FEL Sustainability Benefit

Policy

Workers are entitled to a future economic loss (FEL) sustainability benefit if they have no actual or anticipated wage loss, but they are

  • participating in work reintegration (WR) activities, or
  • back at work, but the ability to perform the job is in doubt, or
  • working in an accommodated job.

Purpose

The purpose of this policy is to outline when a worker is entitled to a FEL sustainability benefit.

Guidelines

Definitions

The FEL sustainability benefit

The FEL sustainability benefit is a nominal benefit of $1 per year which

  • recognizes that workers may not be able to maintain their earnings, and
  • allows the WSIB to pay a FEL supplement if a worker requires WR assistance to restore earnings, or a medical rehabilitation program.

No wage loss

Workers have no wage loss if their pre-injury net average earnings (NAE) are matched or exceeded by their post-injury NAE.

An accommodated job

An accommodated job is one which

  • includes significant work or workplace modifications that would not generally be available in the general labour market
  • 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
  • if eliminated, restricts the worker's ability to find new employment with similar clinical precautions/accommodations in the general labour market.

NOTE

If the worker returns to accommodated employment and that job is no longer available at the time of the final review, the decision-maker may refer the worker for work transition (WT) services, see 18-04-20, Final FEL Benefit Review.

When is it appropriate?

If the worker participates in WR activities

If a worker is participating in WR activities and it is anticipated that the worker will not have a wage loss, the worker is entitled to a FEL sustainability benefit.

If the decision-maker is concerned about the worker's ability to sustain these earnings at the completion of the plan, this is noted in the claim.

If the worker returns to work (unaccommodated)

If a worker returns to work without accommodation and has no wage loss, but the decision-maker has doubts about the worker's ongoing ability to perform the job, the worker is entitled to a FEL sustainability benefit. If the worker becomes unable to perform the job due to a clinical deterioration, the worker may be entitled to a FEL supplement, see 18-04-12, Supplement Following Significant Deterioration.

When evaluating the worker's ongoing ability to perform the job, the decision-maker considers all available evidence, such as medical opinions, etc.

If the decision-maker anticipates that the worker may be laid off due to economic conditions only, the worker is not entitled to a FEL sustainability benefit.

If the worker returns to work (accommodated)

If a worker returns to work in an accommodated job at no wage loss, the worker is entitled to a FEL sustainability benefit. This acknowledges that the

  • employer may not be able to continue to provide the job, and
  • worker may not be able to keep working in the job due to the work-related condition.

If an accommodated job is eliminated, the worker may not be able to find a new job under similar circumstances. Paying a FEL sustainability benefit enables the decision-maker to pay a supplement if the accommodated job is no longer available due to the reasons stated and the worker requires WR assistance.

0% NEL

Workers are not entitled to a FEL sustainability benefit if they are rated for NEL at 0%, see 18-04-15, Effect of a 0% NEL Rating on FEL Benefits.

When is entitlement determined?

The WSIB may determine entitlement to a sustainability benefit when a FEL is first paid, or at any review.

More information

For information on WR, see 19-02-01, Work Reintegration Principles, Concepts and Definitions19-02-02, Responsibilities of the Workplace Parties in Work Reintegration and 19-03-05, Work Transition Plans.

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 18-04-13 dated August 1, 2007.

This document was previously published as:
18-04-13 dated October 12, 2004
18-04-13 dated June 15, 1999
7.12 dated January 1, 1998.

References

Legislative Authority

Workplace Safety and Insurance Act, 1997, as amended
Sections 47(9), (13), 102, 106, 107, 108

Workers' Compensation Act, R.S.O. 1990, as amended
Section 43

Minute

Administrative
#31, January 28, 2013, Page 507