- You must be unable to work at your regular occupation because of illness or an accident which did not occur at work. You will be eligible for benefits only if you are unable to perform the regular duties you were performing immediately prior to the onset of your disability.
- Work-related disability benefits are provided by WSIB. In the event that a member has exhausted his final appeal with the Workplace Safety Insurance Board, and the WSIB has rejected the claim on the basis that it is not work related, a claim for disability benefits under this Plan will be considered, but payment of benefits will be subject to a determination by the Plan’s claims adjudicator that the disability is not work related or related to a prior work injury.
- You will not receive benefits for those days you are not under the care of a legally qualified physician(i.e. the days before your first visit or treatment), or during which you engage in any work for remuneration or profit.
- If you become disabled immediately after recovering from another disability, and the second disability has no connection with the first, and you have returned to work or have been available for work for at least one full day, the second disability is considered as a new disability. The waiting period and maximum period of payments start again.
- If you become disabled again after recovering from the same or a related disability, and you have returned to work for less than 450 hours, the second period of disability is considered an extension of the first. Payments will start again immediately and continue until you recover or receive the maximum total payments, including payments received in the first period of disability.
- If you become disabled again after recovering from the same or a related disability, and you have returned to work for at least 450 hours, the second period of disability is considered as a new disability. The waiting period and maximum period of payments start again.
Benefits for any period of disability are payable from the 1st day of disability resulting from an accident or from the 8th day of disability due to illness.
Integration with EI Sickness Benefits
The benefits under this Plan are integrated with the sickness benefits under the Employment Insurance Program. EI sickness benefits are paid after 2 weeks of disability (the waiting period) and are paid for a maximum of 15 weeks. The Plan will pay benefits during the EI waiting period and will resume payment when EI sickness benefits have ceased, provided you are still disabled. No benefits will be paid under the Plan for any period during which you are eligible to receive EI sickness benefits (but you may be eligible for benefits under the SUB Plan – see the section for Supplementary Unemployment Benefits on this site), including any period during which EI sickness benefits have been reduced because benefits under a motor vehicle insurance policy are payable.
If you qualify for sickness benefits under EI but are not eligible to receive the full 15 weeks, or you do not qualify for EI sickness benefits but were covered by EI, paid EI premiums and are totally disabled, the Plan will pay you your benefits as long as you remain disabled and continue to satisfy all the eligibility conditions. If you are not covered by EI or do not pay EI premiums, or if EI refuses to pay benefits because you have breached an EI eligibility rule (e.g. left the country or failed to claim EI benefits on time) or for any other reason, the Plan will not pay benefits for any portion of the 15 weeks that EI sickness benefits would have been payable.
If you are eligible, you will be entitled to a short term disability benefit of $543.00 per week, payable for a maximum of 104 weeks (inclusive of the period during which EI sickness benefits are, or would have been, payable). This amount will be reduced, dollar for dollar, by any payments from the Local 46 Pension Plan or another pension plan (including from the CPP retirement benefit if applicable), Workplace Safety Insurance Board and any employer or group association disability plan. In addition, the benefit will be adjusted, if necessary, to ensure that your total income from all sources does not exceed 80% of your gross income prior to disability.
When you become disabled, you must immediately apply for EI sickness benefits. At the same time, apply for your short term disability benefits under this Plan. Do not wait until you have received EI benefits to claim; if you do, you will miss the filing deadline and benefits will not be paid under this Plan. If you are denied EI sickness benefits or do not receive the full 15 weeks of benefits, notify the Benefits Office and send a copy of the Letter of Denial and/or your final payment stub from EI.
You must apply for short term disability benefits within 90 days of the commencement of your disability. Do not wait until after you have received all EI benefits to apply. If you do, you will miss the filing deadline under the Plan. If you are still disabled when your short term disability benefit ceases, you may apply for long term disability benefits.
Please note that the Short and Long Term Disability Plans do not cover any charges made by a doctor for completion of claim forms or medical reports.