Discussion and analysis
The WSIB is one of the most comprehensive workplace injury and illness compensation benefit systems in North America. Between Schedule 1 and Schedule 2 employers, we cover 16 industries and employers that are self-insured within the province of Ontario. In 2017, we served more than 5.4 million workers and over 300,000 employers, registered 239,000 claims, and issued $2,672.7 million in benefit payments. The WSIB is committed to ensuring a sustainable insurance system for employers and employees, and improving outcomes for those injured at work.
The Accounts and Claims Enterprise System (ACES), the WSIB’s recently implemented case and account management solution, revealed that some limited-entitlement claims were inaccurately coded as lost-time claims.
Limited-entitlement claims are claims where:
- health care benefits are granted, and
- loss-of-earning benefits are not granted because appropriate modified work is available.
This is a reporting issue only. It does not affect how claims are managed or the WSIB’s financial liabilities.
We are correcting our claims coding for 2017 to ensure clarity and accuracy in future reporting. The WSIB strongly believes that ensuring people receive the benefits that they are entitled to is important to the integrity of the Workplace Safety and Insurance system. We will therefore continue to track limited-entitlement claims and assess their impact on employees’ benefits.
Summary of performance for Schedule 2
The WSIB’s integrated recovery and return-to-work approach continues to result in positive outcomes for both employees and employers. Over the past 10 years, the workforce covered by the WSIB has grown by 15 per cent while the number of registered claims decreased by 12 per cent. The 2017 lost-time injury rate was 2.04 and is 20 per cent lower than in 2008, despite increasing slightly this year. In 2017, registered claim volumes increased by four per cent compared to 2016, while the covered workforce increased by two per cent.
People and claims
Continued focus on high-impact claims
High-impact claims are a subset of allowed lost-time claims that have significant impacts on recovery and return-to-work time. These claims involve injuries related to the lower back, shoulders, and fractures. They typically have higher treatment costs and longer recovery times. In 2017, high-impact claims represented 24 per cent of lost-time claims and 28 per cent of total benefit payments, down from 29 per cent and 34 per cent, respectively, in 2013.
Access to timely, quality health care is an important factor in supporting recovery and return-to-work for injured employees and employers. That is why we continue to enhance the network of specialized assessment and treatment services across the province for lower back and shoulder injuries. These improvements in health care approaches have enhanced our overall case management of high-impact claims. In addition, high-impact claims as a percentage of all Schedule 2 claims have been declining over the past five years.
Recovery and return-to-work outcomes
The average number of days lost within one month post injury or illness increased to 7.4 days in 2017 but still remains relatively low in comparison to previous years and also when compared to Schedule 1. The percentage of people receiving loss-of-earnings benefits at three months from injury or illness increased to 12 per cent in 2017 from 10 per cent in 2016, while the percentage receiving loss-of-earnings benefits at six months increased to eight per cent in 2017 from five per cent in 2016.
The WSIB continues to emphasis an integrated approach to recovery and return-to-work, including specialized medical assessment and treatment services. Our work transition program also continues to result in positive outcomes. Approximately 97 per cent of injured and ill employees returned to work upon completion of their work transition plan in 2017, as compared to 98 per cent in 2016.
In 2017, the WSIB’s return-to-work staff made over 22,000 visits to Schedule 1 & 2 employers to build case-specific plans for people and their employers early in the claim and to demonstrate an increased focus on return-to-work in case management. In addition, approximately 89 per cent of Schedule 1 and 2 people with injuries were off full loss-of-earnings benefits within a month of a Return-to-Work Specialist's visit. We have more than 200 professionally designated work transition specialists who provide additional return-to-work support in circumstances where the person requires a longer plan. Our vision is to support people to return to productive and safe employment. For employers, our approach ensures minimal disruption to their workforce as they continue to have an experienced and productive employee stay with their company.
Improved outcomes for employees and employers
The WSIB continues to make investments in service quality and timeliness. We have an ongoing commitment to improving our systems resulting in a more sustainable and transparent compensation board, one which provides effective and efficient service to employees and employers.