Date of Determination

Policy

The WSIB determines, where possible, the amount of a worker's future economic loss (FEL) benefit due to a work-related injury

  1. in the 12th consecutive month that the worker is temporarily disabled, or
  2. within one year after the WSIB is notified of the worker's accident, if during that year the WSIB determines that the worker is permanently impaired, or
  3. within 18 months after the WSIB is notified of the worker's accident, if the worker's medical condition prevents a determination within the time stated in 1 or 2, whichever applies.

If a worker is not receiving compensation at the time of the usual determination dates, and entitlement to compensation is in dispute, these time limits may be extended.

Guidelines

Medical condition preventing earlier determination

The WSIB postpones the calculation of a worker's FEL benefit up to a maximum of 18 months after being notified of the injury only when

  • because of the worker's medical condition, the WSIB cannot yet provide the worker with a work transition (WT) assessment and, therefore, identify a suitable occupation, and/or develop a WT plan, and/or
  • it is impossible, given the worker's medical condition, for the worker to participate in work reintegration activities.

Cases in dispute

If a dispute regarding entitlement to compensation prevents the WSIB from determining the FEL benefit by the usual determination dates, the WSIB determines the FEL benefit as soon as the issue in dispute is resolved.

Application date

This policy applies to all FEL decisions made on or after February 15, 2013, for accidents from January 2, 1990 to December 31, 1997.

Document History

This document replaces 18-04-03 dated October 3, 2007.

Previously, this document was published as:
18-04-03 dated October 12, 2004
18-04-03 dated June 15, 1999
7.2* dated January 1, 1998
05-05-03* dated February 12, 1992.

*Documents were replaced by 18-04-03 dated June 15, 1999.

References

Legislative Authority

Workplace Safety and Insurance Act, 1997, as amended
Sections 102, 105

Workers' Compensation Act, R.S.O. 1990, as amended
Sections 43(10), 43(12)

Minute

Administrative
#25, January 28, 2013, Page 506