Policy
If a worker is entitled to temporary total or partial disability benefits for a recurrence of the work-related injury/disease, the average earnings of the worker are the greater of the
- average earnings at the date of the accident, or
- average earnings at the date of the most recent employment.
Purpose
The purpose of this policy is to outline the earnings that are used to calculate temporary total or partial disability benefits when a worker has a recurrence of a work-related injury/disease.
Guidelines
Most recent average earnings
"Most recent average earnings" are used to calculate temporary disability benefits in a case where a worker experiences a recurrence of a work-related injury/disease. The most recent average earnings are the earnings preceding the date of recurrence.
However, escalated pre-injury average earnings are used to calculate temporary disability benefits for the recurrence if there are no most recent average earnings or if the most recent average earnings are lower than the escalated pre-injury earnings. This also applies to situations involving optional insurance, see 12-03-02, Optional Insurance.
NOTE
If a worker is under the age of 21 at the time of the accident, a special minor's wage basis can be used in a re-opened claim if
- the date the claim is re-opened is six months or more from the date of the accident, and
- the worker's most recent earnings are below the minor's rate set by the WSIB, or
- the worker is unemployed prior to the re-opening of the claim, for reasons unrelated to the claim (e.g., attending school).
The minor's wage basis is never used to pay the original temporary disability benefit.
To determine the benefit payable, apply NEC 01 (single worker, no dependants) to the minor's wage basis.
Escalated average earnings
If the earnings year is different than the year of the recurrence, the average earnings are updated to protect them against the effects of inflation. This is called escalation and is done by applying the appropriate indexing factor to the average earnings for each indexing date between the earnings date and the date of the recurrence. The applicable indexing factor for each indexing date can be found in 18-01-03, Benefit Dollar Amounts - Accidents before 1998.
Accidents prior to April 1, 1985
If the original accident date is prior to April 1, 1985, but the date of the recurrence is on or after April 1, 1985, the most recent average earnings are based on the four weeks earnings prior to the date of the recurrence.
Accidents on or after April 1, 1985
If the original accident date and recurrence date are on or after April 1, 1985, the most recent average earnings are based on the daily or hourly rate of pay.
Recalculating temporary disability benefits
If the worker or the employer do not agree with the temporary disability benefit payable for the recurrence because it does not fairly represent the average earnings of the worker, the WSIB recalculates the benefit using one year's prior earnings, or a lesser period if the worker has not been with the accident employer for one full year, see 18-06-01, Calculating Temporary Total Disability Benefits.
Changes to the net exemption code
If the net exemption code (NEC) has changed since the date of accident, the NEC in effect on the date of the recurrence will be applied to the higher of the pre-injury average earnings and most recent average earnings for the purpose of calculating the temporary disability benefit.
Application date
This policy applies to all decisions made for entitlement periods on or after January 1, 2018, for accidents prior to January 1, 1998.
Document History
This document replaces 18-06-04 dated October 12, 2004.
This document was previously published as:
05-02-04 dated December 10, 1990.
References
Legislative Authority
Workplace Safety and Insurance Act, 1997, as amended
Section 102
Workers' Compensation Act, R.S.O. 1990, as amended
Sections 26, 40(7), 144, 145, 146
Workers’ Compensation Act, R.S.O. 1980, as amended
Sections 40, 43, 44, 132
Minute
Administrative
#16, November 15, 2017, Page 545