Qualifying for Income Replacement Benefits If You Cannot Work After a Crash

accident victim disabled and cannot workIf you have been involved in a crash and cannot work due to your injuries, you may be eligible for income replacement benefits. Your eligibility will depend on the extent of your injuries and the calculation of your income loss. These benefits are offered as part of Ontario’s Statutory Accident Benefits Schedule (SABs), which every auto insurance policy in the province must provide.

Income replacement benefits help give some financial relief to accident victims – up to age 65 – whose injuries prevent them from being able to work at all or in the same capacity as before. The disability may arise as a result of physical, mental or psychological impairment from the accident.

Below, our legal team discusses these benefits in great detail. To see if you qualify to receive payments to help cover your lost income, contact our office to set up a free consultation. There is no obligation after meeting with us to hire our firm. We charge nothing up front to investigate or handle a case.

Eligibility for Income Replacement Benefits

Certain criteria must be met in order to be able to receive income replacement benefits. Your injuries must be severe enough that you are unable to work or unable to work in the same way you did prior to being injured.

You must also meet one or more of the following conditions:

  • Be employed or self-employed when the crash happened
  • Have worked for 26 weeks or more out of the 52 weeks before the crash
  • Be receiving employment insurance when the accident occurred
  • Unemployed but at least age 16 and be excused from attending school when the crash happened

How Much Can You Receive to Cover Your Lost Income?

You could receive up to 70 percent of your gross weekly income, or up to a maximum of $400 per week, whichever is less. The exact figure will be based on your employment history before the crash. Income replacement benefits are also not payable for the first seven days immediately after the accident.

If you were employed when the accident happened, your benefits will generally be calculated based on:

  • Your gross income in the 52 weeks before the crash; or
  • Your gross income in the four weeks before the crash, multiplied by 13

Additionally, your benefit amount will be reduced if you are receiving any other source of income replacement. This could include income assistance from an employer or another insurance policy.

Is There Any Way to Increase the Limit?

Yes, as long as it is done prior to an accident. If you are currently making over $400 per week ($20,800 a year), you could ask your insurer to purchase additional coverage to increase your income replacement benefits. You may be able to increase the limit to $600, $800 or $1,000 per week (instead of the $400).

How Long Do These Benefits Last?

Income replacement benefits are payable for up to 104 weeks (or 2 years) following the accident. You must have suffered a substantial inability to perform the essential tasks of your employment. After 104 weeks, the criteria to qualify for these benefits will change and become more difficult.

You will need to show that due to the crash, you have suffered a complete inability to engage in any employment for which you are reasonably suited by education, training or experience. Your insurer may require a medical assessment to determine that you still meet the disability requirements.

Information Needed to Apply for Income Replacement Benefits

Your insurer must be informed about your injuries within seven days from the date of the accident. You must complete your initial Application for Accident Benefits (OCF-1) within 30 days of the crash to be able to receive income replacement benefits. Additionally, the following forms must be submitted:

  • Unless you are self-employed, your employer will need to fill out and submit an Employer’s Confirmation Form (OCF-2). This document requires information regarding your salary, weekly income, tips, and any other compensation.
  • Whether employed or self-employed, you will also need to complete a Disability Certificate (OCF-3) detailing that you cannot work as a result of the accident.

Greg Monforton & Partners is Here to Help

An experienced Windsor car accident lawyer from our firm is ready to help you understand all of your options and advocate on your behalf if the insurance company refuses to pay your income replacement benefits. Our firm has recovered millions of dollars in compensation on behalf of our clients.

An initial consultation is complimentary without any obligations. There is no up front cost to utilize our services and no fees while we investigate and work on a case. We are available 24/7 to take your call.

Talk to a lawyer today. Ph: (866) 320-4770