Document name
Earnings Verification
Document number
PRO 13/2021
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
Purpose:
To establish guidelines for verifying earnings for workers receiving long-term earnings loss benefits.
BACKGROUND
POL 13/2021, Earnings Verification establishes the requirement for an annual earnings verification of claims receiving long-term earnings loss benefits.
PROCEDURE
General
- How do Operations staff verify the annual earnings of workers receiving long-term earnings loss benefits?
- An annual Verification of Income Statement form (REQ) with a request for tax information and a Notice of Assessment (NOA) from the Canada Revenue Agency (CRA) is issued 60 days prior to the anniversary date of the commencement of the worker’s loss of earnings.
- What happens when information from the CRA is not available?
- If information from the CRA is not available, Operations staff will determine what other form of earnings verification may be required.
- This will generally include verifiable documentation about the worker’s earnings from the previous year which may include, but is not limited to, the following documents:
- A record of employment.
- T4.
- Paystubs.
- Bank statements.
- There may be situations where CRA tax information is not available and verification of earnings may not be required (e.g., where a worker is living in a long-term care facility or where the worker is clearly unable to perform any gainful employment). Operations staff must review the worker’s file to determine if there is any evidence of the worker securing earnings from employment.
- What happens when a worker does not return the information necessary to verify their earnings?
- If a worker does not return the necessary documentation for an annual review, Operations staff will notify the worker verbally (i.e., over the phone) and provide written notice.
- Depending on the circumstances of each claim, Operations staff may extend long-term earnings loss benefits for up to two months prior to referral to the Operations’ Customer Care Facilitator who has the discretion to determine what, if any, ongoing compensation is payable.
- If a worker still does not provide earnings verification information, their long-term earnings loss benefits may be suspended (POL 10/2021, Suspension of Benefits) until the complete required documentation is received.
- Once earnings verification information has been received, Operations staff will review and confirm that the information received is sufficient to authorize ongoing long-term earnings loss benefits.
- What information do Operations staff review when verifying a worker’s earnings?
- Operations staff will review a worker’s information received from CRA to verify:
- Earnings from the previous year.
- Changes to tax exemption status (TD1), and
- If they receive CPP/QPP disability or survivor benefits.
- Operations staff will review a worker’s information received from CRA to verify:
- What happens when a worker’s earnings change during the course of the year?
- Workers are encouraged to contact the WCB if there is a significant increase or decrease to their earnings throughout the course of the year (e.g., part-time to full-time employment).
- Operations staff will recalculate benefits and adjust earnings capacity to avoid a potential overpayment during the annual earnings verification process.
Benefit Adjustments
- Under what circumstances will Operations staff adjust a worker’s long-term earnings loss benefits?
- Operations staff will adjust a worker’s long-term earnings loss benefits 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.
- Operations staff will adjust a worker’s long-term earnings loss benefits when:
- When do adjustments to long-term earnings loss benefits take effect?
- Subject to point 9, adjustments to long-term earnings loss benefits resulting from annual earnings verification are effective in the current year on the anniversary of the worker’s commencement of loss date.
Retroactive Adjustments
- Under what circumstances may Operations staff retroactively adjust a worker’s long-term earnings loss benefits?
- Operations staff 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 Workers’ Compensation Act, 2013, 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.
- Operations staff may recalculate and retroactively adjust a worker’s long-term earnings loss benefits when:
- Long-term earnings loss benefits that are retroactively adjusted will also be modified in the current verification year to reflect the actual or estimated earnings of the worker.
- How are retroactive adjustments to long-term earnings loss benefits calculated?
- The retroactive adjustment will be 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).
Policy references
Section heading
Legislative Authority
Legislative Authority
The Workers’ Compensation Act, 2013
Sections 20, 25, 44, 47(1), 68, 81(6), 95, 100(1), 100(2), 112, 180.
Section heading
Document History
Document History
(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).
Section heading
Complements
Complements
POL 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
POL 10/2021 Suspension of Benefits