What Happens If You Are Unable To Return To Work Following A Serious Motor Vehicle Accident?

If you have been injured because of an automobile accident in Ontario, and as a result, have to take time off work because of injuries and/ or disability; there are options for you.

Accident Benefits (Income Replacement)

The first recourse for those who can no longer work as a result of injuries sustained in an automobile accident is through their insurance policy via the Income Replacement Benefit. If you were employed prior to the accident, you may be eligible to receive a payment every 2 weeks to partially replace your lost income. The duration of these payments last up to 104 weeks after your disability.

The income replacement benefit is paid bi- weekly and subject to a maximum of $400 a week. The benefits are generally calculated based on your gross income in the year prior to the accident or your gross monthly income, and can cover up to 70% of your pre- injury income. You may be eligible for a higher maximum if you purchased the optional benefits on your policy. Short-falls in lost income is recoverable from the insurer of the motorist who caused the accident.

You must notify your insurance company of the accident within 7 days of the accident, and the income benefit applications must be filed within 30 days of the accident. To ensure that you do not miss a deadline or misfile a form, it is strongly advised to seek the expertise of a legal professional to assist you.

For a more comprehensive look at some of the available benefits under the SABS, see our previous article here or accident benefits overview.

CPP Disability

The Canada Pension Plan (CPP) also provides disability benefits, provided you have made enough contributions to the pension. To qualify for the CPP disability benefit, you must meet the following conditions:

1. Have a “severe and prolonged” disability.

The CPP will review your application to determine if it meets the threshold of “severe and prolonged”. While there are no hard and fast rules, a “severe and prolonged” disability generally means a mental or physical disability that is long term, and regularly prevents (you) from doing work.

2. Be under 65 years of age.

3. Meet the CPP contribution requirements.

To meet the contribution requirements, you must have contributed to the CPP in 4 of the last 6 years, or 3 of the last 6 years if your contribution is at least 25 years.

Filing for CPP benefits involves an application and decision process that can take up to 4 months to complete. According the CPP Canada, the average benefit is about $930 a month, subject to a maximum of $1290 a month.

All approved applicants will receive at least the minimum amount of $471. Additionally, if you can no longer work, your dependent children may be eligible for a children’s benefit.

Employment Insurance (EI)

You may also be eligible for benefits under your employer’s Employment Insurance program, depending on your contributions. Because you are unable to work as a result of your injuries, you would not apply under the “regular” stream of employment insurance (which mandates that you are able to work), but rather possibly under the “EI sickness benefit”.

This benefit program offers temporary assistance to workers unable to work because of sickness, injury, or quarantine. To be eligible, you must:

1. Be employed in insurable employment.
2. Meet the specific criteria for EI sickness benefits.
3. Have your normal weekly earnings reduced by greater than 40%.
4. Have accumulated 600 hours or more of insurable employment during the qualifying period.

If approved, you could receive up to 55% of your average insurable earnings subject to a maximum annual amount of $51300, or $543 a week. The duration of these benefits last up to 15 weeks.

For more information on these benefits, your potential eligibility, and how to apply, contact Grillo Law today.