Area of Law: Workers' Compensation
Answer # 634
What type of workplace safety and insurance benefits are available?Region: Ontario Answer # 634
If you are a worker with a work-related injury or disease which causes you to lose wages, you may qualify for one or more of three types of benefits available from the Workplace Safety and Insurance Board (WSIB). The three main types of benefits are: 1) loss of earnings benefits; 2) non-economic loss benefits; and 3) loss of retirement income benefits.
In addition to loss of earnings benefits, health care and medical aid benefits which may be required as a result of the work-related injury or disease are available.
These may include:
- prescription drugs,
- special medical treatment,
- medical devices, and
- transportation costs.
Loss of Earnings benefits (LOE)
Loss of earnings benefits are compensation for loss of wages due to injury or disease, and become payable as soon as your income is affected. These benefits will continue until you are capable of earning your normal salary again. If your injury makes it impossible for you to return to work, these benefits can be paid until you turn 65 years of age. With respect to wages on the day of injury, the Workplace Safety and Insurance Act requires employers to pay an injured employee their regular pay for the day.
Generally, LOE benefits will pay a large percentage of your normal take-home salary. Currently, LOE benefits are paid based on 85% of pre-injury, net average earnings, up-to the maximum entitlement in the year of the injury. If you worked for more than one employer at the time of the injury, you will normally be entitled to collect a percentage of your earnings from all employers. If your salary was not always the same during the past one or two years, because you changed jobs or were out of work for a while, then your benefit amount may be based on your average earnings during the past one or two years.
If you return to work, start to earn income, or if your condition improves, the WSIB will assess your ability to earn the same income as before your injury. Depending on how much your situation has improved, your benefits may be reduced or your benefits may end. If you have been receiving benefits for six years, the amount will be set permanently and not reviewed, unless you return to work or become capable of returning to work.
Non-Economic Loss benefits (NEL)
If you have been permanently impaired from a workplace injury or loss, you may be entitled to the second type of benefits called non-economic loss benefits (NEL). These benefits are paid to compensate for the negative effect the impairment has had upon your life. The WSIB determines your benefit amount based on calculating the degree of physical, functional, or psychological loss the impairment causes, along with a legislated base amount, and your age.
NEL benefits are in addition to loss of earnings benefits. If you are eligible for NEL benefits, you may receive a lump-sum payment or, depending on the amount of the award, a monthly payment for life. Workers, however, have the right to choose to receive a lump-sum payment if that suits them better. The amount you are entitled to is based on a special calculation taking into consideration your age and permanent medical restrictions.
Loss of Retirement Income benefits (LRI)
If you have been receiving loss of earnings benefits for at least 12 months in a row, you are also eligible for the third type of benefit called loss of retirement income (LRI) benefit, which is a savings plan for when you reach 65. Since the amount of LOE benefits may make it difficult to save for retirement, and since your employer only has to continue contributing to group insurance and pension plans for one year following the accident, this benefit provides assistance by contributing to your retirement savings.
If you are eligible for LRI benefits, the WSIB will set aside an additional 5% of your loss of earnings benefits. You also have the choice of contributing to this retirement savings plan by having WSIB deduct an additional 5% from your payments. This money will be invested until you are 65, at which time it will be paid to you, your surviving family or your estate. The LRI benefit includes the amount the WSIB set aside for you, plus any contributions you made, together with investment income that these contributions earned. You will have the choice of a number of payment schemes and, in the case of a small benefit amount, the Board will pay it in one lump-sum.
LRI benefits do not affect any other retirement income from other plans, such as CPP or employer pension plans.
If you die because of your injury before reaching 65 years of age, your dependants will receive survivors’ benefits instead of the WSIB portion of your LRI benefits.
For more information, contact the Workplace Safety and Insurance Board.
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