Sunday 24 November 2013

Benefits for Sick Employees

There are few good reasons to find oneself suddenly unemployed. However, of all the reasons to find oneself suddenly unemployed, the worst must be because one is sick.

This post will look at how to replace (at least in part) the income stream lost when an employee must focus his or her efforts on, and devote his or her time to, getting better rather than working.

There are a number of ways an employee who is unable to work for medical reasons can maintain an income stream. This post will look at three of the most common options:
  1. Long-term disability benefits;
  2. Employment agreements; and
  3. EI Sickness Benefits.

Long-Term Disability Benefits


The first way sick employees can maintain an income stream while absent from work because of their illness is with private long-term disability benefits. Employees who have access to disability benefits through either a group plan at work or through benefits they may have purchased on their own should contact their insurer to see what sort of application process is necessary in order to obtain benefits in a timely manner. If employees are unsure whether they have benefits, they should ask their employer to confirm. Employers should be mindful that if they fail to advise their employees of access to such benefits or intentionally misrepresent whether such benefits exist, they can be found liable to employees for those benefits if the employee misses an application date on account of the bad information.

If you are in Ontario and are having issues with your long-term disability insurer, it may be prudent to seek professional legal advice. The employment lawyers at Ottawa's Kelly Santini LLP would be happy to be of service to you with respect to your case. To contact the author of this blog, Sean Bawden, you may email sbawden@kellysantini.com or call 613.238.6321 x260.

Employment Agreements


The second way sick employees can maintain an income stream while absent from work because of their illness is if their employment agreement contemplates sickness benefits. Some employers, especially in the collective bargaining arena (read: unionized environments,) will provide for sickness benefits to their employees when they become ill. These benefits are similar to private LTD benefits, but are provided to employees directly by employers. Again, employees would be wise to ask their employers are what benefits are available.

Employees working in Ontario should be aware that there is no legal obligation to provide sickness benefits, aside from any such contractual agreement. While the Ontario Employment Standards Act, 2000 provides that certain, larger employers must afford their sick employees time off from work without those employees having to worry about being fired, the law does not provide that that time must be paid time off of work.

If you are in Ontario and are having issues with your employer, it may be prudent to seek professional legal advice. The employment lawyers at Ottawa's Kelly Santini LLP would be happy to be of service to you with respect to your case. To contact the author of this blog, Sean Bawden, you may email sbawden@kellysantini.com or call 613.238.6321 x260.

Employment Insurance Sickness Benefits


Unfortunately, fewer and fewer employees have access to private disability plans or employer-provider sickness benefits. In those cases, employees will have to look to publicly funded benefits.

If you work as an employee in Ontario, you will have no doubt paid into the Employment Insurance ("EI") system. While most people think of EI as covering those who lose their jobs, EI also provides benefits for those who become sick.

While the government's comprehensive website with information about EI Sickness Benefits is available by clicking this link: Employment Insurance Sickness Benefits, if you are a worker thinking about claiming EI Sickness Benefits here are the three things you need to know:
  1. You must be eligible;
  2. You must have your doctor complete the necessary paperwork; and
  3. You must apply.


Eligibility


You may be entitled to receive EI Sickness Benefits if:
  • you have paid EI premiums;
  • you meet the specific criteria for receiving EI Sickness Benefits;
  • your normal weekly earnings have been reduced by more than 40%; and
  • you have accumulated at least 600 hours of insurable employment during the qualifying period or, if you are a self-employed fisher, you have sufficient insurable earnings from self-employment in fishing during the qualifying period.
You have paid EI premiums

To be eligible to receive EI sickness benefits, you need to have paid EI premiums. These are premiums your employer deducts from your wages or salary. There is no minimum or maximum age for paying EI premiums.
You meet the specific criteria for receiving EI Sickness Benefits
EI sickness benefits are payable only to those people who are unable to work because of sickness, injury, or quarantine but who would otherwise be available for work if not for their incapacity due to medical reasons. To receive sickness benefits, you need to obtain a medical certificate signed by your doctor or approved medical practitioner. The employee is responsible for any fees your doctor or approved medical practitioner charges you for completing the medical certificate.

To obtain a copy of the medical certificate, click this link: Employment Insurance Sickness Benefits Medical Certificate (SC INS5140)
You have to apply.
The final point I wish to make is that the employee is responsible for applying for EI Sickness Benefits. While the employer is responsible for issuing a ROE, that does not change the fact that it is the ultimately the employee who is responsible for making the application. (Note also, ROEs can now be electronically filed. For more information on this topic consider my post Dude, Where's my ROE?)


Applying for EI Sickness Benefits is not as straightforward as one may want. Accordingly, one would be prudent to apply for EI Sickness Benefits as soon as possible after he or she stops working. For those thinking about applying for EI Sickness Benefits, a review of the government's website is probably a good idea.

Takeaways for Employees


The takeaways for employees is that if you are experiencing are or anticipating experiencing an interruption in earnings because of an illness, you may have options to replace your income. If you are not aware of what options are available to you, ask. If you know what options you have, apply. If you experience challenges in applying for benefits, are denied benefits, or otherwise experience issues, it may be appropriate to seek professional legal advice. The employment lawyers at Ottawa's Kelly Santini LLP would be happy to be of service to you. To reach the author of this blog, Sean Bawden, email sbawden@kellysantini.com or call 613.238.6321 x260.

Of course, if you are fired because you become sick, it is always prudent to seek professional legal advice. For an overview of the issue, consider my earlier post: Chronic Absenteeism: Employee Rights.

Takeaways for Employers


If you are an employer, the takeaway is that you have certain legal duties to your sick employees. For one, you must be honest with them about the benefits to which they have access. Second, under applicable Human Rights legislation, you must accommodate the employee to the point of undue hardship. For employers looking for more information with respect to their rights and responsibilities with respect to the chronically absent, consider my post Chronic Absenteeism: Employer Rights and Obligations

Of course, if you are an Ontario employer and are having legal issues with respect to one of your employees, your insurer, or the government, the employment lawyers at Ottawa's Kelly Santini LLP would be happy to be of service to you as well. To reach the author of this blog, Sean Bawden, email sbawden@kellysantini.com or call 613.238.6321 x260.

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As always, everyone’s situation is different. The above is not intended to be legal advice for any particular situation and it is always prudent to seek professional legal advice before taking any decisions on one’s own case.

Sean Bawden, publisher of the law blog for the suddenly unemployed, can be reached by email at sbawden@kellysantini.com or by phone at 613.238.6321.

Sean P. Bawden is an Ottawa, Ontario employment lawyer and wrongful dismissal lawyer practicing with Kelly Santini LLP, and part-time professor at Algonquin College teaching Trial Advocacy for Paralegals. He is a trustee of the County of Carleton Law Association for 2013.


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