Long Term Disability insurance is wage replacement insurance, which provides you a monthly income if you become so totally disabled by a accidental bodily injury or disease while insured under this plan and under the age of 65 that you can no longer work for your living. Long Term Disability insurance covers you for those total disabilities that last beyond the period covered by the Weekly Wage Replacement Benefit. This benefit does not apply to dependents.
Definition of Total Disability: You will be considered "totally disabled" during the qualifying period and the next 52 weeks of a period of disability if you are unable, solely because of disease or accidental bodily injury, to work at your own occupation. Your own occupation means the type of work in which you were engaged and is not limited to the actual job you were performing prior to the start of a period of total disability. After this 52 week period, and during the same period of disability, you are totally disabled only if you are incapacitated to the extent that solely because of a disease or accidental bodily injury, you are unable to work at any occupation or employment for which you are, or may reasonably become, qualified by education, training or experience. Such disability must result from a medically determinable physical or mental impairment.
Maximum Period of Payment
You will be eligible for your first income payment from the plan after you have completed the qualifying period, which is the first 52 weeks of a period of total disability, or the duration of the Weekly Wage Replacement benefit, whichever is greater. However, you will not receive an income payment if you reach age 65 before you complete the qualifying period.
After completing the qualifying period, you will be eligible for income payments during the continuance of a period of total disability for a maximum of 5 years, or to retirement, or to age 65, if either occurs before 5 years.
A period of total disability is considered to cease:
- a)when you commence work at a reasonable occupation;
- b)when you fail to furnish proof of the continuance of total disability or refuse to be examined by a physician;
- c)when you cease to be under the care of a physician;
- d)the date of your death.
Amount of Monthly Income
The Long Term Disability benefit will be payable monthly in the amount specified in the “SUMMARY OF BENEFITS”.
The benefit is taxable however no tax will be withheld from your monthly payments. You will receive a T4A for all paid amounts by the end of February of the following year.
The maximum income payment from the Long Term Disability plan is described in the “SUMMARY OF BENEFITS”.
Direct Offsets
The amount of the gross benefit specified in the “SUMMARY OF BENEFITS” shall be reduced by any benefits under the Workplace Safety and Insurance Act. You must apply for all benefits for which you may be eligible under Workplace Safety and Insurance. If you are receiving WSIB benefits for an injury or disease which is totally unrelated to the disability for which you are receiving this LTD benefit, the insurance company will not reduce this LTD benefit by that WSIB benefit.
If you are disabled and receiving full benefits from this plan, and elect a different and lesser paid occupation not related to the an approved Program of Rehabilitation as described later in this website, the gross benefit payable under this plan shall be reduced by 50% of the earnings from the lesser paid occupation, subject to the All Source Maximum.
