Document name

Benefits – Long-Term Earnings Loss

Document number

PRO 01/2018

POL 01/2018, Determining Long-Term Earnings Loss Benefits establishes guidelines around determining a worker’s long-term earnings loss benefits.

Establishing Earnings Capacity

1. How do Operations staff establish a worker’s earnings capacity?
   1. A Vocational Rehabilitation Specialist (VRS) will establish the worker’s earning capacity by completing an employability assessment and transferable skills analysis to determine if a worker is employable, as per POL 23/2016, Vocational Rehabilitation – Programs and Services.
   2. If the worker cannot return to their pre-injury job, the VRS will determine the worker’s earning capacity by researching suitable productive employment opportunities and will consider:
      1. Current and future employment availability.
      2. Physical demands.
      3. Skills and abilities (qualifications).
      4. Starting wages, and
      5. Staged wage increases.
2. What information is used to establish the earnings capacity?
   1. VRS staff will use information from at least three sources to determine a worker’s earning capacity. At their discretion, VRS staff will use any available sources suitable to the worker’s individual circumstances, which may include:
      1. Local employment information (e.g., Saskjobs.ca).
      2. Saskatchewan Polytechnic Graduate Employment Report.
      3. Federal or provincial wage data (e.g., Employment and Social Development (ESDC) Job Bank, Union contracts).
      4. Local employers of the identified occupation.
      5. Any other reputable job research source.
3. How are benefits calculated once an earnings capacity is established?
   1. VRS staff will discuss a number of suitable productive employment opportunities with the worker. If the worker:
      1. Finds employment that reasonably represents their earning potential, the VRS will recommend that long-term earnings loss benefits should be based on the worker’s actual earnings.
      2. Does not find employment or actual earnings from employment the worker obtains is below their earning capacity, the VRS will recommend long-term earnings loss benefits be based on their earning capacity from suitable productive employment.
   2. Based on the earnings capacity established by the VRS, the Case Manager (CM) will determine and authorize long-term earnings loss benefits based on the difference between:
      1. The worker’s average weekly earnings prior to the commencement of earnings adjusted to date by increases to the Consumer Price Index, and
      2. The greater of the worker’s actual earnings or earnings capacity from suitable productive employment.
   3. Team Leader approval is required to authorize the long-term earnings loss benefit the worker will receive.
4. Is an earnings capacity always needed to determine long-term earnings loss benefits?
   1. A CM will not need a VRS to establish a worker’s earnings capacity if:
      1. The worker has medical restrictions because of the injury that prevents them from returning to any form of employment. In this case, the CM will determine the worker does not have an earning capacity.
      2. The worker returns to work with a minimal loss of earnings. The CM may determine that the worker is at an optimal earning capacity and will issue long-term earnings loss benefits based on the worker’s actual earnings.

Adjusting Earnings Capacity

Staged Wage Increases

5. What benefit will a worker receive if they are able to acquire employment that receives staged wage increases (i.e., periodic wage increments)?
   1. The CM will authorize the gradual reduction of long-term earnings loss benefits to reflect staged wage increases.
   2. The timing of staged wage increases and rationale for the adjustments will be documented on the claim when the worker is placed on long-term earnings loss benefits. Operations staff will explain the rationale for the staging to the worker.

Consumer Price Index

6. Are benefits adjusted to reflect percentage increases to the Consumer Price Index (CPI)?
   1. If a worker’s earning capacity is not adjusted based on the provisions outlined above, it will be adjusted annually to reflect changes to the CPI (POL 07/2013, Consumer Price Index (CPI) – Annual Indexing), and
   2. The adjustments will be effective on the anniversary of the worker’s commencement of earnings loss date.
7. If the worker is subject to the maximum wage rate, is a worker’s earnings capacity adjusted annually by the CPI?
   1. Yes; but adjustments will not exceed the annual increase to the maximum wage rate. This applies to all workers to the maximum wage rate (i.e., pre-2014 and post-2014 maximum wage rates as per POL 07/2020, Maximum Wage Rates).
   2. Operations staff will recalculate earnings loss benefits, during annual review of the worker’s file, for those years that the percentage increase to the CPI exceeded increases to the maximum wage rate (e.g., increases to the CPI exceeded increases to the maximum wage rate for workers receiving the pre-2014 maximum wage rate in 2016 and 2018).

Commissioned Sales or Self-Employment

8. What if self-employment is chosen as suitable productive employment?
   1. To ensure a successful transition into commissioned sales or self-employment, the VRS, CM and Team Leader will determine if the worker will be provided a stabilized level of support with a structured schedule of staged earnings loss benefits.
   2. The earnings capacity for these workers will be staged, as outlined in the Appendix, Earnings Capacity – Commissioned Sales or Self-Employed.
   3. The estimated earning capacity will commence the first day of employment.

Minimum Wage

9. Are benefits adjusted if the worker’s earnings capacity is at the minimum wage level?
   1. The CM will authorize earnings loss benefits be adjusted following increases to the provincial minimum wage, as per POL 26/1990, Provincial Minimum Wage, Effect of Increase.

Annual Earnings Verification

10. Are benefits adjusted based on a worker’s actual earnings?
    1. The CM will annually verify a worker’s earnings to ensure long-term earnings loss benefits reflect the worker’s earnings capacity.
    2. Long-term earnings loss benefits will be adjusted if the information used to calculate the benefit was incorrect (POL 07/2016, Earnings Verification).
11. Are benefits adjusted if the worker is capable of earning more than their earnings capacity?
    1. The CM will request the VRS review and update the worker’s earning capacity if the worker demonstrates they are capable of, and are working in, suitable productive employment that earns more than the earnings capacity initially established through vocational rehabilitation.
    2. This includes, but is not limited to, non-employment income or other earnings potential, such as:
       1. Earnings from an excluded industry where coverage has not been purchased (i.e., self-employment), or
       2. They receive other business income (i.e., director’s earnings, etc.).
    3. The CM will adjust the worker’s long term-earnings loss benefits to reflect changes to their earnings capacity.

Travelling for Work

12. Is a worker expected to travel for suitable productive employment?
    1. A worker will be expected to travel to work if suitable productive employment is within 75 km from their home.
    2. If a worker travelled more than 75 km to work before the injury, they may be expected to travel that amount for the new job.
13. What information does Operations staff consider to determine if a worker is expected to travel for employment?
    1. The VRS will consider:
       1. The worker’s physical ability to drive to work.
       2. Starting wages for suitable productive employment within an acceptable travel radius, and
       3. Wage potential for suitable productive employment within an acceptable travel radius.
    2. The VRS may still expect a worker to travel to and from work even if the worker does not drive for reasons other than a physical inability (e.g., loss of licence post injury, no licence).

Moving for Work

14. What if the worker cannot find suitable productive employment near their home?
    1. The VRS may approve a move to a more suitable place (POL 02/2014, Vocational Rehabilitation – Moving Allowance).
    2. The VRS may also approve an additional move if the worker wants to move after two years, if they find employment that will reduce their long-term earnings loss benefits.
15. What benefit will the worker receive if they do not want to move?
    1. The VRS will determine the worker’s earning capacity based on suitable productive employment near the worker’s home.
    2. The VRS will inform the worker that their earning capacity may change in two years.
       1. For the first two years:
          1. The CM will reduce the worker’s earnings loss benefits based on suitable productive employment opportunities within 75 km of the worker’s home.
       2. After two years:
          1. If the worker still does not want to move, the VRS may determine the worker’s earning capacity based on suitable productive employment in another city or town.
          2. The worker’s earnings loss benefits will be reduced based on suitable productive employment opportunities in larger cities or towns.
          3. The VRS will consider the worker’s individual circumstances and if a move is practical before determining if benefits will be reduced. This includes considering the merits and justice of each case.

Suspension of Benefits

16. Are benefits suspended if the worker does not participate in vocational planning?
    1. If the VRS is not able to estimate the worker’s earning capacity, the CM and TL may authorize the suspension of earnings loss benefits (POL 15/2016, Suspension of Benefits).

Notification

17. How is a worker notified of what benefit they will receive?
    1. The CM will send the worker a letter once they are placed on long-term earnings loss benefits outlining:
       1. The amount of long-term earnings loss benefits they will receive, and
       2. How the amount was determined.