Delay in receiving NEL decision

Workers who sustain a permanent impairment because of a work-related
injury or illness are eligible for a non-economic loss (NEL) benefit. An
assessment is first conducted to determine the degree of permanent
impairment.

In this case, the worker had been assessed and her level of impairment
was determined. However, 18 months later she complained to the
Commission that she was still waiting for her NEL decision.

The Commission’s review revealed that although the worker’s
representative had followed up with the WSIB several times, no one at
the WSIB referred the worker’s claim to the Permanent Impairment (PI)
program for a decision on the NEL benefit.

In contact with a WSIB manager, the Commission addressed the delay
issue and key documents on file. The manager facilitated a review, action
plan, and referral to the PI program for an expedited decision.

Within a few weeks, the worker was allowed a 25 percent PI,
resulting in a NEL benefit payment retroactive to the completion of the
assessment.