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Disability Criteria
The Statutory Accident Benefits Schedule sets out criteria
to use when assessing the applicant's disability. The chart below
is a general guide to help you determine if the applicant's
disability continues.
FOR ACCIDENTS THAT OCCUR ON OR AFTER NOVEMBER 1, 1996
Benefit / Claimant Category
Disability Test during first 104 weeks of disability
Disability Test after 104 weeks of disability
Income Replacement Benefits
Employed, working at the time of the accident.
Unemployed, but worked 26 weeks during the 52 weeks before the
accident.
Future employment, had accepted a job offer to start work within
one year of the accident.
As a result of the accident, it the applicant substantially
unable to perform the essential tasks of the employment they were
engaged in at the time of the accident?
As a result of the accident, is the applicant substantially
unable to perform the essential tasks of the employment in which
they spent the most time during the 52 weeks before the accident?
As a result of the accident, is the applicant substantially
unable to perform the essential tasks of the employment they
would have begun?
As a result of the accident, the insured person is suffering a
complete inability to engage in any employment for which he or
she is reasonably suited by education, training or experience.
As a result of the accident, the insured person is suffering a
complete inability to engage in any employment for which he or
she is reasonably suited by education, training or experience.
As a result of the accident, is the applicant suffering a
complete inability to carry on normal life?
Caregiver Benefit
As a result of the accident, is the applicant substantially
unable to carry out the caregiving activities they performed at
the time of the accident?
As a result of the accident, is the applicant suffering a
complete inability to carry on normal life?
Non-Earner Benefit
As a result of the accident, is the applicant suffering a
complete inability to carry on normal life?
As a result of the accident, is the applicant suffering a
complete inability to carry on normal life?
FOR ACCIDENTS THAT OCCUR ON OR AFTER JANUARY 1, 1994 AND BEFORE
NOVEMBER 1, 1996
Benefit / Claimant Category
Disability Test
Income Replacement Benefits
Employed: working at the time of the accident, or on pregnancy or
parental leave, lockout, strike or layoff from employment.
Future employment: had accepted a job offer to start work within
one year of the accident.
Unemployed, but worked during the three years before the accident.
Is the applicant substantially unable to perform the essential
tasks of his or her employment at the time of the accident?
Is the applicant substantially unable to perform the essential
tasks of the employment he or she would have begun?
Is the applicant substantially unable to perform the essential
tasks of the employment in which he or she spent the most time
during the three years before the accident?
Education Benefits: was enrolled in elementary, secondary or post-secondary
school or had completed school less than one year before the
accident, but was not employed at the time of the accident in a
job that reflected his or her education or training.
Is the applicant substantially unable to continue the education
program he or she was enrolled in at the time of the accident? or
Is the applicant substantially unable to engage in employment
that reflects his or her education or training? or
Is the applicant substantially unable to carry out his or her
normal daily activities? (See description below.)
Caregiver Benefits
Is the applicant substantially unable to carry out the caregiving
activities that he or she performed at the time of the accident?
or
Is the applicant substantially unable to carry out his or her
normal daily activities? (See description below.)
Disability Benefits
Is the applicant substantially unable to carry out his or her
normal daily activities? (See description below.)
Normal Daily Activities
A person is partially unable to perform his or her normal daily
activities if he or she is substantially unable to do one or more
of the following activities. A person is totally unable to
perform his or her normal daily activities if he or she is
substantially unable to do all of the following activities:
· personal care activities that the person ordinarily did before
the accident
· mobility activities that the person ordinarily did before the
accident
· household activities that the person ordinarily did before the
accident
· activities that the person ordinarily did before the accident
that require exercise of cognitive powers
· activities that the person ordinarily did before the accident
that require the ability to control emotions or behaviour
· activities that the person ordinarily did before the accident
that require communication abilities
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