Allowance – Clothing
Effective date: January 1, 2012
Last updated: October 16, 2012
Application: All workers eligible under Section 79 for the clothing allowance on and after the effective date.
Policy subject: Allowance and expenses
To establish guidelines for providing clothing allowances.
- The Workers’ Compensation Board (WCB) has approved POL 19/2010, Allowance – Clothing, which establishes guidelines for providing clothing allowances for eligible workers under The Workers’ Compensation Act, 2013 (the “Act”).
- The following provides detailed guidance for the implementation of the policy.
- The Case Manager will identify clothing allowance eligibility in accordance with the following criteria:
- The worker requires a prosthetic device for upper, lower or both upper and lower limb amputations;
- The worker requires a rigid back, neck, leg or full-length brace or similar rigid supportive device; or
- The worker is confined to a wheelchair as the result of a compensable injury.
- Initial eligibility for clothing allowance begins as of the date of the provision of the prosthesis, brace or wheelchair, and does not require proof of repair or damage to clothing.
- Payment for rigid braces or supports is contingent on the identification of need provided by the attending physician, and periodic confirmation that the worker continues to wear the device.
- Where the worker requires rigid braces or supports on a temporary basis, the WCB will issue clothing allowance monthly. Where the worker initially qualifies for clothing allowance, entitlement will begin on the date the worker starts wearing the device. Following initial qualification, monthly payments will continue until the device is no longer required, or medical evidence shows that the worker permanently requires the use of the device.
For example, the worker begins wearing the device August 13, 2010. The worker is paid from August 13 to 31, 2010 (18/31 x monthly clothing allowance). Thereafter, the worker is paid monthly until the device is no longer required.
- For temporary clothing allowance, the Case Manager will provide authorization for payment. The authorization will indicate the type of allowance payable (e.g., upper limb) and the duration for monthly payments. The Case Manager will diarize the claim for the end of the authorization period to determine if there is a need to extend the duration of payment for clothing allowance.
- Where the attending physician directs that the worker permanently requires an appliance, the WCB will issue clothing allowance on an annual basis. Where the worker initially qualifies for clothing allowance, entitlement will begin on the date the worker starts wearing the device, and continue for the period up to the end of the year (December 31). Beginning the following January and in January of every year thereafter, the worker will receive an annual clothing allowance payment covering a period of 12 months.
For example, the worker begins wearing the device August 13, 2011. The worker is paid from August 13, 2011 to December 31, 2011 ([18/31 x monthly clothing allowance] + [4 months of clothing allowance]). In January 2012, and in January of each year thereafter, the worker receives an annual clothing allowance payment covering a period of 12 months.
- Annual indexing of clothing allowance will be applied in January of each year (increases effective January 1st).
- The Case Manager will review the worker’s eligibility for clothing allowance annually. If eligibility continues, authorization will be provided and 12 months of clothing allowance will be issued by the end of January.
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