Job Specification

Purpose of Position :

To provide quality service, advice, in-depth investigation, representation and education services for non-unionized injured workers or dependants through all stages of the workplace insurance claims and appeals process. To promote early case resolution and avoidance of disputes in the handling of workers safety and insurance claims appeals. To contribute to partnerships within the workplace prevention and insurance system and with community partners.

Duties / Responsibilities :

In a regional office of a decentralized Ministry, work is performed for various areas of the Province by: 1. Conducts preliminary face-to-face or telephone interviews with clients, providing advice or information wherever possible without further detailed review, such as provisions in the Workplace Safety and Insurance Act and regulations, WSIB claim and appeal policies and procedures. Advises on the claim process, such as identifying evidence needed to support their claim; identifying, documenting and alerting claimant to limitation periods. 2. Co-ordinates specific case management systems for own and others cases (e.g.: providing consultation to Intake Counsellors in identifying threshold issues on legally complex cases). Coordinating with in-house counsel concerning sensitive or precedent-setting cases, etc. Consults and discusses with peers and other OWA staff issues concerning case management, strategy, previous experience, etc., in order to effectively represent clients' needs. 3. Investigates events and circumstances of claim, obtaining and analyzing the WSIB file for relevant information; conducting in depth interviews (e.g.: with worker, witnesses, employers, and co-workers, workers physician, specialists, ergonomists, occupational hygienists and epidemiologists, hospitals) to obtain information, evidence and expert opinions to support or clarify claim and obtain related documents (e.g.: job descriptions, physical needs analyses, photos). For specific cases: researches legal, medical and scientific aspects on computer-based, paper or oral data, contacting specialists (e.g.: medical experts; Canadian Centre for Occupational Health and Safety); finding and evaluating relevance of precedents in Ontario and other jurisdictions; referring to standard texts, medical dictionaries; compiling the case on the computerized case management system, evaluating and assessing its merits. 4. Advises and directs injured workers, survivors, their families and community partners regarding issues, evidence required for a successful resolution, potential risks. Identifies and diverts from the appeal system those cases which patently have no merit and provides a detailed, comprehensible, written explanation to the claimant. 5. Advocates and presents cases on behalf of clients at all appeals levels. Discusses claim with the employer and WSIB officials to achieve early resolution where possible (e.g.: negotiating terms of rehabilitation and return to work, bearing in mind variables such as: recurrence prevention, health and safety, commutation of pension, medical aid, change to accident or disease entitlement, and future economic loss entitlement/review); reviewing interpretation and application of workplace compensation policies, providing additional information or explaining circumstances of claim, following up on outstanding claims, cheques. Prepares clients and witnesses for hearings or appeal, including coping with questioning and cross-questioning. Makes written or oral presentations to Appeal Resolution Officers and/or to WSIAT panels, including examining and cross-questioning witnesses, presenting evidence and arguments, rebutting other parties' evidence and arguments, etc at ARO and WSIAT hearings. Follow-up on hearing outcomes.

Staffing and Licencing :

Licensed by the Law Society of Upper Canada and entitled to provide legal services in Ontario.

Proficiency in oral and written French at the advanced level.

Knowledge :

Job requires in-depth knowledge of content and intent of current and predecessor Workplace Safety and Insurance Act and Regulations, policies, procedures, precedents, and case jurisprudence; and knowledge of structure, policies and procedures of WSIB and WSIAT to interpret, advice, represent and assist claimants. Job requires knowledge of alternative dispute resolution and negotiation techniques to make successful arguments and promote early resolution. Job requires knowledge of employer rights, responsibilities and needs, to facilitate win/win solutions in individual and systemic dispute resolution. Job requires working knowledge of legal and medical terminology, and quasi-judicial protocols, including rules of evidence. Job requires and understanding of information research, analysis and evaluation techniques. Job requires knowledge of client service principles and project management techniques. Job requires oral and written communication techniques for interviewing, presenting, questioning cross-questioning, counselling, explaining and advising. Job requires knowledge of and skills in consultation and representation techniques; and knowledge of related provincial and federal legislation (eg: Statutory Powers and Procedures Act, Occupational Health & Safety, EI, Human Rights Code, Employment Standards, Canada Labour Code), public service and community organizations and roles; workplace safety and insurance provisions in other jurisdictions; and concepts and principles of administrative law (eg; rules of natural justice). Job requires appreciation of community outreach, development techniques, educational and consultation services in order to assist clients and partners.

Skills :

Job requires skills in advocacy and presentation in a quasi-judicial system, alternative dispute resolution and negotiations, combined with judgement and problem-solving skills to bring about fair results as early as possible. Job requires case management and administrative skills, initiative, results orientation and project management skills to manage a caseload and develop community outreach plans. Job requires written and oral communications skills to marshall facts, articulate issues, interview witnesses, represent clients, explain and persuade. Job requires case leadership, relationship management, team work and client service skills, respect for confidentiality, and ability to solve problems, work independently, and ensure quality service to bring about successful conclusions to cases. Job requires ability to establish working relationships and client confidence quickly (eg: when running intake clinics at remote locations). Job requires analyzing information to assess viability of each case, guide and counsel clients, and represent them in WSIB negotiations and appeals. Job requires research, file/information management, investigative and analytical skills to probe in interviews, gather and assess case information and develop arguments for claim. Job requires team work to provide input to other cases, and development of improved procedures. Job requires proficiency in using available PC-based/networked software (eg: spreadsheet, word processing, presentations, graphics, case management, Quick Law, research, data input, etc). Job requires ability to meet tight deadlines, work within a high volume work environment, travel throughout the province, and manage sometimes irregular, extended work hours.

Freedom of Action :

Job requires working in accordance with OWA, WSIB and WSIAB policies and procedures and within related legislation, and established precedents, but with autonomy latitude for interpreting and applying these provisions appropriately bearing in mind the variables for each individual case. Job requires determining approach for case management, researching facts and interviewing witnesses. Job allows freedom to choose how to advise clients and represent their case on their behalf, including written materials, negotiation and cross-questioning strategies, and alternative dispute resolution techniques. Job requires judgement determining when to seek assistance for unusual and unprecedented situations from OWA specialist staff, peers and/or Manager.