Job Specification

Purpose of Position :

To provide quality service, advice, in-depth investigation, representation and education services for non-unionized injured workers or dependents 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 for own and others' cases. Co-ordinating 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 client's 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, worker's 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 Appeals 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. Follows-up on hearing outcomes.

6. Participates in alternative dispute resolution with the employer, representatives of both the WSIB and the WSIAT, including providing mediation assistance on behalf of injured workers to facilitate an early and safe return to work. Negotiating with the employer on return to work issues, sometimes in partnership with a Board representative. Follows-up on outcomes.

7. Refers injured workers in financial need to federal, provincial and municipal agencies (e.g.: social service benefits and services). Advises client of possible benefits available, how they interface with WSIB benefits, and application procedures.

8. In the context of a plan, undertakes community outreach and development to improve workers' knowledge of the workplace safety and insurance system and provisions, and seeks out opportunities for co-operative initiatives and partnerships, particularly with major non-union employers to build and maintain positive relationships and promote understanding of WSI provisions, issues and roles and organizations (e.g.: ethnic communities, social service agencies, MPPs and municipalities). Provides consultation and education services, develops and adapts resource material for community and system partners and self-education information. Provides intake clinics to remote communities.

9. Supports initiatives to improve internal OWA system efficiency, teamwork and develop strong working partnerships with the community served, WSIB, WSIAT and within the OWA. Identifies opportunities to develop innovative solutions with WSIB and WSIAT for caseload management, such as group alternative dispute resolution for like cases. Liaises regularly with WSIB and WSIAT offices to foster good working relations and remain current with developments. Remains informed about changes in legislation, policy and procedural provisions in Ontario and other jurisdictions. Participates in agency-wide system partnership projects (e.g. with prevention organizations).

10. Participates as a team member in reviews of OWA policies and procedures, resource and educational materials; provides feedback and recommendations to management on key service issues and potential areas for improvement. Works collegially within the OWA to ensure information, knowledge and experience is shared (e.g.: on areas where incumbent has developed specific case-type expertise). Provides advice, assistance and mentoring to new staff.

11. Participates in developing regional/local office and program delivery procedures (e.g.: for development of reference library, setting up office filing system, intake methods, and waiting list procedures). Provides feedback and recommendations to Manager on key front-line service issues and potential areas for improvement. Maintains records on Case Management System, including data updates, etc. Performs tasks related to special projects.

12. Management has the right to assign other duties.

Staffing and Licensing :

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 an 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 (e.g. Statutory Powers and Procedures Act, Occupational Health & Safety, El, 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 (e.g. rules of natural justice). Job requires appreciation of community outreach techniques, educational and development 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 marshal 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 (e.g. 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 case related 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 (e.g.: 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 WSIAT policies and procedures and within related legislation, and established precedents, but with autonomy and 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 in determining when to seek assistance for unusual and unprecedented situations from OWA specialist staff, peers and/or Manager.