Area of Law: Workers' Compensation
Answer # 641
What are Loss of Earnings benefits?Region: Ontario Answer # 641
Loss of Earnings benefits
Loss of Earnings (LOE) benefits are monthly payments from the Workplace Safety and Insurance Board (WSIB) that replace some of a worker’s lost future wages after a workplace injury.
The amount of LOE benefit you receive is based on a percentage of pre-injury earnings. The percentage used is dependent on the date your injury occurred. For injuries that occurred on or after January 1, 1998 your LOE benefits are paid based on 85% of pre-injury, net average earnings, up-to the maximum entitlement in the year of the injury. For injuries that occurred from April 2, 1985 to December 31,1997 your benefits are based on 90% of your net average earnings. For injuries that occurred before April 1, 1985, 75% of net income is paid.
Normally, in the first twelve weeks, the WSIB calculates the benefit amount based on the worker’s earnings at the time of the injury. If you are not a permanent regular employee, the WSIB may lower your payment in the thirteenth week. In addition, the WSIB will request two years of earnings information to determine the worker’s average earnings. If the worker was not a regular employee, such as a seasonal worker, the benefit amount will likely be reduced.
LOE benefits are paid every two weeks. If the amount of the benefit is less than 10% of what the worker would have received if they were not able to work at all, the benefit becomes a lump-sum payment.
Future Economic Loss (FEL) benefits
If a worker was injured after January 1, 1990, but before January 1, 1998 and has suffered a permanent impairment or has been disabled temporarily for 12 continuous months, the worker may be entitled to Future Economic Loss (FEL) benefits. If the worker was not working at the time of the FEL assessment, benefits are based on earnings for jobs suitable for the worker – known as a suitable occupation. In this case, the FEL award is 90% of the difference between what the WSIB believes the worker can earn and the amount the worker earned before the injury. If the worker was working at the time of the injury, and at a job the WSIB believes is reasonable given their medical condition, the FEL award will be 90% of the difference between their actual wages and the wages before the injury occurred.
An FEL benefit award is paid monthly.
When do benefits end?
The WSIB can periodically review an award of either LOE or FEL benefits in a variety of circumstances, such as a deteriorating or improved medical condition, non-compliance with health care requirements, or a change in income or return to work status. Benefits may be partially indexed for inflation. The Board will conduct a final review of an award five years after the benefit was first awarded. WSIB may change or stop the payment of benefits after a review.
FEL benefits end when the worker turns 65. LOE benefits end when the worker is no longer impaired by the work-related illness or injury, they no longer have a loss of earnings, or they reach the age of 65. If a worker is still impaired when they turn 65, LOE benefits will end, however, loss of retirement income benefits may apply.
What if you do not agree with the benefit amount awarded?
If a worker disagrees with either their LOE or FEL benefit amounts, they can make an objection to the WSIB, which generally must be made within six months of the decision. If the worker is still not satisfied after the WSIB reviews the decision, they can appeal to the Workplace Safety and Insurance Appeals Tribunal.
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