance ....................... 1 - 9 Independent Living Devices over $250 Who can receive an Independent Living Device over $250? .... 1 - 9 How you get an Independent Living Device over $250 .......... 1 - 10 Guide and Support Dog Allowance Who can receive a Guide and Support Dog Allowance ......... 1 - 10 How you get a Guide and Support Dog Allowance................. 1 - 11 Travel and Escort Payments Travel ....................................................................................... 1 - 12 Parking ..................................................................................... 1 - 12 Escorts...................................................................................... 1 - 13 Hotels and meals ...................................................................... 1 - 13 How to claim travel and escort costs ....................................... 1 - 14



Quality of Life, Sports and Hobby Activities Sports ....................................................................................... 1 - 18 Hobbies .................................................................................... 1 - 18 Family life................................................................................ 1 - 19 How to apply............................................................................ 1 - 19

Part 2: Benefits Kinds of WSIB benefits ........................................................... 2 - 1 Benefits depend on Workplace Safety and Insurance Act....................................2 - 1 Definitions Consumer Price Index (CPI)...................................................... 2 - 1 Benefits: Future Economic Loss (FEL)..................................................... 2 - 2 Loss of Retirement Income benefits .......................................... 2 - 2 Non-Economic Loss (NEL) ....................................................... 2 - 2 Survivor benefits........................................................................ 2 - 3 Benefits for workers seriously injured before 1998 Benefits stay the same with the current Act ............................... 2 - 4 Report changes quickly to WSIB............................................... 2 - 4 Job retraining ............................................................................. 2 - 4 Reviewing Future Economic Loss (FEL) benefits..................... 2 - 5 Cost of living increases for FEL recipients................................ 2 - 5 Benefits for workers seriously injured in 1998 or later Loss of Earnings (LOE) benefit ................................................. 2 - 6 Cost of living increases.............................................................. 2 - 7 LOE payments ........................................................................... 2 - 8 LOE payment reviews................................................................ 2 - 8 Calculating average earnings ..................................................... 2 - 9 Reviewing your average earnings Reasons for requesting a review .............................................. 2 - 10 Your employer may request a review ...................................... 2 - 10 Non-earning periods................................................................. 2 - 11 Non-Economic Loss (NEL) benefit Establishing your NEL benefit................................................. 2 - 11 Calculating your NEL base amount......................................... 2 - 12 How the NEL benefit is paid ................................................... 2 - 13



NEL reviews ............................................................................ 2 - 13 Loss of Retirement Income benefits for workers injured from 1990 to 1997 Loss of Retirement Income amount......................................... 2 - 14 Can my family collect my Loss of Retirement Income benefit after my death?............................................................. 2 - 15 Loss of Retirement Income benefits for workers injured after 1997 Loss of Retirement Income amount......................................... 2 - 16 Who can receive my Loss of Retirement Income benefit? ...... 2 - 16 Pre-retirement death benefits ................................................... 2 - 17 How do I apply for Loss of Retirement Income benefits?....... 2 - 18 Survivor benefits Who can receive Survivor benefits? ........................................ 2 - 18 Lump sum payments ................................................................ 2 - 19 Splitting Survivor benefits for spouses .................................... 2 - 20 Dependent children where there is no spouse.......................... 2 - 20 Monthly payments .....................................................2 - 21 to 2 - 23

Part 3: Health Care Paying for health care costs ....................................................... 3 - 1 Health care outside Ontario ....................................................... 3 - 2 Advanced Practice Nurse Case Managers ................................. 3 - 2 Testing and treatment Getting referred to a Specialty Clinic ........................................ 3 - 3 Therapies Brain injury rehabilitation.......................................................... 3 - 4 Psychotherapy ............................................................................ 3 - 5 Chiropractic care........................................................................ 3 - 5 Physiotherapy, occupational therapy and speech therapy.......... 3 - 6 Pain therapy (TENS unit)........................................................... 3 - 6 Other therapies ........................................................................... 3 - 7 Health-related living aids Prosthetic devices (artificial limbs) ........................................... 3 - 8 Orthotic devices (corrective devices)......................................... 3 - 8



Eyeglasses and hearing aids....................................................... 3 - 8 Wheelchairs and scooters...........................................................3 – 9 Prescription drugs.................................................................... 3 - 9 Home care and supported living Short-term home care............................................................... 3 - 10 Long-term home care............................................................... 3 - 10 Residential facilities................................................................. 3 - 10

Part 4: Services New Law ................................................................................... 4 - 1 Key changes to the Act............................................................. 4 - 2 Obligations of employers under the current Act ........................ 4 - 2 Penalties for employers who do not co-operate......................... 4 - 3 Obligations of workers under the current Act ............................ 4 - 3 Penalties for workers who do not co-operate............................. 4 - 3 Early and Safe Return to Work.............................................. 4 - 4 While you are off the job ........................................................... 4 - 4 When you are able to come back to work.................................. 4 - 4 When you are back at work ....................................................... 4 - 5 Return to work for construction workers ................................... 4 - 6 Making changes in your workplace ....................................... 4 - 6 Labour Market Re-entry Replacing Vocational Rehabilitation ......................................... 4 - 7 How the Board decides to do a Labour Market Re-entry assessment........................................ 4 - 8 The Labour Market Re-entry assessment process ..................... 4 - 8 Goals of the Labour Market Re-entry plan ................................ 4 - 9 What the plan looks like ............................................................ 4 - 9 When might my Labour Market Re-entry plan change? ......... 4 - 10 Labour Market Re-entry costs paid for by the WSIB.............. 4 - 11 How Labour Market Re-entry costs are paid........................... 4 - 11 Making changes to your home Home changes.......................................................................... 4 - 12 Elevators .................................................................................. 4 - 12 Making changes to your vehicle ........................................... 4 - 13



Part 5: Community Contacts Ontario Brain Injury Associations ............................................ 5 - 1 Ontario Head Injury Associations............................................. 5 - 1 Family and Peer Support Groups.............................................. 5 - 6 Canadian Paraplegic Association.............................................. 5 - 8 Canadian Abilities Foundation ................................................ 5 - 10 Abilities magazine ................................................................... 5 - 10 Ability Web site and EnableLink............................................. 5 - 10 Easter Seals/March of Dimes National Council ...................... 5 - 11 Paralyzed Veterans of America ............................................... 5 - 12

Part 6: Sample Forms Using WSIB Forms to Claim for Expenses…………………..6 - 1 Serious Injury Program Health Care Expenses Form – 3039A....................................... 6 - 2 WSIB Medication Reimbursement Form – 0806A .................. 6 - 3 WSIB Worker Health Care Travel Expense Form – 3462A..... 6 - 4

December 2003 1 –1 2264A (12/03)

Your Guide to Independent Living Part 1: Allowances

Attendant’s Allowance/Personal Care Allowance An attendant is someone who helps with daily activities, such as washing, eating and dressing.

The Workplace Safety and Insurance Board pays for one or more attendants if you need them.

Depending on what you need, an attendant might be: • a health professional • a family member • someone the court has made responsible for your care • someone you choose who can best help you.

Kinds of attendants Skilled attendants are health professionals who give you health care you may need, such as special medicine.

Personal attendants help you with daily tasks such as dressing, bathing, and exercising.

Around the clock attendants monitor equipment such as ventilators, give night time care, and do housekeeping.

How you get this allowance Your Occupational Therapist/Independent Living Consultant or Nurse

The WSIB will send a staff member called an Occupational Therapist/Independent Living Consultant, or a nurse, from the Serious Injury Program to help you decide what kind of attendant care you need. These persons have a good understanding of your medical condition.

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The Activities of Daily Living Scale (ADLS)

The Occupational Therapist/Independent Living Consultant or nurse will gather information from you in order to complete an Activities of Daily Living Scale (ADLS). A family member or friend can also help with the evaluation.

The ADLS Scale asks questions such as: • What things can you do without help? • What things do you need help with? • How often do you need help? • Who is helping you now? • How much time does it take to help you?

Rating your needs

After the meeting, the Occupational Therapist/Independent Living Consultant or nurse will decide how much the WSIB will pay for an attendant. The consultant or nurse will send you a letter explaining:

• how much you will get each month • how they made the decision.

The allowance might cover all or part of the cost of the attendant. It might cover one or more attendants, depending on your needs.

How we send you the allowance

The WSIB can send your attendant’s allowance/personal care allowance in two ways:

• They can mail you a cheque. • You can arrange for the money to go directly into your bank

account.

When you get the allowance

The allowance starts from the date that you began to need an attendant. The WSIB sends the money during the last two weeks of each month.

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Reviewing your allowance

In most cases, the WSIB reviews your allowance every three years. But if your health changes, the Occupational Therapist/Independent Living Consultant or nurse will do a review sooner.

If the change in your health is small, the consultant will do a simple review over the phone. If the change is big enough to affect your need for an attendant, the Occupational Therapist/Independent Living Consultant or nurse will come to your home and rate your needs again with the ADLS scale. If you are hospitalized for more than 60 days it is your responsibility to notify us. Your personal care allowance will be suspended on the 61st day and reinstated upon discharge home to your caregiver.

Hiring and paying an attendant Who hires the attendant?

In most cases, you are responsible for: • choosing an attendant • hiring the attendant • telling your attendant how to help you.

Who pays the attendant?

In most cases, you are responsible for paying the attendant out of your attendant’s allowance/personal care allowance.

If you need help

If you have no family member or friend to help provide attendant care to you, the WSIB may hire a home care agency to provide the care for you.

Call the Serious Injury Program if you need advice, and talk to your Occupational Therapist/Independent Living Consultant or nurse. The telephone numbers are on pages Introduction - 3 to Introduction - 5 of this manual.

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Respite

The personal care allowance will continue for a two-week period once per year while the attendant takes a well-deserved break. The WSIB will cover the cost of replacement attendant care during this time period. This change is being made to incorporate the new practice initiated by the Serious Injury Program in June 2001.

Your responsibilities as your attendant’s employer Are you your attendant’s employer?

You are the employer if your attendant cares for you for more than 24 hours a week. That means:

• If you receive a personal care allowance you should contact the Canada Revenue Agency (CRA).

• You must pay Employer Health Tax. • You must also be registered as an employer with the WSIB.

The Serious Injury Program will take care of all the paperwork to make sure your attendant has workplace safety insurance.

The Serious Injury Program will pay for these extra costs in your allowance.

Registering with the Canada Revenue Agency (CRA) As an employer, you will have to make the following regular remittances to the CRA.

• employer and employee contributions for Canada Pension Plan (CPP)

• employer and employee contributions for Employment Insurance

• income tax deductions for your attendant.

The Canada Revenue Agency (CRA) will send you a statement telling you how much to deduct and remit. Give a copy of this statement to the Serious Injury Program and they will adjust your allowance to cover the costs.

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Employer Health Tax

The Employer Health Tax (EHT) is a percentage of your attendant’s gross salaries and benefits.

The Ontario Ministry of Revenue will send you a statement telling you how much you must pay. Once you have paid, send a copy of the statement to the Serious Injury Program. We will increase your allowance to cover this cost.

Other employer responsibilities

You may need to register with other federal and provincial agencies. Your Occupational Therapist/Independent Living Consultant will tell you if anything else needs to be done.

Hiring a bookkeeper to help you Bookkeeping fees

You may need to hire someone to help you carry out your responsibilities as your attendant’s employer. The WSIB will pay up to $720 a year for bookkeeping fees as part of your allowance.

How to claim the fees

Follow these steps to claim your bookkeeping fees:

1. Ask your bookkeeper for an invoice that shows: • their name and address • how many hours they worked for you • the cost.

2. Pay the bookkeeper out of your own money.

3. Get a receipt for the money you paid.

4. Mail the invoice and receipt to the Serious Injury Program with your claim number on it.

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The Serious Injury Program’s address is:

Workplace Safety and Insurance Board Serious Injury Program 200 Front Street West Toronto ON M5V 3J1

Fax: (416) 344-4684

After they have reviewed your claim, the WSIB will increase your allowance to cover the cost.

Clothing Allowance You can receive a yearly Clothing Allowance if you must wear a prosthetic device, such as an artificial limb, or an orthotic support. This allowance covers the cost of wear and tear on clothing caused by these devices.

Upper body prosthetic and orthotic devices: • back brace (Harris type) • wheelchair • arm prosthesis • arm brace • back support or corset • wrist gauntlet • cervical brace • crutches.

Lower body prosthetic and orthotic devices: • leg prosthesis • leg brace • knee brace.

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Who can receive a Clothing Allowance? You are eligible for a Clothing Allowance if you meet all of these conditions:

1. You have recovered from your injuries as much as possible. This is often called Maximum Medical Rehabilitation or MMR.

2. You have a permanent impairment and have received a Non-Economic (NEL) or permanent disability benefit.

3. You have been wearing a prosthetic or orthotic device for one year since you received your permanent disability benefit.

4. The WSIB has approved the prosthetic or orthotic that you wear.

You are not eligible for a clothing allowance for: • a prosthesis you wear because of an amputation below the

ankle or wrist • an orthotic for your ankle or foot • soft cervical collars.

How you get a Clothing Allowance Your Clothing Allowance is based on the number of hours a week that you wear your prosthetic or orthotic device. You can receive a maximum of two allowances per year – one for upper body devices and another for lower body devices.

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Your Serious Injury Adjudicator will help you fill out your application for a Clothing Allowance. On the application, describe how often you use your prosthetic or orthotic and the actual damage to your clothing.

If you wear an orthotic device, you may be asked to give medical information showing your need to continue using it. In certain cases, we may refer you to an orthopaedic specialist.

When you get your Clothing Allowance You will get your Clothing Allowance each year on the date you first received your permanent disability or non-economic loss (NEL) award.

Reviewing your Clothing Allowance In most cases, you must re-apply for the Clothing Allowance each year. However, the Board will make arrangements so that paraplegic, quadriplegic, and double amputee workers won’t have to re-apply for an allowance each year.

Independent Living Allowance Who can receive an Independent Living Allowance? You can have an Independent Living Allowance if:

• you are 100 % permanently disabled, or • you receive a 60 % non-economic loss (NEL) award.

An Independent Living Allowance pays for services and devices which help you live more fully and independently.

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The allowance covers: • inside and outside home maintenance costs, such as painting • yard maintenance, such as snow shovelling, lawn and yard

care • non-vocational services, such as recreational programs,

group therapy, Internet fees or user support • non-vocational devices that cost less than $250, such as a

cordless telephone.

How you get an Independent Living Allowance The amount of the allowance for 2004 is $3,177.57. You will receive your allowance as a lump sum once a year. It is up to you to decide how to spend the money. You do not have to give receipts to the WSIB. You do not have to re-apply for the allowance each year.

Independent Living Devices over $250 Who can receive an Independent Living Device over $250? If you receive an Independent Living Allowance (ILA), you may also purchase Independent Living Devices that cost more than $250 – unless your ILA could be used to purchase a service that would meet the same objective. For example, the WSIB won’t pay for a snowblower when your ILA can pay for snow shovelling service.

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Independent Living Devices help restore your ability to: • communicate • be mobile • take care of personal hygiene • prevent further injury or health complications.

These devices include but are not limited to: • personal computers • automatic page turners • easylift/veculator-type chairs • motorized scooters • hobby/sports equipment • specialty hospital beds.

How you get an Independent Living Device over $250 You can ask the WSIB for an Independent Living Device over $250 if your doctor makes a recommendation to your Occupational Therapist/Independent Living Consultant.

Guide and Support Dog Allowance Who can receive a Guide and Support Dog Allowance? You may need a guide and support dog if you have:

• impaired sight • profound deafness, or • significant mobility needs.

For 2004 the annual benefit for guide and support dog allowance is $860.75. This benefit is indexed annually.

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The allowance pays for: • feeding and caring for your guide and support dog • veterinary care.

Note: If you have to pay more than your annual allowance for unexpected/special veterinary care, send the receipts to the Board for payment.

How you get a Guide and Support Dog Allowance You can ask the WSIB for a Guide and Support Dog Allowance if your doctor makes a recommendation to your Occupational Therapist/Independent Living Consultant. The WSIB will pay for your guide and support dog as well as the training required for you and your dog to work as a team.

Travel and Escort Payments The WSIB will reimburse you for the costs of your coming to WSIB programs or appointments that we schedule. Costs include:

• travel • parking • your escort • hotel and meals for you and your escort.

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The WSIB must approve your costs in advance. The costs are based on your health care needs. Please note the following:

Travel If public transit is available and you are able to use it, the Board will only pay for this.

If you cannot take public transit, the Board will pay for a cab or mileage, based on the most direct route.

If you have to stay in hospital far from home, the Board will pay travel costs for one trip home per month.

You may ask for more than one trip home a month for compassionate reasons. The Board will review each request.

If you are not able to travel, you can ask the Board to pay travel costs for a relative to visit you.

Parking The Board will pay for your parking if :

• you are not able to take public transit and must use a car or van

• public transit is not available and you must use a car or van • parking receipts will be required.

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Escorts If you need an escort for health reasons or because you are under 16, the WSIB will pay for your escort’s time and travel costs. Your escort can be:

• a health care professional • a registered nurse • a parent • your spouse • your adult child.

Escorts are paid a daily rate. This is a set amount established by the Board. The Board also pays for their travel, hotel and meals.

Note: You must get WSIB approval for an escort before your appointment.

Hotels and meals The WSIB pays for hotels and meals when workers and their escorts must stay away from home to attend Board-scheduled appointments.

There is a maximum amount set that we will pay for meals each day. Check with your Serious Injury Adjudicator to learn this amount.

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How to claim travel and escort costs When you pay out money for travel and escort costs to come to a Board-approved appointment, you can get that money back by claiming it.

This section tells you how to: • calculate your mileage, if you will be coming in your car or

van • claim for health-related appointments, such as doctor’s

examinations or physiotherapy appointments • claim for job-related appointments such as vocational

rehabilitation or labour market re-entry.

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How to calculate your mileage

Follow these steps to calculate your mileage and make a claim:

Step Action

1 Before you start your trip, write down the number of kilometers on your odometer.

2 When you get to your appointment, write down the new number on the odometer. Note: The Board will only pay for driving by the

most direct route.

3 Subtract the old number from the new number. Result: This is the number of kilometers you can

claim for the first part of your trip.

4 Repeat Steps 1 through 3 to get the number of kilometers on the trip back.

5 Add up the total number of kilometers for both ways.

6 Multiply your total number of kilometers by the Board’s set rate per kilometer. Result: This gives you the dollar amount you can

claim for mileage. Note: You can get help with calculating your

mileage from your Serious Injury Adjudicator.

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How to claim expenses for health-related appointments

Follow these steps to claim expenses for health-related appointments, such as a doctor’s examination or a physiotherapy appointment.

Step Action

1 Gather all of your receipts for: • travel • parking • your escort’s daily rate • hotel and meals for you an your escort.

Important: You must have receipts for each expense you claim.

2 If you used your own car or van, write down and calculate your mileage. (See the section “How to calculate your mileage.”)

3 Include your health appointment cards for each appointment. Note: You can also ask your doctor’s office for a

list of your appointment dates. This must include:

• the date • the reason for the visit • the condition that was treated.

4 Make and keep copies of your receipts, mileage

and appointment cards.

5 Mail your claim to your Serious Injury Adjudicator. (see address page 1-6) Be sure to include all: • receipts • mileage • appointment cards or a list from your doctor.

Result: Your Serious Injury Adjudicator will add up

your expenses and the Board will mail you a cheque to cover the costs you claimed.

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How to claim expenses for job-related appointments Follow these steps to claim expenses for job-related appointments such as:

• vocational rehabilitation • market re-entry • return to work.

Note: This does not include a routine job search.

Step Action

1 Gather all of your receipts for: • travel • parking • your escort’s daily rate • hotel and meals for you an your escort.

Important: You must have receipts for each expense you claim.

2 Fill out a Worker Health Care Travel Expense Form (Form 3462A). Note: There is an example of this form at the

back of this Guide. You can make copies of it to fill out. You can also print the form off the WSIB Web Site, wsib.on.ca. Go to Your Guide to Independent Living, Part 6, Sample Forms.

3 If you used your own car or van, write down and calculate your mileage. See the section “How to calculate your mileage.”) Enter your mileage on the Worker Health Care Travel Expense Form (Form 3462A.)

4 Sign and date the completed form. 5 Make and keep photocopies of the form and all

of your receipts.

6 Attach your original receipts to the form.

7 Mail your expense claim to your Occupational Therapist/Independent Living Consultant. (see address page 1-6) Result: Your Occupational Therapist/Independent

Living Consultant will approve your expenses and the Board will mail you a

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cheque to cover the costs you claimed.

Quality of Life, Sports, and Hobby Activities The WSIB will buy you a special wheelchair, prosthetic or attachment so you can continue to:

• enjoy a sport • work at a hobby • take part in family life

The following are some examples of things the Board will pay for through the independent living allowance policy or the assistive devices policy.

Sports A worker who has lost an arm wants to start bowling again. The Board will pay for a special arm prosthetic so the worker can hold and throw a bowling ball.

Another worker who now uses a wheelchair wants to play basketball. The Board will pay for a special chair so the worker can play wheelchair basketball.

Hobbies A worker who enjoyed fishing before losing an arm wants to start fishing again. The Board will pay for a special fishing rod attachment so the worker can fish.

Another worker wants to make leather crafts at home. The WSIB will pay for tools and start-up supplies.

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Family life A worker enjoys watching TV with the family, but cannot get to the basement where the family room is. The WSIB will pay for an elevator so the worker can get to the basement.

How to apply Ask your Occupational Therapist/Independent Living Consultant. This person will work with you and your family to arrange for equipment, supplies, or home modifications.

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Your Guide to Independent Living Part 2: Benefits

Kinds of WSIB benefits This part of the Your Guide to Independent Living is about the benefits you are entitled to as a seriously injured worker.

WSIB provides several kinds of insurance money in the form of: • benefits for loss of earnings and impairment • Loss of Retirement Income benefits, and • Survivor benefits.

Benefits depend on Workplace Safety and Insurance Act The benefits you receive depend on the law called the Workplace Safety and Insurance Act (WSI Act). The WSI Act replaced the Workers’ Compensation Act on January 1, 1998.

Cost of Living Increase If you receive a 100% permanent disability in one claim or 100% FEL then you receive a full cost of living increase each January. The cost of living increase is based on the Consumer Price Index.

Consumer Price Index The Consumer Price Index (CPI) is sometimes called the cost of living index because it measures the cost of buying things such as food, housing, clothes, and transportation.

Each year, over 400 goods and services are measured to find out how much their prices go up or down from the year before. Some benefits have full or partial cost of living increases. The Consumer Price Index is set by the federal government.

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Benefits If you have a work-related injury or illness and cannot work, the WSIB provides two kinds of benefits: Future Economic Loss (FEL) benefits: FEL benefits are paid to workers whose claims started between January 2, 1990 and December 31, 1997. FEL benefits replace lost wages you would have earned had you not been injured. For workers whose claims started on or after January 1, 1998, these benefits are called Loss of Earnings (LOE) benefits.

Loss of Retirement Income benefits The WSIB sets aside additional funds equal to 10 % of every FEL payment made to a worker. For workers who receive a loss of earnings (LOE) benefit for more than 12 continuous months, the WSIB sets aside additional funds equal to 5 % of every LOE payment beyond 12 months.

In addition to this 5 % that is set aside in all cases, the WSIB offers workers the option of contributing 5 % of each LOE payment to the Loss of Retirement Income (LRI) Fund.

The contributions made to the LRI Fund plus the investment income it accumulates, is used to fund the Retirement Income benefit.

Non-Economic Loss (NEL) benefits:

If your workplace injury or illness is severe enough to cause a permanent impairment, you also get a Non-Economic Loss (NEL) benefit.

You get a NEL benefit when:

• your health care professional does not think your condition will improve much more (you reach maximum medical recovery - MMR), and

• there is permanent impairment resulting from work injury.

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Survivor benefits Survivor benefits provide money to the survivors of workers who have died. These benefits:

• cover costs of transporting the worker’s body to his or her home community,

• help pay burial or cremation costs,

• provide grief counselling for the surviving spouse and children in the first year after the worker’s death,

• can help a spouse return to the workforce, and

• pay lump sum and monthly survivor payments.

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Benefits for workers seriously injured before 1998 Benefits stay the same with current Act The Workplace Safety and Insurance Act took effect on January 1, 1998. If you were injured before 1998 your benefits did not change under the current Act. Your insurance money is based on the Workers Compensation Act that was in place when your claim started. Your cheque stays at the same benefit level if you were receiving insurance money for a:

• 100% permanent disability, • Future Economic Loss (FEL), or • 60% Non-Economic Loss (NEL).

Report changes quickly to WSIB If your income, medical condition, or work status changes, you must tell the WSIB within 10 days. This helps ensure that you get the right amount of money.

Job retraining If you planned to do job skill training, and WSIB approved your vocational rehabilitation (VR) before January 1998, then the Board will continue to honour its commitment. This includes all travel expenses provided for those plans. As of January 1998, return to work services offered are:

• Early and Safe Return to Work (ESRTW), and • Labour Market Re-entry (LMR) assistance.

Please See page 2-16 for details.

Please see Part 4 for details about these programs

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Reviewing Future Economic Loss (FEL) benefits If you get FEL benefits, the WSIB will review them:

• whenever you report a change in income, medical condition, or work status;

• annually if necessary; or • 72 months after the date of your accident for the last time.

If you receive a 100% permanent disability in one claim or 100% FEL benefit, then you receive a full cost of living increase each January.

For example, in 1998, the cost of living went up by 1.5%. If you are receiving a 100% permanent disability amount in one claim, this 1.5% increase is applied to the earnings basis used to calculate your benefits. If you receive a FEL, this 1.5% is applied to your actual disability cheque.

Cost of living increases for FEL recipients

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Loss of Earnings for workers seriously injured in 1998 or later This is what you must do to receive benefits, called Loss of Earnings (LOE) benefits, if you were injured in or after 1998:

• apply for insured benefits within six months.

• ask your health care professional to give your employer information about your ability to do a job. They do this by filling out a Functional Abilities Form. This way when the time comes you and your employer can plan for you to return safely to work.

• let the Board know within 10 days if your income, work status or medical condition has changed.

Loss of Earnings (LOE) benefit A Loss of Earnings (LOE) benefit is 85% of your average pre-injury take-home pay, less any wages you get after your injury, up to an annual maximum. For example, if your pay (after deducting income tax, CPP and UIC) was $800 every 2 weeks, then:

1. Multiply $800 x .85 = $680.00 2. Subtract any wages - 0.00 3.This is your LOE benefit. $680.00

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Cost of living increases You may also get a cost of living increase, based on the Consumer Price Index. The Consumer Price Index (CPI) is sometimes called the cost of living index because it measures the cost of buying things such as food, housing, clothes, and transportation. Each year, over 400 goods and services are measured to find out how much their prices go up or down from the year before.

The following table shows how the WSIB calculates your cost of living increase.

If you receive then you get 100% LOE, or 100% PD Award, or 100% FEL less than 100% LOE,

full CPI 1/2 CPI – 1, up to a maximum of 4%. For example, if CPI is 2.5%, the formula is: 2.5% /2 =1.25% – 1 = .25%.

CPI= Consumer Price Index

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Loss of Earnings (LOE) payments Your Loss of Earnings (LOE) benefit is paid every two weeks.

LOE payments start: • the day after the injury (your employer must pay your wages

on the day of injury) or

• when you stop getting your take-home pay. LOE payments stop when you: • are no longer impaired because of the injury, • no longer have a loss of earnings, or • reach age 65, whichever comes first.

Note: If you are 63 or older when you are injured, the benefit may be paid for up to 2 years after the injury.

Loss of Earnings (LOE) payment reviews During the first 6 years after your injury, the WSIB may review your LOE benefit annually, or if your income, work status, or medical condition changes.

If you did not report a change in income, work status or medical condition during the first 6 years, which you should have, the WSIB may review and change your LOE benefit after the 6 years.

In some cases, workers 55 or older may not have as many LOE reviews.

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Calculating average earnings To calculate your Loss of Earnings benefit, the WSIB needs to know your average weekly rate of earnings. It estimates the average as follows:

If your claim is in weeks

and you work then your LOE benefit is 85% of your

The average is based on all earnings from all employers

1 - 12 in any kind of job

short-term average weekly earnings.

in a permanent, regular job

during the last year before your injury.

on contract work, through a union hall, or seasonally

during the 2 years before your injury.

13 or more

for more than one employer at the same time

long-term average weekly earnings.

based on the nature of the jobs.

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Reviewing your average earnings Reasons for requesting a review You may request a review if you were in a permanent job when you were injured, and just before your injury happened:

• your average hours of work changed, • you changed from seasonal or contract, to permanent, • you changed from permanent to seasonal or contract, • you were promoted or demoted, • you earned occasional overtime, • you were unemployed and received employment insurance

benefits, or • you worked for another employer.

As a result, you might have earned more or less than usual. Your short-term average earnings might not show this fairly. You can have your average reviewed based on what you earned with your employer in the year before your injury.

Your employer may request a review Your employer may also request a review of your short-term average earnings if you were laid off during the year before injury because of a shortage of work.

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Non-earning periods So that your earnings are not unfairly reduced, some non-earning periods are not part of the review. These include:

• maternity, paternity, or parental leave, • full-time study, • illness or long-term disability, and • periods on workers’ compensation benefits.

Non-Economic Loss (NEL) benefits

If your workplace injury or illness is severe enough to cause a permanent impairment, you also get a Non-Economic Loss (NEL) benefit.

You get a NEL benefit when: • you reach maximum medical recovery (MMR), • your health care professional does not think your condition

will improve much more, and • your body or mind is still impaired.

Establishing your Non-Economic Loss (NEL) benefit The following process is used to establish your NEL benefit:

1. WSIB gives you a list of health care professionals trained to assess your injury or illness.

2. Within 30 days, you must arrange to be examined by a health care professional from the list.

Note: You must tell WSIB the name of the person you chose. If they work outside your area, the Board will pay your travel expenses and lost wages.

Accidents after January 1, 1990

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3. If you do not contact WSIB within 30 days, WSIB will choose a health care professional for you.

4. After examining you, the health care professional will write a report and send it to: - the WSIB, - you, and - your employer.

5. WSIB will decide your NEL benefit based on your medical file and the medical report. This is done using guidelines to assess the percentage of your impairment.

6. The benefit is your NEL base amount multiplied by the percentage of your permanent impairment.

Calculating your Non-Economic Loss (NEL) base amount The 1990 original base amount, set out by law and indexed to inflation, was $45,000. The base amount goes up or down each January based on a cost of living index.

The index is half the Consumer Price Index (CPI) - 1 (up to 4 %).

For every year your age is under 45, add $1,000. For every year your age is over 45, subtract $1,000. The maximum amount you can add to or subtract from the base is $20,000. This means that the maximum base amount is $65,000, and the minimum base amount is $25,000. If you are under age 25, the maximum base amount is still $65,000. The following table shows some examples of base benefit amounts.

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AGE NEL BASE BENEFIT AMOUNT

25 $65,000 (maximum) 35 $55,000 45 $45,000 55 $35,000 65 $25,000

These base benefit amounts listed are then multiplied by the percentage of your permanent impairment.

How the Non-Economic Loss (NEL) benefit is paid If your NEL benefit is more than $11,456.30, you can get the money all at once or in monthly payments for the rest of your life. You have 30 days after your NEL review to let the Board know if you want to get monthly payments or a lump sum (if the award is more than $11,456.30). If you ask for a lump sum, you cannot change your mind.

Non-Economic Loss (NEL) reviews Since January 1998, reviews of NEL benefits are subject to new policies on:

• second medical assessments, • lump sum payments, and • reviews of decisions.

Second medical assessments:

If there wasn’t enough information in the first medical assessment, WSIB can request a second medical assessment for claims referred for a NEL review.

Reviews of decisions:

If your first NEL benefit was rated at 0%, you cannot request a review of the decision.

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Loss of Retirement Income benefits for workers injured from 1990 to 1997 If you receive a Future Economic Loss (FEL) benefit, you will get a Loss of Retirement Income benefit from the Board when you reach age 65.

Loss of Retirement Income amount WSIB puts an extra 10% of each FEL payment into your retirement fund. Your Retirement Income benefit is based on the funds set aside, plus the income from their investment.

When you reach age 65, WSIB determines based on the legislation whether to pay you a lump sum or a monthly amount during your retirement. The decision is based on your account balance. if your WSIB account balance will provide a yearly benefit of

then WSIB pays you

$1,000 (1990 dollars) or less, a lump sum.

$1,000 (1990 dollars) or more, a monthly amount each year during your retirement. This is called an annuity.

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Note: The $1,000 is indexed annually, based on 1990 dollars. In other words, if the cost of living goes up, then the yearly amount will go up. If the cost of living goes down, the amount will go down. For 2004, the amount is $1,159.43. There are many annuity options. For example, you can choose to receive:

• a joint and survivor annuity (if you have a spouse); or

• a life annuity (if you don’t have a spouse).

This Loss of Retirement Income benefit does not affect any other pensions you may get from:

• employment pension income,

• old age security (OAS) benefits,

• Canada Pension Plan (CPP) retirement pension, and

• continuing NEL benefit.

Can my family collect my Loss of Retirement Income benefit after my death? If you die because of your workplace injury or illness, your spouse and dependants are entitled to Survivor Benefits.

If you die of some other cause, we (WSIB) will pay a Pre-Retirement Death Benefit.

Please see Survivor benefits at the end of this part of the guide

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Loss of Retirement Income benefits for workers injured after 1997 You receive a Loss of Retirement Income benefit if:

• your accident date is January 1, 1998 or later, and • you received Loss of Earnings (LOE) benefits for more than

12 continuous months.

Loss of Retirement Income amount The Board will contribute an extra 5% of every LOE payment to your retirement fund. You may also choose to contribute 5% from your LOE benefit payments.

Your Loss of Retirement Income benefit is based on the funds set aside by the WSIB and any extra money you choose to put in, plus the income from their investment.

If yearly pension is Then you

Under $1,159.43 (year 2004 $) Will get a lump sum payment

Over $1,159.43 (year 2004$) Will get a retirement annuity.

Who can receive my Loss of Retirement Income Benefit? WSIB pays your loss of retirement income as follows.

If you Then WSIB

Live to age 65 Pays your benefit to you

Die before age 65 May pay death benefits, as shown below

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Pre-retirement death benefits If you die before age 65, your survivors may get pre-retirement death benefits. WSIB pays them as follows. If your death And your accident

happened on or after Then WSIB

Is not related to your workplace injuries,

January 2, 1990 • pays your survivor, beneficiaries or estate the contribution made by the WSIB plus investment income earned

Is not related to your workplace injuries

January 1, 1998 • pays your survivor, beneficiaries or estate the 5 % contribution made by the WSIB plus the 5 % contribution you made (if you made this contribution) plus investment income earned.

Your survivor benefit is paid to: • your spouse, • if no spouse, any dependent children in equal shares, • if no dependent children, other dependents in equal shares,

or • if no spouse or dependents, the estate.

This Retirement Income benefit does not affect any other pensions you may get from:

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• employers, • Canada Pension Plan or Quebec Pension Plan, or • Old Age Security.

How do I receive Loss of Retirement Income benefits? The WSIB will pay you this loss of retirement income when:

• you turn 65, provided • you were getting FEL or LOE benefits for more than 12

continuous months. This benefit is automatically triggered when you turn 65.

Survivor benefits WSIB pays survivor benefits to your dependents based on the table below.

If you had your accident Then WSIB pays survivor benefits if

Before January 1, 1990 After January 1, 1990

your death resulted from your work injury, or you were getting a 100% disability benefit under one claim. In this case, your death may or may not result from your work injury or illness. your death must be a result of your work injury.

Who can receive Survivor benefits? Family members who depended on your earnings while you were alive get survivors’ benefits. These dependants might include your:

• spouse (either by marriage or common-law) or • natural or legally adopted children, or step-children who

normally lived with you. If there is no surviving spouse or children, other dependants may be eligible for survivor benefits, such as parents, step-parents or persons who acted as your parent.

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Lump sum payments Spouses

If your spouse is 40 years old, he or she receives $40,000 as the base amount for lump sum payments. For each year under age 40, he or she gets another $1,000. For each year over age 40, he or she gets $1,000 less. The base amount and the amount change each January based on cost of living.

Some sample ages and amounts are listed here: Age Survivor Income benefit

20 $60,000 (maximum) 30 $50,000 40 $40,000 50 $30,000 60 $20,000

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Splitting survivor benefits for spouses

If more than one person is entitled to benefits as a spouse, the lump sum payment and the monthly ongoing payments are split among them. The total lump sum payments to all spouses may not exceed the maximum set for the spousal lump sum benefit for that year.

A separated spouse is entitled to benefits if: • you were required to make support payments until you died,

or • the spouse can prove dependency on you at the time of your

death. Dependent children where there is no spouse

To receive survivor benefits, dependent children must be: • under age 19, or • if enrolled in an educational program, under age 25.

Dependent children share equally the lump sum that would have been payable to a dependent spouse at age 40. WSIB may pay the children directly or send their benefits to their:

• parent, • guardian, • lawyer, • public guardian and trustee, or • other person acting in their best interest.

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Monthly payments Cost of Living

To reflect the cost of living, the monthly payments change each year on January 1.

Pension plan benefits

When calculating the monthly payment, WSIB considers the Canada Pension Plan or Quebec Pension Plan benefits paid to the surviving spouse or dependants.

Net average earnings

WSIB benefits are based on a percentage of the worker’s net average earnings, up to the annual maximum. In this section, “earnings” refers to net average earnings.

Surviving spouse with no children

Your spouse receives a percentage of your earnings based on his or her age when you died. Your spouse cannot receive less than 20% or more than 60% of your net average earnings. This percentage does not change with age and is paid for life.

Some sample ages are listed below. If your spouse is Then he or she will receive

20 or under, 20% of your net average earnings 30 30% of your net average earnings 45 45% of your net average earnings 60 or over 60% of your net average earnings

Surviving spouse with dependent children

Family members who depended on your earnings while you were alive, will receive monthly payments. The monthly benefit will be based on 85% of your net average earnings at the time of your death.

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When your first child turns 19, WSIB reviews the benefits. If he or she is enrolled in an educational program, 10% of your surviving spouse’s payment will be deducted and paid to the child until he or she attains a college diploma, an undergraduate degree, or age 25, whichever comes first.

When the child is no longer entitled to the 10% payment, it reverts back to the spouse if one or more dependent children remain in the spouse’s care and custody.

When the youngest child turns 19, your spouse’s monthly benefits are reduced. The percentage of your net average earnings is the same as your spouse’s age. For example, if your spouse is 50 when the youngest child turns 19, your spouse’s benefits would drop to 50% of your net average earnings. (Each child age 19-25 will receive 10% as long as he or she continues to attend school.)

Dependent children when there is no surviving spouse

The first or only child receives 30% of your net average earnings. If there is more than one child, 10% is paid for each additional child, to a maximum of 85% of net average earnings. Each child’s benefits are paid until he or she completes a first degree, or age 25, whichever comes first. The children’s guardian will receive benefits until the youngest child turns 19.

Child incapable of earning wages

A dependent child who is physically or mentally incapable of earning wages may receive monthly payments:

• until he or she can earn wages or • until he or she dies.

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Splitting survivor benefits for spouses

If more than one person is entitled to benefits as a spouse, the ongoing monthly payments (maximum 85% of your net average earnings) are split among them. A separated spouse is entitled to benefits if:

• you were required to make support payments until you died, or • the spouse can prove he or she depended on you when you

died.

Other dependants but no surviving spouse or children

To receive benefits, other dependants must prove they were financially dependent on you. Benefits will be paid for as long as you would reasonably have been expected to provide support.

The maximum benefit is 50% of your net average earnings when you died.

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Your Guide to Independent Living Part 3: Health Care

The Workplace Safety and Insurance Board is responsible for helping you to get the health care you need, when you need it. The Board or your health care professional can refer you to specialists and clinics that can help you recover and live with your injury.

Paying for health care costs The Board pays for health care costs related to your injury or illness. Health care costs include:

Testing and treatment • Getting referred to a Specialty Clinic

Therapies • Brain injury rehabilitation • Psychotherapy • Chiropractic care • Physiotherapy, occupational therapy and speech therapy • Pain therapy (TENS unit) • Other therapies

Health-related Living aids • Prosthetic devices (artificial limbs) • Orthotic devices (corrective devices) • Eyeglasses and hearing aids • Wheelchairs and scooters

Home care and supported living • Short-term home care • Long-term home care • Residential facilities.

Prescription drugs

In addition to your work-related prescriptions, WSIB will also pay for non work-related prescription drugs. WSIB uses an external company to arrange payment for your prescriptions. They will pay your pharmacist for these prescriptions even if they are not related to your injury.

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Health care outside Ontario If you want to get health care treatment outside Ontario, please talk to your Serious Injury Adjudicator. The Board does not usually support treatments outside Ontario if you can get it in your community or through a Board-approved Specialty Clinic in Ontario. (Please see the section on Specialty Clinics for a list of these clinics.)

Advanced Practice Nurse Case Managers In the spring of 1998, Nurse Case Managers were hired at the WSIB to guide and support workers through their treatment and recovery. Within 48 hours (or sooner) of learning about your serious accident or receiving your claim, an Advanced Practice Nurse Case Manager will work with your Serious Injury Adjudicator to make sure you get the most appropriate health care.

The Advanced Practice Nurse Case Manager will: • contact you, or your family, and do an injury and health

assessment (if needed) • contact the health care professionals treating you to develop

a treatment and recovery plan • set up any medical referrals needed.

If you want to know more about the treatment, your care and/or your health care needs feel free to speak with your Advanced Practice Nurse Case Manager. If you don’t know the person’s name, phone our general enquiry clerk and the clerk will direct you.

Testing and treatment Twelve Toronto clinics provide special health care testing and treatment for injured workers. Right now, all of the clinics are in Toronto hospitals. Soon, there will be Specialty Clinics in other Ontario cities. Also other health centres may provide testing and treatment.

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Getting referred to a Specialty Clinic

Your Serious Injury Adjudicator or your Advanced Practice Nurse Case Manager will tell you when a Specialty Clinic could help you. They will contact the medical consultants in the Specialty Clinic Liaison Office to set up an appointment.

This chart shows the Specialty Clinics where you can be tested and treated:

If you need testing or treatment for…

THEN you could be referred to:

amputation prosthetics orthotics burns

Sunnybrook & Women’s Health Sciences Centre (Toronto) St. John’s Rehabilitation Hospital (Toronto) West Park Health Centre (Toronto)

brain injury Toronto Rehabilitation Hospital

chronic pain

Toronto Western Hospital

hand injury Toronto Western Hospital Trillium Health Centre

upper limb/extremity injury

St. Joseph’s Health Care London Hotel Dieu Hospital – Kingston

psycho traumatic disorder

Centre for Addiction and Mental Health (Toronto)

shoulder and/ or elbow injury

Orthopaedic and Arthritic Institute (Toronto)

occupational diseases St. Michael’s Hospital (Toronto) traumatic stress London Health Sciences Centre

Traumatic Stress Service Workplace Program (London)

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Therapies Brain injury rehabilitation If you have suffered an injury to your brain because of a workplace accident, the Board will pay for services such as:

• learning how to do things again • speech therapy • pain management and medication • psychological counselling • work readiness • job coaching.

This is the process you go through to take part in a brain injury rehabilitation program:

1. The Board will send you to a health care professional for assessment.

2. The health care professional will develop a treatment plan and present it to the Board.

3. You begin the program once the Board approves the treatment plan.

4. The health care professional who provides your program submits progress reports every three months.

The progress report tells the Board about: • your goals • the time you need to meet each goal • your treatment progress • the reason for your success with the program • changes in your treatment • reasons why your treatment has changed.

The Board may extend your program based on the progress reports. Program providers are paid for their services directly, based on a fee schedule set by the WSIB.

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Psychotherapy A registered psychologist provides this care. The treatment must be for a specific problem and have a time limit.

The psychologist will talk to you about: • your treatment goals and expectations • how many treatment sessions you should have • how often you should have treatment sessions.

Your treatment plan must be pre-approved by the WSIB. The psychologist submits progress reports to the WSIB every three months.

If your condition does not improve, the WSIB will tell the psychologist to stop the treatment.

Chiropractic care The Board will pay for up to 12 weeks of chiropractic care. After the 12 weeks are finished your chiropractor may ask to continue the treatments. The WSIB must approve the extra treatments.

Your chiropractor may also refer you for consultation to another health care professional.

To get approval for the referral, follow these steps: 1. Tell the WSIB about the referral at the time it is made. 2. Make sure that the WSIB receives a copy of the consultation

report after your referral exam.

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Physiotherapy, occupational therapy and speech therapy Your health care professional can refer you for up to 12 weeks of treatment to a:

• physiotherapist • occupational therapist or • speech therapist.

If your health care professional feels that you need extra treatments, he or she must send the Board a report asking for an extension. The WSIB will review your case regularly.

If you are placed in the hospital for physiotherapy treatment, the WSIB must pre-approve this treatment.

Pain therapy (TENS unit) Your health care professional may recommend that you use a Transcutaneous Electrical Nerve Stimulator (TENS) unit to help relieve pain.

The WSIB will pay for the TENS unit if you meet all of the following conditions:

• a WSIB health care consultant approves the TENS unit • during a three-hour test, the unit reduces your pain • the unit helps you to reduce or stop using painkillers • the unit helps you to sleep or do daily activities better.

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Other therapies If you need another therapy, such as acupuncture or massage, your health care professional must talk to the WSIB. These treatments must be pre-approved. Your Serious Injury Adjudicator or Advanced Practice Nurse Care Manager will let you know the number of therapy sessions you are allowed.

Your health professional sends a report to the WSIB that evaluates your condition. The report talks about:

• your diagnosis • the type of treatment recommended • how long your treatment will take.

The WSIB will continue to review your health care professional’s regular reports before more therapy sessions are paid for.

Health-related living aids A health-related living aid is any special:

• item • clothing, or • equipment that contributes to your health and well-being,

and makes it easier for you to do things. When your health care professional prescribes a health-related living aid for you, you pay for the item and send your receipt to the WSIB. If you need the item because of your injury, the Board will reimburse you.

Depending on your needs, the WSIB may pay for the following items.

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Prosthetic devices (artificial limbs) A prosthetic device replaces or substitutes for a missing body part. The Board will pay for:

• buying the prosthetic device • attachments and special clothing, such as special gloves for

artificial hands, stump socks, daw sheaths etc. • repairs and replacements for prosthetic devices.

Orthotic devices (corrective devices) An orthotic device, such as a back brace or orthopaedic shoes, helps to correct or strengthen a body part that has been damaged. The Board will pay for buying, repairing and replacing orthotic devices.

Eyeglasses and hearing aids The WSIB pays for eyeglasses and hearing aids, if they are prescribed by a health care professional because of a workplace injury.

Check with your Serious Injury Adjudicator to see if the WSIB will pay for glasses or a hearing aid before you buy them.

December 2003 3 –9 2264A (12/03)


Wheelchairs and scooters Wheelchairs and scooters are for people who:

• have lost one or both legs because of a workplace accident • have a hip disarticulation • have paralysis of the legs.

Your health care professional must prescribe a wheelchair or scooter for you. The WSIB will pay to:

• buy • maintain, and • repair your wheelchair or scooter.

You are responsible for arranging regular inspections and repairs for your wheelchair or scooter.

Prescription drugs You do not have to pay for prescription drugs. The WSIB uses an external company to arrange payment for your prescriptions. They will pay your pharmacist for prescriptions and then bill the WSIB.

Home care and supported living The WSIB may sponsor you in a supported living program and pay some or all of the costs. The Board decides on sponsorship based on an assessment of your needs.

Sponsorship does not cover the costs of every day expenses like: • room and board • personal items • leisure activities (such as church, bingo, a sports club

membership). You have to pay for these costs.

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Short-term home care Your health care professional may recommend hiring a home care agency for you on a short-term basis. Here are some examples of when the Board might hire a home care agency for you:

• an out-patient program does not meet your needs • you need at least one professional service such as nursing

physiotherapy, or speech therapy • treatment at home helps you to get better.

The WSIB will pay the home care agency directly.

Long-term home care If you need long-term home care, your Occupational Therapist/Independent Living Consultant will help you to get an attendant and apply for an Attendant’s Allowance from the WSIB. For more information, read about “Attendant’s Allowance” in Part 1 of this manual.

Residential facilities If you are unable to live independently at home, you may need short-term or permanent care in a residential facility. Your Serious Injury Adjudicator will help make the arrangements. The facility may prepare you to live independently at home or, if that is not possible, may provide care on a long-term basis.

December 2003 4 –1 2264A (12/03)

Your Guide to Independent Living Part 4: Services

This section of Your Guide to Independent Living is about the services you are entitled to as a seriously injured worker. The WSIB’s Serious Injury Program can help you to:

• return to work when you are ready • make changes to your workplace so that you can do a job • make changes to your home or vehicle so that you can live

as fully and independently as possible. This section of the guide discusses:

• changes to the Workplace Safety and Insurance Act that affect your services

• Early and Safe Return to Work (ESRTW) • making changes to your workplace so that you can do your

job • Labour Market Re-entry (LMR) • making changes to your home • making changes to your vehicle.

Your Occupational Therapist/Independent Living Consultant will be happy to talk with you about these services in greater detail.

New Law The services you receive depend on a new law called the Workplace Safety and Insurance Act (WSI Act). The WSI Act replaced the Workers’ Compensation Act (WCB Act) on January 1, 1998. The new Act and WSIB policies help workers and employers to co-operate with one another and with the Board. They promote an early and safe return to work for injured workers. In addition to compensating workers, the new Act places greater importance on:

• preventing workplace injuries and illness • making sure workers get the best health care at the right

time.

December 2003 4 –2 2264A (12/03)


Key changes to the Act Here are some key changes in the Act which affect your services, regardless of when your claim started:

• The injured worker and the employer have more responsibility for returning the injured worker to work, through their obligations under the new Act.

• The WSIB plays a support role by providing information, monitoring and dispute mediation.

• The employer and injured worker must meet their obligations for co-operation.

• The WSIB’s Early and Safe Return to Work and Labour Market Re-entry services replace Vocational Rehabilitation. These services pay for training and support so that workers can learn marketable skills. However, the Board is not obliged to ensure that the worker finds a job.

Obligations of employers under the current Act The employer’s obligations include:

• registering with the WSIB within 10 days of hiring an employee

• co-operating with Early and Safe Return to Work • giving the Board information when asked • telling the Board if they are going out of business • telling the Board about any other changes that might affect

their risk of going out of business.

December 2003 4 –3 2264A (12/03)


Penalties for employers who do not co-operate If an employer does not co-operate in the return to work process, the WSIB will:

• find out whether the employer is meeting its re-employment obligations under the Act

• tell the employer about its obligation to co-operate • tell the employer about the financial penalties for non-cooperation • levy financial penalties, including payments to the worker.

Obligations of workers under the current Act The worker’s obligations include:

• giving the WSIB the information needed to adjudicate a claim

• taking part in health care • attending health exams requested by the WSIB and the

employer • co-operating in Early and Safe Return to Work or Labour

Market Re-entry.

Penalties for workers who do not co-operate If workers do not co-operate with the return to work process:

• their benefits may be reduced or stopped during the time that they are not co-operating

• their employer may also be penalized a percentage of the worker’s benefit costs during that period, if they are not co-operating.

December 2003 4 –4 2264A (12/03)


Early and Safe Return to Work The Workplace Safety and Insurance Board recognizes that the responsibility for returning injured workers to work is in the hands of the people who are affected the most - workers and their employers.

The Act encourages self-reliance and co-operation among employers and workers to achieve an Early and Safe Return to Work. The goal of this process is for you to return to suitable and available work, within your functional abilities.

Your functional abilities are what you can do on the job, taking into account any physical or mental limits you may have because of your workplace injury. The WSIB provides support by:

• promoting injury prevention • providing return to work information • monitoring the progress of each case • helping to resolve difficulties and disputes.

While you are off the job Your employer must keep paying their share of benefits such as private health insurance or life insurance. They must do this for up to one year while you are off work because of the injury. They must only do this if your share was paid up at the time of the injury, and you continue to pay your share.

When you are able to come back to work The law says your employer must offer you work for a limited time after your workplace injury or disease, if you meet these three conditions: • You were on the job for one year or more before you were

injured or became ill. • Your employer normally employs 20 or more workers. • You were injured after January 1, 1990 (or after May 11, 1992

if you are a construction worker).

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Even when all of these conditions are met, the Board cannot force your employer to give you a job. But the Act says that you and your employer must co-operate to try and re-employ you. Employers who do not co-operate can face a large fine.

If your employer’s obligation to re-employ you under the new Act offers you greater protection than your collective agreement does, then the employer must obey the obligation under the Act.

If you are able to perform work without risk to yourself or others (safe return to work), the employer must offer one of the following:

• the same job you had before the accident • a similar job that is as good as the old job and pays close to

what the old job paid, or • a suitable job - work that you know how to do and can do

safely, given your injury or illness. The employer must continue to meet the obligation to employ you until the earliest of the following times:

• two years after the date of your injury or illness • one year after the WSIB tells your employer that you are

able to do the essential duties of your pre-accident job • your 65th birthday.

When you are back at work If your employer lets you go within six months of being re-employed, they must show that they did not let you go because of your injury.

If your employer lets you go more than six months after re-hiring you, the law says you must prove that it was because of your injury and not some other reason.

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Return to work for construction workers Construction workers have the right to return to their jobs after recovering from a work-related injury. There are special rules for employers and workers that take into account the short term nature of most construction projects and the different trades involved.

Construction workers who were injured on or after January 1, 1998 have re-employment rights even if they worked less than 1 year with an employer who has less than 20 workers.

Making changes in your workplace When you return to work, your employer must make changes to your work or your workplace to accommodate your needs.

The Board will assess your workplace and arrange the changes that you need to return to work. Changes to the workplace might include:

• installing a ramp so that you can get into your workplace • making sure your washroom is wheelchair accessible • buying devices which will make it easier for you to work.

The Ontario Human Rights Code sets out your employer’s obligation to accommodate your needs in the workplace. The new Act says that, as of January, 1998, your employer does not have to send the Board written details of the accommodations they are making.

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Labour Market Re-entry Early and Safe Return to Work means that you and your employer work together to get you back on the job, with little or no loss of earnings.

If Early and Safe Return to Work is not possible, or if your wages fall below your pre-injury earnings, then the Board may do a Labour Market Re-entry assessment to help you train for a job you can do.

Replacing Vocational Rehabilitation Under the Workplace Safety and Insurance Act, Labour Market Re-entry assessments and plans replace Vocational Rehabilitation (VR). This chart shows how Vocational Rehabilitation plans that started before 1998 will be handled.

IF… THEN…

Your VR plan was approved before 1998

The WSIB will honour it until you finish it, including all travel costs provided for in the plan

You previously had VR services and need further assistance in 1998, and your employer is unable to re-employ you

You may be entitled to a Labour Market Re-entry assessment and plan.

You were injured before 1998 and are applying for VR services now

You may be entitled to Early and Safe Return to Work or a Labour Market Re-entry assessment and plan

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How the Board decides to do a Labour Market Re-entry assessment Jointly, your Occupational Therapist/Independent Living Consultant and your Serious Injury Adjudicator will decide to do a Labour Market Re-entry assessment if:

• even with accommodations, it is unlikely you’ll be re-employed by your accident employer because of the kind of injury you’ve sustained

• your accident employer is unable to offer you work that matches your functional abilities and restores you to your pre-injury wage, or

• your employer is unwilling to co-operate in your Early and Safe Return to Work.

In most cases, you will only be entitled to one Labour Market Re-entry assessment and plan.

You must agree to the labour market re-entry plan at the beginning. They will also consult with your employer and your health care professional.

The Labour Market Re-entry assessment process When doing the Labour Market Re-entry assessment, the WSIB tries to help you prepare for a suitable job. This is a job or a grouping of similar jobs.

The Occupational Therapist/Independent Living Consultant will: • assess your need for a formal plan to help get you back into

the labour market (Labour Market Re-entry Plan - LMR) • consult with you in determining a suitable employment or

business job • decide if you need a formal plan to get back into the work

force • monitor your progress throughout the plan • determine your Loss Of Earnings (LOE) payments while

you are completing the program aimed at getting you back to work.

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Goals of the Labour Market Re-entry plan A Labour Market Re-entry plan is designed to achieve the following goals in the most cost-effective way:

• help you re-enter the labour market in a job that matches your functional abilities

• improve the skills, knowledge and abilities you already have, or train you in new skills and abilities

• reduce or eliminate your loss of earnings because of your work-related injury

• help you re-enter the labour market in a job that is safe.

What the plan looks like The plan will set out the goals and costs of your Labour Market Re-entry plan, based on your Suitable Employment or Business (SEB) job.

The plan would include: • training costs • assistive devices • modifications to your workplace • room and board during training • other accommodations you need to do the Suitable

Employment or Business (SEB) job. Types of training paid for by the WSIB might include:

• English as a second language (ESL) • academic upgrading • skills training • training at a university or college • creative job search techniques.

December 2003 4 –10 2264A (12/03)


When might my Labour Market Re-entry plan change? The Board might change your plan under the following conditions:

When… Then…

Your health gets worse

your Occupational Therapist/Independent Living Consultant will arrange for you and your health care professional to:

• review and change your job goal and

• revise your plan.

The Board will do everything it can to accommodate your condition before changing your plan.

Your health gets better

your Occupational Therapist/Independent Living Consultant will review your:

• Suitable Employment and Business (SEB) job and

• Loss of Earnings (LOE) benefit.

Your Labour Market Re-entry plan may be stopped.

You get a job offer that

• is within your functional abilities

• pays the same or more than your pre-injury job

• pays a bit less

your Occupational Therapist/Independent Living Consultant will decide whether to stop your Labour Market Re-entry plan, based on:

• whether it is better for you to take the job than to continue with your training.

• how far along you are in your training

• whether you could have a relapse in your condition if you

December 2003 4 –11 2264A (12/03)


went back to work.

December 2003 4 –12 2264A (12/03)


Labour Market Re-entry costs paid for by the WSIB The WSIB will pay for costs that are to determine your training needs. These costs might include:

• registration, tuition and exam fees • textbooks and course materials • tutor assistance • transcript fees • mileage or public transit costs from your home to the

training program • room and board • relocation • tools, equipment or protective clothing.

How Labour Market Re-entry costs are paid Your Occupational Therapist/Independent Living Consultant will arrange for the training institution to bill the WSIB directly for training costs, and tell you how to claim for an assistive device or accommodation.

You can claim for travel, room and board using a Worker Health Care Travel Expense Form (Form 3462A).

December 2003 4 –13 2264A (12/03)


Making changes to your home The Serious Injury Program is responsible for making it possible for you to live at home after a workplace injury or illness. The Board will look at your home to plan the changes needed and will pay for making these changes.

Home changes Examples of home changes include:

• widened doorways • inside or outside elevating devices • garage height increases for vans with an extended roof • ramps and railings • automatic door openers.

If changes to the home you have now will not meet your needs, the Board may consider:

• building an addition, or • approving a budget for changes to a new home at a cost

equal to renovations. The WSIB will also consider changes to your house for a job you do from home, a hobby, or leisure activities.

Elevators The Serious Injury Program has a list of preferred companies from across Ontario that install and maintain elevators. These companies give reliable service with regular inspections and maintenance, and guarantee their work. Please speak to your Occupational Therapist/Independent Living Consultant about the companies that serve your area.

December 2003 4 –14 2264A (12/03)


Making changes to your vehicle The WSIB may pay for changes to your personal vehicle to:

• increase your mobility and independence • allow you to take part in social activities • help you return to work.

These changes must help you to operate your vehicle safely or allow you to get in and out of the vehicle independently. Some examples include:

• hand controls • lifts • special seats • special switches • steering devices.

Transport Canada has given the Serious Injury Program a list of all registered companies certified to modify vehicles for seriously injured workers. Before you start any modifications, please talk to your Occupational Therapist/Independent Living Consultant who can give you the names of companies in your area, and help you decide what type of vehicle would best suit your needs.

As well, the major North American automakers have rebate programs for factory installed devices. If you’re planning to buy a vehicle for conversion, or modify the one you have, contact the following companies for program details:

General Motors - Canada GM Mobility Program 1-800-GM-DRIVE Chrysler Canada Physically Challenged Assistance Program 1-800-265-6908 Ford Canada Mobility Plus Program 1-800-265-8985

December 2003 5 –1 2264A (12/03)

Your Guide to Independent Living Part 5: Community Contacts

Here is a list of support groups in your community and other organizations that can help you. ONTARIO BRAIN INJURY ASSOCIATIONS (OBIA) AND HEAD INJURY ASSOCIATIONS (HIA)

Ontario Brain Injury Association P.O. Box 2338 St. Catharines, ON L2R 7R9 Phone: (905) 641-8877 or (800) 263-5404 Fax: (905) 641-0323 E-mail: [email protected] Web site: www.obia.on.ca

HIA Brantford & District 75 Chatham St., P.O. Box 488 Brantford, ON N3T 5N9 Phone: (519) 756-3350 Fax: (519) 756-0838 Contact: Arthur Lefebvre, President

Brain Injury Association of Chatham Kent Ste. 3B463 St. Clair Street, Chatham, ON N7L 3K6 Phone: (519) 351-0297 Fax: (519) 351-7600 E-mail: [email protected] Web site: www.biack.com Contact: Janice Kominek, Executive Director

HIA Dufferin 19 Wellington Street Orangeville, ON L9W 2L2 Phone: (519) 941-0322 Contact: Ken Norris

HIA Durham Region 459 Bond Street East Oshawa, ON L1G 1B9 Phone: (905) 723-2732 Fax: (905) 723-4936 Contact: Frank Murphy, Executive Director

December 2003 5 –2 2264A (12/03)


Erie Shores Brain Injury Association 594 Queensway West, Simcoe, ON N3Y 4J9 Phone: (519) 428-1808 Fax: (905) 871-7832 Contact: Wayne Houghton

HIA Fort Erie & District 649 Niagara Boulevard Fort Erie, ON L2A 3H7 Phone: (905) 871-7789 Fax: (905) 871-7832 E-mail: [email protected] Contact: Donna Summerville, Program Coord.

Four Counties Brain Injury Association 360 George Street N. Unit 27 Peterborough, ON K9H 7E7 Phone: (705) 741-1172 Or 1-800-854-9738 Fax: (705) 741-5129 E-mail: [email protected] Web site: www.nexicom.net/~fcbia Contact: Marg Malloy

HIA Grey Bruce P.O. Box 708 Markdale, ON N0C 1H0 Phone: (519) 924-2033 Contact: Leah Bateman

HIA Huntsville & District P.O. Box 5311 Huntsville, ON P1H 2K7 Phone: (705) 789-2990 Contacts: Howard Wright/June Spires


December 2003 5 –3 2264A (12/03)


Lanark County Brain Injury Association P.O. Box 122 Smith Falls, ON K7A 4F9 Phone/FAX: (613) 284-1643 Contact: Nancy Andison President Phone/FAX: (613) 284-0228 Contact: Harry Bligh

Brain Injury Association of London & Region 111 Waterloo Street, Suite 307 London, ON N6B 2M4 Phone: (519) 642-4539 Fax: (519) 642-4124 Web site: www.braininjurylondon.on.ca Contacts: Gary Davies, Executive Director

Brain Injury Association of Niagara 111 Church Street St. Catharines, ON L2R 3C9 Phone: (905) 984-5058 Fax: (905) 984-5354 E-mail: [email protected] Webpage: www.niagara.com/hian Contact: Suzanne Mason or Pat Dracup

HIA Ottawa Valley 312-211 Bronson Avenue Ottawa, ON K1R 6H5 Phone: (613) 233-8303 Fax: (613) 233-8422 Contact: Teresa Van Dongen, President

December 2003 5 –4 2264A (12/03)


Peel & Halton Brain Injury Association 2155 Leanne Drive Suite 240 Mississauga, ON L5K 2K8 Phone: (905) 823-2221 Toll-free: 1-800-565-8594 E-mail: [email protected] Web site: www.biaph.com Contact: Tina Guilbeault, Managing Director

HIA Sarnia & Lambton 387 Exmouth Street Sarnia, ON N7T 5N8 Phone: (519) 337-5657 Fax: (519) 332-1504 Contact: Tim Johnson, Board President

HIA Sault Ste. Marie & District 31 Old Garden River Road #127 Sault Ste. Marie, ON P6B 5Y7 Phone: (705) 946-0172 Fax: (705) 946-0594 E-mail: [email protected] Contact: Tanya Elliott, Executive Director Simcoe County Brain Injury Association 4 Cedar Point Drive, Unit S-2 Barrie, ON L4N 5R7 Phone: (705) 734-2998 Fax: (705) 734-2866 Contact: Anita Farmer, Executive Director

Brain Injury Association of Sudbury & District Branch 19 Regent Street South Sudbury, ON P3C 4B7 Phone: (705) 670-0200 E-mail: [email protected] Contact: Donna Chartrand


December 2003 5 –5 2264A (12/03)


Timiskaming Brain Injury Association 213 Whitewood St., Unit A-7 New Liskeard, ON P0J 1P0 Phone: (705) 647-1033 Contact: Brenda Wojick, Board Chair

BIA Toronto (temporarily closed, call OBIA, Page 5-1) # 410-1300 Yonge Street Toronto, ON M4T 1X3 Phone: 416-513-1903 Fax: 416-513-1879 E-mail: [email protected] HIA Waterloo Wellington 532 Park Street Kitchener, ON N2G 1P1 Phone: (519) 579-5300 Fax: (519) 576-0118 E-mail: [email protected] Contact: Patti Lehman, Executive Director

HIA Windsor − Essex #203-647 Ouellette Ave. Windsor, ON N9A 4J4 Phone: (519) 977-7180 E-mail: [email protected] Contact: Kathy Labbe /Tammy Filiault

Brain Injury Services of Northern Ontario Regional Office (BISNO Service) 185 Court Street South Thunder Bay, ON P7B 2X7 Phone: (807) 345-1188 (can call collect) Fax: (807) 345-1428 Contact: Alice Bellavance, Executive Director

December 2003 5 –6 2264A (12/03)


Family and Peer Support Groups Disabled Workers’ Complex Case Network Darrell Sanderson, President 132 Burriss Street Thunder Bay, ON P7A 3E4 Phone: (807) 344-8580 (H) Toll-free: 1-888-290-9065 Fax: (807) 344-8580 (H)

Hamilton-Wentworth Head Injury Family Support Group C/O Chedoke-McMaster Hospitals Holbrook Building, Box 2000 Hamilton, ON L8N 3Z5 Phone: (905) 521-2100 Ext. 4632 Contact: Shirley Blair, Administrator Sam Garcea, President

Huron Bruce Brain Injury Support Group R.R. 3 Teeswater, ON N0G 2S0 Phone: (519) 398-8442 Contact: Joanne Bregman

Phoenix Support Group 387 Exmouth Street Sarnia, ON N7P 5N8 Phone: (519) 337-5657 Fax: (519) 332-3446 Contact: Roger Farnula

December 2003 5 –7 2264A (12/03)


Survivor's Right Support Group for Head Injured #601-12 Broadway Avenue Toronto, ON M4P 3C5 Phone: 416-484-9649 Contact: Dale Antunik York Region Head Injury Support Group 11181 Yonge Street, Room 201 Richmond Hill, ON L4S 1L2 Office voicemail: (905) 780-1236 Fax: (905) 888-9435 E-mail: [email protected] Contact: Carolyn Barton Phone: (905) 888-9020 or Contact: Elizabeth Dilley Phone: (905) 472-6826


December 2003 5 –8 2264A (12/03)


Canadian Paraplegic Association (CPA) Attendant Service Outreach Program 1193 Weston Road Toronto, ON M6M 4P6 Phone: 416-241-1433 Fax: 416-241-2466

Barrie CPA Office 80 Bradford Street, Suite 210 Barrie, ON L4N 6S7 Phone: (705) 726-4546 Toll Free: 1-800-870-5670 Fax: (705) 737-2496

London CPA Office 388 Dundas Street London, ON N6B 1V7 Phone: (519) 433-2331 Fax: (519) 433-3987

Ontario Division CPA Office 520 Sutherland Drive Toronto, ON M4G 3V9 Phone: 416-422-5644 Fax: 416-422-5943

December 2003 5 –9 2264A (12/03)


Ottawa CPA Office 1101 Prince of Wales Drive, Unit 230 Ottawa, ON K2C 3W7 Phone: (613) 723-1033 Fax: (613) 723-1060

Thunder Bay CPA Office 1201 Jasper Drive, Suite B Thunder Bay, ON P7B 6R2 Phone: (807) 344-3743 Fax: (807) 344-9490

December 2003 5 –10 2264A (12/03)


Canadian Abilities Foundation Canadian Abilities Foundation Publisher of Abilities magazine Raymond D. Cohen Publisher/Editor-In-Chief 340 College Street, Suite 650 Toronto, ON M5T3A9 Phone: 416-923-1885 Fax: 416-923-9829 E-Mail: [email protected] Web site: www.enablelink.org

Abilities magazine Canada's lifestyle magazine for people with disabilities Publisher/Editor-In-Chief Raymond D. Cohen 340 College Street, Suite 650 Toronto, ON M5T 3A9 Phone: 416-923-1885 Fax: 416-923-9829 E-Mail: [email protected] Web site: www.enablelink.org

Enablelink

Linking injured workers and other people with disabilities to a world of resources.

www.enablelink.org

http://www.enablelink.org/

December 2003 5 –11 2264A (12/03)


Easter Seals/March of Dimes National Council Easter Seals/March of Dimes National Council 90 Eglinton Avenue East, Suite 511 Toronto, ON M4P 2Y3 Phone: 416-932-8382 Fax: 416-932-9844 Web site: www.esmodnc.org Contact: Sue VanRietPaap

People in Motion Canada's Premier Exhibitors’ Show for People with Disabilities Box 74059, 260 Guelph Street, Georgetown Brampton, ON L7G 5L1 Phone: (905) 702-1121 Toll-free: 1-877-745-6555 Fax: (905) 702-1244 Contact: Ian Mellor, Producer

War Amps Key Tags Customer Service 1 Maybrook Drive Scarborough, ON M1V 5K9 Phone: 416-297-2660, extension 261 1-800-250-3030 Fax: 1-800-219-8988/416-297-2650 Contact: Victoria Hardy

December 2003 5 –12 2264A (12/03)


Paralyzed Veterans of America National Office Paralyzed Veterans of America National Office Gordon Mansfield, Executive Director 801 Eighteenth Street, NW Washington, DC 20006, USA Phone: (202) 872-1300 Web site: www.pva.org

Paralyzed Veterans of America National Office Publisher of Paraplegia News (PN News) 2111 East Highland Avenue, Suite 180 Phoenix, AZ 85016-4702, USA Phone: (602) 224-0500 Fax: (602) 224-0507 E-mail:[email protected]


December 2003 6 - 1 2264A (12/03)

Your Guide to Independent Living Part 6: Sample Forms

Using WSIB Forms to claim for expenses The WSIB pays all your health care expenses because you were injured at work. (See Part 3: Health Care.) The WSIB also pays travel costs connected with your injury such as travel to medical appointments. (See Part 1: Allowances.) To claim for expenses connected with your injury, you will need to use these forms.

If you have any questions about the forms, please contact your Serious Injury Adjudicator. A complete list of our staff telephone numbers is on pages four and five of this guide.

You can also call the Serious Injury Program at the general number toll free: 1-800-387-0750, or in the Greater Toronto Area, 416-344-1000.

The multilingual hotline is 1-800-465-5606 or in the Greater Toronto Area, 416-344-4999. TTY is 1-800-387-0050.

On the next few pages we have put sample copies of the front pages of some of the forms you are most likely to use. These are for your information only. You will need to get the real forms from your Serious Injury Adjudicator or by visiting our Web site.

• Serious Injury Program Health Care Expenses Form 3039A (05/01)

• WSIB Medication Reimbursement Form 0806A (04/03) • Worker Health Care Travel Expense Form 3462A (04/03)

Decem2264A


3039A - Serious Injury Program Health Care Expenses Form

ber 2003 6 - 2 (12/03)

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0806A WSIB Medication Reimbursement Form

003 6 - 3 3)

Decembe2264A (1


3462A Worker Health Care Travel Expense Form

r 2003 6 - 4 2/03)

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