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Operational policy manual

FEL: Changes to Net Exemption Code

Benefit Payments
Application Date
This policy applies to all decisions made for entitlement periods on or after January 1, 2018, for accidents from January 2, 1990 to December 31, 1997.
Published
02-Jan-2018
Subject
Future Economic Loss (FEL) (Accidents from 1990-1997)
Title
FEL: Changes to Net Exemption Code
Document No.
18-04-18

Policy

The WSIB initially determines a worker's future economic loss (FEL) benefit by using the net exemption code (NEC) applicable at the time of the initial FEL determination to calculate the worker's net average earnings (NAE). If the NEC changes, the updated NEC is only used when the WSIB conducts a further review of the FEL benefit.

Purpose

The purpose of this policy is to outline when and how a FEL benefit is recalculated following a NEC change.

Guidelines

When a worker's FEL benefit is first determined, the WSIB uses the NEC in effect on the initial FEL determination date to determine the pre- and post-injury NAE.

The formula used at the time of initial determination is

[Pre-injury NAE - post-injury NAE] x 90 per cent = FEL benefit
(initial FEL NEC) (initial FEL NEC)

NEC updates

The WSIB may update the NEC and redetermine the NAE of any worker if

  • the worker's NEC has changed, or
  • an incorrect NEC was reported.

NEC changes

If a worker's NEC changes, the FEL benefit is not recalculated using the updated NEC until the next FEL review.

To update the NEC, CRA documentation validating the change must be submitted for the relevant years (e.g., new TD-1 form, option ‘C’ printout).

Incorrect NEC

If the WSIB determines that a previous calculation took place using an incorrect NEC, the previous calculation is done again using the correct NEC.

FEL reviews

When the FEL benefit is reviewed, the WSIB recalculates the benefit using the same formula as at the time of the initial determination, using the updated NEC if applicable.

The formula used at the time of the review is

[Pre-injury NAE - post-injury NAE] x 90 per cent = new FEL benefit
(new NEC) (new NEC)

These guidelines apply at the time of the FEL review. For information about FEL reviews as a result of material change, see 22-01-02, Material Change in Circumstances - Worker, and 18-04-14, Reviewing FEL Benefits (Prior to Final Review). For information about final FEL reviews, see 18-04-20, Final FEL Benefit Review.

Application date

This policy applies to all decisions made for entitlement periods on or after January 1, 2018, for accidents from January 2, 1990 to December 31, 1997.

Document history

This document replaces 18-04-18 dated October 3, 2007.

This document was previously published as:
18-04-18 dated October 12, 2004
05-05-15 dated June 24, 1993.

References

Legislative authority

Workplace Safety and Insurance Act, 1997, as amended
Sections 102, 107

Workers' Compensation Act, R.S.O. 1990, as amended
Sections 41, 43, 148(2)(b), 151

Minute

Administrative
#5, November 15, 2017, Page 543

Compass: Guiding you to a healthy and safe workplace