Benefits – Concurrent Claims
Effective date: February 3, 2012
Application: Customers with two or more concurrent claims, one of which is subject to Section 70(5) or Section 69(2) of the Act, on and after the effective date.
Policy subject: Benefits - General
To establish guidelines on how to provide compensation to workers that experience concurrent earnings loss claims.
Earnings means the worker’s earnings from all sources of employment, prior to any deductions.
Average weekly earnings, as determined by Section 70(1) of The Workers’ Compensation Act, 2013 (the “Act”), means the greater of:
- One fifty-second of the worker’s earnings for the 12 months preceding the commencement of the worker’s loss of earnings resulting from the injury; and
- The rate of daily, weekly, monthly or other regular gross earnings that the worker was receiving at the commencement of the worker’s loss of earnings resulting from the injury converted, in the case of a daily, monthly or other rate that is not a weekly rate, to a weekly amount.
Adjusted earnings, for the purposes of this policy, means earnings used in the calculation of benefits, subsequent to increases called for by Section 70(5) or 69(2) of the Act.
Net earnings means earnings minus probable deductions called for by Section 2(1)(k) of the Act (i.e., income tax, Canada Pension Plan premiums, and employment insurance premiums).
- The intent of creating policy directed towards concurrent earnings loss claims is to avoid instances of overcompensation where workers have two or more concurrent claims, one of which is subject to Section 70(5) or Section 69(2) of the Act.
- Section 68(1) of the Act directs that where injury to a worker results in a loss of earnings beyond the day of the injury, the WCB shall determine the loss of earnings resulting from the injury and shall ensure compensation to the worker.
- Section 69(2) of the Act requires that the percentage increase in the Consumer Price Index must be the percentage increase for the 12 months ending on November 30 in each year, and that percentage increase must be applied to the average weekly earnings of the worker on the anniversary date of the commencement of the worker’s loss of earnings resulting from the injury in the year following the year in which the calculation is made.
- Section 69(3) states that any adjustment will be subject to the maximum wage rate for that year.
- Section 70(5)(b) of the Act states if a worker is injured on or after January 1, 1980 and is in receipt of compensation for a period of at least 24 consecutive months, the worker’s average weekly earnings on and from January 1, 1983, are deemed to be not less than two-thirds of the average weekly wage as of June in the year preceding the year in which the review respecting their compensation occurs.
- The sum of earnings loss benefits from all concurrent earnings loss claims are not to exceed the equivalent of full earnings loss benefits on the initial claim.
- Where the worker has two or more concurrent earnings loss claims and has been in receipt of earnings loss benefits for 24 consecutive months on the most current claim, the earnings on that claim may be adjusted in accordance with Section 70(5) of the Act.
- Where the adjusted earnings on the most current claim increases above the earnings deduction on the initial claim, either due to the application of Section 70(5) or Section 69(2) of the Act, earnings loss benefits on the initial claim will be based on the difference between 90 per cent of the net adjusted earnings on the initial claim and 90 per cent of the net adjusted earnings on the most current claim.
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