Disability Claims – A Primer For Health Care Workers

As health care professionals, you are aware of the risk of becoming disabled at any age.

Prior to the pandemic, Canadian workers took an average of 8.5 days of leave for illness and disability in 2019.[1]

The pandemic has had a significant impact on frontline health care workers’ mental health. A Statistics Canada survey, Mental health among health care workers in Canada during the COVID-19 pandemic, February 2021, revealed that 7 in 10 health care workers reported worsening mental health due to the pandemic.[2]

For those who find themselves unable to continue working due to impaired mental health, chronic stress, or other health related disabilities, it is important to understand which benefits may be available to you.

Workplace Safety and Insurance Benefits (WSIB) are available to many hospital workers, provided that the illness or impairment is sustained by accident, arising out of and in the course of one’s employment.[3]  Critically, amendments to the Workplace Safety and Insurance Act in 2017 now permit chronic or traumatic mental stress arising out of and within the course of the worker’s employment to be insurable.[4]  A diagnosis of post-traumatic stress can also qualify certain enumerated workers for benefits, provided certain conditions are met. [5]

Your employer may also offer a short term disability plan. Short term disability insurance, as the name suggests, is intended to replace a portion of your income for a short period of due to disability requiring you to be off work. While each plan may vary, typically, short term disability will provide coverage ranging from 60 percent to 80 percent of your income for up to six months.[6]  

If your employer does not offer a short term disability plan, or you do not qualify for the benefit, you can apply for Employment Insurance (EI) sickness benefits. EI benefits can provide you with up to 15 weeks of financial assistance if you cannot work for medical reasons. You could receive 55% of your earnings up to a maximum of $595 a week.[7]

Long term disability benefits are intended to provide coverage for a longer period of time, generally up to age of retirement for those who qualify, and typically begin when short term disability or EI benefits end.  These disability benefits typically replace 60 percent to 70 percent of your income.[8] Long term disability benefits are often available either through a group plan (such as your employer or union, college or professional affiliations) or can be purchased privately. Often group plans provide basic coverage.  For high income earners, it is wise to purchase additional long term disability coverage privately. If you pay the entire amount of the disability premium yourself (e.g. by funding your own private insurance, or as a source deduction from your paycheque), your disability benefits will be tax-free. If your employer pays all or part of the disability premium, your disability benefits will be subject to deduction for income tax.

Again, each disability plan is different so you should review your policy to see what you might be entitled to should the need arise. 

Another source of benefits is the Canada Pension Plan Disability (CPPD) benefits. They are intended to provide partial income replacement to eligible CPP contributors who are under age 65 with a severe and prolonged disability, as defined in the Canada Pension Plan legislation. There are two eligibility criteria for the CPPD program:

• Applicants must have made contributions to the program in four of the last six years, with minimum levels of earnings in each of these years, or three of the last six years for those with 25 or more years of contributions; and

• They must demonstrate that their physical or mental disability prevents them from working regularly at any job that is substantially gainful, and that it is long-term and of indefinite duration or is likely to result in death.[9]

Not all disabilities can be plainly seen or are easily recognized. The benefits outlined above are intended to safeguard you from an unexpected disability, including impaired mental health and chronic stress, that effects your ability to work and earn an income.

If you are looking for assistance, connect with us for a no cost consultation. We are here for you.

This article was originally written for and published in Hospital News January 2022 Edition by a member of the Personal Injury Team at McKenzie Lake. If you require assistance with a personal injury matter or wish to speak to a personal injury lawyer at McKenzie Lake Lawyers LLP, please call (519) 672-5666.

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[1] https://www.canada.ca/en/employment-social-development/news/2021/11/healthcare-workers-and-sick-days-news-release.html

[2] https://www150.statcan.gc.ca/n1/daily-quotidien/210202/dq210202a-eng.htm

[3] Workplace Safety and Insurance Act, 1997, S.O. 1997, c.16, SCHED. A, s.13(1)

[4] Ibid., s.13(4) & (5)

[5] Ibid., s.14.  The list of workers is long, and includes, among others, paramedics, members of an emergency response team, emergency medical attendants, ambulance service managers, and members of the College of Nurses directly involved in patient care.

[6] https://www.canada.ca/en/financial-consumer-agency/services/insurance/disability.html

[7] https://www.canada.ca/en/services/benefits/ei/ei-sickness.html

[8] Supra note 6

[9] Canada Pension Plan (R.S.C., 1985, c. C-8), s.44(1)(b); https://www.canada.ca/en/employment-social development/programs/pension-plan-disability-benefits.html