Workers Compensation Claims Management Training

Employers (Supervisors, Managers) receive practical training ensuring their understanding of the current policies of the Workplace Safety and Insurance Board. The training focuses on 4 key areas that provide the best outcomes in protecting against preventable and unjustifiable WSIB claim costs.

1. Initial investigation and reporting procedures to ensure accurate and complete information is provided to the WSIB.

2. Return to work – accommodations, light duty offer assurance and how this activity limits the loss of earnings potential in a claim, effectively minimizing unnecessary assessment costs.

3. Maintaining appropriate communications during the workers recovery period.

4. Ensuring new and previously unrecognized factors are identified and reported for review.

Employer obligations and regulations are delineated to ensure their understanding of the negative financial impacts that are incurred by their employer when the critical steps are not followed.

When there are delays in injury onset or reporting, training about initiating early investigation and maintaining appropriate communication is examined.

This WSIB training program is designed to empower the supervisor/manager with activities that will result in preventing unjustifiable WSIB claims costs and follows a proactive modelling. 

WSIB Investigations

Claims Investigations

Professionally trained and experienced WSIB Investigators provide timely investigation services and comprehensive reports relating to all claim’s entitlement matters. The primary objective of our Claims Investigator is to systematically identify, secure and report on information required for the determination of entitlement in a WSIB claim. This is achieved through various investigative methods which may include statements from the injured worker, supervisor(s), witnesses, and any other relevant party. The statements focus on assisting the WSIB in rendering an accurate decision based on entitlement policies under the Workplace Safety & Insurance Act (WSIA).                

WSIB entitlement policies can be broad in nature and may entail proof of accident, repetitive strains, “disablement arising out of and in the course of” enquiries to name just a few. The injuries/disabilities include musculoskeletal, psychiatric, and varying types of cancers and diseases.

It is very important to understand and overcome the potential difficulties in securing accurate information from sources such as witnesses or supervisors; a lapse in time since the inception of the claim exacerbates these adversities. Potential information shortcomings are often detrimental to the decision-maker in trying to render an appropriate and accurate decision as all information impacting the decision may not be accessible.

An investigator must be fully cognizant of WSIB policies and have experience with how the decision-maker will weigh the evidence particular to a certain policy circumstance. There can be a significant number of variables, even in claims that appear at first glance to be straight forward, that requires expert knowledge to control potential costs.  

Some of the cases that require expert WSIB Claims Investigations include:

• Complex Policy Issues

• Multiple Concerns (delay in reporting, medical, concurrent employment etc.)

• Fight Claims

• Cancers

• Occupational Diseases

• Fatalities

• Mental Stress Claims

• Review for potential surveillance (fraud, degree of disability)

Surveillance Investigations

Workers’ compensation claims can be difficult to manage, even for the WSIB decision- makers, who must rely on the validity of the information they receive to render decisions. Sometimes the completeness and/or accuracy of the evidence received is tenuous and this may not be self-evident.  

Investigative Risk Management’s surveillance investigators are highly trained professionals with extensive backgrounds and credentials. These professionals have been instrumental in leading IRM to the position of being one of the most successful businesses in the industry. Evidence is gathered using the latest advanced technical equipment while assuring all legal proprieties, continuity, and practices to ensure the best possible results for our clients. Investigative Risk Management utilizes pixelization technology which protects the privacy of non-targeted individuals captured during video surveillance.

 IRM has a proven track record of providing factual and unbiased evidence in the form of state-of-the-art video and photograph surveillance, resulting in the recording of fraudulent and level of disability activities. WSIB claims can be complex to investigate requiring a high degree of acumen and prudence. Our professional surveillance investigators are highly trained in applicable WSIB policies to ensure effective and impactful investigation results.

 Open-Source Intelligence Investigation (OSINT)

A technologically advanced detailed investigation of social media platforms, open-source databases, and the deep web to provide the client a certified comprehensive report of findings that may be utilized in legal proceedings. For example, Merlin is our “social media listener”.  MERLIN, The Smart Solution (Social Media Analytical Research Technology), captures social media posts by location from anywhere in the world, the time and date, keywords, and usernames; 24/7, 365 days a year. 

Merlin has access to over 10 million data sources, as such, can review, and returns information as if you had hundreds of investigators working for you at the same time. It also has extensive filter capabilities, which allows you to refine the results using location, keyword, and data source restrictions, to help ensure accuracy.  This means that we can search massive amounts of data for information relating to high profile investigations.  This platform also allows us to set up continuous monitoring, so if you have a high-profile investigation on-going, you can monitor and discover who else in the public is speaking about it.

The “Pandora” program allows us to assemble massive volumes of data from open sources including social media, messengers, blockchains, and the Dark Web to analyze and visualize a holistic picture for streamlining data-driven investigations. With Pandora, we can see, and visualize, connections between individuals, accounts, and events.

 Due Diligence & Background Investigations

The IRM team has a proven record in locating persons across Canada, USA or overseas.  IRM investigators are experts in finding deceit, deception and uncovering the truth. Background checks will help to verify the validity of a criminal record, education credentials, or employment history.