What is covered?

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:

If you are required to use your driver’s license in your job duties, and you lose your license, or it is suspended, because of illness (unrelated to alcoholism or drug addiction) you are considered to be totally disabled during the elimination period and the following 24 months, but only while such license continues to be withheld for the same reason.

2. You can’t do an alternative job (after 24 months)

While it (a state of incapacity) continues thereafter, prevents the employee from engaging in any commensurate occupation for which he/she is or becomes reasonably qualified by education, training or experience.

3. You must be under active care of a medical doctor

In no event, however, will an employee be considered Totally Disabled if during any period he/she does not take part cooperate in a reasonable and customary treatment program.

 You will not be paid disability benefits if:

  •   the total disability resulted from self-inflicted injuries, attempted suicide, commission of a criminal offence, war (unless exposed to it by the performance of your duties as directed by your employer), active duty with any armed forces (including civilian noncombatant units serving in such forces), or participation in a riot, civil commotion or insurrection.
  • Under certain conditions, if you have a pre-existing condition.  During the first year of your coverage under the DI plan, you may experience a worsening of a condition that you had when hired. If this preexisting condition results in total disability, you will only get DI benefits if: .   You had a consecutive 13 week period when you did not need medical attention for that condition.  AND . You were not absent from work for more than two full days. Unless you meet both conditions, your claim will not be paid. This restriction no longer applies after your first year. It does not apply to any other disabling condition that is unrelated to your pre-existing condition.

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September 22, 2013
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