Policy
The WSIB determines the future economic loss (FEL) benefit for workers who are not earning at the time of the initial determination based on the suitable occupation (SO) and earnings identified at the time of the return-to-work (RTW) assessment.
A RTW plan may be prepared to achieve the SO, see 19-02-10, RTW Assessments and Plans. At the completion of the plan, the WSIB reviews the SO earnings identified at the time of the RTW assessment, and confirms or varies these earnings, see 18-04-14, Reviewing FEL Benefits (Prior to Final Review).
Purpose
The purpose of this policy is to outline how FEL benefits are calculated for workers who are not earning at the time of initial determination.
Guidelines
Definitions
Suitable occupation
A SO represents a category of jobs suited to a worker’s transferable skills that are safe, consistent with the worker’s functional abilities, and that to the extent possible, restores the worker’s pre-injury earnings. The SO must be available with the injury employer or in the labour market, see 19-02-10, RTW Assessments and Plans.
Date of determination
For information about the time-frames the WSIB uses to determine FEL benefits, see 18-04-03, Date of Determination.
FEL benefit
A FEL benefit is 90 per cent of the difference between pre-injury net average earnings (NAE) and post-injury NAE.
FEL determination
Calculate pre-injury NAE
The WSIB calculates pre-injury NAE to determine FEL benefits in the same way it does for temporary total disability benefits, see 18-06-01, Calculating Temporary Total Disability Benefits (Accidents between 1985 and 1998).
The statutory minimum does not apply to the calculation of the FEL benefit.
Escalated pre-injury earnings
If the earnings year is different than the year of the initial determination, the pre-injury earnings are updated to protect them against the effects of inflation. This is called escalation and is done by applying the appropriate indexing factor to the earnings for each indexing date between the pre-injury earnings date and the date of the initial determination. The applicable indexing factor for each indexing date can be found in 18-01-03, Benefit Dollar Amounts – Accidents before 1998.
Determine the SO and earnings
For details about the determination of the SO and earnings, see 19-02-10, RTW Assessments and Plans.
Calculate post-injury NAE
To calculate the FEL benefit, the WSIB determines post-injury NAE by deducting from the gross SO earnings the probable:
- income tax
- Canada Pension Plan (CPP) premiums and/or the probable Quebec Pension Plan (QPP) premiums, and
- Employment Insurance premiums
payable by the worker.
CPP/QPP benefits
The CPP/QPP disability benefits a worker is receiving, either in whole or in part, due to a work-related injury/disease must be taken into account as post-injury earnings when determining the FEL benefit, see 18-01-13, Calculating CPP/QPP Offsets from FEL/LOE Benefits.
Formula
Post-injury earnings that equal or exceed pre-injury earnings
If the worker is participating in a RTW assessment or plan, and the SO will result in the post-injury NAE equaling or exceeding the pre-injury NAE, the WSIB identifies the claim as entitled to a FEL sustainability benefit, and a FEL supplementary benefit is paid to the worker for the duration of the RTW plan.
For information about:
- claims identified as entitled to a FEL sustainability benefit, see 18-04-13, FEL Sustainability Benefit
- FEL supplements, see 18-04-11, Supplements for Programs and Return-to-Work Activities Before and After 24 Months.
Post-injury earnings less than pre-injury earnings
If the worker is participating in a RTW assessment or plan, and the SO will not restore pre-injury NAE, the worker is entitled to a FEL benefit based on the difference between the pre-injury NAE and the NAE of the SO. A FEL supplementary benefit is paid to the worker for the assessment or plan's duration, see 18-04-11, Supplements for Programs and Return-to-Work Activities Before and After 24 Months.
Non-co-operation
Workers are not entitled to a FEL supplement if they do not co-operate in a RTW assessment or plan. The WSIB identifies the SO and earnings, and bases the FEL benefit on the proposed SO and earnings, see 19-02-08, RTW Co-operation Obligations and 19-02-09, Re-employment Obligations.
Annual indexing
On January 1 every year, the WSIB indexes ongoing FEL benefits by applying the indexing factor to the amount payable, see 18-01-14, Annual Indexing.
Loss of retirement income (LRI) benefit
The WSIB sets aside additional funds equal to 10 per cent of every FEL payment, including FEL supplements, for the worker's LRI benefit, see 18-04-17, Loss of Retirement Income Benefits (Accidents from January 2, 1990 to December 31, 1997).
Application date
This policy applies to all decisions made for entitlement periods on or after March 1, 2021, for accidents from January 2, 1990 to December 31, 1997.
Document History
This document replaces 18-04-06 dated January 2, 2018.
This document was previously published as:
18-04-06 dated February 15, 2013
18-04-06 dated August 1, 2007
18-04-06 dated June 1, 2005
18-04-06 dated October 12, 2004
18-04-06 dated March 1, 2002
18-04-06 dated June 15, 1999
7.5* dated January 1, 1998
05-05-05* dated November 22, 1993
* documents were replaced by 18-04-06 dated June 15, 1999.
References
Legislative Authority
Workplace Safety and Insurance Act, 1997, as amended
Sections 40, 42, 44, 102, 107, 107.1, 108
Workers' Compensation Act, R.S.O. 1990, as amended Sections 41, 43, 44
Minute
Administrative
#33, March 24, 2021, Page 589