SUMMARY OF LONG TERM DISABILITY INCOME PLAN TERMS
The following provisions are considered as general statements only. For more complete information, contact your Human Resources Department to view the plan text or to obtain a copy of the plan commentary.
The Disability Income Plan shall be administered by 3sHealth in accordance with the terms of the plan.
(b) Application For Benefits
Application for benefits must be received by 3sHealth no later than six (6) months following an Employee’s date of total disability, or ninety (90) days from the denial or termination of WCB, SGI or other full indemnity benefits. To apply for benefits, claim forms must be completed by the Employee, their physician and their Employer. Application forms are available from the Employer.
The following Employees, if under the age of 65, are eligible to participate in the Disability Income Plan:
(d) First One Hundred Nineteen Calendar Days Of Disability
During the first one hundred nineteen calendar days of total disability, Employees shall use and continue to accumulate sick leave credits in accordance with Article 12 [Sick Leave] of the HSAS Collective Agreement.
If an Employee’s sick leave credits are exhausted before the end of the one hundred nineteen calendar days qualifying period, she may be eligible for disability benefits through Employment Insurance. However, it is the responsibility of the Employee to apply for these benefits.
Any balance of sick leave credits remaining at the end of 119 calendar days remains to the Employee’s credit until she returns to regular work.
(e) Disability Benefits
The Disability Income Plan will provide a benefit of 75% of pre- disability gross (before tax) regular earnings commencing after one hundred and nineteen (119) consecutive days of total disability. Disability benefits are taxable for income tax purposes. The benefits will continue until total disability ends, age 65, death, or the date an Employee establishes permanent residence outside of Canada, whichever occurs first.
(f) Definition of Disability
Totally disabled means for the Qualifying Period (119 days) and the first twenty four (24) months immediately following, a condition in which an Employee is disabled by illness or accidental injury which prevents them from performing any and every duty of their pre-disability occupation. This is called an Employee’s “own occupation” period.
Thereafter, totally disabled means a condition in which an Employee is unable to perform any and every duty of occupation for which they could be reasonably fitted by education, training or experience.
(g) Disability Benefits Are Reduced By:
(h) Claim Continuance
Any claim which is admitted for a period of disability, which commences while the Employee is protected by this Plan, will continue to be payable by the terms of the Plan, regardless of the fact that the Plan may have subsequently been discontinued or succeeded by a new program.
(i) Mental Illness
Any claim attributable to a mental illness will be treated as a claim for any other illness. A claim attributable to a mental illness will be paid according to the terms of the Plan.
(j) Benefits Are Not Paid For Claims:
(k) Independent final adjudication of disability claim appeals will be handled as per Memorandum of Agreement between SAHO and the Health Care Unions signed December 18, 2003.