Effective date: January 1, 2022
Application: Applies to all new and existing long-term earnings loss claims on or after the effective date.
Policy subject: Benefits for workers - Long term benefits
To establish guidelines for verifying earnings for workers receiving long-term earnings loss benefits.
Earning capacity means the amount of income a worker could be expected to generate, post injury, through the performance of suitable productive employment, given their restrictions and unique vocational profile.
- Workers entitled to compensation are required to provide any proof of claim that the WCB requires (Section 44(2) and Section 47(1)).
- Payments made to a worker may be reviewed by request of the WCB, the worker, their dependent or the worker’s employer. Upon review, the WCB may terminate, diminish or increase payments to a worker (Section 100(1)(2)).
- Canada or Quebec Pension Plan (CPP/QPP) disability or survivor benefits may offset a worker’s earnings loss benefits (Section 95).
- No person shall knowingly provide false or misleading information to the Board (Section 180(a)).
- The WCB will complete ongoing reviews of a worker’s actual or estimated earnings, when they are entitled to long-term earnings loss benefits as established through POL & PRO 01/2018, Benefits – Long-Term Earnings Loss.
- Annually, the WCB will review a worker’s long-term earnings loss benefits on the anniversary of the commencement of the worker’s loss of earnings resulting from the injury. Verification will ensure that the information used for calculating long-term earnings loss benefits is reflective of the actual or estimated earnings of the worker.
- The WCB will review a worker’s information received from the Canada Revenue Agency (CRA), to verify their:
- Tax exemption status (TD1), and
- If they receive CPP/QPP disability or survivor benefits.
- If CRA tax information is unavailable, the WCB may use alternate means of verifying a worker’s earnings and tax exemption status.
- The WCB will adjust a worker’s long-term earnings loss benefits based on actual reported earnings from the previous year.
- Subject to points 7 to 9, all adjustments that result from the annual earnings verification process will take effect in the current year on the anniversary of the worker’s commencement of loss date.
- The WCB may adjust a worker’s long-term earnings loss benefits in the current year when:
- There is a change of earnings capacity based on a difference between estimated and actual earnings.
- There is a change to a worker’s TD1 status.
Retroactive Benefit Adjustments
- The WCB may retroactively adjust a worker’s long-term earnings loss benefits from previous estimated years. A retroactive adjustment is calculated based on the date when the adjustment to the worker’s benefit entitlement is determined to have occurred (e.g., January 1st of the income tax year).
- The WCB may recalculate and retroactively adjust a worker’s long-term earnings loss benefits when:
- There is more than a 10 per cent difference in earnings capacity adjustment between estimated and actual earnings.
- There is a change of earnings capacity as a result of a breach of the Act; such as suspected or alleged fraud, deliberate misrepresentation or withholding of information affecting entitlement was involved.
- Approved or adjustments to CPP/QPP disability or survivor benefits.
- Any other situation determined by the Board.
- Retroactive long-term earnings loss adjustments may result in either an underpayment or overpayment of benefits to a worker. The WCB will pursue all overpayments resulting from a recalculation (POL 17/2016, Overpayment Recovery – Compensation).
- The WCB will not recalculate and retroactively adjust long-term earnings loss benefits to include salary increases or promotions effective after the day of injury that change pre-injury earnings.
(1) POL & PRO 07/2016, Earnings Verification (effective June 1, 2016 to December 31, 2021).
(2) POL & PRO 12/2010, Verification of Earnings (effective May 1, 2010 to June 1, 2016).
(3) POL & PRO 19/1998, Verification of Earnings (effective November 16, 1998 to May 1, 2010).
PRO 13/2021 Earnings Verification
POL 01/2018 Benefits – Long-Term Earnings Loss
PRO 01/2018 Benefits – Long-Term Earnings Loss
POL 03/2007 Calculation of Probable Compensation
POL 22/2016 Offset of Canada or Quebec Pension Plan Disability Benefits
POL 17/2016 Overpayment Recovery – Compensation
POL 05/2017 Privacy of Information