Document name
Temporary Additional Allowance
Document number
POL 15/2008
Effective date: December 1, 2008
Last updated: November 4, 2008
Application: All injured workers who as a result of a temporary work injury, as well as those waiting for a PFI assessment, incur additional expenses not covered by any other WCB policy.
Policy subject: Allowance and expenses
Purpose:
To establish guidelines for paying additional, incidental expenses related to the work injury.
DEFINITION
Additional expense is that portion of expense which is over and above what a customer incurred while working (pre-injury) and is not covered elsewhere by WCB policy. These expenses may include the following: child-care, care of a family member incapacitated by injury or illness, transportation costs, meal preparation, housecleaning or other general day-to-day home maintenance (e.g., lawn care or snow removal). Home maintenance does not include major renovations to a property or home.
BACKGROUND
- Section 111(b) of The Workers’ Compensation Act, 2013 (the “Act”) enables the Workers’ Compensation Board (WCB) to authorize assistance to the injured worker not specifically covered elsewhere in the Act that will lessen or remove “any barriers resulting from the worker’s injury.” Section 115 of the Act authorizes the WCB to “expend moneys from the [Injury] fund for any expenses incurred in the administration of this Act”.
- The purpose of this policy is to assist a worker in maintaining their pre-injury status (not to improve upon it). As a result of a work injury and ensuing medical treatment or return-to-work (RTW) programming, customers sometimes incur temporary additional expenses that are over and above what they would normally have paid while working.
- The eligibility period for customers is usually short-term and based on the nature and severity of the injury. However, additional expenses may be reimbursed where the effects of the injury may be temporary (full recovery is expected) or permanent (a PFI may be awarded in the future).
POLICY
- Workers may be reimbursed for those additional expenses that arise out of any of the following injury-related circumstances:
- The severity of the injury makes it impossible to perform these tasks (e.g., bilateral casts or confinement to a wheelchair);
- While convalescing following surgery;
- While attending secondary or tertiary treatment centres;
- While travelling for medical or other appointments;
- While hospitalized;
- While participating in RTW programs;
- While the customer requires an attendant for transportation between health care facilities.
- Only expense(s) that exceed what a worker paid pre-injury is eligible and only to maintain the current standard of living. For example, expenses paid by a worker during their normal working hours, such as child care, will not be eligible for reimbursement. However, child care needed during the worker’s non-working hours (e.g., evenings while hospitalized) would be considered an additional expense.
- While there is no maximum, the amount and duration of reimbursement will not exceed what is reasonable in the circumstances and determined by medical evidence.
- If the additional expense items identified under this policy are reimbursed through a personal care allowance (POL 10/2014) or independence allowance (POL 31/2016) reimbursement under this policy will be discontinued.
Policy references
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