Disability insurance

September 22, 2013
File No.    (date)   To Whom It May Concern:                       Brother/Sister XX has asked me to intervene on his/her behalf concerning a decision taken by Sun Life Assurance Company of Canada to deny his/her claim for disability insurance benefits.  Brother/Sister XX has recently provided me with related medical and non-medical documentation involving his/her case.  I am writing to you to have this situation resolved in as expeditious a manner as possible.
September 22, 2013
(Adapted from the Guide de L’Expertise Médicale de la  Société des Médecins Experts du Québec) Revised April 2004 Preamble: The Guide to Third Party Medical Evaluation provides rules of ethical conduct to be used by all CSME members for the purpose of third party medical evaluation.   SECTION I General Duties 1.1          Medical evaluators shall conform to the code of ethics, scope of practice and regulations of their professional college.
September 22, 2013
Help with navigating federal governent disability insurance plans: the claims process, medical evaluation, confidentiality, duty to accommodate.
September 22, 2013
Get the paperwork right .One of the most frequent reasons for claim rejection is that medical documentation given to Sun Life by claimants and medical professionals isincomplete. 
September 22, 2013
Your claim is first processed by a claims adjuster at Sun Life. If the information you give is not sufficient to enable Sun Life to make a decision on the claim, they will request more specific and detailed information. Keep copies of everything you send them. If you give sufficient evidence, the claim is approved. If not, the claim is denied.
September 22, 2013
Processing and approval of your DI claim takes time. Be prepared for delays.  When your DI benefits have been approved, payments start either: After your paid sick leave or injury-on-duty leave expires; or if these payments last less than 13 weeks; After 13 weeks of disability (the “elimination period”). The 13 weeks does not need to be continuous. It may, under certain circumstances, be accumulated for the same disability over a period of one year.
September 22, 2013
For the first 24 months, as long as you are disabled from working in your own job.  After 24 months, DI plan members will continue being paid benefits when they can provide medical proof that their disabling condition prevents them from doing a “commensurate occupation” for which they are reasonably qualified by education, training or experience. According to the DI policy, “commensurate occupation” means a job for which the rate of pay is not less than 66 2/3% of the current salary for your regular job.
September 22, 2013
A “Total disability” means that you are totally disabled from working. General Meaning 1. You can’t do your job (the first 24 months) You must be in a continuous state of incapacity due to illness which continues during the Elimination Period (13 weeks or the expiry of your accumulated sick leave credits, whichever is later) and the following 24 months, and prevents you from performing all duties of your regular occupation or employment. Note:
September 22, 2013
PSAC tries to help members understand the complexities of the Disability Insurance Plan. We also explain who does what in the union, and how to contact them.
September 18, 2013
Many workers who have been off work and receiving disability insurance will eventually return to the workplace in some capacity. The majority of disability insurance policies which apply to PSAC members have provisions for rehabilitation assistance. However, the basic principals of the duty to accommodate, apply in these types of situations and can facilitate a successful reintegration back into the workplace.

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