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FUTURE ECONOMIC LOSS AWARDS
(For Accidents After
January 1, 1990, but Before January 1, 1998)
What Is a Future Economic Loss (FEL) Award?
A FEL award is a monthly payment from the Workplace
Safety and Insurance Board (WSIB) that replaces, in part,
lost future earnings due to a long-term workplace injury.
When Can You Get a FEL Award?
You may be entitled to a FEL award if you were
injured after January 1, 1990, but before January 1, 1998, and you
have a permanent impairment or you were temporarily disabled for
12 continuous months. Where possible WSIB makes its decision whether
to award FEL benefits:
- in the 12th consecutive
month that a worker is temporarily disabled, or
- within one year after WSIB is notified
of a worker's accident, if during that year WSIB determines that
the worker is permanently impaired, or
- within 18 months after WSIB is notified
of a worker's accident, if the worker's medical condition prevents
a determination within the times stated above.
If a worker is not receiving compensation at
the time of the usual determination dates, and entitlement to compensation
is in dispute, these time limits may be extended.
How Much Is a FEL Award?
If you are not working at the time of your
FEL assessment, WSIB benefits will be based on the earnings that
WSIB determines you are able to earn in the jobs that are suitable
for you. WSIB calls this your suitable employment or business (SEB).
Your FEL award will be 90% of the difference between what WSIB believes
you can earn and the amount that you made before your injury. If
you are working at a job WSIB believes is reasonable given your
medical condition, your FEL award will be 90% of the difference
between your actual wages and your wages before your injury. If
you receive a 100% FEL award, your benefits will be fully indexed
for inflation. In all other cases, your FEL benefits will only be
partially indexed for inflation.
What Else Does WSIB Consider When Deciding Your
FEL Award?
When deciding the amount of your FEL award,
WSIB should also consider:
- your personal and vocational characteristics
(for example, an older worker may not be able to find work as
easily as a younger worker, and a person who has worked for many
years at the same job may have trouble adapting to a new job),
- your chance of being successful in
an LMR program,
- the availability of suitable work
in your local area,
- some or all of the money you receive from
the Canada
Pension Plan (CPP) or Quebec
Pension Plan (QPP) for your disability.
At the time WSIB decides or reviews your FEL
award, you may choose to receive an amount equal to the full Old
Age Security (OAS) pension instead of FEL benefits, if:
- you are at least 55 years of age when
WSIB decides or reviews your FEL award,
- you have not returned to work, and
- WSIB believes you are unlikely to benefit
from an LMR plan.
When Can WSIB Review Your FEL Award?
- WSIB can review your FEL award every
year or whenever you report a material change in circumstances.
WSIB considers any change in your income, return to work status,
or medical condition to be a material change that must be reported
within ten days of the change occurring. For more information,
see OWA Fact Sheet 7 called Material
Change in Circumstances.
- WSIB can review your FEL award when
you continue to experience a wage loss after completing your early
and safe return to work (ESRTW) program or LMR plan.
- WSIB can review your FEL award if
your condition deteriorates to the point that your non-economic
loss (NEL) benefits increase.
- WSIB will stop your FEL benefits if
you are not permanently impaired.
- WSIB will conduct a final review of
your FEL award after five years from when your FEL benefit is
first awarded.
- FEL benefits end when you turn age
65.
- WSIB may change or stop payment of your
FEL benefits after a review.
Will WSIB Review Your FEL Award After Five Years?
Generally, WSIB cannot review your FEL award
after the final 60-month (five-year) review. There are some
exceptions to this rule. See OWA Fact Sheet 21(b) called Future
Economic Loss (FEL): Reviews after the 60 Month Final Review.
What Is a FEL Sustainability Benefit?
You may get a FEL sustainability benefit if
your earnings are the same or more after your work injury than before
your work injury. You will only receive this benefit when it is
uncertain whether your work-related condition will allow you to
continue doing your job, or if you are participating in an ESRTW
program or an LMR plan. For example, this would apply if your employer
created a job suitable to your condition at no wage loss, but such
a job may not exist with another employer, or else another employer
would pay less than you earned before the accident. A FEL sustainability
benefit is only one dollar ($1) per year, but it allows WSIB to
pay you a FEL supplement in the future, should you require more
medical treatment or help returning to work.
When Are You Eligible for a FEL Supplement?
If your FEL award is lower than your earnings
before the injury and you are co-operating in a medical rehabilitation
program, an ESRTW program, or an LMR assessment or plan, then WSIB
may pay you a FEL supplement. A FEL supplement will be added to
your FEL award so that, together, you will receive 90% of your net
earnings before your injury.
What If You Disagree With the Amount of Your
FEL Award?
If you disagree with the amount of your FEL
award you can object to the decision, first at the WSIB level and
finally, you can appeal your case to the Workplace
Safety and Insurance Appeals Tribunal (WSIAT). WSIB or WSIAT
will decide your case based on your circumstances at the time of
the initial decision. WSIB and WSIAT will not consider things that
happened after that time.
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IMPORTANT INFORMATION
There are time limits for appealing WSIB decisions. If you
wish to appeal a decision, contact a qualified representative
as soon as possible. For more information on time limits,
see OWA Fact Sheets 24 and 25 called Appealing
to WSIB and Appealing
to WSIAT.
This Fact Sheet contains general information only. It is
not a legal document. To see what the law says, you should
look at the
Workplace Safety and Insurance Act and WSIB policies.
If you require help and do not have a union to assist you,
contact the Office of the Worker Adviser:
- Our toll free telephone
number is 1-800-435-8980 (English) or 1-800-661-6365 (French)
- or visit our website at http://www.owa.gov.on.ca
Cette feuille-info est
aussi disponible en français
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OWA Fact Sheet 21(a) - July
2007
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