The Plan will pay Wage Indemnity (WI) benefits when you are Totally
Disabled and prevented from working as a result of an accident or
sickness for which WorkSafe Compensation benefits are not payable.
|Weekly Benefit Amount
||The current Employment Insurance (EI) maximum
|Employment Insurance (EI) Carve-Out
||If you are eligible for Employment
- we will provide benefits for the first
week of disability, and
- EI will provide benefits from the 2nd week of disability for up to 15weeks and
- we will provide benefits up to an overall maximum of 34 weeks including period of EI Sick Benefit payments.
|Maximum Benefit Period
||34 weeks with the following exception:
if you reach termination age while
receiving benefits and have then
received payments for less than 15
weeks, benefit payments will continue
during disability until you receive 15
weeks of benefits.
||Age 65 or earlier retirement
The elimination period is a period of time, when you are continuously
disabled, which must be completed before your claim for benefits will
be considered. Benefits commence on the day after the elimination
period expires or on the first day your were seen and treated by a
physician or chiropractor whichever is later and will be paid only
during periods of disability when you are under his or her regular care
and following the treatment prescribed. Certification of disability
beyond a 6 week period must be made by a physician.
A recurrent disability means a disability that is related to or due to the
same cause(s) as a prior disability for which you received benefit
payments. A recurrent disability will be considered part of the prior
disability if, after receiving WI benefits, you returned to work on a fulltime
basis and were able to perform all the essential duties of your
occupation for less than 2 weeks. Once you have resumed work on a
full-time basis and have been at work for 2 consecutive weeks, any
subsequent injury or sickness will be considered a new disability.
If you are Totally Disabled when this insurance terminates, your WI
benefits will continue as though your insurance had not terminated, up
to the maximum benefit period, provided you remain Totally Disabled.
Coordination with other Income Sources
Your WI payment will be coordinated with benefits received from other
sources so that the total benefits received, for the same disability, will
not exceed your normal take home pay on the date you became Totally
Third Party Liability
Benefits will be paid for disabilities due to an accident in which a third
party is liable. However, you must reimburse the Plan when you receive
payment from the third party.
Are Benefits Taxable?
Benefits are taxable as your employer contributes to the cost of your
Termination of Benefit
Your benefit payments will cease on the earliest date one or more of the
- you are no longer disabled;
- you are no longer receiving continuing medical care and treatment
from your physician;
- you fail to submit satisfactory proof of continuing disability as
required by the Plan;
- you refuse a medical examination by a physician chosen by the
- you are no longer following the treatment recommended for your
- you leave the province, state or country where you normally work
and live, for reasons other than to obtain treatment that is not
available locally or that may be available sooner elsewhere. Such
treatment must be recognized by the government plan (i.e. the
Medical Services Plan of British Columbia and similar programs in
other parts of Canada) as medically necessary. If you normally
reside outside Canada, such treatment must be approved by the
- you perform any work for compensation or profit;
- the end of the maximum benefit period indicated in the Schedule
- you retire; or
- you die.
Benefits are not payable for any period of disability:
- arising from any of the following:
- self-inflicted injury or sickness;
- participation in a criminal offense;
- civil commotion, insurrections, any act of war (whether
declared or not) or hostilities between nations, or service in
the armed forces of any nation;
- pregnancy related sickness
- during any period of formal maternity leave and/or
- during any period in which Employment Insurance (EI)
benefits are being paid;
- substance abuse, including but not limited to alcoholism or
drug addiction, unless you are receiving continuing treatment
for substance abuse from your physician; or
- medical or surgical care which is cosmetic, unless considered
medically necessary as a result of injury or sickness.
- that commenced prior to the date you were otherwise eligible for
benefits or during a period when you were not eligible for benefits
for any reason, unless the plan has agreed in writing;
- while you are
- in a jail or penitentiary;
- on leave of absence or paid vacation;
- receiving benefits for the same or related disability from WCB
or similar legislation; or
- if you become disabled during a strike or lockout at your place of
employment; however, your right to benefits will be reinstated
when the strike or lockout ends.
The following steps must be taken as soon as possible after becoming
"disabled" (unable to work):
- Obtain an E.I. Claims Kit from a post office or the Employment
Office. The physician's report must be completed and a
copy sent to the Administrator's office.
- If the Member is not eligible for EI Sick benefits, he/she must
obtain the 2-page Machinists Fitters and Helpers Union Local
#3 CLC Welfare Plan Wage Indemnity Benefits Claim form
from the Administrator's office, as he/she is entitled to submit
a claim to the Wage Indemnity Plan, provided that a copy of
the EI rejection letter accompanies the claim. Claimants must
be under the care of a physician and be treated in person
during the period claimed for.
- Complete Section 1 of the claim form.
- The attending physician must complete Section 2 of the claim
form. If there is any charge for completing this form, it is the
- Send the second page of the claim form to the employer to
complete Section 3.
- All pages of the claim form must be completed and presented
to the Administrator's office within 30 days unless specified
circumstances prevent such.