FAQs about claims and COVID-19
VPlease visit the WSIB site for more details: https://www.wsib.ca/en/faqs-about-claims-and-covid-19
Extracted from WSIB Web site
COVID-19 claims and coverage
I think I contracted coronavirus (COVID-19) at work. Should I file a claim?
While the nature of some people’s work may put them at greater risk of contracting the virus, for example those treating someone with COVID-19, any claims received by the WSIB will need to be adjudicated on a case-by-case basis, taking into consideration the facts and circumstances.
- If you contracted COVID-19 while at work (you have a diagnosis or symptoms of COVID-19), you should tell your employer about your illness and any medical treatment you received right away, and you may file a claim to determine if you are eligible for WSIB coverage.
- If you believe you were exposed to COVID-19 while at work, but you are not ill at this time (you do not have a diagnosis or symptoms of COVID-19), please do not file a claim. Instead, you can report an exposure incident. Reporting your exposure is voluntary, but if you become ill in the future we'll be able to process your claim faster.
How will the WSIB determine if a COVID-19 claim will be allowed?
Multiple potential sources of COVID-19 may now exist in the community, at home and outside of work, creating challenges in establishing work-relatedness when adjudicating claims.
For a COVID-19 claim to be allowed, evidence must show that the person’s risk of contracting the disease through their employment is greater than the risk to which the public at large is exposed and that work significantly contributed to the person’s illness.
To determine the work-relatedness of COVID-19 claims, the WSIB will look at details such as the person’s employment activities, their symptoms and whether they have a diagnosis of COVID-19.
While the nature of some people's work may put them at greater risk of contracting the virus, for example those treating someone with COVID-19, this is a constantly evolving situation and any claims received by the WSIB will need to be adjudicated on a case-by-case basis, taking into consideration the facts and circumstances.
Please note: The WSIB does not provide coverage for people who are symptom-free without a COVID-19 diagnosis, even when quarantined or sent home on a precautionary basis. However, should someone who is symptom-free develop symptoms or illness while on quarantine, they may be eligible for WSIB coverage.
Read more about how we make decisions about COVID-19 claims (PDF).
I had a reaction to a COVID-19 vaccine. Can I get WSIB benefits/file a claim?
If you received a vaccine as a compulsory part of your employment and experienced an adverse reaction, you may be eligible for benefits.
Expected reactions to a COVID-19 vaccine, per public health guidance, may include fever, chills, pain at the injection site, fatigue and headaches which should resolve on their own in a few days. These do not generally constitute an adverse reaction for the purposes of entitlement to WSIB benefits. An adverse reaction is a serious, unexpected reaction to a vaccine.
When determining whether a reaction to a COVID-19 vaccination is work-related, the WSIB considers:
1. Whether the vaccination was a compulsory part of your employment
- A vaccination will generally be a compulsory part of your employment if your employer has a rule or policy that requires employees to be vaccinated or if your employer uses some element of coercion for vaccination (e.g. threat of termination of employment, job changes or penalties).
2. Whether the reaction is adverse, e.g. serious and unexpected, such as the types of events that should be reported to a local public health unit
- If the reaction requires medical treatment beyond first aid and/or requires your absence from work for more than a few days, this indicates that the reaction – in its severity or duration – has likely gone beyond the expected reaction from vaccination.
If you received a COVID-19 vaccine as a compulsory part of your employment and experienced an adverse reaction, you should report this to your employer and file a claim so the WSIB can determine if you are eligible for benefits.
While the nature of our work may put us at greater risk of contracting the virus, for example those treating someone with COVID-19. If you believed you are exposed or contracted the COVID-19 at work, this would require to make a report or a claim to WSIB.
OPSEU has developed a questionnaire designated for our members to self-document potential work exposures at the onset of suspected exposure for their personal records rather than relying on memory.This information would be cruicial for the entitlement to WSIB benefits should member subsequently be diagnosed with COVID-19 and require OPSEU representation. This is not something the member submit to WSIB, but rather a means to help the member document what they know for the purposes of the WSIB claim as there maybe delays in adjudication.
any claims received by the WSIB will need to be adjudicated on a case-by-case basis, taking into consideration the facts and circumstances.
· If you contracted COVID-19 while at work (you have a diagnosis or symptoms of COVID-19), you may file a claim to determine if you are eligible for WSIB coverage.
· If you believe you were exposed to COVID-19 while at work, but you are not ill at this time (you do not have a diagnosis or symptoms of COVID-19), please do not file a claim. Instead, you can file an exposure incident form through the WSIB Program for Exposure Incident Reporting (PEIR) program. This is a voluntary reporting program and you will be assigned an incident number. If you become ill in the future, we'll be able to process your claim faster. The WSIB will not adjudicate based on this form alone, this forms sole purpose is notification to WSIB that a worker feels there has been a potential risk of exposure. Members do not require a confirmed diagnosis for this form, only a suspected exposure at work. The WSIB has provided information on how and when to file claims related to file claims related to COVID-19.
To report an exposure, please complete and fax the appropriate form below to 1-888-313-7373 or call the WSIB at 1-800-387-0750, Monday to Friday, from 7:30 a.m. to 5 p.m.
File Area Header