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Operational policy manual

Sections 147(2) and 147(4) Supplements (Permanent Disability)

Benefit Payments
Application Date
This policy applies to all decisions made for entitlement periods on or after January 1, 2018, for accidents prior to January 2, 1990.
Published
02-Jan-2018
Subject
Permanent Disability Benefits (Accidents before 1990)
Title
Sections 147(2) and 147(4) Supplements (Permanent Disability)
Document No.
18-07-10

Policy

A worker with an injury date prior to January 2, 1990 who was in receipt of a partial permanent disability benefit after July 26, 1989 may be entitled to a supplement if the worker

  • would likely benefit from and co-operates in a work transition (WT) plan that could help to increase the worker's earning capacity to the extent that the sum of the worker's earning capacity after the WT plan and the amount of the worker's partial permanent disability benefit approximates the worker's pre-injury gross average earnings or pre-injury net average earnings (NAE) (s. 147(2) supplement), or
  • is not likely to benefit from a WT plan or if the worker's earning capacity did not increase to the extent expected following completion of a WT plan (s. 147(4) supplement).

The s. 147(2) and s. 147(4) supplements are

  • calculated with regard to factors such as post-injury earnings and other WSIB benefits paid in the claim
  • subject to review, and
  • indexed annually.

Purpose

The purpose of this policy is to provide guidelines respecting entitlement to, and the payment and review of, the s. 147(2) and s. 147(4) supplements.

Guidelines

Eligibility guidelines can be found in prior versions of this document for workers who were in receipt of the following supplements when the s. 147(2) and s. 147(4) supplements came into effect on July 26, 1989:

  • supplement under s. 43(5) of the pre-1985 Workers' Compensation Act
  • supplement under s. 45(5) of the pre-1989 Workers' Compensation Act
  • supplement under s. 45(7) of the pre-1989 Workers' Compensation Act

Entitlement: s. 147(2) supplement

A worker who is receiving a partial permanent disability benefit is entitled to a s. 147(2) supplement if the worker

  • has a wage loss as a result of a work-related injury/disease, whether working or not, and
  • is likely to benefit from and co-operates in a WT plan that could help to increase the worker’s earning capacity to the extent that the sum of the worker’s earning capacity after the WT plan and the amount of the worker’s partial permanent disability benefit approximates the worker's pre-injury gross average earnings (for injury dates prior to April 1, 1985), or pre-injury NAE (for injury dates between April 1, 1985 and January 1, 1990).

To decide whether a worker is likely to benefit from a WT plan, and to what extent, the WSIB identifies a suitable occupation (SO) for the worker, and determines earnings for the SO, see 19-03-03, Determining Suitable Occupation.

When determining whether the combined value of the SO earnings and partial permanent disability benefit approximates the pre-injury gross average earnings or pre-injury NAE, the WSIB must be satisfied the combined value comes reasonably close to these earnings. The statutory maximum for average earnings does not apply when making this determination.

NOTE

To compare a worker's pre-injury gross average earnings or pre-injury NAE to the combined value of the worker’s partial permanent disability benefit and earning capacity after the WT plan, the WSIB updates (escalates) the worker's pre-injury gross average earnings by applying the applicable indexing factor to them for each indexing date between the earnings date and the date of entitlement to the s. 147(2) supplement.

Workers not in the workforce

A worker who has permanently exited the workforce (e.g., voluntarily retires) or who is not actively engaged in the workforce generally is not expected to benefit from a WT plan. However, if the WSIB is satisfied such a worker is still interested in pursuing employment, the worker may be entitled to a s. 147(2) supplement if the WSIB determines the worker is experiencing a wage loss as a result of the work-related injury/disease and would benefit from a WT plan.

Duration

The s. 147(2) supplement can be paid only while the worker is participating in a WSIB-approved WT assessment or plan. Participation begins when the worker starts the activities of the WT assessment or plan, and continues until the WT assessment or plan is completed.

If a worker could benefit from a WT plan but is uncooperative, or if a worker fails to co-operate during a WT plan, the WSIB cancels the assessment or plan and stops paying the s. 147(2) supplement. In such cases, the worker

Multiple claims

A worker can only be entitled to a single s. 147(2) supplement, regardless of how many claims the worker has.

Payment: s. 147(2) supplement

The s. 147(2) supplement is paid as a monthly amount.

The value of the monthly amount is dependent on factors such as

  • the worker’s claim limit (i.e., 75 per cent of pre-injury gross average earnings for injury dates prior to April 1, 1985 or 90 per cent of pre-injury NAE for injury dates between April 1, 1985 and January 1, 1990, subject to the statutory maximum average earnings)
  • the worker’s partial permanent disability benefit amount
  • the worker’s post-injury earnings (i.e., 75 per cent of gross average earnings after the injury for injury dates prior to April 1, 1985 or 90 per cent of NAE after the injury for injuries dates between April 1, 1985 and January 1, 1990)
  • any disability payments paid under the Canada Pension Plan/Quebec Pension Plan in respect of the work-related injury/disease.

Entitlement: s. 147(4) supplement

A worker who is receiving a partial permanent disability benefit is entitled to a s. 147(4) supplement if the WSIB determines

  • the worker is not likely to benefit from a WT plan as described in the “Entitlement: s. 147(2) supplement” section, or
  • the worker’s earning capacity after completing a WT plan did not increase to the extent that the worker's earning capacity after the WT plan and the amount of the worker’s partial permanent disability benefit approximates the worker’s pre-injury gross average earnings or pre-injury NAE.

Duration

The s. 147(4) supplement is paid until the worker is eligible for benefits under the federal Old Age Security Act. This generally occurs when a worker turns 65.

When a worker entitled to a s. 147(4) supplement gets close to age 65, the WSIB notifies the worker that the supplement will soon expire due to eligibility for federal Old Age Security (OAS) benefits. However, if the worker is not eligible for federal OAS benefits and provides evidence of this (e.g., a formal rejection letter to the worker’s application for federal OAS benefits), the WSIB continues to pay the s. 147(4) supplement.

Multiple claims

A worker may receive more than one s. 147(4) supplement if the worker has more than one claim in which the worker is entitled to a permanent disability benefit.

Payment: s. 147(4) supplement

The s. 147(4) supplement is paid as a monthly amount.

Subject to the statutory maximum (a full monthly benefit under s. 3 of the federal Old Age Security Act), when determining the monthly amount payable, the WSIB considers factors such as the

  • claim limit (i.e.,75 per cent of pre-injury gross average earnings for injury dates prior to April 1, 1985 or 90 per cent of pre-injury NAE for injury dates between April 1, 1985 and January 1, 1990, subject to the statutory maximum average earnings)
  • partial permanent disability benefit amount
  • post-injury earnings (i.e., 75 per cent of gross average earnings after the injury for injuries that occurred prior to April 1, 1985 or 90 per cent of NAE after the injury for injury dates between April 1, 1985 and January 1, 1990)
  • disability payments paid under the Canada Pension Plan/Quebec Pension Plan in respect of the work-related injury/disease.

Blending benefit payments

If a worker is entitled to a s. 147(4) supplement and becomes entitled to additional WSIB benefits, the WSIB continues to pay the s. 147(4) supplement, and if

  • the worker is entitled to receive temporary total disability benefits under the same claim in which a s. 147(4) supplement is being paid, the temporary total benefits are reduced by the amount of the partial permanent disability benefit and the s. 147(4) supplement.
  • the worker is entitled to receive temporary total disability benefits in a different claim, the temporary total disability benefits are not reduced.
  • the worker is entitled to FEL benefits or LOE benefits in a different claim, neither the FEL nor LOE benefits are reduced (a worker entitled to FEL benefits may be eligible for a FEL supplement).

Review of a s. 147(4) supplement

The WSIB reviews s. 147(4) supplements

  • in the 24th and the 60th month after one is allowed, or
  • if a permanent disability benefit is terminated.

After 60 months, reviews can only take place if the worker failed to notify the WSIB of a material change that occurred prior to 60 months, or engaged in fraud or misrepresentation in connection with the claim for benefits.

Exception

If a worker’s partial permanent disability benefit changes, the WSIB does not wait until the next review date to recalculate the s. 147(4) supplement. Rather, the WSIB recalculates the s. 147(4) supplement any time the partial permanent disability benefit changes so as not to exceed the claim limit (i.e., 75 per cent of pre-injury gross average earnings for injury dates prior to April 1, 1985 or 90 per cent of pre-injury NAE for injury dates between April 1, 1985 and January 1, 1990, subject to the statutory maximum average earnings).

Recalculating a s. 147(4) supplement

Upon review, if the WSIB determines there is a change to account for in the s. 147(4) supplement (e.g., post-injury earnings changed), it is recalculated. Otherwise, it continues to be paid as is.

Effect of Canada/Quebec Pension Plan disability benefits

When a worker receives Canada/Quebec Pension Plan (CPP/QPP) disability benefits and supplementary benefits under s. 147, the WSIB offsets 100 per cent of the CPP/QPP disability benefits paid in relation to the work-related injury/disease from the s. 147 supplement.

The full amount of the gross CPP/QPP disability benefits paid in relation to the work-related injury/disease and the gross post-injury earnings are used as post-injury earnings when calculating either the s. 147(2) or the s. 147(4) supplements.

Earnings above maximum

When pre-injury gross average earnings or pre-injury NAE exceed the maximum in effect at the time of the accident, the CPP/QPP disability benefit is deducted from the maximum average earnings to create a revised pre-injury gross average earnings or NAE.

Annual indexing

On January 1 every year, the WSIB indexes ongoing s. 147(2) and s. 147(4) supplements by applying the indexing factor to the amounts payable, see 18-01-14, Annual Indexing.

While the s. 147(4) statutory maximum (a full monthly benefit under s. 3 of the federal Old Age Security Act) applies when the s. 147(4) supplement is calculated or recalculated, it does not apply when it is indexed.

Application date

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

Document history

This document replaces 18-07-10 dated February 15, 2013.

This document was previously published as:
18-07-10 dated February 18, 2009
18-07-10 dated March 3, 2008
18-07-10 dated August 1, 2007
18-07-10 dated January 3, 2007
18-07-10 dated October 12, 2004
18-01-03 dated November 30, 2000.

References

Legislative authority

Workplace Safety and Insurance Act, 1997amended
Section 110, 111

Workers' Compensation Act, R.S.O. 1990, as amended
Section 147

Workers' Compensation Act, R.S.O. 1980, as amended
Sections 24, 41

Minute

Administrative
#14, November 15, 2017, Page 544

Compass: Guiding you to a healthy and safe workplace