Ten months after a worker sustained injuries in a work-related motor vehicle accident, his case manager noticed that he had not been asked to choose between claiming benefits from the WSIB or suing any third party with potential responsibility for the incident. At the time, the worker was still undergoing medical assessments and performing a modified work plan.

The WSIB held the claim in abeyance while the worker considered his options and claim activity came to a standstill. Two months later, the worker confirmed that he would continue to claim benefits through the WSIB. He left several messages for the case manager but received no response.

The worker was finding it increasingly difficult to manage his modified work duties, and the WSIB had yet to address the treatment recommendations made by the specialty clinic prior to his claim being put on hold. The worker tried to escalate his complaint, but the manager had the case manager respond on their behalf. The case manager referred the claim to a return-to-work specialist, but the treatment recommendations for the worker remained unaddressed.

The employer then complained to a manager on the worker’s behalf and the manager committed to having the case manager address the matter. Two weeks later, the worker had not heard from the case manager, so he contacted the Commission.

When the Commission made an inquiry, the manager acknowledged that the WSIB should have sent the worker to a specialty clinic for further assessment after the worker confirmed he would continue to seek benefits through the WSIB. Given the extended disruption to the worker’s treatment, the WSIB facilitated an immediate referral back to a specialty clinic to clarify the appropriate treatment and for consideration of whether or not the worker may have a permanent impairment.