Workplace Safety And Insurance Board Research Articles

Central Vestibular Dysfunction in Head Injury.

This study aims to provide an overview of dizziness post head injury in those with prominent features for central vestibular dysfunction (CVD) in comparison to those with a post-traumatic peripheral vestibular etiology. Retrospective. University Health Network (UHN) Workplace Safety and Insurance Board (WSIB) database from 1988 to 2018 were evaluated for post-traumatic dizziness. The UHN WSIB neurotology database (n = 4291) between 1998 and 2018 was retrospectively studied for head-injured workers presenting with features for CVD associated with trauma. All patients had a detailed neurotological history and examination, audiovestibular testing that included video nystagmography (VNG) and cervical vestibular-evoked myogenic potentials (cVEMPs). Imaging studies including routine brain and high-resolution temporal bone computed tomography (CT) scans and/or intracranial magnetic resonance imaging (MRI) were available for the majority of injured workers. Among 4291 head-injured workers with dizziness, 23 were diagnosed with features/findings denoting CVD. Complaints of imbalance were significantly more common in those with CVD compared to vertigo and headache in those with peripheral vestibular dysfunction. Atypical positional nystagmus, oculomotor abnormalities and facial paralysis were more common in those with CVD. Symptomatic post-traumatic central vestibular injury is uncommon. It occurred primarily following high-impact trauma and was reflective for a more severe head injury where shearing effects on the brain often resulted in diffuse axonal injury. Complaints of persistent imbalance and ataxia were more common than complaints of vertigo. Eye movement abnormalities were highly indicative for central nervous system injury even in those with minimal change on CT/MRI.

Administrative Burden of the Compensation Claim System - Physicians and Union Compensation Representatives’ Views

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, causing 3.23 million deaths in 2019. Cigarettes are the leading cause of this disease. However, workplace exposures, including those in the mining industry, may also lead to COPD. These exposures include dust and fumes that can be higher for mineral industry workers who work in confined areas. As a result, workers in the minerals industry may submit compensation claims. Sadly, work-related COPD is not well compensated or recognized by the Ontario Workplace Safety and Insurance Board (WSIB). Physicians and union representatives struggle to complete forms and have claims approved, and because of this, workers can struggle with money, family, and mental health problems. This qualitative narrative study used in-depth telephone interviews (eight) to collect information. The information collected from physicians (four) and union representatives (four) was analyzed to understand their perspectives and experiences when assisting workers with compensation claims. This is the first study to examine how COPD could affect underground mineral workers in Northeastern Ontario. Themes identified in this study include 1) additional administrative and human support resources are required, 2) smoking cessation is essential, 3) COPD is a crippling disease, 4) education is required to support documenting an occupational illness, 5) the compensation claim process is challenging; 6) occupational diseases are challenging to prove, 7) occupational COPD is costly. This study may help with compensation services and provide support for physicians and union representatives involved with an underground mineral worker diagnosed with occupational COPD.

Worker's compensation usage and return to work outcomes for Ontario public safety personnel with mental stress injury claims: 2017–2021

This study explored approved worker's compensation claims made by public safety personnel (PSP) with work-related psychological injuries to the Workplace Safety and Insurance Board (WSIB) of Ontario's Mental Stress Injury Program (MSIP) between 2017 and 2021. This worker's compensation program provides access to health care coverage, loss of earnings benefits, and return to work support services for psychologically injured workers. In 2016, the Government of Ontario amended legislation to presume that, for this population, posttraumatic stress disorder (PTSD) is work-related, potentially expanding access to the program. The aim of this study was to understand the volume and types of claims, return to work rates, and differences between PSP career categories in the first 5 years after the legislative change. Using a quantitative descriptive approach, statistical analysis revealed that claims increased over the 5-year period, with significantly more claims made in 2021 (n = 1,420) compared to 2017 (n = 1,050). Of the 6,674 approved claims, 33.5% were made by police, 28.4% by paramedics, 21.6% by correctional workers, 9.4% by firefighters, and 7.1% by communicators. Analysis of claim type revealed that police, firefighters, and communicators made more cumulative incident claims, while paramedics made more single incident claims. Differences were also observed in return to work rates, with fewer police officers, firefighters, and communicators assigned to a return to work program, and more paramedics successfully completing a return to work program. This study sheds light on differences among PSP in their WSIB Ontario MSIP claims and underscores the importance of continued research to develop a more robust understanding of these differences, to inform policy development for both employers and worker's compensation organizations.

Return to Work Experiences of Ontario Public Safety Personnel with Work-Related Psychological Injuries.

Public safety personnel (PSP) perform work that puts them at greater risk of psychological injury than the general public. PSP who subsequently develop posttraumatic stress disorder (PTSD) or other mental health conditions may need to take time off of work and use the workers compensation system. Very little is known about the experiences of PSP making this type of claim in Ontario to the Workplace Safety and Insurance Board (WSIB), or which healthcare professionals (HCP) PSP access as part of the treatment and return to work (RTW) process. This study captures the experiences of Ontario PSP in their RTW journeys, including with employers, WSIB, and HCPs. A survey-based study was conducted, using email and social media platforms to distribute the survey to PSP across Ontario. Quantitative data were summarized using means and frequencies, and open text results were analyzed using qualitative framework analysis. 145 survey respondents met the inclusion criteria for the study. On a scale out of 5, PSP rated their experience with WSIB and employer support as poor on their first RTW attempt with an average rating of 2.93 and 2.46 respectively. The top three HCPs accessed by PSP were psychologists (61%), occupational therapists (OT; 60%) and general practitioners (GP; 44%). Respondents identified the cultural competence of HCPs in understanding their work demands and work culture as very important. To improve RTW experiences for PSP who make a workers compensation claim for a psychological injury, an increase in HCP cultural competence related to PSP work is indicated, as well as improved RTW processes and workplace support.

Linkage of administrative and compensation databases for work-related asthma surveillance in Ontario: A proof of concept study

RATIONALE: Approximately 15% of all asthma cases are work-related and eligible for workers’ compensation in Ontario. However, compensation rates of work-related asthma (WRA) are far less than predicted, making it difficult to estimate the prevalence of the disease. OBJECTIVES We aimed to estimate prevalence of compensated WRA in Ontario; profile the pattern of compensated WRA by demographic, temporal and geographic factors; and demonstrate the potential for database linkage to monitor rates of compensated WRA cases. METHODS Compensated WRA claims data were linked to asthma cases in the Institute of Clinical Evaluative Sciences (ICES) asthma database via encrypted health card numbers. WRA claims between April 1998 and March 2002 were accessed from: i) the Ontario Workplace Safety and Insurance Board (WSIB) Occupational Disease Information Surveillance System (ODISS); and ii) a University of Toronto research database (RD) created by abstracting the same WSIB ODISS claim files. MAIN RESULTS: The estimated prevalence of WRA among individuals with asthma in the asthma database was less than 1% compared to an expected prevalence of 15-20%. Sensitivity of the Asthma database for including individuals with asthma with WRA was very good but differed significantly based on claims category (p < 0.001) compared to the RD as the gold standard. CONCLUSIONS Our findings suggest WRA is severely under-reported. Approximately 11-15% of compensated WRA claims are not captured by the asthma database. Factors accounting for discordance between databases should be explored in order for administrative data linkage to be used to monitor the rates of compensated WRA cases in Ontario.

Experiences, impacts and service needs of injured and ill workers in the WSIB process: evidence from Thunder Bay and District (Ontario, Canada).

Individuals experience negative physical, social and psychological ramifications when they are hurt or become ill at work. Ontario's Workplace Safety and Insurance Board (WSIB) is intended to mitigate these effects, yet the WSIB process can be difficult. Supports for injured workers can be fragmented and scarce, especially in underserved areas. We describe the experiences and mental health needs of injured and ill Northwestern Ontario workers in the WSIB process, in order to promote system improvements. Community-recruited injured and ill workers (n = 40) from Thunder Bay and District completed an online survey about their mental health, social service and legal system needs while involved with WSIB. Additional Northwestern Ontario injured and ill workers (n = 16) and community service providers experienced with WSIB processes (n = 8) completed interviews addressing similar themes. Northwestern Ontario workers described the impacts of workplace injury and illness on their professional, family, financial and social functioning, and on their physical and mental health. Many also reported incremental negative impacts of the WSIB processes themselves, including regional issues such as "small town" privacy concerns and the cost burden of travel required by the WSIB, especially during COVID-19. Workers and service providers suggested streamlining and explicating WSIB processes, increasing WSIB continuity of care, and region-specific actions such as improving access to regional support services through arm's-length navigators. Northwestern Ontario workers experienced negative effects from workplace injuries and illness and the WSIB process itself. Stakeholders can use these findings to improve processes and outcomes for injured and ill workers, with special considerations for the North.

Nurses Perceptions of the Utilization of the Violence Assessment Tool (VAT) in Northeastern Ontario

Workplace violence (WPV) is an ongoing problem in health care. Most of the cases of WPV are caused by the patients, patients’ families, and friends. Violence in hospitals among registered nurses has led to 56% of lost time injuries, and in 2018, Ontario’s Workplace Safety and Insurance Board (WSIB) reported 13% of lost time injuries due to WPV. The Public Services Health and Safety Association (PSHSA) created the Violence Assessment Tool [VAT] to predict the possible risk of violence from patients in acute care settings. Health care workers can use the VAT to assess risk, apply possible control measures and improve their safety. As part of a larger study, the aim of this research is to explore nurses’ perceptions of the utilization of the VAT in assessing the potential risk of violence, and to identify any gaps, challenges, or improvements needed in the VAT. An Interpretive Description research design by Sally Thorne in (2016) will be used. The model that will guide this study is the Haddon Matrix framework of workplace violence prevention. The study will involve three focus groups via zoom virtual meetings with 6 to 8 participants per session, and an expected total of 18-24 participants. Focus group interviews will use semi-structured questions to guide the discussion among nurses working in a Northeastern Ontario hospital. Interpretive description data analysis will be guided by Thorne’s processes of data analysis. This will be the first study to examine nurses’ perceptions of the VAT in Ontario. The findings of this study will help to determine the predictive validity of the VAT and any potential changes that may be needed. The findings of this study could lead to reduced violence and associated costs within the healthcare sector.

Modernizing First Aid

At the dawn of 2021, the Ministry of Labour, Training and Skills Development (MLTSD) submitted for review by all Ontarians a big tent approach to the delivery and oversight of first aid training in the province - Proposal 21-MLTSD 001. This Ontario Regulatory Registry proposal, if approved, will see care and control of first aid training in the Province of Ontario transferred from the Workplace Safety and Insurance Board (WSIB), to the MLTSD. Proposal 21-MLTSD 001 seeks to do so by revoking R.R.O. 1990, Reg. 1101: First Aid Requirements under the Workplace Safety and Insurance Act (WSIA) and granting the MLTSD the right to not only reshape the regulation, but to enforce it. Currently, the WSIA applies to approximately 76% of employers in Ontario, with a fraction of that subset subject to R.R.O. 1990, Reg. 1101: First Aid Requirements. Transferring care and control of first aid training to the MLTSD, and enacting a new first aid regulation within the Occupational Health and Safety Act, would ensure that, with very few exemptions, all of the 7.1 million working Ontarians would be safer in their workplace.

Mining-Related Lower Back Injuries and the Compensation Process: An Injured Worker's Journey.

Background: In Ontario, when an occupational injury occurs in the mining industry, there is often a need to interact with the Workplace Safety and Insurance Board (WSIB). During this process, miners experience economic, social, and mental health-related issues that can affect their overall well-being. This study aimed to determine the impact of a lower back injury and the WSIB claim process experience expressed by some male, underground miners in Sudbury, Ontario, Canada. Methods: A qualitative descriptive study design that utilized in-depth, individual qualitative interviews was conducted. Twelve male participants (underground miners) were interviewed in Sudbury, Ontario. Interviews were transcribed and thematically analyzed. Findings: The results emphasized the need for improved communication, the necessity for resources to be allocated to enhance public discussion about injury prevention, the social and economic burden that miners and their families face, and the power imbalances between injured miners and the companies that were meant to support them. Conclusion/Application to Practice: The findings indicate that several areas require improvement for an injured miner who submits a WSIB claim. Ideally, participants wanted an improved and streamlined process for reporting an injury and for WSIB claim management. These findings suggest that occupational health practices that foster a safe and healthy work environment in the mining industry must be promoted, which will help to guide future policies that enhance support for an injured worker and the WSIB claim process.

Dermatitis among workers in Ontario: results from the Occupational Disease Surveillance System

ObjectivesDermatitis is the most common occupational skin disease, and further evidence is needed regarding preventable risk factors. The Occupational Disease Surveillance System (ODSS) derived from administrative data was used to...

Examining lung cancer risks across different industries and occupations in Ontario, Canada: the establishment of the Occupational Disease Surveillance System

BackgroundThe Occupational Disease Surveillance System (ODSS) was established in Ontario, Canada by linking a cohort of workers with data created from Workplace Safety and Insurance Board (WSIB) claims to administrative...

Sex differences in work-related traumatic brain injury due to assault

To examine the etiology, prevalence and severity of assault-precipitated work-related traumatic brain injury (wrTBI) in Ontario, Canada through a sex lens. Cross-sectional study using data abstracted from the Ontario Workplace Safety and Insurance Board (WSIB) claims files in 2004. Descriptive analyses were conducted to determine the distribution of worker/employment/incident characteristics. Workplace physical violence that resulted in a TBI accounted for 6.6% percent of all TBI injury claims. Female workers, primarily in the health care/social services sector, accounted for over half of all TBIs. Most workers were assaulted by consumers/clients. Forty five percent of injuries occurred among workers with less than 3 years of employment. This paper identifies profiles of workers and workplaces for targeted preventive efforts. Future studies are needed to further address risk factors by sex and outcomes, such as length of disability and health care cost.

Olfactory and cochleovestibular dysfunction after head injury in the workplace: an updated series.

The objective of this study was to determine the incidence of olfactory dysfunction in workers following head injury in the work place, to define its relationship to the site, severity of injury and direction of force. The demographics of head injured workers were also assessed to determine whether those with olfactory loss were more likely to have sustained a cochleovestibular injury. Retrospective case analysis. Tertiary referral university hospital in Toronto, Ontario. A total of 3438 consecutive patients referred from the Workplace Safety and Insurance Board (WSIB) in the province of Ontario who sustained a work-related head injury were assessed between 1987 and 2014. Olfactory and cochleovestibular dysfunction assessed by history, clinical examination and subjective and objective tests. Olfactory dysfunction (OD) was identified in 413 of 3438 patients (12.0%) of which 321 were diagnosed with anosmia and 92 with hyposmia. In our series, injuries from a fall were the commonest cause for OD and a frontal or mid-face impact was more likely to result in OD than other regions (P = 0.0002). A loss of consciousness (LOC) of any duration correlated with OD. In those with olfactory dysfunction, an associated skull fracture occurred in 37.1% of patients and a CSF leak in 4.1%, which was significantly higher compared with those without OD(<0.0001). Patients with OD had a higher incidence of cochlear and vestibular loss (19.9% and 20.6%, respectively) compared with those without OD (14.3% and 17.1%, respectively). Post-traumatic olfactory dysfunction is more likely to occur in patients who experienced a moderate to severe head injury, LOC and more likely to result from a frontal or mid-face blow to the skull. Cochleovestibular dysfunction is likely to occur concurrently with olfactory dysfunction.

One side of the story: Examining newspaper coverage of workplace injury and fatality in Ontario, 2007–2012

News coverage in popular media can shape public perspectives on occupational issues. Few studies exist concerning how occupational injury and fatality are represented in the news. This study examined how injuries, fatalities and worker characteristics were represented in newspapers compared with official government statistics. It also examined what individuals or organizations were most often included by reporters to provide interpretations of injuries and fatalities. Quantitative content analysis was used to examine 304 newspaper articles from between 2007 and 2012 representing the nine most populous cities in the province of Ontario, Canada. Government data came from reports compiled by the Workplace Safety and Insurance Board (WSIB) of Ontario. Compared to workers' compensation board records, physical characteristics of injuries and fatalities were skewed toward the acute traumatic. Women were dramatically underrepresented in newspaper articles. Age distributions were represented. Goods-producing, transportation and resource extraction occupations were overrepresented while services were underrepresented. Worker voices were largely absent in newspaper accounts compared with law enforcement, the State and management. How workplace injury and fatality are framed, and who contributes to these frames, serves to shape public interpretations of occupational injury and fatality and how occupational health and safety issues might be addressed in the future.

Association of worker characteristics and early reimbursement for physical therapy, chiropractic and opioid prescriptions with workers’ compensation claim duration, for cases of acute low back pain: an observational cohort study

ObjectiveTo assess the association between early reimbursement for physiotherapy, chiropractic and opioid prescriptions for acute low back pain (LBP) with disability claim duration.DesignObservational cohort study.Setting and participantsFrom a random sample...

The Added Value of Collecting Information on Pain Experience When Predicting Time on Benefits for Injured Workers with Back Pain.

Objectives Some injured workers with work-related, compensated back pain experience a troubling course in return to work. A prediction tool was developed in an earlier study, using administrative data only. This study explored the added value of worker reported data in identifying those workers with back pain at higher risk of being on benefits for a longer period of time. Methods This was a cohort study of workers with compensated back pain in 2005 in Ontario. Workplace Safety and Insurance Board (WSIB) data was used. As well, we examined the added value of patient-reported prognostic factors obtained from a prospective cohort study. Improvement of model fit was determined by comparing area under the curve (AUC) statistics. The outcome measure was time on benefits during a first workers' compensation claim for back pain. Follow-up was 2years. Results Among 1442 workers with WSIB data still on full benefits at 4weeks, 113 were also part of the prospective cohort study. Model fit of an established rule in the smaller dataset of 113 workers was comparable to the fit previously established in the larger dataset. Adding worker rating of pain at baseline improved the rule substantially (AUC=0.80, 95% CI 0.68, 0.91 compared to benefit status at 180days, AUC=0.88, 95% CI 0.74, 1.00 compared to benefits status at 360days). Conclusion Although data routinely collected by workers' compensation boards show some ability to predict prolonged time on benefits, adding information on experienced pain reported by the worker improves the predictive ability of the model from 'fairly good' to 'good'. In this study, a combination of prognostic factors, reported by multiple stakeholders, including the worker, could identify those at high risk of extended duration on disability benefits and in potentially in need of additional support at the individual level.

0182 Predictors of Workers’ Compensation Claim Duration among Workers Disabled Due to Low Back Pain

ObjectivesLow back pain (LBP) is a common complaint among workers receiving Workers’ Compensation wage replacement benefits. We used the administrative data from the Ontario Workplace Safety and Insurance Board (WSIB)...

Using Serious Games and Virtual Simulation for Training in the Fire Service: A Review

Fire fighting is an extremely physiologically and psychologically demanding occupation, requiring tremendous resources for training personnel as well as incurring significant workplace safety and insurance board (WSIB) costs. Approximately 33% of fire fighter injuries result from exposure to fire leading to the possibility of reducing these injuries through training fire fighters to make better decisions, particularly when under stress. Simulation (and virtual simulation in particular) offers a safe and cost-effective alternative to practice with real fire, offering entry level training to aid fire fighters to reach a specific competency level. With the ubiquity of video game play and advent of new consumer-level physical interfaces for video games (e.g., the Nintendo Wii Fit balance-board and the Microsoft Kinect), serious games (games whose primary purpose is education and training), are able to provide users with innovative interactive techniques that are highly engaging and immersive. This paper reviews the development of serious games and virtual simulation applications that may be utilized for training in the fire service. Current technology allows for the simulation of fire spread and smoke movement along with training certain fire fighting skills and incident command co-ordination. To date, gaming technology is not capable of providing a real world scenario that is completely and faithfully accurate in a dynamic virtual environment. Future work could utilize serious games to also recreate the decision making processes and the physical requirements that fire fighters encounter in an emergency situation. These could be incorporated into a simulation environment where the physical and psychological stresses are analogous to live fire fighting situations.

Workers’ Compensation, Fibromyalgia, and Kafka

In this issue of The Journal Mary-Ann Fitzcharles and colleagues present statistics describing the appeals process for patients with “fibromyalgia” (FM) whose indemnity claim for workers’ compensation had been denied by the Workplace Safety and Insurance Board (WSIB) of Ontario, Canada1. No doubt these descriptive statistics will be of interest to and even have use for those involved in this process in Ontario. They may even be relevant to actuaries and policy-makers in other jurisdictions. But are they of interest to anyone else? In particular, are they of interest to rheumatologists who are not involved in the workers’ compensation indemnity scheme of Ontario? I will argue the affirmative; this process is a window on the social construction of illness and on the role of the physician in determination of disability. I have a personal bias in that this fascination has captured a great deal of my scholarly efforts for many decades. A recent monograph bears witness and hopefully can imbue the reader with a similar level of interest2. Workers’ compensation indemnity schemes made landfall in North America almost exactly a century ago. However, unlike the Prussian precedent that swept Europe country by country, this species of social legislation was met with a politic that resulted in distinctive programs in each Canadian province and American state. All these schemes were designed to serve a particular ethic: any worker who is injured in the course of working should not fear for loss of wages while recovering from the injury or after recovery. The initial notion of “injury” was straightforward, the damage that resulted from a violent event. Injury of this nature still accounts for the vast majority of … Address correspondence to Dr. N.M. Hadler, UNC 3330 Thurston Building, CB 7280, Chapel Hill, NC 27599-7280, USA. E-mail: nmh{at}med.unc.edu

Impact of a Cleaners’ Strike on Compensation Claims for Asthma among Teachers in Ontario

A review of Workplace Safety and Insurance Board (WSIB) claims in Ontario from 1998 to 2002 showed an unusual spike in the number of claims accepted for work-exacerbated asthma (WEA) in April 2001. To identify the cause for the spike in the number of WSIB claims for WEA in April 2001. File reviews were performed to identify the occupations of workers with claims accepted for WEA in April 2001 compared with claims during March and May 2001, and during the same months in 2000 and 2002. In April 2001, there were 61 accepted WEA claims; the most common occupation was 'teacher'. In contrast, among educational workers, there was only one WEA claim in the previous month and one in the following month. From March to May in the preceding and following years, there were only four and two claims, respectively. The most frequently implicated causative agents were dust and dirt exposure, which were responsible for 98% of claims; the mean (± SD) number of lost workdays was 6.5±10. The only identified environmental change associated with this spike was a cleaners' strike at all elementary and high schools in the Toronto District School Board in Ontario, which started on March 31, 2001 and ended on May 1, 2001. [corrected] The spike in accepted WEA claims in Ontario in April 2001 was temporally associated with a strike by Toronto District School Board cleaners, suggesting acute symptomatic effects of poor workplace (school) maintenance on asthmatic employees. The WSIB database was sufficiently sensitive to capture this phenomenon.