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Provincial Workers Compensation and
Insurance Board Services

Dealing with the provincial workers compensation boards can be frustrating, time-consuming and without the proper background, experience and training can be very costly to a company.

Regulations differ greatly between provinces and what may be permissible in one location may be illegal in another. Without the proper training and resources, a single misstep in any portion of the claims management process could cost thousands if not hundreds of thousands of dollars in surcharges, claim costs, rating increases and increased overhead factors charged by these agencies.

DarkHaven Consulting Services has provided these services to a variety of clients in different sectors and over the past 12 years and we have been successful in reducing surcharges by over $16,500,000. At the same time, with properly modified work programs and injury management, we have prevented clients from entering into a surcharge position and maintained them in a rebate position.

In the wake of consistent changes to the WSIB Act, as well as amendments and additions to provincial operational policy guidelines and provincial COR programs, any firm will require proper claims management, return to work programs, and preventative measures to keep in a rebate position.

DCS has over 20 years experience in dealing with provincial compensation boards and we have had very good success with clients both large and small. In the last 10 years alone we have recovered or prevented over 7 million dollars in claim costs/surcharges for Ontario businesses, not to mention similar services provided for our out-of-province clients.

We believe our programs can improve the overall position of all your branches and continue to provide a fully managed program.

DCS provides the following services:

WSIB Program Summaries

Regardless of what program you are under, understanding information about these programs can sometimes be a challenge. DCS provides your firm with a clearly defined summary of :

  • Monthly Accident cost statements
  • NEER Program summary
  • CAD 7 Program summary
  • NEER/CAD 7 rebate and surcharge statements

Understanding these statements is key in managing your claim costs and ensuring that all parties involved know what the different codes, costs and charges mean to the day to day operations of your firm.

Return to Work Programs

We will provide immediate service in case of a workplace injury identifying suitable modified work in accordance with Canadian medical Association guidelines.

This service will include the drafting of the “offer of modified work” to the employee, following up with provincial board to ensure that the board has received a copy of the offer and that it has been filed on the claim, then monitoring of the progress of the injured employee in his/her return to work progress.

We will also inform senior management, location management, Union and JOHSC (where required by law or company policy) of the progress of the injured worker in the return to full and regular duty.

As some clients may be self-insured for Short-term disability we will also provide this service for non-work related claims when requested by the client.

Back on Track Program

Has your company suffered from poor safety performance in the past? Have you been identified for a WSIB Core Value (workwell) audit? Have you received compliance orders from the Ministry of Labour? Is your safety program simply not up to your own standards?

Our Back On Track program can help businesses of all sizes overcome poor past performance, and get their business back into good standing with the WSIB and Ministry of Labour.

Cost Statement Reviews

We will review the monthly and quarterly provincial agencies’ accident cost statements to ensure that all charges are correct and applied to the correct claim, claims are closed when closure dates are met, and coding for claims is correct and properly reflected in any costs charged to the account.

We will also project the annual rebate/surcharge based on these cost statements for each location so that the client can monitor, improve and correct identified issues well before they become a financial burden to the location.

Claims Management

We will provide a full range of claims management services including the items identified above, 1st level appeals, claim objections, transfer of costs to Second Injury Enhancement Funds and filings for cost relief.

Modified Work

If required, we will examine all job tasks and develop a modified work inventory for each location.

This will include submission guidelines for CMA acceptance, job task analysis, and annual updates to each inventoried position.

Claim Challenges

Where the client believes there is grounds to file a challenge to a claim, we will review the claim objection to determine if the objection falls within the purview of the provincial board.

If so, we will file the claim objection on behalf of the client. If the claim is refused we will file the secondary objections or appeal if possible.

Medical Disputes

Where there is a dispute either between the provincial boards, the employee or the client we will provide independent medical advice by our associate MD.

We provide this service within 72 hours of the request being received at our office.

Workplace Occupational Illness Claims

As these claims are dealt with in a totally different stream within the provincial boards and are often quite costly to the employer, DCS will manage the initial filing and 1st level appeal.

Should the claim proceed to appellate stage, DCS will provide a costing to the client on the projected legal fees, filing fees, and other costs associated with the claim. We will also provide a detailed cost benefit analysis so that the client can decide whether or not to move forward with the claim with the most current information possible.

Training

Supervisors and managers are our front line of defence in claims management. Most, however, do not understand most of the processes involved in dealing with a work related injury.

We can provide high-level claims management training to all managers and supervisor, JOHSC members, and HR Staff, to ensure that your key staff are well-aware of the best practice in dealing with workplace injury.

Ongoing Review

We monitor changes to provincial legislation that will have an impact on our client’s operation in regards to workers compensation issues.

These changes are immediately communicated to our clients’ senior and location management.

Reporting Hotline

We provide for our clients a 24/7 reporting hot line that management, supervisors, or injured workers can use to report workplace injuries or to obtain guidance.

Other

Should an issue arise not identified in the above, we will perform those services on a cost-recovery basis for clients who execute a service agreement.

For those clients without a service agreement an hourly rate is charged.


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