Effective date: June 1, 2016
Last updated: April 12, 2016
Application: All claims on long-term earnings replacement.
Policy subject: Benefits for workers - Long term benefits
Purpose:To establishes guidelines for an annual earnings verification of claims receiving long-term earnings loss benefits.
POL 07/2016, Earnings Verification establishes the requirement for an annual earnings verification of claims receiving long-term earnings loss benefits.
- Long-term earnings loss benefits will not be paid without some form of annual earnings verification.
- An annual questionnaire with a request for tax information and a Notice of Assessment from the Canada Revenue Agency (CRA) is issued 60 days prior to the workers commencement of loss date.
- If information from CRA is not available, Case Management Support (CMS) staff are responsible to determine what other form of earnings verification is required. This must include verifiable documentation about the customer’s earnings from the previous year and would include, but is not limited to: a record of employment, T4, paystubs, bank statements, etc.
- If a customer does not return the annual questionnaire or provide tax information and a NOA for the annual verification of earnings to be completed, the Payment Specialist (PS) may extend one month of benefits. If information is still not received, the CMS may extend a second month of benefits. After two months of benefit extensions, the file must be referred to the Case Manager who has the discretion to determine what, if any, ongoing compensation is payable.
- Where CRA tax information is not available, verification of earnings may not be required (e.g., where a customer is living in a rehabilitation centre or where the worker is clearly unable to perform any gainful employment). The CMS must review the customer’s file to determine if there is any evidence of the customer securing earnings from employment.
- The PS will review and confirm that the information received is sufficient to continue ongoing long-term earnings loss benefits.
- The PS will review the customer’s earnings from the previous year, any changes to their tax exemption status and if they are in receipt of Canada or Quebec Pension Plan Disability (CDP/QPP) Benefits and adjust long-term earnings loss benefits accordingly.
- If it is determined upon review of the information that a customer’s long-term earnings loss benefits were calculated using incorrect earnings information, the PS will recalculate and increase or decrease the customer’s long-term earnings loss benefit, as follows:
- Recalculations and adjustments of earnings will be made retroactively to the date the incorrect information would have affected a customer’s long-term earnings loss benefits.
- Any overpayments resulting from a recalculation will be pursued by the WCB (POL 17/2016, Overpayment Recovery – Compensation).
- Changes to TD1 status and indexing of CDP benefits resulting from the annual earnings verification are effective on the anniversary of the worker’s commencement of loss date.
- Long-term earnings loss benefits will not be recalculated or retroactively adjusted to include a salary increase or promotion effective after the day of injury that change pre-injury earnings.
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