In Canada, the Ontario provincial Workplace Safety and Insurance Board (WSIB) appears to be on track to closing its unfunded liability gap. This is the difference between what the WSIB needs to fund payouts to injured workers in Ontario and how much money it actually has on hand.

Steering the WSIB into a more sustainable future is Elizabeth Witmer, who took over the helm of Ontario's workers compensation board in 2012. In in two years under her watch, the WSIB has narrowed its unfunded liability gap by $2 billion: from $14 billion to $12 billion (still a big number).

Charting a sustainable course for the once beleaguered provincial worker's compensation board meant transforming it. Central to the changes has been a focus on return-to-work outcomes for Ontarians injured on the job.
Eschewing traditional practices

What to do with an injured worker? The traditional approach to rehabilitation has been disjointed, with workers often staying off work for long periods.

Yet, international research declares long periods of inactivity actually work against an injured worker's recovery, and have a negative effect on health.

Longer recovery drives up medical costs and increases the likelihood of the worker never returning to work. Dropping out of the workforce permanently means the injured worker has to go on indefinite wage support. In transforming the WSIB there has been attention to the key components of successful rehabilitation.

With the change in approach, the return to work rate has increased from 85 per cent in 2008 to 92 per cent. Early reintegration is key to these high return to work rates.

Improving customer service reduces costs

As in many systems, claims managers at WSIB spent most of their time processing claims and paying bills. The new look WSIB boasts an army of 300 claim managers actively engaged in helping employers and workers create and implement Return to Work plans, to get workers back to work sooner.

Claims managers now have a greater role to play when it comes to health care. They can advise injured workers with musculoskeletal conditions on what medical care they can seek. When it comes to more complicated cases, claims managers have access to a network of specialist care providers that they can quickly refer clients to.

Claims managers taking a greater role in the rehabilitation of clients has seen medical costs fall by 11 per cent. In 2009, medical costs in Ontario's workers compensation scheme were increasing at 8.5 per cent annually.

If the nature of the injury prevents the worker from returning to his or her original job, claims managers take the initiative in transitioning an injured worker from one type of work to another. Approximately 70 per cent of injured workers who take part in the WSIB's current work transition program find new employment; double that of the previous work transition program.

• Streamlining the claims processes, eliminating backlogs, and greater engagement with all stakeholders in the claims process has seen customer service scores improve year on year. Ninety per cent of respondents in customer service surveys report satisfaction with phone and online services.

Examples of changes include:

• Employers and workers can make claims over the phone (Teleclaim);
• Online services, such as online issuing of clearance certificates;
• Ninety two per cent of eligibility decisions are made with two weeks of the claim being filed; and
• Streamlining the appeals process, resulting in doubling the percent of cases unresolved at six months.

Thinking “win-win”

Getting workers back to work has seen a major drop in the number of injured workers exiting the workforce permanently and going onto wage support. This improvement was good for the provincial economy.

In a speech to the Toronto Region Board of Trade, Witmer stated that early intervention, and a safe and speedier path to return to work, added 2 million productive hours to the local economy in 2012. By focusing on restoring injured workers to work, everybody wins: injured workers, employers, and the local economy.

The fundamental lesson is that by taking an active role in an injured worker's recovery, a claims manager plays a pivotal role in shortening the recovery time and restoring a worker to a meaningful, productive life. And, that this can happen at a system or policy level.