SEGA Workplace Consulting

Frequently Asked Questions.

Simply, SEGA can save your company time and money!!

We specialize in Workers’ Compensation claims management, return to work issues, employer appeals, program development, obtaining cost relief in all provincial jurisdictions, classification and financial forecasting to list a few.

Together, SEGA partners with employers to realize the maximum rebate/merit potential available to them, thus minimizing their compensation costs.

Workers’ Compensation Cost recovery is a process that allows SEGA to review our client’s WSIB/WCB claims and cost history. The objective is to discover and obtain overpayments in over 20 different areas such as calculation errors, penalties, service charges, reclassifications, assessment changes and cost relief savings and have them returned to our client. The process is transparent and professional to ensure that all relevant stake holders are kept informed throughout the engagement. The majority of the information we require to perform our review is retrieved directly from the applicable Workers’ Compensation boards with minimal time investment or effort required from our clients.
This process will not affect your relationship with the WSIB/WCB. As we work with many employers across Canada, our objective is to ensure we represent our clients whether at the WSIB/WCB Tribunal, Appeals or WSIAT act with the upmost professionalism for all stakeholders.

SEGA’s team has enjoyed significant success in recovering savings for our clients on issues over twenty years old. Furthermore, they have established jurisprudence on a number of issues that have generated significant refunds for our clients.
Regardless, if the claim is still under review by the provincial Workers’ Compensation Board, there are a number of avenues that can help reduce claim costs. For example, the claim may be eligible for cost relief, third party transfer, amalgamation, and other cost reduction policies.

Many SEGA clients have been through this process before, despite this, our success rate remains high. This is true whether the previous results were marginal or very successful. Our diverse group of WCB/WSIB paralegal and claims consultants are skilled in many different facets of Workers’ Compensation. Quite often we improve upon the results of other claims consultants, discover new issues that were previously overlooked or have decisions reversed based on new information brought forward.
We do not wish to waste your time, ours on issues that have no financial implications.

SEGA will not interfere with any issue which the employer or their current consultant may be working on. The WCB/WSIB will only respond to whoever provides the most current authorization. All we ask is that we have an opportunity to review the issues once the initial review is complete. We are still able to perform our services within the areas that have been overlooked or are no longer part of your process.

Often, workers’ compensation legislation is evolving and complex. The information required for SEGA to obtain results can be quite lengthy,  requiring many different facets of our expertise (medical, legal, accounting and appeals). For an employer to maintain a staff of this magnitude in many cases does not justify the costs. In most cases, our discoveries determine that the in-house person has fulfilled their requirements however SEGA is able to provide additional pertinent information otherwise unavailable to the employer, simply based on expertise acquired from the experience of working with thousands of North American employers.

While the bulk of information required by SEGA is received directly from the WCB/WSIB, the client on occasion will be asked to provide specific information on the nature of the WCB/WSIB claim or readily available documentation such as copies of your accident forms (Form-7’s), offers of modified work,  experience rating statements. In most cases we will come to your offices and limit your involvement to as little as possible. In the meantime, you will be kept informed of all issues as we move forward in the process.

Our cost recovery service is provided on a contingency basis meaning SEGA is only paid if we generate real savings on your behalf. We are remunerated after our client receives a cheque or credit from the WCB /WSIB. All costs to perform our services are absorbed by SEGA, if we are unable to obtain any savings, there is no charge for our efforts whatsoever.