Severely impaired workers are entitled to an annual independent living allowance to
- help them function as independently as possible where they work, where they live, and in society, and
- improve their quality of life.
Workers are considered severely impaired if their disabilities/impairments are
- permanent and have been rated for either permanent disability (PD) benefits totaling at least 100%, or non-economic loss (NEL) benefits totaling at least 60%, or
- likely to be permanent in the opinion of a WSIB medical consultant, and are likely to meet one of the criteria above.
To determine whether workers who have both PD and NEL benefits are severely impaired, the WSIB must review these benefits under one rating schedule (i.e., either the PD or the NEL rating schedule, whichever is most appropriate). Once the benefits are reviewed under one schedule, the WSIB applies the rule described above.
"Independent living" describes the ability to function personally and socially with reduced reliance on assistance from family, other people, or institutions.
Quality of life
Severely impaired workers normally experience a change in their quality of life, because the physical and psychological consequences of their injury or disease may reduce the ability to fully participate in personal, family, and social activities.
Purpose of the allowance
The allowance is intended to off-set the cost of services (regardless of cost) and devices and other items (less than $250), in order to improve a worker's ability to live independently and the quality of his or her life.
Spending the allowance
Workers can spend the allowance as they wish and are not required to provide receipts.
Workers who qualify for the allowance cannot claim separately for any independent living services, devices, etc. that are provided for in the allowance.
Workers may be entitled to additional reimbursement for devices that cost more than $250, if those devices are not intended to accomplish any of the objectives of the services covered by the allowance. See 17-06-03, Independent Living Devices.
Costs associated with guide and support dogs are covered as described in 17-06-04, Guide and Support Dogs.
Workers may use the allowance to pay for independent living services, such as
Indoor/outdoor maintenance (principal residence only)
- snow shoveling
- lawn and yard maintenance
- cleaning (including the cleaning of eaves, pools, etc.)
- house repair, and
- general maintenance.
- taxi service to participate in social or community activities
- supportive therapy, physical fitness, or recreational programs (e.g., art/music therapy, fitness centre membership)
- non-vocational instruction such as "help line" support for computer programs
- internet access.
This list is not exhaustive.
Devices and other items
Workers may use the allowance to pay for devices and other items that cost less than $250, such as
- hobby supplies
- sports equipment (e.g., a specialized baseball glove), and
- household items (e.g., a food processor).
Additional costs for WSIB-supplied devices
The allowance may also be used to pay for costs incurred because of WSIB-supplied devices, such as increased electrical costs or increased home or vehicle insurance.
The allowance is paid annually as a lump sum. The first allowance is paid when there is evidence on file that the worker is severely impaired. It is paid retroactively from the date of entitlement, which is
- the date of the accident (in the most recent claim for workers with multiple claims), or
- the date this policy came into effect,
whichever is later.
The amount of the initial payment is based on the number of months from the date of entitlement to the end of the year in which the worker becomes entitled. Subsequent allowances are paid as a lump sum every January.
If a worker becomes entitled to the allowance because of a deterioration of the work-related condition, the allowance is paid from the date of the recurrence, or the permanent worsening date in NEL claims, or from the equivalent date in PD claims.
The WSIB reviews a worker's entitlement to the allowance whenever a material change in circumstances occurs which affects entitlement to the benefit. See 22-01-02, Material Change in Circumstances - Worker.
When does the allowance stop?
The allowance is paid for the life of the worker. After the worker's death, payment is discontinued at the next payment date. A benefit-related debt is not created.
The allowance is reviewed every year to determine if it needs to be adjusted to keep up with changes in the cost of living. See 18-01-05, Table of Rates, for the current amount.
This policy applies to all decisions made on or after January 1, 2001, for all accidents.
This document replaces 17-06-02 dated April 6, 2001
This document was previously published as:
17-06-02 dated December 13, 1999
17-06-02 dated June 15, 1999.
Workplace Safety and Insurance Act, 1997, as amended
Sections 32, 33
Workers' Compensation Act, R.S.O. 1990, as amended
Sections 50, 52
#4, June 30, 2004, Page 385