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The CSST at a glance
If workers cannot continue holding their position due to an employment injury or occupational disease, the Act respecting industrial accidents and occupational diseases guarantees them financial assistance until they can return to their job, obtain an equivalent position, or find other suitable employment. The first 14 days are paid by the employer, and if the CSST considers the problem an employment injury, the employer will be reimbursed on receipt of her or his application. The income replacement indemnity or compensation represents 90% of the worker's net salary at the time of the accident.
The physician chosen by the worker plays a key role throughout the process. This physician is known as the attending physician. His or her reports are determining factors, and the CSST is bound by them in rendering their decisions.
The CSST may at any time require that the worker be examined by one of their own physicians. Employers also have 30 days from the time they read the attending physician's report to obtain a physician of their choosing for an opinion on the same issues. The attending physician may then present a complementary report, including her or his response to the reports of the employer's or CSST's physicians (who are obligated to furnish copies of their reports to the worker's physician).
If medical opinions diverge, the entire file is submitted to a member of the Bureau d'évaluation médicale for a decision. The CSST is then bound by the opinion of the member of the Bureau d'évaluation médicale, who is also a physician.
Once a physician has determined that treatment for the injury has concluded, an assessment of the after-effects must be made. This is done first by the attending physician, and, again, the opinion may be contested, either by the employer or the CSST. Once this has been established, the worker will be entitled to a lump-sum payment based on the degree of permanent impairment, a percentage that is calculated according to the table of bodily injury.
Once permanent impairment and functional disability have been established, the file is transferred to the rehabilitation department. A number of measures are available: vocational guidance counsellors, psychologists, etc.
The goal of rehabilitation is to facilitate job reinstatement by helping the worker deal with the personal and social consequences of the employment injury.
The CSST's actions are based on the participation of all parties in the search for solutions. The involvement of workers is most important at this stage of the process. Once the CSST has judged that the person is unable to return to work—modified or adapted—for the same employer, or that an equivalent position is unavailable with the same employer, it will look for a solution outside the workplace.
The Act stipulates four choices:
- the determination of suitable employment of any kind;
- the possibility of training and acquisition of new knowledge in order to broaden employment possibilities;
- a grant to the employer to enable workplace training or an internship for the acquisition of new skills and experience;
- financial assistance for the worker to help her or him become self-employed, within the limits imposed by her or his functional disability.
Each of the CSST's decisions may be contested within the 30-day time limit stipulated by the Act. Compliance with the time limit is very important. There are two levels of contestation: review and appeal. In both cases, you will be given the opportunity to submit your remarks and arguments orally or in written form. The final tribunal is the Commission des lésions professionnelles. Independent of the CSST, it is a tribunal of physicians and decision-makers who will study your file before rendering a decision. At this stage, it is extremely important to be prepared: submit all the necessary proof, be well represented, and even, when applicable, have the opinion of a medical expert. You have 45 days in which to bring a decision of the Bureau de révision before the Commission des Lésions professionnelles.
In cases of recurrence, relapse or aggravation, the same diligence is necessary. The file will be considered again, following each of the above-mentioned steps. If the aggravation exacerbates the permanent impairment and/or functional disability, and the CSST considers that these new limitations prevent you from returning to the suitable employment established previously, you will again be eligible for the rehabilitation service. This includes professional, as well as physical and social rehabilitation.
No employer can dismiss, suspend, relocate or otherwise sanction a worker who is a victim of an employment injury or has exercised her or his rights under the Act respecting industrial accidents and occupational diseases . In such a situation, unionized workers can use the grievance or complaint procedure pursuant to section 32 of the Act respecting industrial accidents and occupational diseases , and non-unionized workers have no other choice but to file a complaint with the CSST. The complaint should be filed with the CSST within 30 days of receiving the sanction. It should be written and signed by the worker. A copy must be given to the employer. An order for reinstatement and/or monetary compensation may be issued by the CSST.
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