What Happens After You File a WSIB Claim? (Timeline & What to Expect)

You submitted your Form 6 to WSIB. Now what? For many injured workers, the waiting is the hardest part. You are in pain, worried about money, and have no idea what happens behind the scenes. The good news is that the WSIB claim process follows a predictable path. Once you know the steps, the timeline, and what WSIB expects from you, you can stay ahead of problems before they derail your claim.

This guide walks you through every stage of the WSIB claim process after you file, with real timelines so you know exactly what to expect.

Stage 1: WSIB Receives Your Claim (Day 1)

The clock starts the moment WSIB receives your Form 6 (Worker's Report of Injury). If your employer also filed a Form 7 (Employer's Report of Injury) and your doctor filed a Form 8 (Health Professional's Report), WSIB now has the three key documents it needs to begin reviewing your claim.

What Happens Right Away

• WSIB assigns your claim a claim number. You will receive this by mail or through your online WSIB account.
• Your claim is assigned to an adjudicator (also called an entitlement specialist or claims manager).
• WSIB checks that the basic information is complete: your name, employer, date of injury, and description of what happened.

Tip: If you have not already, create an online account at wsib.ca. This lets you check your claim status, upload documents, and receive messages faster than waiting for mail.

Stage 2: Initial Review (Weeks 1-2)

During the first one to two weeks, your adjudicator reviews the initial paperwork and decides whether they have enough information to make a decision.

What Your Adjudicator Is Looking At

• Your Form 6: Does your description of the injury make sense? Is the date clear? Does it connect to your work?
• Your employer's Form 7: Does the employer's version match yours? Did they report it on time?
• Your doctor's Form 8: Does the medical evidence support a work-related injury? What diagnosis and restrictions did your doctor provide?

You May Get a Phone Call

It is common for WSIB to call you during this stage. They may ask you to:

• Clarify details about how the injury happened
• Describe your current symptoms and limitations
• Confirm your employment details and earnings
• Provide additional medical records

Important: Answer WSIB calls promptly. If you miss a call, call back the same day if possible. Delays in responding can slow your entire claim.

What Could Slow Things Down

• Missing or incomplete forms (especially if your employer has not filed the Form 7)
• Conflicting information between your report and your employer's report
• WSIB requesting additional medical evidence from your doctor

Stage 3: The Entitlement Decision (2-6 Weeks, Typically Around 45 Days)

This is the big one. WSIB decides whether to allow or deny your claim. The legal term is "initial entitlement."

What WSIB Is Deciding

WSIB must answer three basic questions:

1. Did an accident or occupational disease occur? WSIB looks at the facts to confirm something happened.
2. Is it work-related? The injury must have arisen "out of and in the course of employment."
3. Does the medical evidence support the claim? Your doctor's report must connect your diagnosis to the workplace event.

How Long Does It Take?

WSIB aims to make most initial entitlement decisions within 45 calendar days of receiving the claim. However:

• Simple, straightforward claims (clear accident, employer agrees, strong medical evidence) can be decided in as little as 2 weeks.
• Complex claims (gradual onset, occupational disease, employer dispute) can take 6 weeks or longer.
• If WSIB needs to gather additional evidence, such as ordering an independent medical exam or getting records from another province, the timeline can stretch further.

You Will Receive a Written Decision

WSIB sends you a letter (and posts it to your online account) explaining:

• Whether your claim is allowed or denied
• The reasons for the decision
• Your right to object within six months if you disagree

Stage 4: Benefits Begin (If Allowed)

If WSIB allows your claim, benefits can start flowing. Here is what you may receive.

Loss of Earnings (LOE) Benefits

If you are missing work because of your injury, LOE benefits replace 85% of your pre-injury net earnings (minus any post-injury earnings if you are working reduced hours or modified duties).

• LOE benefits are paid every two weeks.
• They are retroactive to the date you stopped working (after the day of injury, which your employer covers).
• WSIB calculates your benefit based on your average earnings in the 12 weeks before your injury.

Health Care Benefits

WSIB covers reasonable and necessary health care related to your workplace injury, including:

• Doctor visits and specialist referrals
• Physiotherapy and chiropractic care
• Prescription medications
• Medical devices (braces, crutches, etc.)
• Travel costs to medical appointments

You do not need WSIB pre-approval for most initial treatments, but ongoing treatments like physiotherapy may require authorization.

Other Benefits You May Be Entitled To

• Non-Economic Loss (NEL) award: A lump sum if you have permanent impairment (more on this later in your claim).
• Labour Market Re-Entry (LMR) or Work Transition services: If you cannot return to your pre-injury job, WSIB may fund retraining.
• Survivor benefits: In fatal injury cases.

Stage 5: Your Ongoing Obligations (Throughout Your Claim)

Getting your claim allowed is not the finish line. WSIB expects you to stay engaged throughout the life of your claim. Failing to meet your obligations can result in reduced or suspended benefits.

What WSIB Expects From You

• Keep your medical appointments. Follow your treatment plan and attend all scheduled visits.
• Provide medical updates. WSIB will periodically ask your doctor for progress reports (Functional Abilities Forms). Make sure your doctor submits these on time.
• Cooperate with return-to-work efforts. You have an obligation to participate in return-to-work planning with your employer.
• Report changes. Tell WSIB if your condition changes, you start working, your address changes, or you are receiving other income.
• Respond to WSIB communications. Answer calls, reply to letters, and meet deadlines.

The Return-to-Work (RTW) Process

Return to work is a major focus for WSIB. Under Ontario's Workplace Safety and Insurance Act, both you and your employer have obligations to cooperate in the RTW process.

• Your employer must offer you suitable modified or alternative work if available.
• You must make reasonable efforts to return to work in some capacity.
• If your employer offers suitable work and you refuse without good reason, WSIB may reduce your benefits.
• If your employer fails to accommodate you, WSIB can penalize the employer.

Your doctor plays a key role here. Make sure they clearly document what you can and cannot do on the Functional Abilities Form. Vague restrictions like "light duties" are less helpful than specific ones like "cannot lift more than 10 pounds" or "must sit every 30 minutes."

Stage 6: Key Reviews and Milestones

The 72-Week Review

At the 72-week mark (about 18 months), WSIB conducts a Loss of Earnings review. This is one of the most important milestones in your claim.

During this review, WSIB determines whether you can earn wages in some capacity, even if not at your pre-injury job. If WSIB decides you have the ability to earn income (based on a Suitable Occupation or SO determination), your LOE benefits may be reduced even if you have not actually found work.

This is a critical point where many workers are caught off guard. Preparing for the 72-week review should start months in advance.

Maximum Medical Recovery (MMR)

At some point, your doctor (or a WSIB-appointed specialist) will determine that you have reached maximum medical recovery. This means further treatment is unlikely to significantly improve your condition.

After MMR, WSIB may:

• Arrange a Non-Economic Loss (NEL) assessment to evaluate permanent impairment
• Transition you from active treatment to maintenance care
• Finalize your long-term benefit entitlements

What to Do If Your Claim Is Denied

If WSIB denies your claim, do not give up. You have options.

Step 1: Understand the Reason

Read the decision letter carefully. WSIB must explain why your claim was denied. Common reasons include insufficient medical evidence, a dispute about whether the injury is work-related, or missing documentation.

Step 2: File an Objection (Intent to Object)

You have six months from the date of the decision to file a formal objection. Start by notifying WSIB of your Intent to Object as soon as possible, even if you need time to gather evidence.

Step 3: Gather Supporting Evidence

• Get a detailed narrative report from your treating physician that clearly links your injury to your work.
• Collect witness statements from coworkers who saw the accident or can speak to your work conditions.
• Gather medical records that document your condition before and after the injury.

Step 4: Submit Your Objection

Send your objection and supporting documents to WSIB's Appeals Services Division. They will assign a new decision-maker (not the original adjudicator) to review your case.

Step 5: If Still Denied, Appeal to WSIAT

If the internal objection is unsuccessful, you can appeal to the Workplace Safety and Insurance Appeals Tribunal (WSIAT). This is an independent body outside of WSIB. You have six months from the objection decision to file a WSIAT appeal.

Common Mistakes That Delay or Hurt Your Claim

1. Not filing on time. Report your injury to your employer and file your Form 6 as soon as possible. Delays raise red flags.
2. Gaps in medical treatment. If you stop seeing your doctor, WSIB may assume you have recovered.
3. Incomplete forms. Missing information means WSIB has to come back and ask, which slows everything down.
4. Not responding to WSIB. Ignored calls and missed deadlines can lead to benefit suspensions.
5. Downplaying your injury to your employer. What you say to your employer early on can end up in your WSIB file. Be honest and consistent.

Track Your Deadlines and Claim Health

Keeping track of every deadline, document, and milestone in your WSIB claim is overwhelming, especially when you are dealing with pain and stress. Missing even one deadline can set your claim back by months.

Free Tools from ClaimNexus

Deadline Calculator -- Enter your key claim dates and instantly see every deadline that applies to your claim, from objection windows to the 72-week review. Never miss a critical date.

Claim Health Check -- Answer a few simple questions about your claim and get a personalized report on where things stand, what might be missing, and what to do next.

Try them free at claimnexus.io/tools

Summary: Your WSIB Claim Timeline at a Glance

Final Thoughts

The WSIB claim process can feel slow and confusing, but it follows a clear path. Knowing what comes next at each stage puts you in control. Stay on top of your deadlines, keep your medical documentation current, respond to WSIB promptly, and do not hesitate to push back if something does not seem right.

You have the right to benefits if your injury is work-related. Understanding the process is the first step to protecting those rights.

---

This article is for informational purposes only and does not constitute legal advice.