Prescription Eyewear

Law

The Workplace Safety and Insurance Act provides:

s.32

Health care is defined as including assistive devices and prostheses.

s.33(1)

A worker who sustains an injury is entitled to such health care as may be necessary, appropriate and sufficient as a result of the injury and is entitled to make the initial choice of health professional.

s.39(1)

The Board may pay to repair or replace a worker's assistive device or prosthesis if it is damaged as a result of an accident in the worker’s employment.

s.39(2)

If the worker is unable to work because of the damage to his or her assistive device or prosthesis, the worker is entitled to benefits under the insurance plan as if the inability to work had been caused by a personal injury.

Guidelines

Definitions

Eyewear - An assistive device is a broad term with several subcategories, one of which is prescription eyewear. "Prescription eyewear" is a device, prescribed by a health care practitioner, that serves as an extension of the body by correcting and improving the worker’s vision and includes

  • prescription glasses (frames and lenses)
  • prescription safety glasses (if worker paid for original prescription safety glasses and not the employer)
  • prescription contact lenses
  • prescription sunglasses (including non-corrective sunglasses if prescribed for medical conditions such as photophobia).

For information regarding provision of an artificial eye, see 17-07-05, Orthopaedic.

Entitlement criteria for allowing prescription eyewear

Sight impaired due to work-related injury/disease

The purchase of prescription eyewear is authorized when

  • a work-related eye injury results in sight impairment and the sight in the injured eye can be improved, or
  • a work-related eye injury results in total loss of sight in one eye, and corrective eyewear is required to protect the vision in the remaining eye, or
  • a work-related injury, affecting the head or brain, requires eyewear to improve vision.

Prescription eyewear damaged during work-related accident - eyewear worn

The repair/replacement of prescription eyewear is authorized when

  • the eyewear was being worn at the time of the work-related accident, and
  • the damage to the eyewear was caused by a specific external force, arising out of and in the course of employment. (An example of a specific external force would be eyewear knocked off a worker's face by an opening door. However, there would be no specific external force if the eyewear “simply fell off” due to loose fit, etc.)

Prescription eyewear damaged during work-related accident - eyewear not worn

There is no entitlement if the prescription eyewear was not being worn on the face at the time of the work-related accident, unless the loss or damage to the eyewear is caused by a specific external force, arising out of and in the course of employment and occurs in the following circumstances

  • when an emergency situation requires that the eyewear be removed and the eyewear is kept on the person (e.g., to wear breathing apparatus, to wipe off unusual debris such as mud or water that is splashed onto glasses), or
  • when a condition of the employment requires that the eyewear be removed and the eyewear is kept on the person (e.g., reading glasses used to review blueprints and then removed to conduct site inspection).

NOTE

To qualify for entitlement for prescription eyewear, damaged during a work-related accident, the worker does not have to sustain a physical injury to him/herself. However, the worker must

  • be involved in a work-related accident where a specific external force causes the damage to the eyewear, and
  • the eyewear must either be worn at the time of the work-related accident or be on the person.

If the eyewear is removed from the person and left on a desk, skid, etc., there would be no entitlement for damage to the eyewear.

Criteria for payment

The WSIB pays for a worker’s prescription eyewear if

  • the worker requires prescription eyewear as a result of one or more of the situations described in the section called “Entitlement criteria for allowing prescription eyewear”, and
  • the eyewear is prescribed for the worker by a health care practitioner, and
  • the eyewear is approved by the WSIB.

Prescriptions

Workers must provide the WSIB with a prescription the first time they request new or replacement eyewear. A new up-to-date prescription must be provided each time the worker requests replacement of the eyewear purchased by the WSIB for the work-related physical injury. Prescriptions not initially approved by the WSIB may not be reused to obtain future approval.

The prescription must be provided by the treating health professional, which may be an ophthalmologist or optometrist. Either an ophthalmologist, optometrist, or optician may dispense the eyewear.

Approval before purchase

Before obtaining initial, replacement, or repaired prescription eyewear, workers should get approval from the WSIB.

In the event that

  • the WSIB does not approve the purchase, or
  • the price exceeds the amount that would be authorized by the WSIB,

the WSIB is not responsible for the cost of the prescription eyewear, or the costs above the amount authorized.

Repairs and replacements

Regardless of whether repair and/or replacement for the prescription eyewear arises out of

  • a work-related eye injury
  • another work-related injury (e.g., head or brain)
  • damage to eyewear due to a work-related accident caused by a specific external force

the WSIB pays only for the component(s) of the prescription eyewear that needs to be repaired or replaced. If, for example, the lenses were damaged but the frames remained unaffected, the WSIB pays only for the cost of replacing the lenses.

The cost of repair or replacement is based on the replacement value of the existingeyewear (e.g., if a worker had basic frames which were damaged beyond repair, the WSIB will not pay for upgraded designer frames). Any cost above the replacement value of existing eyewear is the worker’s responsibility.

Eyewear for work-related physical injury (ongoing entitlement)

The WSIB pays for the ongoing repair and replacement of prescription eyewear required as a result of a work-related injury that caused sight impairment.

Repairs will be covered as needed. Replacements are limited to once every two years.

If the eyewear, purchased by the WSIB, is lost or stolen, the WSIB replaces it on a once-only basis. Replacement of the same eyewear, if it is lost or stolen again, is the worker’s responsibility.

The WSIB does not pay for repair or replacement if

  • the eyewear needs to be changed due to a presbyopic addition (i.e., adjustments necessary due to the normal aging of the wearer, such as bifocals), or
  • the eyewear is deliberately damaged or misused, or
  • the instructions for proper care and maintenance are not followed.

If the worker requests a second pair of glasses, safety glasses, or sunglasses, all costs related to this purchase, repair and/or replacement are the worker's responsibility.

Eyewear damaged during work-related accident (once only entitlement)

The WSIB pays for the repair or replacement of prescription eyewear damaged during a work-related accident on a once-only basis. Exceptions are made only if it can be shown that the subsequent breakdown is a direct result of the initial accident (e.g., the replacement arm on the eyeglass frame is faulty and requires further repair).

Entitlement summary
Situation Entitlement to eyewear Repair or Replacement No entitlement to eyewear
Prescription eyewear required for injured eye Work-related injury results in sight impairment.

Repairs as needed.

 

Replacements limited to once every two years.

Change in eyesight is not compatible with work-related accident (e.g., related to age, caused by pre-existing condition, etc.).
Prescription eyewear required due to other injuries
(e.g., head, brain, etc.)

Work-related injury results in total loss of sight in one eye. Corrective eyewear is required to protect the vision in the remaining eye.

 

Work-related injury, affecting the head or brain, results in sight impairment (e.g., double vision) which can be improved by corrective eyewear.

Repairs as needed.

 

Replacements limited to once every two years.

Compensable injury did not cause sight loss or impairment (e.g., need is related to age, caused by pre-existing condition, etc.).
Prescription eyewear worn at time of work-related accident Damage to eyewear caused by a specific, external force at work.

Repair of damaged components or complete replacement of eyewear, if needed.

 

Limited to once only.

Eyewear gradually scratched or damaged through normal wear and tear.

 

Eyewear gradually pitted during grinding, welding, etc.

 

Eyewear "simply fell off" (e.g., due to loose fit, etc.).

Work condition requires removal of prescription eyewear and eyewear kept on person

Emergency situation at work requires removal of eyewear and eyewear kept on the person (e.g., to wear breathing apparatus, to remove unusual debris such as mud or water splashed onto lenses).

 

Exceptional condition of employment requires removal of prescription eyewear and eyewear kept on the person (e.g., reading glasses used to review blueprints and then removed to conduct site inspection).

 

For entitlement to exist in the above two situations, damage to prescription eyewear must be caused by a specific external force at work.

Repair of damaged components or complete replacement of eyewear, if needed.

 

Limited to once only.

Eyewear removed for normal use and care, not directly connected to the conditions of employment (e.g., eyewear removed for normal cleaning).

 

Eyewear removed and not kept on the person (e.g., left on a desk, skid, etc.).

Application date

This policy applies to all decisions made on or after March 3, 2003, for all accidents.

Document History

This document replaces 17-07-01 dated April 11, 2003.

This document was previously published as:
06-04-05 dated October 2, 1991.

References

Legislative Authority

Workplace Safety and Insurance Act, 1997, as amended
Sections 13, 32, 33, 39

Workers' Compensation Act, R.S.O. 1990, as amended
Sections 4, 50

Minute

Administrative
#2, June 11, 2004, Page 365