Willful misconduct

If an employee's injury is caused by their own intentional and reckless behaviour, they will not receive any benefits from the insurance plan unless the injury is severe enough to result in the employee's death or serious impairment.

Compensation

If a worker has a loss of earnings because of an injury, they are entitled to receive payments from the date when the loss of earnings started. These payments will continue until:

• the worker's loss of earnings ends,

• the worker reaches 65 years of age (if they were less than 63 years of age on the date of the injury), or

• two years after the date of the injury (if the worker was 63 years of age or older on the date of the injury), or

• the worker is no longer impaired because of the injury.

The amount of the payments is 85% of the difference between the worker's net average earnings before the injury and the net average earnings that the worker earns or is able to earn in suitable and available employment or business after the injury. There are minimum payment amounts set for full and partial loss of earnings.

If the worker is cooperating with health care measures, and their early and safe return to work or all aspects of a labour market re-entry assessment or plan, the payments will be based on the difference between their net average earnings before the injury and any net average earnings the worker earns after the injury.

The Board will determine the worker's earnings after the injury to be the earnings that the worker is able to earn from the employment or business that is suitable for the worker and available.

The amount of the payment is adjusted each year for inflation and any disability payments paid to the worker under the Canada Pension Plan or the Quebec Pension Plan will also affect the payment amount.

If the worker fails to cooperate in health care measures, their early and safe return to work, or all aspects of a labour market re-entry assessment or plan provided to them, the Board may reduce or suspend payments to the worker.

Workers who are permanently impaired are entitled to compensation for their non-economic loss, which is calculated based on the percentage of their permanent impairment.

The amount of compensation is determined by multiplying this percentage by a set amount, which varies depending on the worker's age at the time of the injury. The maximum and minimum amounts that can be paid are also set out in the legislation.

Workers can choose to receive their compensation either as a lump sum or as monthly payments for the rest of their lives.

• The rules regarding payment depend on when the worker becomes entitled to compensation, with different rules applying before and after a specified date.

The worker is required to undergo a medical assessment, and the physician performing the assessment must be selected from a roster maintained by the Board. The physician's report is used to determine the percentage of the worker's permanent impairment.

In case of death

The Board must pay a lump sum equal to two years' earnings to the deceased worker's spouse if the worker was living with their spouse at the time of their death.

if the deceased worker was not living with their spouse at the time of their death, the spouse is not entitled to the lump sum payment. Instead, the spouse may be entitled to periodic payments, which will be calculated based on the worker's earnings.

if the worker was not living with their spouse at the time of their death, and the spouse is not entitled to payments, the spouse may be entitled to payments as if the worker had died. This means that the spouse would receive periodic payments based on the worker's earnings as if the worker had died.

the amount of periodic payments that are payable to the worker's children. If the worker had one or more dependent children, the Board must pay an amount equal to 10% of the worker's net average earnings to each child until they reach the age of 18. If the worker had two or more dependent children, the total amount payable must not exceed 35% of the worker's net average earnings.

If the Board determines that the spouse and children do not reside together, or that the children are not in the custody or care of the spouse, the Board may apportion the amount payable in a manner that it considers appropriate among the children, the spouse, and any other person who has the care, control, or custody of the children.

if the deceased worker was required to make support or maintenance payments under a separation agreement or judicial order to a person who had been their spouse, that person is entitled to benefits under this section as a spouse. The Board may also pay benefits to a person who had been a spouse of the deceased worker as if they were a spouse if that person was dependent on the worker at the time of their death.

If there is more than one person entitled to payments under this section as a spouse of the deceased worker.

The total lump sum payments to the spouses must not exceed $121,009.87, and the total periodic payments to the spouses must not exceed 85% of the worker's net average earnings.

The Board must apportion the payments among the spouses based on the relative degree of financial and emotional dependence of each spouse on the deceased worker at the time of death, the period of separation of each spouse from the deceased worker, and the size of the relative entitlements of those entitled without reference.

Upon request, the Board must provide a spouse with a labour market re-entry assessment and any necessary modifications with respect to the labour market re-entry plan. If the spouse fails to comply with regulations.

Ontario Workplace Safety and Insurance Act s. 17, 22, 43-48