About-2013
Short-term Disability

The following information can be found on this page:

Eligibility & benefitHow to claim
Benefit periodBenefit for disability
Continuous period of disabilityExtension of benefits
Exclusions & limitationsSubrogation
ReductionsAppeal process

 

Eligibility & benefit

Full-time permanent employees are eligible for coverage based on the following classifications and length of employment:

ClassGroupServiceWaiting PeriodWeekly Salary
001NSGEU, FUNSCAD, Unit IILess than 5 years3 months85%
002FUNSCAD Unit ILess than 5 years1 month85%
003Union Exempt Less than 5 year1 month95%
004All Employees5 years or moreNone100%

 

How to claim

To apply for STD benefits an employee must contact either the Director of Human Resources, or the Payroll and Benefits Coordinator for completion of the proper forms and instructions.

Benefit period

The benefit period commences on the 11th day of disability due to injury or sickness and will terminate at the end of 15 weeks of continuous disability following the date the benefit period commenced.

If the employee attains age 65 while receiving benefits, benefits will continue to be paid until the employee has received a total of 15 weeks of benefits or until the employee is no longer disabled, whichever occurs first.

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Benefit for disability

While an employee is wholly disabled by an injury or disease, the Administrator will pay the weekly benefit during the benefit period. The weekly benefit and benefit period are specified in the Schedule of Benefits above. Disability must commence while the employee is protected under this coverage. Benefits are subject to the conditions outlined on this page.

Wholly disabled shall mean the employee is incapacitated to the extent that the employee is not able to perform any and every duty of the employee's occupation or employment.

No more than one benefit will be payable during any period of disability whether the employee is disabled by one or more causes.

Continuous period of disability

If an employee becomes disabled for the same or related causes within two weeks after the return to active work, it will be considered one continuous period of disability. If an employee has returned to active work for one full day and becomes disabled from different and unrelated causes, it will be considered a new period of disability.

Exclusions and limitations

No benefit shall be payable:

a)     for the portion of a period of disability during which the employee is not under treatment by a physician;
b)     for any disability resulting from intentionally self-inflicted injuries, whether the employee is sane or insane;
c)     for any disability resulting from participation in civil insurrection, war or riot;
d)    for any disability resulting from the commission for attempt to commit and assault or criminal offence;
e)    for a disability which commences on or after the date a strike or lay off begins, subject to any provincial employment or Labour Standards Act;
f)    for any disability resulting from an illness or injury while working for compensation for more than 20 hours per week for another employer.

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Subrogation

If an employee is entitled to recover compensation for loss of income for a third party as a result of the an incident which caused or contributed to the disability, for which benefits are paid or payable, the Administrator will be subrogated to all the rights of recovery of the employee for loss of income, to the extent of the sum of benefits paid or payable by the Administrator. The employee shall execute such documents as required by the Administrator.

In the event that the insured employee provided proof to the Administrator that the said employee has not recovered full compensation for loss of income, the Administrator shall determine the proportion of damages actually recovered and share pro rated in that amount.

Should the employee choose to settle the matter prior to judicial determination, the employee understands that the sum reached in settlement will be deemed to be full compensation for loss of income, and the Administrator's right to subrogation will apply.

The term compensation shall include any lump sum or periodic payments which the employee received or is entitled to receive on account of past, present or future loss of income.

Extension of Benefits

If the agreement or weekly disability income benefit terminates and the employee becomes wholly disabled prior to such termination, the Employer continues to be liable as though the provision remained in force.

If a disability recurs within six continuous months after termination of this benefit, the Employer will continue to pay benefits to the employee but only for the remainder of the original maximum benefit period.  Such disability must have been caused by an accident or sickness that occurred before termination.

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Reductions

The amount of any benefit payable under this coverage shall be reduced by any income or benefit payable under:
    a) any other plan or program provided to the employee by or through the employer;
    b) The Canada/Quebec Pension Plan (primarily benefits only);
    c) any other plan or program of any government or subdivision or agency of the government, including any plan or program established pursuant to a provincial automobile insurance act.

Notwithstanding the above, if this weekly disability income benefit plan is registered for Employment Insurance Premium reduction, the amount of benefit payable under this coverage shall only be reduced in respect of a source of income which has been approved as an acceptable limitation for registered plans under the Employment Insurance Act.

If an employee is receiving any income or benefit payable under any government plan or program for an injury or disease totally unrelated to the injury or disease that caused the current disability, the Administrator shall not reduce the weekly benefit by that amount.

Appeal Procedure

If an employee appeals the denial/termination of a Weekly Disability claim, he/she must submit to the Insurer, a written notice of appeal.  The notice must be submitted to the Insurer within 60 days of the date of the Insurer's denial/termination notice. Medical or other supportive documentation are the responsibility of the employee.

If the above provision is in conflict with the applicable law of the employee's province of residence, the provision shall be deemed amended to conform with the minimum requirements of that law.

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