Ontario has mandatory no-fault insurance coverage for individuals injured through the use or operation of a motor vehicle. This coverage includes the right to an income replacement benefit (“IRB”). A common misconception is that an income replacement benefit covers 100% of your wages. This blog will explain what rights you, as an injured Plaintiff, have in receiving an income replacement benefit with your accident benefits insurer.

How long were you employed for prior to the accident?

First, you must establish one of the following:

  1. You were employed on the date of the accident; or
  2. You were not employed on the date of the accident but you worked 26 of the 52 weeks before the accident. You must prove that you were employed by getting your employment file from your employer and have your employer fill out an OCF 2 (Employment Confirmation Form).

Do you meet the legal tests?

An income replacement benefit is not payable for the first week of missed work. After the first week, you must suffer a substantial inability to perform the essential tasks of your employment. The test changes after 2 years. After 104 weeks (2 years), the question is whether you suffer a complete inability to engage in any employment, for which you are reasonably suited by education, training, or experience.

What forms do I need?

You’ll need to submit an OCF 1 (application for accident benefits), an OCF 2 (Employment Confirmation Form), and an OCF 3 (disability certificate from your doctor or therapist). In addition, you’ll have to submit all relevant medical documentation to substantiate your claim.

How much will I receive?

If you’ve met the tests in part 1 and 2 and submitted the forms in part 3, you may now be entitled to an income replacement benefit. The maximum benefit under a standard automobile insurance policy is $400 per week. If you’ve purchased the upgraded benefits package you may receive more than $400 per week.

Contact a lawyer

Entitlement and quantum of an income replacement benefit can be very confusing, especially for individuals who are self-employed. Contact one of our experienced lawyers to help guide you through the process and ensure that you receive the benefits that you are entitled to.