TABLE OF CONTENTS
STRATEGIC CLAIMS MANAGEMENT PROGRAM
	Page#			
1.	INTRODUCTION	1		
	
	1.1	Program Objectives	1		
	1.2	Program Structure	1
	1.3	Supporting Information	1


2. 	BASIC PRINCIPLES OF WORKPLACE SAFETY & INSURANCE ACT	2			
	2.1	Overview:	2


3.	GOVERNING LEGISLATION	3-9								
	
	3.1	Bill 162	3
	3.2	Dual Award System	3			3.3	Non-economic loss (NEL) Award	3			3.4        Future-economic loss FEL Award	4		
	3.5	Maintenance of benefits	6		
	3.6	Vocational rehabilitation 	6		
	3.7	Reinstatement/Accommodation	8		
	3.8	Reclassification Schedule 1 Employers:	9		
	3.9	Reporting Assessable Payroll.	10	.	
	3.10	Calculation Annual Assessments	10
	3.11	WSIB Audits	10
	3.12	Checklist  Prior to WSIB Audit:	11
	3.13	Optional  Coverage	11
	3.14	Contracting Companies	11
	3.15	Funding	11

4.0  WORKERS' COMPENSATION REFORM - BILL 99	12-16


5.0 NEER (NEW EXPERIMENTAL EXPERIENCE RATING PROGRAM)	17-25

	5.1	Overview	17
	5.2	Neer Assessments	17
	5.3	Insurance Factors	18
	5.4	Neer Statements	18
	5.5	The Neer Cover Sheet	19
	5.6	Interpreting The Neer Statement	21
	5.7	NEER  Calculations	23
	5.8	Company's  NEER Performance 	23
	5.9	Factors Affecting NEER Costs	24
	5.10	Projected Future Costs	25
	5.11	NEER Strategies	25
	5.12	Changes to Experience Rating 	26

5.B	CAD 7 (Construction Experience Rating Program)	27

	5B1	Overview	28
	5B2	Calculations	29
	5B3	Definitions used for Calculations	30
	5B4	Abbreviations/Components	31


6.0  WORKWELL	27


7.0 WSIB  SERVICES	28

	7.1 Specialized Services	28
	7.2 Additional Services	28
	7.3 Translation Services	29


8.0 RIGHTS AND RESPONSIBILITIES	30-34

	8.1 Employer's Responsibilities	30
	8.2 Supervisor and Manager Responsibilities	32
	8.3 Employer's Rights	32
	8.4 Employees' Responsibilities	33
	8.5 Employees' Rights	34

9.0 FIRST AID REQUIREMENTS 	35

10.0  ACCIDENT PREVENTION STRATEGIES 	38

	10.1 Establish Cost Accountability / Location	38
		10.2 Pre-employment / Pre-placement Screening	38
	10.3 Accident Trend Analysis	39
	10.4 Physical Demands Analysis Job Classifications	39
		10.5 Enforcement Protective Equipment	39
		10.6 Training	39
	10.7 Health & Safety Committee Meetings	39
	
11.0 DEALING WITH ACCIDENTS	40-43

	11.1 Accident Reporting 	40
	11.2 Accident Investigation 	40
	11.3 Accident definition	41
	11.4 Specific accident	41
	11.5 Disablement	42
	11.6 Industrial disease	42
	11.7 Types of Accidents	43
	


12.0 THE CLAIMS PROCESS	44-48

	12.1 Overview	44
	121.2 Form 6:  	44
	12.3 Form 7:  	44
	12.4 Form Re07:	45
	12.5 Form 8:	  45
	12.6 Form 26: 	45
	12.7 Form 9:	45
	12.8 Completion Of Form #7's	46
	12.9 Reporting Aggravation Of Pre-Existing Conditions	47
	12.10 Reporting Recurrences	47


13.0 CLAIMS MONITORING & CONTROL	49

	13.1	 Follow-Up With Worker	49
	13.2 	Contact With The Worker's Physician	49
	13.3 	Follow-Up With WSIB	50
	13.4 	Treatment Monitoring	50
	13.5 	Record Keeping	51


14.0 RETURN TO WORK PROGRAM

INTRODUCTION

14.1	 Program Objectives				
14.2	Governing Legislation On Return To Work (Bill 99)
14.3	Employer's New Responsibilities  
14.4	Worker's New Responsibilities
14.5	WSIB's New Responsibilities
		14.6	Health Professional's New Responsibilities
14.7	Steps For Promoting Program
14.8	Worker Obligations
14.9	When To Contact WSIB For Rehabilitation Assistance
14.10	WSIB  Responsibilties Labour Market Re-Entry Process
14.11	Employer's Key Objectives On Return To Work In Priority
14.12	How To Choose A Rehabilitation Provider 
14,13	Rehabilitation Services 
14,14 	Cost Benefit Analysis Appropriate Rehabilitation: 


15.0 THE APPEAL PROCESS	62-65

	15.1 Reasons To Appeal	65








16.0 SIEF REQUESTS	66

	16.1 When To Apply For SIEF	66
	16.2 Appeal  Guidelines - SIEF	67
	16.3 Defining Accident Severity	67
	16.4 Defining Pre-Existing Conditions	68


17.0 FILING & RECORD KEEPING	69-71

	17.1 Tickler System for Active NEER Cases:	69
	17.2 Individual Medical Files:	70
	17.3 Monthly Cost Statements 	70
	17.4 NEER Statements:	71

18.0 STATISTICAL REPORTING AND TRACKING SYSTEM	72

APPENDICES

											Appendix 

Accident Investigation Form	A
Accident Investigation Policy	B
Health & Safety Policy Committment	C
Health & Safety Policy	D
Modified Duty Forms	E
New FAE Form	
Normal Healing Times	F
WSIB Forms	G
-	Form 6
-	Form 8
         	-	WSIB FAE form
Company's  NEER Statement & Reserve Factors	H
Statistical Report	I
Introduction to the Manual

	

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