RTW Assessments and Plans

Policy

When a worker suffers a work-related injury/disease, the workplace parties (worker and injury employer) work together with the WSIB to enable the worker's return to work. 

If there are challenges that impact the worker's return to work that the workplace parties cannot resolve on their own, the WSIB conducts a return-to-work (RTW) assessment. 

Following the RTW assessment, if necessary, the WSIB develops a RTW plan that outlines the assistance and services the worker requires to enable their return to work with the injury employer or in the labour market.

The WSIB conducts the RTW assessment and develops the RTW plan in collaboration with the workplace parties/authorized representatives and, where necessary, the worker's treating health professional.

Purpose

The purpose of this policy is to outline when RTW assessments are conducted and RTW plans are developed, and how suitable occupations (SO) are determined.

Guidelines

Prioritization of suitable RTW opportunities

The WSIB makes every effort to enable a worker's return to their pre-injury job (with or without accommodation). However, when that is not possible, the WSIB prioritizes other suitable RTW opportunities with the injury employer before considering new employment in the local or broader labour market.  

RTW assessments

The RTW assessment is initially used to determine if the worker is, or will be, medically able to return to their pre-injury job (with or without accommodation) or to a new job.  

When conducting the RTW assessment, the WSIB considers a number of factors, such as:

  • the nature of the work-related injury/disease 
  • the pre-injury job duties 
  • the worker's transferable skills, and
  • all of the worker’s impairments/disabilities, including those that are work-related and non-work-related (e.g., including non-physical disabilities such as a learning disability) in accordance with human rights legislation.

Generally, one RTW assessment is conducted. However, a re-assessment may be appropriate where, for example, the work-related impairment significantly changes. 

RTW in pre-injury job

If the WSIB determines that a worker is, or will be, able to return to their pre-injury job (with or without accommodation), a RTW plan (without training) may be developed. 

This type of RTW plan outlines the assistance and services a worker requires to enable their return to their pre-injury job. For example, the worker may require special equipment or other modifications to perform work duties.

Most workers return to their pre-injury job following a work-related injury/disease. As a result, this is the most common type of RTW plan. 

The remainder of the policy addresses circumstances when a worker is permanently unable to return to their pre-injury job. In such cases, the worker may require assistance and services to enable their return to work in a new job.

RTW in new job

If the WSIB determines that a worker is permanently unable to return to their pre-injury job (with or without accommodation), the WSIB determines if there are other RTW opportunities with the injury employer. This review must take into account any co-operation and re-employment obligations applicable to the workplace parties. See 19-02-08, RTW Co-operation Obligations, and 19-02-09, Re-employment Obligations

If there is no RTW opportunity with the injury employer, the WSIB reviews RTW opportunities in the labour market.

In both cases, the review of RTW opportunities may include jobs for which the worker already has existing or transferable skills to be able to perform, or jobs for which the worker requires training to be able to perform (e.g., trade, technical or academic programs).  See 19-02-07, RTW Overview and Key Concepts, for more information regarding the RTW goal.

A RTW plan (with training) may then be developed that outlines the assistance and services a worker requires to enable their return to work. A number of the services that may be included in a plan are outlined in the Appendix. Decisions about the services provided to a worker, and their duration, are made based on the individual circumstances of the worker. 

In some cases, limited services are required. For example, if the WSIB identifies a RTW opportunity in the labour market that the worker already has the skills to perform, the plan may only consist of job search training and/or employment placement services.

Generally, a plan will not exceed three years in duration.

NOTE

If the WSIB determines the RTW opportunity identified with the injury employer does not have a reasonable prospect of continuing in the longer term, it may review RTW opportunities in the labour market.

Determining a SO

To develop a RTW plan (with training), the WSIB generally identifies a SO for the worker. 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, meaning it exists and is in demand to the extent that the worker has a reasonable prospect of obtaining employment in the occupation.  

The WSIB makes every effort to provide the worker with effective and meaningful input and choice when determining a SO. For example, the worker is encouraged to suggest possible SOs and provide any supporting research. 

The WSIB considers a number of factors when determining a SO, including:

  • the worker's functional abilities, transferable skills, education, aptitudes and interests
  • the worker's work-related and non-work related  impairments/disabilities, including non-physical disabilities such as a learning disability, and any other human rights-related accommodation requirements
  • the worker's pre-injury earnings and work hours (a worker would not be expected to significantly increase their work hours in the SO)
  • labour market trends and the likelihood of the worker being able to secure and maintain employment in the SO 
  • whether the SO has a reasonable prospect of continuing in the longer term, and
  • whether the SO is achievable within a reasonable cost structure.

In some cases, the WSIB may determine that no SO is appropriate for the worker based on various factors, including those listed above. 

Part-time employment

If a worker was working part-time hours, they are not expected to either significantly increase the number of work hours or obtain full-time work in the SO. However, if they are interested in pursuing full-time work, they may be supported in doing so, provided it is within their functional abilities. 

If a worker was working full-time hours, but a return to full-time hours is not feasible due to the work-related injury/disease, a SO with part-time hours may be considered.

Local labour market

The WSIB generally prioritizes available SO opportunities in the local labour market before considering the broader labour market. 

A local labour market is not limited to a particular city or town but also comprises any surrounding areas to which the worker might reasonably commute. 

To identify a reasonable commuting distance for a SO, the WSIB takes into consideration a number of factors, including:

  • the worker’s commuting pattern in the pre-injury job
  • the expected travel requirements of the SO, and
  • the extent of the worker’s permanent impairment and any associated physical or psychological limitations on them being able to travel.

Broader labour market

If there are no available SOs in the local labour market, the labour market may be expanded to the broader labour market to identify available SOs. In such cases, relocation may be an option considered, since the broader labour market would be outside a reasonable commuting distance for the worker.

If the worker chooses to relocate, the WSIB will pay for appropriate expenses directly related to them looking for work in the broader labour market.

Once the worker has received a bona fide offer of employment in the broader labour market, the WSIB will pay for appropriate expenses associated with relocation.

If the worker chooses not to relocate to obtain an available SO in the broader labour market, RTW plan (with training) services will be closed and loss of earnings (LOE) benefits adjusted based on what the worker is able to earn in the SO, see 18-03-02, Payment and Reviewing LOE Benefits (Prior to Final Review).

Labour market information

The WSIB generally uses the federal government's National Occupational Classification (NOC) system and labour market information from the federal and Ontario governments as the preferred sources of information to help identify SOs and RTW plan (with training) services the worker may require.

Determining earnings for the SO

The earnings for the SO are an estimate of what the worker is capable of earning when re-entering the labour market in a SO. They are established based on whether the RTW plan (with training):

  • involves the worker acquiring a new skill set or entering a new field. If this is the case, updated entry-level wages are used to determine post-injury earnings, or
  • is designed to improve the worker’s existing or transferable job skills. If this is the case, updated mid-level wages are used to determine post-injury earnings.

RTW plans (with training): further information

Coverage while participating in a RTW plan (with training)

The WSIB extends coverage under the existing claim if a worker sustains a new injury while participating in the following RTW plan (with training) activities:

  • in training at a training institution/facility, trade school, or workplace (covered or not covered under the Workplace Safety and Insurance Act, 1997) that is part of the plan 
  • in an education/academic service (including public, community and private institutions) that is part of the plan, or
  • travelling that is required during the course of participating in plan activities, and is directed by the training institution/facility, trade school, workplace (including training on the job, TOJ), or education/academic service.

The WSIB does not provide coverage to a worker while commuting to the location of a training institution/facility, trade school, workplace (including TOJ), or education/academic service where plan activities will occur.

On an extenuating basis, the WSIB may extend coverage under the existing claim if a worker sustains a new injury while travelling at the specific direction of the WSIB for the purpose of the plan if the work-related impairment dictates the means of travel and the worker takes the specified pre-arranged means of travel. 

RTW plan (with training) interruptions

The WSIB will consider reasonable and justifiable absences from the RTW plan (with training), provided it does not jeopardize successful completion of the plan.

Significant change to the work-related impairment or the labour market

The SO and/or RTW plan (with training) may be revised to accommodate a significant change to the work-related impairment or the labour market. 

If the SO is revised, it would be used to calculate LOE benefits at the end of the plan rather than the original SO.

Post-accident, non-work-related change in circumstances

If a worker's ability to participate in a RTW plan (with training) is impacted by a post-accident, non-work-related change in circumstances, the WSIB will attempt to facilitate the worker's successful completion of the plan through accommodation. However, in some cases, the SO and/or plan may need to be revised, see 15-06-08, Adjusting Benefits Due to Post-accident, Non-work-related Change in Circumstances.

RTW plan (with training) closure

A RTW plan (with training) is closed and the worker’s benefits are adjusted accordingly when the worker:

  • successfully completes the plan or returns to work 
  • fails to participate in the development of the plan or the completion of plan activities 
  • is unable or unavailable to complete the plan because of a change in circumstances unrelated to the work injury/disease 
  • has voluntarily withdrawn from the work force (e.g., has retired), or
  • has received extensive plan services and the provision of further services would not likely lead to successful return to work.

RTW plans (with training): special cases

Maximizing young workers’ earnings potential through an enhanced plan

Usually, a RTW plan (with training) will be aimed at restoring a worker’s earning capacity to reduce or eliminate a wage loss resulting from a work-related injury/disease. However, in some cases, the worker can achieve higher earnings than pre-injury through an enhanced plan without significantly increasing the cost or duration of the plan. 

This concept may also allow the WSIB to consider an enhanced SO option, presented by a worker, that would exceed pre-injury earnings for a comparable investment in retraining.

Workers may be eligible for an enhanced plan if, on the date of injury, they:

  • are between the ages of 15-24
  • are not students, learners, or apprentices*
  • due to their permanent work-related impairment, are unable to return to their pre-injury job and/or have permanent work restrictions, and
  • had low pre-injury earnings (i.e., less than 50% of the average industrial wage, see 18-01-02 Benefit Dollar Amounts - Accidents from 1998).

The enhanced SO would be used to calculate LOE benefits at the end of the plan.

*For workers who are students, learners or apprentices on the date of injury, see 18-02-08, Determining Average Earnings-Exceptional Cases that outlines special rules for these workers.

Option for workers 55 and older

A worker who is 55 years of age or older when the WSIB determines they are entitled to LOE benefits, and who requires a RTW plan (with training) consisting of vocational skills training (as defined in the Appendix) to achieve employment in a SO has two options:

  • participate in a RTW plan (with training) to achieve the SO, or
  • choose a 12 month self-directed transition plan to achieve the SO.

The self-directed transition plan option is chosen in conjunction with the irrevocable no-review option for LOE benefits payable to age 65.  After the worker signs the irrevocable election, full LOE benefits will continue for the 12-month period of the plan.

At the end of 12 months, LOE benefits will be recalculated based on the estimated earnings of the SO as reflected in current labour market information.

Expenses

The WSIB pays for expenses that it considers appropriate to enable the worker to engage in the RTW assessment and RTW plan (with training).

The expenses the WSIB pays for during the RTW assessment consist primarily of service fees for assessments/evaluations, interpreters where necessary, and travel expenses, see 17-01-09, Travel and Related Expenses.

The expenses the WSIB pays for during the RTW plan (with training) may include, but are not limited to, expenses for services, tuition fees, books, supplies, special accommodation needs, equipment, travel, and assistive devices. The expenses are set out and agreed to before the commencement of the plan and are generally paid until the plan is completed or discontinued. However, they may be modified during the plan if necessary. 

Living accommodation expenses

In cases where a worker must attend a training facility as part of the RTW plan (with training), every effort is made to select one that is within daily commuting distance of their principal residence. If that is not feasible, they may require a secondary residence on a temporary basis. The WSIB pays for accommodation expenses in such cases (e.g., hotel/motel, apartment rental) while they are co-operating in the plan.

The WSIB and the worker consider the most suitable, reasonable, and cost-effective secondary residence, having regard for the worker’s circumstances.

If a worker chooses to stay in non-commercial lodgings, such as with a relative or friend, the WSIB may pay the equivalent of up to 50% of the usual accommodation rate established for the specific region.

Return trip home

If the WSIB is paying monthly accommodation expenses for a worker, the WSIB may also pay their travel costs for one return trip to their principal residence each month.

Meal allowance

If the worker is:

  • staying in a hotel/motel, they are entitled to the full per diem meal allowance
  • renting an apartment, they are entitled to 50% of the per diem meal allowance, or
  • staying on residence at a training centre or educational institution, they are entitled to 50% of the per diem meal allowance or the cost of a residency meal plan should they opt into a plan. 

For the current meal allowance rate, see 18-01-05, Table of Rates.

Application date

This policy applies to all decisions made on or after November 30, 2020.

Policy review schedule

This policy will be reviewed within five years of the application date.

Document history

This is a new document. 

This document replaces 19-03-03 dated December 3, 2012, 19-03-05 dated December 3, 2012, 19-03-06 dated July 15, 2011 and 19-03-11 dated July 15, 2011. 

References

Legislative authority

Workplace Safety and Insurance Act, 1997, as amended
Sections 40, 42, 43, 53

Minute

Administrative
#4, October 22, 2020, Page 579

Appendix: RTW plan (with training) services

English as a second language training: To improve a worker's ability to communicate in English. The WSIB considers including this service in a plan when the worker's English communication skills are a barrier to gaining employment.

Literacy and basic skills: A form of academic upgrading tailored to workers whose essential reading, writing, math, or basic work skills are below a Grade 9 level. These services are generally followed by short-term vocational skills training.

Academic upgrading: To help workers who do not have a high school diploma, but whose skills are above the Grade 9 level, prepare for college or a technical program. However, in some cases, the WSIB considers offering this service in a plan if a specific educational level in itself qualifies the worker for employment.

Vocational skills training: To improve existing job skills and/or teach new skills (includes apprenticeships, trades, technical, or academic programs). It is conducted by a community college, a Ministry of Colleges and Universities (MCU) registered private career college, or a university. 

Training on the job (TOJ): Consists of hands-on training at an employer’s work site where workers learn and acquire new skills. The WSIB arranges the TOJ and a training plan for the worker which includes measurable goals/milestones. It will generally run for a minimum of four weeks and a maximum of 26 weeks.

Job search training (JST): Provides a worker with basic job search skills (e.g., how to identify available job opportunities and apply for them). It is generally offered for up to two weeks.

Employment placement services: May be offered to a worker who has the necessary skills for employment. Workers are expected to actively participate in job search activities during the placement services. It is generally offered for up to 10 weeks.

Work trial: In some cases it is helpful to assess the suitability of a job through a work trial. It enables the worker and employer to evaluate job fit prior to hire. The WSIB will pay the worker full LOE benefits during a work trial. It is generally offered for up to four weeks.