April 2026

Legislative authority

Subsection 7 (3) and 39 (2) of the Act.

Sections 14, 23, 30, 33, 34 and 35 of Regulation 134/98.

Section 4 of Regulation 135/98.

Audit requirements

Financial and participation reviews are completed in accordance with provincial standards.

Documentation is on file to support decisions made.

Files clearly indicate current circumstances of the individual/case with respect to eligibility requirements such as the budgetary needs and available assets or income of the recipient, spouse and dependents in the benefit unit.

Third party verification of eligibility related information (e.g., income and assets) is completed and documented.

All participation agreements and/or action plans are complete and current for participants with active or deferred participation requirements (i.e., all plans have bring forward dates and no date has passed without a review occurring).

The participation activities of recipients reflect current requirements.

A signed copy of the Rights and Responsibilities form is retained on file and a copy provided to the recipient.

Application of policy

Staff are responsible for reviewing a recipient’s circumstances to ensure that the recipient is meeting their requirements for eligibility. This includes a financial eligibility review and participation review. Reviews should be completed in accordance with established timelines and processes.

In addition, staff should regularly monitor eligibility to ensure any changes in a recipient’s circumstances that affect eligibility are identified in the month that they occur. Every effort should be made to ensure that the recipient receives the correct amount of assistance and that overpayments are avoided (see Directive 9.3: Recovery of overpayments for more information).

A process must be in place for recipients to report changes in their circumstances. The delivery agent and delivery partner are encouraged to reinforce the responsibility of the recipient for reporting changes that may impact on eligibility for assistance. Decisions regarding eligibility for financial assistance are communicated in a format and manner approved by the Director within five days following notification of the change.

The income reporting period for eligible Ontario Works recipients has been determined by the Director to be the 16th of one month to the 15th of the following month when calculating monthly entitlement.

Decisions about compliance with participation requirements should be fair and consistently applied.

Financial eligibility reviews

Every 24 months for all cases, the Application for Assistance must be reviewed and updated to determine whether a recipient continues to be eligible for assistance. More frequent updates may be appropriate where there is reason to believe that the information provided at application is inaccurate or out of date.

Updating the application involves

  • Confirming the person’s living situation, financial details, and other eligibility information
  • A mandatory verification of the information with the Canada Revenue Agency (CRA) and Equifax
  • For cases referred to the Ontario Disability Support Program (ODSP), the Application for Assistance Part 1 must be updated if it hasn’t been reviewed and updated within 3 months of the referral date (see Directive 2.4: Referrals to the Ontario Disability Support Program)

Eligibility Verification Process

The Eligibility Verification Process uses a risk-based approach to reviewing Ontario Works recipients’ ongoing eligibility for financial assistance.

The recipient’s credit information and data will be carefully examined to determine if the recipient continues to meet eligibility requirements and whether a change in the amount of assistance issued is required.

Each month, 3% of high-risk cases will be reviewed.

  • The Eligibility Verification Model (EVM) will identify cases in which there is a high likelihood that there has been a change in the recipient’s financial eligibility, which has not been reflected in the amount of assistance issued.
  • First Nation delivery agents will apply their own business processes to review the 3% of high-risk cases.

Third party verification

Eligibility reviews include third party checks, which are completed to verify eligibility-related information provided by a recipient.

Third-Party Checks:

The following third-party checks are mandatory to obtain or verify eligibility-related information on behalf of the recipient or any other adult member of the benefit unit:

  • Canada Revenue Agency (CRA): Verifies income and other eligibility-related details
  • Equifax Canada: Verifies personal and financial information

Additional requests:

  • Other checks may be made as needed to verify eligibility information for the recipient or any other benefit unit member, including:
    • Employment Insurance: where there has been recent history of employment and potential eligibility for Employment Insurance benefits
    • Ministry of Transportation: where there has been a history of vehicle ownership or changes in address
    • Family Responsibility Office: where there is spousal support payment information

First Nations delivery sites not using SAMS should follow their existing practices.

Participation reviews

Participation reviews are conducted on a regular basis to ensure recipients are meeting their eligibility requirements and are making progress toward preparing for, finding and maintaining employment.

In non-Integrated Employment Services (IES) sites, participation reviews should be conducted:

  • at least once every three months for Ontario Works recipients, including recipients with a temporary deferral of participation requirements
  • at least once every four months for recipients with a temporary deferral of participation requirements who voluntarily choose to participate
  • at least once every six months for those recipients with a temporary deferral of participation requirements who are sole-support parents with a dependent child or a child in temporary care for whom publicly-funded schooling is not available, or are 65 years of age or older

In IES sites, participation reviews should be conducted with the participant typically every three months, to ensure participants are making progress in their plan and to move towards employment readiness. Caseworkers should decide on appropriate review dates (one, three, six, nine or 12 months) for employment assistance activities depending on the individual’s circumstances, the type of activity and the length/timeframe of the activity.

In some cases, a review and update to participation requirements occurs when a participant completes an employment assistance activity.

When a participant’s circumstances have not changed (e.g., no change to employment assistance activities) the caseworker may update their plan and set a review date as appropriate based on the participant’s circumstances. (see Directive 2.5 Participation requirements)

Agreement to participate

The participation agreement and/or action plan is the plan by which participation requirements are monitored to determine a recipient’s eligibility. All Ontario Works participants, their spouses and any dependent adults included in the benefit unit must complete a plan. This includes recipients whose participation requirements have been deferred. An adult who is solely in receipt of Temporary Care Assistance on behalf of a child does not have participation requirements.

The plan will change as recipients engage in and complete employment assistance activities. It should also respond to temporary or changed circumstances in a recipient’s life such as illness or injury, or lack of appropriate child care or attendant care for dependent family members.

The plan should be reviewed to:

  • note the time frames for meeting a requirement and/or changing the requirement
  • identify where and why participation requirements and time frames are not being met
  • explore opportunities to adjust requirements based on new activities
  • ensure the recipient’s abilities, skills and circumstances are properly documented
  • determine if the participation requirements are reasonable and appropriate for the recipient’s needs, skills, circumstances and interests
  • review the recipient’s progress and next steps

Review outcomes

There are several possible outcomes from a review:

  • there is to be no change in the amount of financial assistance or benefits issued to the recipient
  • there is no change to participation requirements
  • participation activities are amended to reflect activities that best fit the recipient’s skills, needs and abilities
  • financial assistance and/or benefits are varied or suspended due to reported changes in circumstances or non-compliance
  • there is a determination of an overpayment
  • the recipient is found to be ineligible and financial assistance is cancelled or reduced

Where there are changes to be made to financial assistance, it is required that the recipient be sent notification regarding this decision and informed that they can request an internal review if they disagree with the decision in a format and manner approved by the Director.

Recipients with deferrals who choose to participate

Participation monitoring of recipients with deferrals should be completed in the same way as reviews/monitoring for mandatory participants. Information gathered through monitoring of these recipients is only assessed to determine whether their efforts support their continued participation in employment assistance activities.

Recipients with deferrals cannot have their financial assistance reduced or cancelled for refusing or failing to make reasonable efforts to participate in employment assistance activities.

Events that prompt immediate review

In non-IES sites, an immediate review should be carried out if the recipient:

  • is unable to prove that they have been engaging in an independent job search
  • does not participate in agreed upon structured job search activities
  • misses two referrals to any of the following without a reasonable cause: community placement agencies, job interviews, a job placement agency, a self-employment development agency, a program for the treatment of substance abuse, basic education, job-specific skills training, or literacy assessment and/or training
  • refuses an offer of paid employment
  • fails to attend basic education, job-specific skills training, literacy assessment and/or training, a job placement agency, a self-employment development agency, a program for the treatment of substance addiction or community placement for more than three days (or more than three times, if applicable) without authorized absence
  • is reported to attend community placement or employment placement agency but does not participate in assigned activities
  • attends basic education or job-specific skills training or literacy assessment and/or training but does not meet the requirements set by the program
  • is not meeting self-employment development goals while with a self-employment placement agency

In IES sites, an immediate review should be carried out if the recipient:

  • does not engage or participate in their action plan
  • does not attend appointments with the caseworker or with the service providers
  • does not participate in employment services when determined employment ready
  • fails to progress toward their identified goal without a reasonable explanation, and
  • refuses to accept employment and to make reasonable efforts to maintain employment

After reviewing the plan with the recipient, it may be necessary to change the participation requirements or determine that the participant is ineligible for assistance.

Ineligibility for non-compliance reasons

Types of non-compliance with participation requirements:

  • refusal to contribute to the development of a plan
  • refusal to attend appointments with the caseworker or service providers
  • refusal to accept employment and to make reasonable efforts to maintain employment
  • refusal to accept a referral for participation in an employment assistance activity, without a reasonable cause
  • failure to make reasonable efforts to meet participation requirements without reasonable excuse

Additionally, in IES sites, refusal to participate in employment services when the participant is determined employment ready can lead to non-compliance.

Participants who quit or are fired from their job are not subject to a period of ineligibility unless the participant fails to make reasonable efforts to accept and maintain employment or to participate in an employment assistance activity.

Where a delivery agent has been approved to deliver the Ontario Works Addiction Services Initiative (ASI), a recipient may be made ineligible if they refuse screening, assessment or treatment for substance addiction that is a barrier to participation or employment.

If a recipient or member of the recipient’s benefit unit indicates that they will not accept employment or participate in employment assistance activities, assistance for the recipient can be refused or reduced for the benefit unit, until the recipient or member of the benefit unit agrees to participate.

If a participant or other member of their benefit unit does not comply with or meet the participation requirements, assistance for the participant or member of the benefit unit will be cancelled or reduced for one month for the first occurrence and three months for all subsequent occurrences. At the discretion of the administrator, an individual serving a period of ineligibility may be issued a drug card if the administrator is satisfied that the individual requires prescription drugs to treat a serious illness or health condition.

Where the assistance is reduced because of non-compliance, the amount of the reduction is equal to the basic needs amount, shelter amount and benefits or the basic needs amount and benefits (in a board and lodging situation) for that individual. The non-compliant participant is required to attend all participation and financial reviews that are scheduled for the benefit unit.

Where the assistance amount for a benefit unit is reduced due to non-compliance, any assets belonging to the non-compliant individual are still included in the total assets for the benefit unit. In addition, any income received by the non-compliant individual is still included in the calculation of assistance for the benefit unit during the period of ineligibility. Earnings exemptions and child care deductions continue to apply.

If the individual relocates to another Ontario Works geographic area, the conditions of ineligibility remain applicable. Conditions of ineligibility are tied to the individual, not the geographic area.

An internal review can be requested by an individual for decisions of ineligibility or reduction of assistance and may be appealed to the Social Benefits Tribunal.

Reasonableness test

The focus of the reasonableness test should be to determine if non-compliance was intentional or if it was the result of a barrier or factor affecting their employability outside the individual’s control.

A determination of reasonableness should be made in accordance with current business practices and should be based on the “best fit” between a recipient’s interest, needs and/or skills and available opportunities.

Delivery agents and partners are expected to use the reasonableness test identified in their approved business plans. The reasonableness test should have the flexibility to respond to the different expectations as required within the employability continuum.

Reasonable criteria could include:

  • temporary illness
  • absence of appropriate child care
  • court appearance or detainment
  • change or shift in the recipient’s personal needs
  • change or shift in the recipient’s individual circumstances
  • inappropriate "fit" for the participant
  • program resources or services to support employability not available within the local community
  • failure of transportation arrangements and no alternative
  • extreme inclement weather which affects mobility

Reinstatement of eligibility

Individuals whose assistance is cancelled or reduced for one or three months because of non-compliance with participation requirements need to reapply or request reinstatement after the expiration of the penalty time period, and must meet the participation requirements to re-qualify. At reinstatement, a new participation agreement and/or action is completed.

If an adult member of a benefit unit fails to comply with program requirements for an extended period (beyond the initial ineligibility period) the benefit unit continues to receive assistance less the pro-rated share of assistance attributable to the adult member in non-compliance. If that member chooses to comply with the requirements at the end of the ineligibility period, then the pro-rated share is restored for the benefit unit.

Closing a file

A case file should be closed if the individual is no longer eligible for assistance or does not provide enough information to determine eligibility.

When closing a file, any assignments for support should be cancelled.

If a decision of ineligibility is made, the case file should be closed using the appropriate reason and documentation including:

  • reason for ineligibility
  • effective date
  • notification date

If a file is closed due to ineligibility, the individual should be notified of the decision and right to appeal in a format and manner approved by the Director.

When closing a file in the Social Assistance Management System (SAMS) or other technologies, appropriate reasons should be identified to ensure the statistical information gathered from the system is accurate.

If a case is closed due to death of the individual, the last month’s financial assistance goes to the estate of the deceased.