Initial Determination - Workers Who are Earning at Time of Determination

Document sections:| Policy | Guidelines | References |

Policy

The WSIB determines the future economic loss (FEL) benefit for workers who are earning at the time of the initial determination based on their post-injury net average earnings (NAE) as a result of work reintegration activities.

For workers participating in a work transition assessment at the time of the initial determination, see 18-04-06, Initial Determination - Where Suitable Occupation has been Determined.

Purpose

The purpose of this policy is to outline how FEL benefits are calculated for workers who are earning at the time of the initial determination.

Back to top

Guidelines

Date of determination

For information on the time-frames that the WSIB uses to determine FEL benefits, see 18-04-03, Date of Determination.

FEL amount

The worker's FEL benefit equals 90% of the difference between the pre-injury NAE and post-injury NAE.

Formula for FEL determination

Calculating pre-injury NAE

Decision-makers calculate pre-injury NAE to determine FEL benefits the same way they calculate temporary total disability benefits, see 18-06-01, Calculating Temporary Total Disability Rate.

The legislated minimum amount of compensation payable does not apply in the calculation of the FEL benefit.

Calculating post-injury NAE

To calculate the FEL benefit, the decision-maker determines post-injury NAE by deducting from the gross earnings the probable

• income tax payable by the worker
• Canada Pension Plan (CPP) premiums and/or the probable Quebec Pension Plan (QPP) premiums payable by the worker, and
• Employment Insurance premiums payable by the worker.

CPP/QPP benefits

CPP/QPP disability benefits which a worker is receiving, either in whole or in part, due to the work-related injury/disease must be taken into account when determining the FEL benefit, see 18-01-13, Calculating CPP/QPP Offsets from FEL/LOE Benefits.

Post-injury NAE

If a worker's post-injury NAE

• is less than the pre-injury NAE at the time of the initial determination, the FEL benefit is 90% of the difference between the pre-injury NAE and the post-injury NAE, or,
• equals or exceeds the pre-injury NAE, but is not sustainable, the decision-maker identifies the claim as entitled to a FEL sustainability benefit, see 18-04-13, FEL Sustainability Benefit.

Indexing

The FEL benefit is indexed annually, see 18-01-03, Benefit Dollar Amounts - Accidents before 1998.

Retirement pension

The WSIB sets aside funds for the worker's retirement pension, see 18-04-17, Loss of Retirement Income Benefits (Accidents from January 2, 1990 to December 31, 1997).

Application date

This policy applies to all FEL benefits payable for entitlement periods on or after February 15, 2013, for accidents from January 2, 1990 to December 31, 1997.

Document history

This document replaces 18-04-05 dated October 3, 2007.

This document was previously published as:

18-04-05 dated June 1, 2005

18-04-05 dated October 12, 2004

18-04-05 dated March 1, 2002

18-04-05 dated June 15, 1999

7.4* dated January 1, 1998

05-05-06* dated November 22, 1993

*documents were replaced by 18-04-05 dated June 15, 1999.

Back to top

References

Legislative authority

Workplace Safety and Insurance Act, 1997, as amended

Sections 102, 107, 108

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

Section 43

Minute

Administrative

#26, January 28, 2013, Page 506

Back to top