High Impact Claims

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High-impact claims by benefit payment percentage

High-impact claims are allowed lost-time claims that have been shown to have significant impacts on employees and employers. The WSIB is focused on return-to-work and recovery outcomes and supporting employees and employers to reduce the impacts of these claims. The WSIB has implemented many initiatives to improve outcomes in these claims, including specialized case management teams, new evidence-based health services, and expedited access to expert medical intervention.

We have identified three types of high impact claims - those involving the lower back, shoulder and fractures. These claim types continue to represent about 28 per cent of all benefits payments and about 24 per cent of all allowed lost-time claims.

High-impact claims average days lost

Due to the nature of high-impact claims, the average days lost within three and six months post injury or illness is usually higher for these claim types in comparison to all other lost-time claims combined.

The WSIB continues to focus on programs aimed at improving recovery and return-to-work outcomes for high-impact claims.

 



Data for average days lost within three months published September 2018 and data for six months will be available in November 2018.

 

High-impact claims as a percentage of all lost-time claims

In 2017, the three types of high-impact claims made up 24 per cent of all lost-time claims, of which lower back claims accounted for the highest proportion at 14 per cent. Between 2016 and 2017, the percentage of fracture claims remained stable while the percentage of shoulder and lower back claims declined slightly.

The percentage of high-impact claims as a total of all lost-time claims for Schedule 2 has decreased in 2017 compared with 2016 and is at its lowest percentage for the past five years.

 



In 2017, the percentage of high-impact claims made by male and female was split at 53 per cent and 47 per cent, respectively. This distribution differs from Schedule 1, where 65 per cent of claims for high-impact injuries are experienced by males. Those in the 50 to 54 year old age group account for the highest proportion of these injuries at 17 per cent.

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Leading high-impact claims characteristics by injury year

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