What is WSIB Health Care Benefits Estimator?
Calculate Your WSIB Health Care Benefit Support Amount
If you've been injured or become ill because of your job or work or occupational disease, you may be eligible for health care benefits through Ontario's Workplace Safety and Insurance Board (WSIB). Our WSIB Health Care Benefits Estimator helps you understand the types of medical benefits you may qualify for based on your injury, treatment needs, and recovery plan.
The WSIB Health Care Benefits Calculator provides an instant estimate of the support amount using the details you enter. It is free to use, needs no sign-up, and is built to help you better calculate the amount and understand the health care assistance that may be available during your recovery.
You can check the final WSIB Healthcare benefits amount just by answering a few simple questions about your injury, diagnosis, and medical treatment. You can receive an estimate of the health care support that may apply in your case. While the tool does not calculate exact amounts and does not guarantee approval, it just helps identify the types of approved services you may be eligible to receive.
Medical Treatment Coverage
- Coverage of Doctor visit & Appointment
- Surgery and Procedures
- Hospitalization & Intensive Care
- Physiotherapy & Rehabilitation
Prescription Drugs Coverage
- Claim-related Treatment
- Direct billing to WSIB at most pharmacy
- Reimbursement for out-of-pocket costs
Medical Devices & Equipment
- Assistive devices (walkers, crutches)
- Braces and supports
- Orthotics and prostheses
- Adjustable bed frames and mattresses
- Wound care supplies
Additional Benefits
- Reasonable travel and accommodation expenses
- Special clothing or footwear costs
- Transportation to health care appointments
Who is This WSIB Healthcare Benefits Calculator Useful for?
This Ontario healthcare benefits calculator is designed for workers who have experienced a work-related injury, illness, or occupational disease and want to understand their potential medical coverage. You may benefit from this tool if you are recovering from a workplace injury or receiving treatment for a work-related illness. It is valuable for those who are planning to begin a WSIB claim or to return to work after a long medical leave. Workers who are wondering whether a specific treatment may be covered and looking for an overview of available health care benefits.
How to Calculate Your WSIB Health Care Benefits
Use our WSIB Health Care Benefits Calculator to estimate the healthcare benefits and reimbursements you may be eligible for. This is the simplest way to calculate the benefits from WSIB. Follow these simple steps:
Step 1: Confirm Your WSIB Claim Status
Start by selecting whether you have an accepted WSIB claim. An approved claim is generally needed to be eligible for most healthcare benefits.
Step 2: Indicate Time Away From Work
Tell the calculator whether your workplace injury or illness caused you to miss work. This helps assess benefits that may be connected to your recovery.
Step 3: Select Your Medical Device Usage
Choose how many hours per week you use your approved medical device (such as 25+ hours per week) to determine the applicable clothing allowance rate.
Step 4: Choose Your Medical Devices
Select all approved and suggested medical devices you currently use, such as a back brace or back support, cervical brace, arm prosthesis, arm brace, wrist gauntlets, or any other. The calculator automatically applies the appropriate allowance based on your selections.
Step 5: Enter Prescription Drug Expenses
Confirm whether you have paid out of pocket for prescription medications related to your workplace injury. Eligible expenses may qualify for reimbursement under WSIB guidelines.
Step 6: Add Medical Equipment and Supply Costs
Specify whether you purchased medical equipment or recovery supplies yourself. Eligible expenses can be included in your estimated healthcare benefits.
Step 7: Include Travel for Medical Appointments
Select whether you travel to attend approved medical treatments or rehabilitation appointments. Travel expenses may be reimbursable depending on WSIB policies.
Step 8: View Your Estimated Benefits
After completing all sections, click Calculate to instantly receive an estimate of your potential WSIB Health Care Benefits, including eligible clothing allowances, healthcare reimbursements, and other covered expenses.
What Health Care Benefits May Be Covered by WSIB Benefits?
Depending on your approved claim and medical needs, WSIB may cover a range of health care services that support your recovery.
| Health Care Benefit |
Description |
| Medical Treatment Coverage |
May cover doctor visits, specialist consultations, hospital services, and medically necessary treatments related to an approved workplace injury or occupational illness. |
| Prescription Medicines |
Eligible prescription medications required for the treatment of a work-related injury or illness may be covered when included in an approved treatment plan. |
| Physiotherapy and Rehabilitation |
May include physiotherapy, occupational therapy, and rehabilitation programs that support recovery, improve mobility, and restore physical function. |
| Diagnostic Testing |
Diagnostic procedures such as X-rays, MRI scans, ultrasound examinations, and laboratory tests may be covered when medically required. |
| Medical Devices and Equipment |
Eligible medical aids, including braces, crutches, wheelchairs, orthotics, and prosthetic devices, may be provided based on recovery and treatment needs. |
| Mental Health Support |
Workers with work-related psychological injuries or mental health conditions may qualify for counselling and other approved mental health treatment services. |
Prescription Drug Benefits
WSIB may cover the cost of prescription medications that are required to treat an approved work-related injury or occupational illness. In some cases, certain non-prescription products may also be covered when they are considered medically necessary as part of the worker's treatment and recovery plan. Every medication or eligible product must be prescribed by an authorized healthcare professional before coverage can be considered.
How WSIB Prescription Medication Coverage Works
- Many participating pharmacies can submit prescription claims directly to WSIB. This allows eligible workers to receive approved medications without paying to farmacy.
- Prescription drugs claims are processed online via the WSIB pharmacy claims system.
- If direct billing is not available, eligible workers can apply for reimbursement with needed form together with their pharmacy receipts.
- Maintenance medications are generally dispensed for a limited supply per prescription, subject to WSIB policies.
- Workers travelling outside their home province may be eligible for an extended medication supply when approved under applicable guidelines.
Health Care Equipment and Supplies
Workers with an approved workplace injury or occupational illness may be eligible for health care equipment and medical supplies that support their treatment, recovery, mobility, or daily living. These products are intended to improve independence, assist with rehabilitation, and help workers safely manage everyday activities during their recovery.
Examples of Covered Equipment and Supplies
- Crutches and replacement tips
- Back support cushions and ergonomic backrests
- Wrist braces, supports, and splints
- Medical urinary care supplies
- Raised toilet seats and bedside commodes
- Bath safety stools, shower seats, and grab bars
- Walkers and related mobility accessories
Important: Always obtain WSIB approval before purchasing any health care equipment or medical supplies. Approval should include the recommended product, supplier, and estimated cost. Purchases made without prior authorization may not be eligible for reimbursement.
Using Approved Suppliers
Whenever possible, workers should obtain approved health care equipment and supplies from suppliers authorized by WSIB. Purchasing through approved suppliers can help avoid out-of-pocket expenses, as eligible costs are generally billed directly to WSIB according to program guidelines.
Information Required for Pharmacy Billing
When processing eligible prescription claims, participating pharmacies may require the following billing details:
- Online Pharmacy claims provider details
- Applicable insurer or carrier identification number
- Required group identification information
- The worker WSIB claim number & associated billing identifier
Details WSIB Healthcare Benefits Calculator Needs
The WSIB Healthcare Support Calculator uses your responses to identify the health care benefits that may apply to your situation. It may consider factors such as:
- Type of workplace injury or illness
- Date of the accident or exposure
- Current medical diagnosis and lab test details
- Recommended treatment and hospitality
- Recovery status and ability to join work
- Existing WSIB claim status
Based on your entered details, the health care benefits calculator offers an itemized overview of possible medical benefits.
Why Use Our WSIB Health Care Benefits Estimator?
Our WSIB Health Support estimator is designed to make understanding potential medical coverage easier.
| Benefit |
How It Helps You |
| Instant Estimate |
Get a quick estimate of the healthcare benefits from WSIB you may qualify for without waiting for a manual assessment. |
| No Fees |
Calculate your potential WSIB healthcare benefits online at no cost and without creating an account. |
| Time Saver |
Avoid manual calculations by receiving results within seconds after entering your information. |
| Ease-of-Use |
The calculator is built with a simple user interface that anyone can use, even without technical knowledge. |
| Better Financial Planning |
Understand your potential medical coverage so you can better plan treatment and recovery expenses. |
| Recovery Planning |
Estimate available healthcare benefits before starting rehabilitation or medical treatment. |
| Quick Eligibility Insight |
Helps you understand whether you may qualify for healthcare-related WSIB support based on your circumstances. |
| Available Anytime |
Use the calculator 24/7 from your computer, tablet, or smartphone whenever you need it. |
| No Registration |
Access the calculator instantly without signing up or providing unnecessary personal information. |
| Educational and Informative |
Learn about the types of healthcare benefits WSIB may cover, including medical treatment and rehabilitation |
Factors That May Affect Your Health Care Benefits Amount
Several factors may impact your WSIB medical benefits available through an approved WSIB claim. These crucial factors may include:
- Nature and severity of the injury
- Medical evidence supporting your condition
- Recommended treatment from your health care provider
- Whether the treatment is work-related
- Approval of the treatment by WSIB
- Progress during recovery
- Ongoing rehabilitation needs
Every claim is reviewed individually based on its specific circumstances.
How to Maximize Your WSIB Recovery Benefits
If you have an approved claim, these practices may help support your recovery:
- Attend all scheduled medical appointments.
- Follow your treatment plan carefully.
- Keep copies of medical reports and prescriptions.
- Inform your health care provider about any changes in your condition.
- Stay in contact with your employer and WSIB representative when appropriate.
- Ask questions if you are unsure about approved treatments or referrals.
Taking an active role in your recovery can help you return to work safely when medically appropriate.
WSIB Clothing Allowance Benefits
Workers who use an approved medical device because of a workplace injury or occupational illness may qualify for an annual clothing allowance. This benefit is intended to help cover the cost of repairing or replacing clothing that becomes worn or damaged through the regular use of eligible medical devices.
Who May Qualify for a Clothing Allowance?
- You have reached Maximum Medical Recovery (MMR) and have a permanent impairment that qualifies for a Non-Economic Loss (NEL) or Permanent Disability (PD) benefit.
- Your medical device has been approved or provided through WSIB.
- You have used the approved device for at least one full year after your permanent impairment or disability benefit was awarded.
- You submit a clothing allowance application each year in accordance with WSIB requirements.
How the WSIB Clothing Allowance Is Determined
The annual clothing allowance is generally based on how often and how long the approved medical device is used during a typical week. The amount may vary depending on the type of device and the extent of wear and tear it causes to clothing.
| Hours Used Per Week |
Percentage of Benefit |
| Less than 15 hours | 0% |
| 15 - 19 hours | 50% |
| 20 - 24 hours | 75% |
| More than 25 hours | 100% |
| Clothing Damage Category |
Medical Devices Included |
| Major Clothing Damage |
- Rigid back brace with metal frame or plastic support
- Back support belt or corset reinforced with steel stays
- Lower-limb prosthesis worn above the ankle
- Custom-fitted knee support brace
- Permanent leg support brace
- Manual wheelchair
|
| Minor Clothing Damage |
- Neck (cervical) support brace
- Upper-limb prosthesis worn above the wrist
- Arm support brace
- Wrist brace or gauntlet
- Forearm-support crutches
- Standard (off-the-shelf) knee brace
- Power wheelchair
- Underarm crutches
|
Calculate Your WSIB Health Care Benefits Today
Recovering from a workplace injury or illness can involve many medical expenses and treatment decisions. Our WSIB Health Care Benefits Estimator helps you understand the types of health care services that may be available through an approved WSIB claim. Use the estimator now to explore your potential medical coverage, learn about available treatment options, and better prepare for your recovery journey.
Frequently Asked Questions
Because assuming can leave you paying out of pocket. This WSIB health benefits calculator shows you what medical costs are covered — prescriptions, equipment, transportation, even clothing damaged by braces or wheelchairs. No surprises when you need treatment.
This WSIB medical expense estimator is for workers with an approved WSIB claim. Whether you missed work or not, if you need prescriptions, physiotherapy, medical equipment, or travel to appointments, this tool helps you understand what WSIB will cover.
100% free. No sign up, no credit card, no hidden fees. This WSIB prescription coverage calculator works for any worker with an active claim. It costs nothing to estimate your medication coverage, clothing allowance, or transportation reimbursements.
No way. This WSIB medical equipment approval tool does not save or share anything. No name, no claim number, no medical details. Your answers stay in your browser. We never see them and we never sell your data. Completely private.
Yes. This Ontario WSIB health benefit tool follows official WSIB rules. That means prescription coverage through direct pharmacy billing, the clothing allowance for device users, transportation to medical appointments, and the requirement to get approval before buying equipment. It won't approve your expenses, but it tells you what you can claim before you pay out of pocket.
