Your Income Replacement Benefit was denied. Here is what to do.

What is the Income Replacement Benefit?

The Income Replacement Benefit is a no-fault accident benefit under Ontario's Statutory Accident Benefits Schedule (SABS). It is paid by your own auto insurer — not the other driver's — regardless of who was at fault.

If you were employed or self-employed at the time of your accident and your injuries prevent you from returning to work, your insurer is required to pay 70% of your gross weekly pre-accident income. The standard policy maximum is $400 per week. This can be higher if you purchased optional enhanced coverage.

IRB begins after a 7-day waiting period. It can continue for up to 104 weeks while you cannot perform your pre-accident job. After 104 weeks the test changes: you must be unable to work in any capacity that your education and experience would allow.

Why insurers deny Income Replacement Benefit claims

Denials are common. These are the most frequent reasons insurers give:

• You do not meet the disability test. The insurer argues you can still do your pre-accident job, usually based on an Independent Medical Examination (IME) it arranged — which often contradicts your own doctors.
• Disputed income or employment status. The insurer challenges your pre-accident earnings, especially for self-employed people, gig workers, or those with irregular income.
• Late application. Accident benefit applications must generally be submitted within 30 days of the accident. Exceptions exist, but late applications are routinely denied at first.
• The 104-week cutover. After two years of receiving IRB, the disability test becomes significantly harder to meet. Insurers frequently stop payments at this point.
• Insurer-ordered assessments. Insurers can require you to attend their own assessments. If you miss one, they can suspend or terminate your benefit.

Deadlines you cannot miss

Ontario's accident benefits process has hard cutoff dates that are rarely extendable.

• 30 days from the accident — notify your insurer and request an application form.
• 30 days from the denial notice — request an internal review from your insurer. This step is mandatory before going to the tribunal.
• 30 days after the internal review response — or 30 days after the insurer's response deadline passes — to file at the Licence Appeal Tribunal (LAT).
• 2 years from the denial date — the outer limitation period for a LAT application. Do not wait — the internal review step must come first.

If you are unsure where you stand in this timeline, do not delay. A missed step usually cannot be recovered.

Your dispute options

There are three stages to disputing a denied IRB in Ontario:

• Step 1 — Internal review. You write to your insurer requesting a formal review of their decision. They have 30 days to respond. This is a required first step before the tribunal.
• Step 2 — Licence Appeal Tribunal (LAT). If the internal review fails or the insurer does not respond, you can apply to the LAT — an independent government tribunal that decides accident benefit disputes in Ontario. Most cases are resolved through written submissions.
• Step 3 — Appeal or judicial review. If the LAT rules against you, further options exist in limited circumstances. A licensed professional can advise whether this applies to your situation.

At any stage, you can be represented by a paralegal or accident benefits lawyer. Many work on contingency — no upfront cost to you.

What a free review with us looks at

When you submit a review through Ontario Accident Review, your information is reviewed for common Ontario accident-benefits issues. The review is not legal advice. We look at:

• Whether a denial, delay, or reduction may be worth a closer look
• Whether income replacement, treatment, or other benefit questions appear relevant
• What practical next steps may be worth considering
• Whether speaking with a legal professional may make sense

There is no cost and no obligation. You do not need to provide your insurance documents or policy number to start. The review takes about two minutes.