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WSIB Hiring Process - Eligibility Adjudicator

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Newbie
Sep 15, 2019
30 posts
10 upvotes
I am an accident benefits adjuster working for a large insurer. I handle catastrophic impairment claims (the most serious injuries). How different is this position to what I do now? I deal with statutory laws and working with lawyers/clinicians to rehab their clients.
Deal Fanatic
Aug 31, 2017
5182 posts
3058 upvotes
Toucann wrote: I am an accident benefits adjuster working for a large insurer. I handle catastrophic impairment claims (the most serious injuries). How different is this position to what I do now? I deal with statutory laws and working with lawyers/clinicians to rehab their clients.
depends which insurance company you're coming from
Sr. Member
Jan 24, 2013
678 posts
686 upvotes
Rainy River
If you are lazy, not very bright, and have a major left-wing bias, you'll be perfect for them and fit right in. If you have initiative stay away, a poorly run, unaccountable government monopoly that sucks the lifeblood out of the private sector. And Ontario provincial governments have been doing absolutely nothing about it now for the last 40 years.
Sr. Member
Jan 24, 2013
678 posts
686 upvotes
Rainy River
Based on dealing with them for 30 years in various claims as an employer. My experience with claims adjudicators is as follows:

1) Brutal, lousy customer service. If you have issues with them you have to leave a message with the claim number as they never answer the phone. They screen everything then if they do call back they do so outside of business hours a lot of the time because they know you won't be there to take the call. In some cases they don't call back at all (guess it's hard to call back when you're on holidays or ill for 8-10 weeks a year).

2)They side with the worker to a ridiculous degree. Their decisions and rulings are based on inaccuracies, exaggeration and outright lies. The only way for an employer to have a chance at justice is to take all contentious claims to the Tribunal. This process usually drags on for 4-5 years. During this waiting period the employer has to pay increased premiums because of experience rating as well as deal with the ramifications of a poor experience rating.

Ordinarily when you pay for a good or service, if you think the service is poor or if you think you are being gouged, or treated unfairly in some way you can at least take your business elsewhere. With WSIB you don't have that option as there is no competition permitted in Ontario. WSIB has a monopoly on workplace insurance so there is no incentive for the WSIB to improve their services or policies/procedures. They have a tremendous amount of power but they aren't accountable to employers in any way, yet they have no issue taking premiums from us.

The turnover of adjudicators is what I would be curious about if I was considering working for them (and I wouldn't be unless I had a ton of power to blow WSIB up, get rid of the deadwood/ deadweight and start over again). I'd want to know why people don't last very long in that job. (This is another problem as usually the best adjudicators are often the ones that have had 15 or 20 years experience). I don't know if it's because they don't like the work, don't like the stress as there would be a lot of conflict in the position. I mean think about it you get a contentious claim you hear one set of supposed facts from an injured worker, then another set of supposed facts from an employer that contradict each other. How are you or anyone from the outside going to discern who is telling you the truth and who is making up fiction. Then you make a decision, if you rule in favour of the employee you have an employer that is livid with you as they now have to pay higher premiums for years to come because of experience rating based on some fiction you took as gold coming to you from an employee or an employee's doctor while completely dismissing what the employer had to say about the supposed incident not being reported/witnessed or perhaps about a recurrence of a pre-existing condition or previous claim that he had with some other employer. Conversely, If you rule in favour of the employer and deny loss of earnings benefits to the employee he/she is going to be angry running to their MPP etc., either way prepare to be bitched at by one party or the other.

I haven't even mentioned the return-to work nonsense, where employees have no incentive to get back to 100% health as they are being paid full-bore to work half-days etc. to not do their regular duties as they are too taxing. Injured workers incentive is to be slow, really slow healers to milk the employer. They then overburden the medical system and go see doctors every few weeks, so a doctor can fill out a form (FAF) where the doctor asks them how much can they lift, range of motion etc. All the doctor does is report back what the employee tells them, then WSIB says the doctor says there are still limitations. Wrong the employee tells the doctor his limitations and the doctor fills out what the employee tells him. It's a complete farce and our provincial government has done absolutely nothing for employers for decades, other than tell us about 3rd party claims management companies, and how to appeal decisions or the process on how to take the claim to the Tribunal. You should talk to some of the claims management companies they despise the Board as well.

I want to be clear that most claims do not feature the scammer type employee trying to get on the system for life, or milk a claim for a ridiculous amount of time, I mean it's probably only 1-2% of total claims. So people may say there are always a few bad apples no need to blow up the system over a few scammers, but the problem is these scammer type claims while few in number usually represent 90% + of a company's total claims cost (at least in my experience) because they somehow manage to get/stay on the system and draw benefits for a completely unreasonable amount of time. As well the scammer type claim will take up 90% of the employer's time and I would presume the Board's time as well, as everything gets appealed endlessly up the chain. It is a horrible process to be a part of so I caution you to think about this before you start working for them. Also, note the endless double standards with regards to WSIB policies, extremely high standard for the employer he/she has to know everything follow your policies/processes to a T, no standard at all for the employee to live up to, a complete farce.
Newbie
Sep 15, 2019
30 posts
10 upvotes
MyNameWasTaken wrote: depends which insurance company you're coming from
It's an auto insurer. We all provide the same product and adjudicate claims using the same legislation.
Newbie
Jan 20, 2009
70 posts
10 upvotes
Hamilton
Damn, retireyoung55 sounds like a bitter employer. Typical.
Sr. Member
Jan 24, 2013
678 posts
686 upvotes
Rainy River
I speak the truth. To all those considering careers with the WSIB don't waste your time. It's unfortunate that the salaries are good certainly not merited. If WSIB had some competition they would of been out of business decades ago.
Newbie
Oct 22, 2020
3 posts
Can anybody provide insight on how difficult it is to pass the practicum for the CM role and would they revoke my offer if God forbid i struggle? Also how does the probationary period of 180 days work?
Newbie
Jul 7, 2008
74 posts
9 upvotes
retireyoung55 wrote: I speak the truth. To all those considering careers with the WSIB don't waste your time. It's unfortunate that the salaries are good certainly not merited. If WSIB had some competition they would of been out of business decades ago.
I am a former WSIB employee (not a case manager however). If you were high performing in the private sector, WSIB is not for you. You will shake your head at how difficult it is to do anything here and if you try to go up the ladder, you'll be in for a rough ride here.

If you want to continue doing the same thing over and over and never try to find better ways to do it, WSIB is perfect for you.
Deal Fanatic
Jul 12, 2008
6048 posts
1945 upvotes
GTA
Yeaheh wrote: Can anybody provide insight on how difficult it is to pass the practicum for the CM role and would they revoke my offer if God forbid i struggle? Also how does the probationary period of 180 days work?
CM practicum is almost an automatic pass but stressful, the real issue is at the EA level which is where people get weeded out/forced out. The 180 working days makes it a bit difficult to move around quickly but apart from this as long as you pass your practicum, it doesn't mean anything.
Newbie
Oct 22, 2020
3 posts
Thank you for your insight BADMAS-do you mind shedding light on what makes the practicum stressful?
Newbie
Aug 7, 2020
7 posts
6 upvotes
Yeaheh wrote: Thank you for your insight BADMAS-do you mind shedding light on what makes the practicum stressful?
The training is poor so you are forced to learn on the job. You have set targets which are achievable provided you can speak to people to gather the information. Claims are a constant he said/she said and you really need to filter through this. There’s always something missing with very little time to get it to meet the target. As you go through the weeks, voicemails and requests for reconsiderations pile up. It’s very doable but you need to be able to review information that is in front of you, understand what is needed and apply policies to make decisions.
Newbie
May 29, 2020
16 posts
9 upvotes
Does anyone know how long it takes from the time you apply for a position for them to reach out if they’re interested?
Toronto Realtor
Deal Fanatic
Jul 12, 2008
6048 posts
1945 upvotes
GTA
DefaultUserYYZ wrote: Does anyone know how long it takes from the time you apply for a position for them to reach out if they’re interested?
2 to 6 weeks after the job closes.
Deal Addict
Sep 22, 2013
2341 posts
1489 upvotes
retireyoung55 wrote: I speak the truth. To all those considering careers with the WSIB don't waste your time. It's unfortunate that the salaries are good certainly not merited. If WSIB had some competition they would of been out of business decades ago.
The funny thing is I would bet good money that you wouldn’t even be able to hack it there.
Sr. Member
Jan 24, 2013
678 posts
686 upvotes
Rainy River
As I said in a previous post, I wouldn't dream of working at WSIB unless I could come in blow it up, get rid of the deadweight and overhaul it completely. To try to get a lower or mid-level job there and fit in to their moronic/naive left-wing culture and way of doing things, there would be no purpose in doing that. I like to use my brain, not check it at the door. I think you have to be like a Canadian politician to work there- don't think, sell the company line no matter how ridiculous it is- no thanks I'm not a trained seal.
Deal Addict
Sep 22, 2013
2341 posts
1489 upvotes
retireyoung55 wrote: As I said in a previous post, I wouldn't dream of working at WSIB unless I could come in blow it up, get rid of the deadweight and overhaul it completely. To try to get a lower or mid-level job there and fit in to their moronic/naive left-wing culture and way of doing things, there would be no purpose in doing that. I like to use my brain, not check it at the door. I think you have to be like a Canadian politician to work there- don't think, sell the company line no matter how ridiculous it is- no thanks I'm not a trained seal.
You clearly have absolutely no idea how the WSIB operates. Surprising considering how much experience you claim to have in dealing with them.

Left wing culture? Sigh. Small minded people.
Deal Fanatic
Jul 12, 2008
6048 posts
1945 upvotes
GTA
hongngu wrote: Anybody know when the next training class is? Does CM position require a vehicle? Can they wfh permanently or just for the pandemic? Thanks.
They have been hiring CMs all the time this year but internals, CM does not require a vehicle, even before the pandemic they were looking at WFH so I assume it will be a hybrid unlikely to be fully at home or fully in the office.

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