If you suffer a severe burn at work in Ontario, you may be entitled to a Non-Economic Loss (NEL) award. This benefit compensates for permanent cosmetic disfigurement and scarring, but it is only assessed after you reach Maximum Medical Recovery (MMR).
Suffering a severe burn injury at work can be a traumatic experience that changes your life forever. Whether you work in a bustling restaurant kitchen in Toronto or a heavy manufacturing plant in Mississauga, workplace burns often require extensive medical treatment. 🏥 While the Workplace Safety and Insurance Board (WSIB) generally covers your lost wages and medical bills during your initial recovery, permanent scarring and disfigurement require a different type of legal and medical assessment. This is where the Non-Economic Loss (NEL) benefit comes into play.
The NEL benefit is designed to recognize the permanent physical and psychological impact of your injury. It does not replace your lost income, but rather compensates you for the loss of quality of life caused by the scarring or restricted movement. 💰 Navigating the WSIB system in Ontario can feel overwhelming, but understanding the steps involved can help you protect your rights and secure the benefits you deserve.
Step-by-Step Process for a Burn Injury WSIB Claim in Ontario
Whether you reside in Ottawa, Hamilton, or London, the WSIB process for permanent burn injuries follows a specific path. Most injured workers will need to go through several stages of medical evaluation before a final NEL award is granted. 📋
Step 1: Seeking Immediate Care and Filing Form 6
Your health is the absolute priority. Immediately after the burn occurs, seek medical attention at the nearest hospital or burn centre. 🚑 Once your condition is stable, you must report the injury to the WSIB by completing a Worker’s Report of Injury/Disease (Form 6). Your employer is also required to file a Form 7, and your treating doctor will submit a Form 8.
Step 2: Reaching Maximum Medical Recovery (MMR)
WSIB will not assess your scarring for a NEL award until your condition has stabilized. This point is known as Maximum Medical Recovery (MMR). 🕘 For severe burns, reaching MMR can take anywhere from 12 to 24 months, as scars continue to heal, contract, and change colour over time. During this period, you may receive Loss of Earnings (LOE) benefits and coverage for treatments like skin grafts or physiotherapy.
Step 3: The Medical Assessment for Cosmetic Disfigurement
Once MMR is reached, your WSIB case manager will refer you for a NEL assessment. An independent medical practitioner, usually a specialist such as a dermatologist or plastic surgeon, will examine your scars. 🤝 They will use the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment to assess the severity of your disfigurement, looking at factors like the size of the scar, its location (e.g., face vs. back), colour, and whether it restricts your mobility.
Step 4: Receiving and Reviewing the NEL Decision
The WSIB will convert the doctor’s assessment into a percentage of permanent impairment. This percentage is then multiplied by a base monetary amount, which varies depending on your age at the time of the injury. 💵 If you disagree with the impairment percentage, you have the right to request a reconsideration and, if necessary, appeal to the Workplace Safety and Insurance Appeals Tribunal (WSIAT). You generally have six months to appeal a NEL decision.
How Much Does it Cost in Ontario?
Filing a claim with the WSIB is entirely free for injured workers in Ontario. However, there are some costs to keep in mind if you need legal representation or additional evidence. 💲
- WSIB Application Fee: $0 CAD.
- Medical Records: Hospitals may charge $30 to $100 CAD to release your clinical notes and records.
- Lawyer Fees: Most WSIB lawyers and paralegals in Ontario work on a contingency fee basis. This means they generally charge 15% to 30% of any retroactive benefits or NEL awards they secure for you. You do not pay upfront.
How Long Does the Process Take?
Patience is essential when dealing with permanent impairment claims. The timeline heavily depends on the medical healing process. 📅
- Initial Approval: Basic LOE benefits are usually approved within 2 to 4 weeks.
- Reaching MMR: Takes 1 to 2 years for severe burns.
- NEL Assessment and Payout: Once MMR is reached, the assessment and final payout generally take 3 to 6 months.
- Appeals: If you appeal to WSIAT, it can add 12 to 24 months to the process.
Frequently Asked Questions (FAQ)
Can I sue my employer for a burn injury in Ontario?
Generally, no. Under Ontario’s workplace safety laws, the WSIB system acts as a historic trade-off. Workers receive no-fault compensation for workplace injuries, but in exchange, they lose the right to sue their employer or co-workers in the Superior Court of Justice.
Does WSIB cover psychological trauma from severe scarring?
Yes. If a permanent cosmetic disfigurement leads to a diagnosed psychological condition, such as depression or anxiety, this can be assessed as a secondary psychological impairment and added to your overall NEL award.
What happens if my scar gets worse after the NEL award?
If your medical condition significantly deteriorates after your NEL award has been finalized, you may be able to apply for a NEL redetermination. This requires new medical evidence showing a worsening of the impairment.
Will a lawyer help me get a higher NEL percentage?
An experienced workplace injury lawyer or paralegal can ensure that the WSIB has all the necessary medical evidence, review the medical assessor’s report for errors, and represent you effectively at WSIAT if your impairment was undervalued.
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