Introduction
When illness strikes, members are covered immediately by the Short-Term Disability Plan (STD) (Article 17 for full-time members). If the illness extends beyond 130 days, employees may qualify for coverage under the Long-Term Disability Plan (LTD) (Article 18 for full-time members).
Partial-load employees’ sick leave and benefits differ somewhat from those of full-time members, and are covered in Article 26 and Appendix V of the Collective Agreement.
For employees whose illness or disability does not require full sick leave, but rather an adjustment of their work conditions or a temporary reduction in their workload, a permanent or temporary accommodation should be arranged, allowing them to continue such work as is possible.
Short-Term Disability Plan (STD)
From your first day of service at the College, you are covered by the STD plan, in a benefit year extending from September 1 to August 31. Each year, twenty (20) days are added to your sick-leave bank. If you are absent from the College because of illness or injury, you’ll receive full pay up to the number of days accumulated in your bank. Full pay includes any co-ordinator’s allowance and/or scheduled overtime. (Article 17.01 F1). The employer covers the cost of this plan.
If you are injured and receiving payments under the Workplace Safety and Insurance Act (formerly Workers’ Compensation), you can use your sick leave to “top up” payments to full salary. If your “regular pay” includes, for example, a coordinator’s step, that amount should be included in the calculation.
If you are still ill once your “sick days” are used up, you shall be paid 75% of your “regular pay” for the period between the date your STD eligibility ends and the date at which you would normally qualify for LTD (Article 17.01 F2). (If your “regular pay” includes, for example, a coordinator’s step, that amount should be included in the calculation.) If the qualifying period for LTD expires while you still have STD sick-leave credits, you may elect to use up these credits before claiming your LTD benefits. Generally, however, it is preferable to retain STD credits once approved for LTD.
The College requires medical evidence to support your claim for STD if your absence from work is greater than five days. This is provided to the college on their Employee Medical Report Form, filled out by your doctor. You may wish to speak with a union officer about the amount and nature of information your doctor should provide. Usually a simple statement of the nature of your illness, e.g. “surgery”, and the expected date of your return to work is all that is needed. This information may be shared at your discretion with the Centre for Equity and Human Rights to assist the college in preparing any accommodation that may be required upon your return.
Long-Term Disability Plan (LTD)
After 130 calendar days of illness and disability, you may be eligible to receive LTD. Sun Life, our health insurance provider, bases its decision on an assessment of the individual’s ability to continue work. To maximize your chances for eligibility for LTD, please consult with a union officer. Your application for LTD benefits should be filed well in advance of the 130-day mark; Sun Life normally requires two (2) months to process the claim.
Generally, LTD payments are 60% of your “basic monthly earnings” and are untaxed (Article 18). (“Extras”, such as coordinators allowances, are not included in the calculation.) The “take-home” value of these benefits is about 95% of regular pay.
To qualify for LTD, you need to be declared “totally disabled” from performing your current job. (This means that you cannot perform the majority of the duties associated with your job.) After two years on LTD, you need to be declared “totally disabled” with regard to performing any occupation. Possible exceptions to this policy are individuals who suffer from periodic flare-ups, as might occur with chronic diseases such as multiple sclerosis or ulcerative colitis. Such individuals may be granted LTD, where required, during these periods, even though they may eventually be able to return to work during periods of remission.
Should you be denied coverage under the LTD plan, you should appeal the decision through Sun Life’s appeal process. You should also appeal through the Joint Insurance Committee (JIC). However, before appealing, please consult with the union office for advice on other means to reverse the decision. Often, it is simply a matter of providing more thorough/exact medical feedback on your condition.
The LTD plan is fully funded by the members through payroll deductions.
Special Accommodation
At certain points during their illness, members may feel capable of continuing to work or returning to work if the College makes some short- or long-term adjustments to their work conditions. The College is obligated to provide reasonable accommodation to the temporarily or partially disabled employee.
You should begin the process by first discussing your circumstances with your immediate supervisor. Minor accommodations can often be arranged very simply and quickly at this stage. Ultimately, however, most accommodations are arranged and monitored through the Centre for Equity and Human Rights and require medical documentation.
Sometimes, employees choose to combine sick-leave and pay in a pro-rated fashion which reflects their partial return to work. This is often a good way to ease one’s way back into the workforce after an extended sick leave.
We encourage you to speak with a union officer or steward to learn more about your sick-leave options and how accommodation is negotiated with the College.
Joint Insurance Committee (JIC)
The Joint Insurance Committee (JIC) facilitates communication between the College Council and OPSEU on the subject of group insurance for CAAT-A employees, including Basic Life Insurance, Supplementary Life Insurance, Dependent Life Insurance, Extended Health Insurance, Long-Term Disability Insurance (LTD) , the Dental Plan, and any other negotiated benefits that may be included in the group insurance plan (Appendix IV).
The committee is composed of four management representatives appointed by the colleges and four from OPSEU, elected at the biennial OPSEU CAAT-A Divisional meeting.
One of the important functions of this committee is to review the unresolved claims of members. If you feel that your claim for medical reimbursement, LTD, or some other benefit has been unjustly refused, please forward it to this committee.
The OPSEU CAAT-A members of the JIC are Heather Giardine-Tuck, Landyn Blais, Ursula Kosecka and Terry Poirier. They (and your Local 560 officers) can answer your questions about various aspects of our insurance plan and advise you on matters such as applying for LTD or appealing denials of your claims for medical, dental or other benefits.
If you have exhausted all other sources of information, another very helpful individual is Guilia Volpe, a Benefits Officer at OPSEU head office (416 443-8888 x 3563). She can answer your questions and assist you in applications and appeals.
More information on Claims and appeals can be found below: