Policy
The WSIB determines, where possible, the amount of a worker's future economic loss (FEL) benefit due to a work-related injury:
- in the 12th consecutive month that the worker is temporarily disabled, or
- within one year after the WSIB is notified of the worker's injury, if during that year the WSIB determines that the worker is permanently impaired, or
- within 18 months after the WSIB is notified of the worker's injury, if the worker's medical condition prevents a determination within the time stated in 1 or 2, whichever applies.
If a worker is not receiving compensation at the time of the usual determination dates, and entitlement to compensation is in dispute, these time limits may be extended.
Purpose
The purpose of this policy is to outline when the WSIB must first determine the amount of a worker's FEL benefit.
Guidelines
Medical condition preventing earlier determination
The WSIB postpones the calculation of a worker's FEL benefit up to a maximum of 18 months after being notified of the injury only when:
- because of the worker's medical condition, the WSIB cannot yet provide the worker with a return-to-work (RTW) assessment, identify a suitable occupation, and/or develop a RTW plan, and/or
- it is impossible, given the worker's medical condition, for the worker to participate in RTW activities.
Cases in dispute
If a dispute regarding entitlement to compensation prevents the WSIB from determining the FEL benefit by the usual determination dates, the WSIB determines the FEL benefit as soon as the issue in dispute is resolved.
Application date
This policy applies to all FEL decisions made on or after March 1, 2021, for accidents from January 2, 1990 to December 31, 1997.
Document history
This document replaces 18-04-03 dated February 15, 2013.
Previously, this document was published as:
18-04-03 dated October 3, 2007
18-04-03 dated October 12, 2004
18-04-03 dated June 15, 1999
7.2* dated January 1, 1998
05-05-03* dated February 12, 1992.
*Documents were replaced by 18-04-03 dated June 15, 1999.
References
Legislative authority
Workplace Safety and Insurance Act, 1997, as amended
Sections 102, 105
Workers' Compensation Act, R.S.O. 1990, as amended
Sections 43(10), 43(12)
Minute
Administrative
#31, March 24, 2021, Page 589