Just Ask Joe Form

Claims after January 1, 1998

Personal Information...
Hi there, If your injury or illness occurred after January 1, 1998, you've come to the right place. We want to give you the most accurate response possible and ensuring our answer to your question is based on the appropriate legislation is extremely important. Please be as thorough as possible with your responses to the questions in the questionnaire as this will impact the accuracy of our answers.

If you require additional time to complete your questionnaire, click the "Save to fill later" document icon at the bottom of the form, on the right side of the question counter and you will receive an email with a link to take you back to where you left off on the questionnaire.
Full Name *

First Name Last Name
Phone Number *

Area Code Phone Number
E-mail *
example@example.com
Date of birth *

Month Day Year
Date
Date of injury or illness *

Month Day Year
Date
Claim Number *
Provide a brief description of injury or illness (example; area of injury):

0/300

This section deals with Non-Economic Loss...
Were you granted a Non-Economic Loss award (NEL) for your injury or illness?
If yes, what is the percentage of your NEL award?
Have you had a NEL Redetermination? If yes, please provide the date of your redetermination?

Month Day Year
Date
If you answered yes, did you receive an increase?
Has your condition deteriorated since your last Non-Economic Loss redetermination?
If yes, have you seen your health care provider regarding your deterioration?

This section deals with Loss Of Earnings Benefits...
Are you currently in receipt of LOE benefits?
Were you able to return to your pre-accident job?
If no, were you provided with Work Reintegration Services?
If yes, was a Suitable Occupation (SO) identified?
Were you successful in obtaining employment in your SO?
Did the WSIB conduct the 72-month Lock-in review of your LOE benefits? *
If yes, please provide the date of the 72-month Lock-in review.

Month Day Year
Date
Was your LOE benefit reduced or taken away at the 72-month Lock-in review?
If you answered yes, please provide the reason(s) the WSIB gave you to reduce or stop your LOE benefits at the 72-month Lock-in review.

0/300
If the WSIB reduced or took away your LOE benefit at the 72-month Lock-in review, did you request a reconsideration of their decision?
If yes, please provide a brief explanation as to the outcome of the reconsideration review?

0/300
If the WSIB decided to maintain the original decision, did you appeal to the WSIB's Appeals Division?
If yes, please provide a brief explanation of the Appeal Resolution Officer's decision including the date of the decision.

0/500
Did you appeal to the Workplace Safety & Insurance Appeals Tribunal?
If your answer was yes, was your appeal granted by the Workplace Safety & Insurance Appeals Tribunal?
Ask your question here. Please note that in the next section you may upload a document for our review, including an Appeal Resolution Officer's decision if it is pertinent to your question.

0/500
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By signing this questionnaire, I agree and understand that I am not being provided with legal advice and that any opinions provided by any of our advisors in connection with my WSIB claim are solely based on his/her direct experiences derived from many years of providing paralegal services for injured and ill workers in Ontario. I also agree and understand that any opinions provided are solely based on the information and the accuracy of said information provided by me in this questionnaire.
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Claims after January 1, 1998