Policy
Workers in receipt of a future economic loss (FEL) benefit, or a FEL sustainability benefit, are entitled to receive a FEL supplement while co-operating in a medical rehabilitation (MR) program, early and safe return to work (ESRTW) program, or labour market re-entry (LMR) services that
The supplement is added to the FEL benefit. The combined total of the FEL benefit and the supplement equals 90% of the worker’s pre-injury net average earnings, see 18-04-06, Initial Determination - Where Suitable and Availabe Employment or Business has been Determined.
A supplement paid based on participation in an MR, ESRTW or LMR program ends upon completion of the program.
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Guidelines
Supplementary benefit entitlement - before 24 months
Workers in receipt of a FEL benefit or a FEL sustainability benefit are entitled to a FEL supplement while they are co-operating in an ESRTW program or LMR services (including an LMR assessment and, if required an LMR plan) that began within 24 months from the initial FEL determination date.
Supplementary benefit entitlement - after 24 months
Workers in receipt of a FEL benefit or a FEL sustainability benefit are entitled to a FEL supplement while they are co-operating in an ESRTW program or LMR services (including an LMR assessment and, if required an LMR plan) that began after the 24-month post-initial determination date if
- it is a continuation of the ESRTW program, or
-
the LMR services began before the 24-month date.
ESRTW program continuation
The continuation of the ESRTW program is accepted if, before 24 months from the initial FEL determination date, the claim file information indicated concerns relating to the suitability or sustainability of the job, or
- availability of the accommodated employment, or
-
need to revise or initiate a new ESRTW program or provide LMR services.
If the worker continues to be unable to perform the pre-accident job past the 24-month date due to the permanent work-related impairment, the worker is considered to
- have begun the ESRTW program before the 24-month date, and
-
to be continuing past the 24-month date.
Job suitability/sustainability concerns
If a worker returns to a job that is subsequently determined to be unsuitable or unsustainable after the 24-month post-initial determination date, the worker is eligible to receive LMR services. In these cases, it is assumed that job suitability and/or sustainability concerns existed about the worker’s ongoing ability to perform the job before the 24-month date.
Accommodated employment
The worker’s job may be considered to be accommodated if it
- includes work or workplace modifications, see 19-03-07, Workplace Modifications and Assistive Devices
-
pays the worker at a rate significantly higher than what the employer pays for similar jobs, or is one where the productivity required of the worker is significantly lower than would normally be expected
-
was created especially for the worker (e.g., tasks and work processes have been specifically accommodated for the worker’s impairment and are not likely to exist with, or be provided by, another employer), or
-
is eliminated, restricts the worker’s ability to find new employment with similar medical precautions/accommodations in the general labour market.
If the worker returns to accommodated employment and the accommodated job is no longer available prior to the final FEL review, the decision-maker may refer the worker for LMR services. This guideline applies as long as the claim file information indicates that, due to the permanent work-related impairment, the worker is unable to perform the pre-accident job and may require LMR services.
Medical rehabilitation program
Workers co-operating in a medical rehabilitation (MR) program before or after the 24-month date are eligible for a FEL supplement, see 18-04-12, Supplement Following Significant Deterioration.
For information on
Co-operation
For information concerning the co-operation guidelines, see 22-01-03, Workers' Co-operation Obligations; 19-02-03, Workplace Party Co-operation; and 19-03-10, Co-operating in LMR.
O% NEL rating
If a worker who is receiving a FEL benefit and supplement is assessed at 0% for non-economic loss (NEL), the WSIB stops paying the FEL benefit and supplement, see 18-04-15, Effect of a 0% NEL Rating on FEL Benefits.
Significant deterioration
For information regarding entitlement to a FEL supplement following a significant deterioration in the work-related condition, see 18-04-12, Supplement Following Significant Deterioration.
Exceptional cases -- post 60 months
After the 60th month post-initial determination, workers may be entitled to further supplementary benefits if
- they were provided with an LMR plan and the plan is not completed when the 60th month period is reached, or
-
the worker suffers a significant deterioration in his/her work-related condition and co-operates and participates in an MR program.
For more information on reviewing FEL benefits and the payment of supplementary benefits beyond 60 months post-initial determination, see 18-03-06, Final FEL Benefit Review.
Application date
This policy applies to all FEL decisions made on or after November 26, 2002, for accidents from January 2, 1990 to December 31, 1997.
Document history
This document replaces 18-04-11 dated October 12, 2004.
This document was previously published as:
18-04-11 dated February 20, 2004
18-04-11 dated December 24, 2003
18-04-11 dated August 1, 2003
18-04-11 dated April 11, 2003
18-04-11 dated May 23, 2000
18-04-11 dated June 15, 1999
7.10* dated January 1, 1998
05-05-11* dated February 13, 1992.
* These documents were replaced by 18-04-11 dated June 15, 1999.
References
Legislative authority
Workplace Safety and Insurance Act, 1997, as amended
Sections 102, 106, 107, 108
Workers’ Compensation Act, R.S.O. 1990, as amended
Sections 42, 43
Minute
Administrative
#34, June 26, 2007, Page 443 Back to top
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