Disability/Personal Injury

WSIB vs. LTD: Understanding the differences

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When it comes to benefits that provide coverage during times of injury or illness, two terms that often come up are WSIB (Workplace Safety and Insurance Board) and LTD (Long-Term Disability).

While both offer financial protection, they cater to different scenarios, have distinct purposes, and provide varying levels of coverage.

What is WSIB?

WSIB stands for the Workplace Safety and Insurance Board. It’s a provincial agency in Ontario dedicated to promoting workplace health and safety. If you’ve suffered an injury or illness because of your job, WSIB steps in.

Think of it as workers’ compensation; it covers lost wages and medical expenses related to work-related incidents.

The primary goal here is to help workers recover and reintegrate into the workplace.

What about Long-Term Disability (LTD)?

LTD, on the other hand, is a type of insurance that kicks in if you’re unable to work for an extended period due to illness or injury, typically occurring outside the workplace.

Long-term disability benefits in Ontario provide a percentage of your income during this period, allowing you to maintain your standard of living even when you’re out of work.

While the specifics vary, it typically begins after short-term disability or sick leave ends.

What’s the Main Difference?

The fundamental distinction between WSIB and LTD lies in the cause and nature of the disability:

  • WSIB is specific to work-related illnesses or injuries.
  • LTD covers prolonged illnesses or injuries that typically occur outside the workplace.

Also, remember that while WSIB is specific to Ontario workers and is more of a statutory benefit, LTD can be a part of your employment package through a group plan or something you purchase individually.

WATCH: Disability lawyer James Fireman highlights five things you should know about LTD claims on an episode of the Disability Law Show.

Can You Receive Both Long-Term Disability and WSIB Benefits?

Navigating the waters between Long-Term Disability (LTD) and WSIB can be complex.

Most standard group LTD policies have clauses that offset benefits if you’re receiving disability compensation from another source, like WSIB. This typically means you can’t collect full benefits from both an LTD policy and WSIB simultaneously.

These ‘offsetting clauses’, common in many group policies, adjust the LTD benefits based on what you receive from other disability programs.

Furthermore, many LTD policies mandate injured workers to not only apply for WSIB benefits but also to contest denials.

Confusion often surfaces when it’s ambiguous whether a subsequent medical condition arises from a prior workplace injury or is an independent issue.

If you’re in this intricate situation, a FREE consultation with an experienced long-term disability lawyer at Samfiru Tumarkin LLP can be invaluable, ensuring proper claim submission, identifying the right disability programs, and assisting with any LTD claim denials in Ontario.

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How long do the benefits last?

  • WSIB: Benefits continue as long as the worker remains unable to return to work due to the job-related injury or illness. The duration can be short-term or extend to longer periods, depending on the severity and circumstances. While WSIB income loss payments stop at age 65, medical coverage can continue for life.
  • LTD: Provides benefits for extended periods, often until the individual can return to work, reaches the age of 65, or for the term specified in the policy.

Are there any exclusions?

WSIB typically covers only those injuries or illnesses directly linked to your job. It’s vital to note that not all workers or sectors are protected under WSIB, so always review your employment details.

On the other hand, LTD policies often come with waiting or “elimination” periods before you can start receiving benefits. Additionally, be cautious as some LTD plans might exclude pre-existing conditions.

How are the benefits calculated?

  • WSIB: Compensation is based on a percentage of the worker’s average earnings before the injury or illness. WSIB pays 85% of your wages, with a maximum annual earnings limit of $110,000.
  • LTD: Benefits typically range from 60% to 85% of the insured’s gross monthly income, as specified in the policy.

How Samfiru Tumarkin LLP can help

If you have questions specifically about your LTD claim, or your request for benefits is denied, contact the experienced team at Samfiru Tumarkin LLP immediately at 1-855-821-5900 for a FREE CONSULTATION.

Our firm has helped many people, like Sandra BullockJulie Austin, and Florence Steele, resolve their insurance and LTD disability disputes. We will review the facts of your situation, tell you if you have a case, and advocate on your behalf.

Get the advice you need, the compensation you deserve.

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