You get injured at work. Fortunately, you have different types of insurance. But which insurance applies can cause a lot of anguish and confusion for injured claimants, especially when insurers begin pointing fingers at each other when it comes time to pay. In Ontario, many employees have access to both Workplace Safety and Insurance Board (WSIB) benefits and long-term disability (LTD) coverage, but it’s important to understand the difference between when you should be applying for WSIB benefits as opposed to disability insurance benefits and vice versa. Understanding which one to claim and when, can directly impact your financial recovery.
The confusion often starts when insurers shift responsibility or when an injury doesn’t fit neatly into one category. Filing the wrong claim or delaying action can cost you time, money, and peace of mind.
This guide breaks down the key differences between WSIB and LTD, when each applies, whether you can claim both, and how to protect your rights from the outset.
TL;DR:
If you’re injured or unable to work in Ontario, the type of claim you file depends on where and how the injury occurred. WSIB benefits apply to workplace injuries and provide wage loss (typically 85% of net income) and medical coverage. Long-term disability (LTD) benefits apply to non-work-related conditions and typically replace about 66-70% of your salary through private insurance. In some cases, you may qualify for both, but offsets often reduce total payments. Choosing the wrong claim or missing deadlines can jeopardize your entitlement, so legal guidance is critical.
What is the difference between WSIB and long-term disability (LTD)?
WSIB (Workplace Safety and Insurance Board)
The Workplace Safety and Insurance Board (WSIB) provides benefits to employees who are injured at work.
Some employers may be required to have WSIB coverage if they meet the regulatory requirements under the Workplace Safety and Insurance Act (“WSIA”). If an employer is deemed to be a Schedule 1 employer under the WSIA, WSIB coverage is mandatory for employees on the job.
WSIB coverage provides employees who have been injured on the job with:
- Loss of earnings
- Health-care benefits
- Return to work support
Example:
If you slip and fall at work, breaking your ankle during your shift and on work grounds, you will typically proceed to apply for WSIB coverage.
Long Term Disability (LTD)
Long term disability (“LTD”) coverage is provided by an insurance company through a private or group policy generally available through employment.
LTD coverage:
- Covers non work related injuries or illnesses
- Provides income replacement should you become disabled from working
- Policies vary, but most cover approximately 60% of pre-disability income
Example:
You would apply for disability coverage if you injure yourself outside of work and were unable to work, such as breaking your arm by slipping and falling outside your house.
Can you receive both WSIB and LTD benefits?
Yes, there are instances where it is possible to collect both WSIB and LTD benefits.
This occurs most commonly when a workplace injury:
- Becomes chronic in nature
- Causes additional medical complications
Example:
You slip and fall at work, fracturing your arm
- You could make a WSIB claim in relation to the arm injury, requesting lost wages and treatment in relation to your arm.
- You later struggle mentally after the arm injury and experience depression and anxiety; you could make an LTD claim in relation to your mental health if that is also preventing you from working.
Important:
- There are offsets that apply if you’re seeking to claim wage replacement from both WSIB and LTD
- Speak with a disability lawyer who could analyze your LTD policy and advise whether an offset applies.
How much do WSIB and LTD pay?
WSIB claims:
- Loss of Earnings are paid based on 85% of your take-home pay.
- Based on income at the time of the injury.
LTD benefits:
- Benefit amounts for LTD policies can vary
- Typically covers 66.67% of your pre-disability salary
WSIB vs LTD – How to decide which claim to file?
Ask yourself:
- Did the injury happen at work?
- Yes – WSIB
- No – LTD
- Did the injury happen at work?
- You may qualify for both
- Do you have disability insurance coverage?
- Check your group benefits plan
- Are you within deadlines?
- WSIB and LTD both have strict filing timelines
Why filing the wrong claim can cost you?
Choosing the wrong path can lead to:
- Denied claims
- Delayed payments
- Loss of benefits entitlement
- Insurers shifting responsibility to avoid paying
This is where many claimants lose leverage, not because they don’t qualify, but because the process was mishandled early.
When to speak to a disability lawyer?
You should seek legal advice if:
- You’re unsure whether your injury is work-related
- Your claim has been denied
- Insurers are disputing responsibility
- You may qualify for both WSIB and LTD
- You want to maximize your total compensation
Early advice helps you stay in control of your claim, not at the mercy of insurers.
Frequently asked questions:
Do I have to choose between WSIB and LTD?
Not always. While many claims fall into one category, some situations allow you to pursue both subject to offsets.
What happens if I apply to the wrong program?
Your claim may be delayed or denied, and you could miss important deadlines. This can impact your entitlement to benefits.
Can WSIB deny my claim and force me onto LTD?
Yes. If WSIB determines your injury is not work-related, you may need to pursue LTD instead.
Do LTD insurers always reduce payments if I receive WSIB?
Most policies include offset clauses, meaning your LTD payments are reduced by amounts received from WSIB.
How long do I have to apply?
Deadlines vary, but both WSIB and LTD claims are time sensitive. Delays can jeopardize your claim.
Contact our disability lawyer
If you need guidance on where to file your disability application, you need to speak to an experienced disability lawyer. The disability lawyers at Whitten & Lublin can help point you in the right direction if you’re struggling to determine where to appropriately file your claim.
Whitten & Lublin offers free consultations for short- and long-term disability claims.
Contact us online or call 416 640 2667.
