I have been involved in a car accident in Ontario. Am I entitled to income replacement benefits?

Being involved in a car accident can be a stressful and painful experience. Uncertainty about the future, and what this means for a victim and their family can be very distressing. A common concern is what will happen when someone is injured so seriously that they cannot work, or are unable to work in the same manner they were working, prior to an accident.

The governing regulation that applies is the Statutory Accident Benefits Schedule. It stipulates what benefits can be received by victims whose injuries have significantly impaired their ability to work. These are commonly referred to as Income Replacement Benefits (IRB), and they assist a victim in receiving lost wages. To be entitled to IRBs, there are a few qualifiers that must be met.

First, a victim’s injuries have to be so serious in nature that work capabilities are substantially affected, and those injuries have to be established as a consequence of the accident. It is imperative to note that both physical and emotional injuries are considered. In addition, potential applicants for IRB must have been working at the time of the accident, or have worked 26 weeks in the year prior to the accident.

After an application is approved, a victim may receive benefits after the first seven days after an accident. The payments cover only a portion of weekly income. There is typically a $400 maximum dispensed per week under a standard policy, and this maximum may be received for up to 104 weeks after the approval of application. Added coverage will provide up to $1,000/week. The available cap is often limited. Any shortfall in income received is recoverable through the tort law suit against the at-fault motorist and their insurer.

In order to have a more comprehensive understanding of Income Replacement Benefits and guidance as to what happens when these benefits run out or are insufficient, feel free to contact our lawyers at Grillo Law P.C. in Toronto, who can help you navigate this complicated process. We will advocate for you to receive what is fair, and just.

Why are income replacement benefits important?

After getting involved in a car accident, one of the biggest challenges is the lack of cash flow if you’re unable to work anymore. Car accidents can cause victims who sustain serious injuries to end up in debt. As there’s no cash flow from the regular income, the family’s financial life is negatively affected. Income replacement benefits can help supplement your finances when injured in a car accident.

These benefits, known as IRBs in short, are designed to help car accident victims who cannot support themselves and their families following the incident in Ontario. They are intended to compensate for the lost income from either employment or self-employment. However, the accident victim must meet all the requirements to qualify for these benefits.

How long can you get the income replacement benefits in Ontario?

Typically, the income replacement benefits are paid up to the age of 65. After this age, you are likely to get lower benefits depending on your estimated life expectancy.

What if you had an undeclared income?

Any income that wasn’t declared on your tax returns may not be included in your income replacement benefit calculation. It will not be considered a pre-accident income.

Are there any deductions in your income replacement benefits?

There could be. If you have any collateral benefits that you may be receiving due to your present or any previous injuries you’ve sustained, they may be deducted from your income replacement benefits. Ideally, the insurer doesn’t want to pay twice. That is why the insured is obligated to tell their insurer of any collateral benefits they receive when submitting their application for income replacement benefits. If you fail to disclose this information and the insurer finds out, you may be required to pay the excess amount. For instance, if you are receiving short-term or long-term disability benefits or some benefits paid under EI or WSIB, these may be deducted from your income replacement benefits.

How to apply for income replacement benefits

When applying for income replacement benefits, the first step is to select between non-earner or income replacement benefits. You will be required to submit a disability certificate, which must be filled by the claimant and the health practitioner and submitted to the insurance company. You may need the help of our lawyer with this to guarantee consistency and accuracy. The list of specialists required to help fill this document is broad, and you need professional advice to enhance your chances of success. Your insurer will get back to you with a response within ten days after receiving your submitted disability certificate.