About Saint Mary's
Long-Term Disability (LTD) benefits provide a continuing monthly income if sickness or injury prevent an employee from working.
- Evidence of Insurability
- Long-Term Disability (LTD) Details
- How To Claim
- When Insurance Terminates
- Taxation Of LTD Benefits
Long-term disability (LTD) is a compulsory employee benefit. Employee shall mean a person who is employed on the full-time staff of the employer and is resident in Canada. An employee shall be deemed to be on the full-time staff of the employer if customary employment with the employer is for 30 or more hours per week, excluding any eligible employee not covered on or prior to March 1, 1981. An employee shall also exclude all Faculty and Professional Librarians, as well as Post Doctoral Fellows hired on a contract basis. If the employer is a partnership, a partner shall be considered to be an employee of the employer for the purpose of this policy if the partner is engaged full-time in the business of the employer. With respect to part-time employees, employee shall mean a person who is employed for a minimum of 17.5 hours per week.
Contract employees who have completed a minimum of 24 consecutive months of contract employment are eligible for long-term disability benefits as defined under the full-time employees' contract; however, the maximum duration of benefits payable is two years.
Contract employees with 5-year contracts or who have worked 5 consecutive years of contract employment are eligible for long term disability benefits as defined for full-time employees.
Note: No benefits are payable for total disability beginning within 12 months of the date upon which a participant becomes insured if in the three months immediately preceding the effective date the participant consulted a health services professional, received treatment or medical care or took medication prescribed by a physician for the condition related to the disability.
Evidence of Insurability is required if:
- An employee applies for insurance more than 31 days after becoming eligible to apply;
- An employee reapplies after insurance has terminated due to non-payment of premium; or
- An employee's amount of insurance exceeds or increases beyond the no-evidence limit.
In the event that an employee becomes totally disabled for the required 90 consecutive days, prior to age 65, known as the Qualifying Disability Period and the employee is under the continual treatment of a legally qualified physician deemed appropriate by the insurer, the employee will receive a monthly income benefit equal to 70% of monthly earnings, plus 10% of monthly earnings to be contributed to the pension plan, subject to the 85% all source maximum described later in the literature. The monthly income benefit will continue for a maximum of 12 months and will cease at attainment of age 66 on the condition that the Qualifying Disability period is met while age 64. The combined maximum benefit is $8,000 per month effective April 01, 2017.
Earnings for the purpose of the employee's disability benefit means the employee's normal earnings which exclude overtime, bonus, commissions, shift differentials and automobile allowance. With respect to employees on Sabbatical or any other leave approved by the employer, earnings shall mean basic earnings in effect on the date immediately prior to the date of leave, including any subsequent salary adjustments to which the employee on leave would normally be entitled if they were not on leave. The Qualifying Disability Period shall begin on the date that the employee returns to 100% salary.
The qualifying disability period starts when the employee first becomes totally disabled and ends after 90 consecutive days, provided the employee's disability is continuous and the employee is under age 65. If the disability is not continuous, the days the employee is disabled will be accumulated to satisfy the qualifying period provided:
- no interruption is longer than 2 weeks;
- the disabilities arise from the same or related disease or injury.
The Maximum Disability Period is the period to age 65.
Benefits will not be payable beyond age 65, unless the employee satisfies the qualifying disability period while age 64, in which case benefits will be payable for a maximum of 12 months.
An employee is considered totally disabled, during the first 24 months in which the employee receives benefits, if the employee is unable to perform any and every duty of the occupation. After this period the employee is considered totally disabled if the employee is unable to perform any and every duty of any occupation for which the employee is reasonably qualified by training, education or experience.
If a disability recurs and it is due to the same or related causes, it will be considered as one continuous disability and will not be subject to the Qualifying Disability Period unless the employee has returned to active, full-time employment for a period of 6 consecutive months or longer.
If the employee's new disability is due to causes unrelated to the prior disability the employee may be eligible for a new disability period, subject to the Qualifying Disability Period, if the employee has returned to active work for at least one full day.
The benefit payable while an employee is totally disabled is calculated by deducting from the employee's benefit any other sources of income, including the following:
- wages or retirement benefits payable from the employer or employer's pension or retirement plan;
- any salary continuance provided by the employer beyond the 90 day Qualifying Disability period.
- any payments on account of the employee's disability from any workers' compensation law or similar law;
- payments received from the Canada or Quebec Pension Plan, excluding payments made in respect of dependent children;
- any income or benefit payable under any other plan or program of any government or the crown or of any subdivision or agency of the government or the crown, including any plan or program established pursuant to a provincial automobile insurance act;
- any income payable as a result of criminal injuries.
All Source Maximum
An employee's total monthly income while disabled (long-term disability benefit plus any income listed above and Canada or Quebec Pension Plan family benefits) cannot exceed 85% of the employee's gross monthly earnings as of the date the employee's disability commenced. If the employee's total income exceeds 85%, the employee's long-term disability benefit will be reduced accordingly.
Exclusions and Limitations
Benefits are not payable for the following:
- for any portion of a period of disability unless the employee is receiving ongoing supervision/treatment by a physician deemed appropriate by the Insurer for the impairment which is causing the disability. The employee will not be paid for any portion of a period of disability during which the employee did not participate in the treatment program recommended by said physician;
- for any portion of a period of disability during which the employee is receiving treatment by a therapist unless such treatment is recommended by a physician deemed appropriate by the Insurer;
- for any portion of a period of disability resulting from substance abuse, including alcoholism and drug addiction, unless the employee is participating in a recognized substance withdrawal program;
- disabilities resulting from self-inflicted injuries or attempted suicide;
- disabilities as a result of participation in a criminal act;
- for the portion of a period of disability during which the employee is:
- imprisoned in a penal institution; or
- confined in a hospital, or similar institution, as a result of criminal proceedings;
- any period of disability, or portion thereof, during any leave of absence (including maternity leave). Leave of absence means a period of time away from work mutually agreed to by the employee and the employee's employer. In the case of maternity leave of absence, the leave shall begin and finish on dates agreed to by the employee and the employee's employer or as required by Provincial or Federal law;
- for a disability which commences on or after the date a strike or layoff begins
- if the employee refuses to participate in a rehabilitation program which is deemed appropriate by the insurer, the attending physician or an independent medical opinion.
If the employee is entitled to recover compensation for loss of income from a third party as a result of the incident which caused or contributed to the disability, for which benefits are paid or payable, the insurer 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 insurer. The employee must execute such documents as required by the insurer.
In the event that the employee provides proof to the insurer that the employee has not recovered full compensation for loss of income, the insurer shall determine the proportion of damages actually recovered and share pro rata 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 insurer's right to subrogation will apply.
The term compensation shall include any lump sum or periodic payments which the employee receives or is entitled to receive on account of past, present or future loss of income.
Disability Case Management Program
Employees' long-term disability insurer has developed a Disability Case Management program. The purpose of this program is to assist in the event that an employee becomes totally disabled and qualifies for benefits to return to productive employment. The disability case management team includes a field coordinator, claim adjudicators and the employee, the employee's employer and the employee's physician to assist with recovery and return to the workplace.
If an employee is disabled, the Insurer may recommend that the employee undergo some suitable rehabilitative training program which would take into account the nature and limitations of the employee's disability. Further details on this aspect will be provided in the event that an employee becomes disabled.
To apply for LTD benefits, an employee must contact the Human Resources Officer, Benefits, Pension & Compensation at the University for the completion of proper forms and instructions. For contact and more information please visit our contact page.
A claim for disability income benefits must be submitted within 6 months of the end of the qualifying disability period.
Insurance terminates in the event of:
- non-payment of premium;
- a change in an employee's classification to one not insured;
- termination of an employee's employment;
- termination or amendment of the policy by the University or the insurer;
- an employee commencing active duty in any armed forces;
- an employee attaining age 65; except as outlined on this website;
- an employee retiring;
Note: In the event an employee is absent from work due to sickness, injury, layoff or approved leave of absence, insurance coverage may continue, subject to payment of premiums. Details are available from the Human Resources Officer, Benefits, Pension & Compensation. For contact and more information please visit our contact page.
The employer is deemed to have paid any portion of the long-term disability premium, accordingly, receipt of a benefit by an employee is taxable in the hands of the employee. To have taxes deducted, employees must make arrangements through the insurer.