{"id":1935,"date":"2024-06-27T14:43:21","date_gmt":"2024-06-27T18:43:21","guid":{"rendered":"https:\/\/johnstonesbenefits.com\/clients\/ila\/?p=1935"},"modified":"2024-05-27T15:07:28","modified_gmt":"2024-05-27T19:07:28","slug":"disabled-employees","status":"publish","type":"post","link":"https:\/\/johnstonesbenefits.com\/clients\/ila\/disabled-employees\/","title":{"rendered":"Disabled Employees"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-7n8iqn-ffee3da15dad0b1b9500009b4bd9d8ac\">\n#top .av-special-heading.av-7n8iqn-ffee3da15dad0b1b9500009b4bd9d8ac{\npadding-bottom:10px;\nfont-size:4vw;\n}\nbody .av-special-heading.av-7n8iqn-ffee3da15dad0b1b9500009b4bd9d8ac .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n#top #wrap_all .av-special-heading.av-7n8iqn-ffee3da15dad0b1b9500009b4bd9d8ac .av-special-heading-tag{\nfont-size:4vw;\n}\n.av-special-heading.av-7n8iqn-ffee3da15dad0b1b9500009b4bd9d8ac .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-7n8iqn-ffee3da15dad0b1b9500009b4bd9d8ac av-special-heading-h2 blockquote modern-quote  avia-builder-el-0  el_before_av_hr  avia-builder-el-first  av-inherit-size'><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >The Journal<\/h2><div class='av-subheading av-subheading_below'><p>Solid Group Plans Made Simple<\/p>\n<\/div><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n<div  class='hr av-62qwv3-99f51102a234030ecc41c7660af23900 hr-default  avia-builder-el-1  el_after_av_heading  el_before_av_heading '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lwpbirls-26b0298ff11208c582d981d4cf59ffde\">\n#top .av-special-heading.av-lwpbirls-26b0298ff11208c582d981d4cf59ffde{\npadding-bottom:10px;\ncolor:#c4a106;\nfont-size:3vw;\n}\nbody .av-special-heading.av-lwpbirls-26b0298ff11208c582d981d4cf59ffde .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n#top #wrap_all .av-special-heading.av-lwpbirls-26b0298ff11208c582d981d4cf59ffde .av-special-heading-tag{\nfont-size:3vw;\n}\n.av-special-heading.av-lwpbirls-26b0298ff11208c582d981d4cf59ffde .special-heading-inner-border{\nborder-color:#c4a106;\n}\n.av-special-heading.av-lwpbirls-26b0298ff11208c582d981d4cf59ffde .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-lwpbirls-26b0298ff11208c582d981d4cf59ffde av-special-heading-h2 custom-color-heading blockquote modern-quote  avia-builder-el-2  el_after_av_hr  el_before_av_hr  av-inherit-size'><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >Disabled Employees<\/h2><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-3hsi6n-5651fb941b2ac38df4acf8ffd764f5b1\">\n#top .hr.hr-invisible.av-3hsi6n-5651fb941b2ac38df4acf8ffd764f5b1{\nheight:30px;\n}\n<\/style>\n<div  class='hr av-3hsi6n-5651fb941b2ac38df4acf8ffd764f5b1 hr-invisible  avia-builder-el-3  el_after_av_heading  el_before_av_one_full '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-2774dr-1b754eee3e5869f69cad80a409759b1f\">\n.flex_column.av-2774dr-1b754eee3e5869f69cad80a409759b1f{\nborder-radius:0px 0px 0px 0px;\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-2774dr-1b754eee3e5869f69cad80a409759b1f av_one_full  avia-builder-el-4  el_after_av_hr  avia-builder-el-last  first flex_column_div av-zero-column-padding '   ><section  class='av_textblock_section av-lwpbmheh-6fec5dad2339ac9331408b4284c7f3db'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p><a href=\"https:\/\/johnstonesbenefits.com\/clients\/ila\/wp-content\/uploads\/2024\/06\/2024_06-Disabled-Employees.pdf\" target=\"_blank\" rel=\"noopener\">Click here to download pdf<\/a><\/p>\n<p><strong>We can help you navigate the process!<\/strong><\/p>\n<p>One of your employees becomes disabled and is unable to work. Depending on the disability \u2013 the cause, the duration, what income replacement plans your organization has in place, etc. \u2013 the process can be somewhat daunting and confusing. Not something an employee or their family or the employer needs in an otherwise difficult time!<\/p>\n<p>Johnstone\u2019s Benefits provides disability claims assistance as a core service to help clients manage the process \u2013 providing answers to their questions, assisting with forms, liaising with the insurer(s) facilitating the application process, reminding stakeholders of their coverage, timelines, etc.<\/p>\n<p><strong>Disability claims process<\/strong><\/p>\n<p>When an employee becomes disabled, we recommend you contact us, as getting the information and steps correct from the start is critical. The application process and approval time for disability claims can be lengthy, and then there\u2019s the paperwork!\u00a0 Insurers require information from the employee, the employer, and the physician(s). These can be submitted separately but the insurer won\u2019t start their adjudication process until all three statements are received. The physician statement will include substantive information about the disability, and may include medical test results, prognosis, and treatment plans. Upon review, the insurer may request additional information to assess the claim and may also ask for an independent medical examination (IME). This creates the potential for missed steps and delays, so having a liaison to assist the flow of the communications is helpful!<\/p>\n<p><strong>Definition of earnings<\/strong><\/p>\n<p>For our TPA clients, we ask they update us with salary changes throughout the year. For non-TPA clients, the establishment of the earnings at the time of disability is critical \u2013 we can help with any queries as to what is included. Not only may incorrect information impact the premiums payable to the insurer(s), but correct earnings information also determines the disability benefit payable to the disabled employee. \u201cEarnings\u201d in the disability insurance policy is used in the calculation of the benefit. Often defined as \u201cregular\u201d weekly (for short-term disability) or monthly (for long-term disability) earnings, it can include commission or other forms of income, but typically does not include dividends or overtime. The disability benefit is established based on the earnings amount as of the date of disability; their salary\/wage cannot be adjusted until the employee returns to work.<\/p>\n<p><strong>Non-evidence maximum (NEM) <\/strong><\/p>\n<p>As part of our TPA services, we regularly remind employees of the NEM \u2013 the amount of disability coverage they are eligible for without providing the insurer evidence of good health \u2013 and the process if they are eligible for and wish to apply for additional coverage based on their earnings. This may not seem important until the employee is disabled when they realize a missed opportunity for a higher benefit.<\/p>\n<p><strong>Types of disability plans<\/strong><\/p>\n<p>For short-term disabilities, employers may offer their employees an insured short-term disability plan (STD) and\/or an employer-paid sick leave plan, or supplementary plans to utilize the government\u2019s Employment Insurance (EI) Sickness Benefit. Supplementary Unemployment Benefit (SUB) plans, approved by Services Canada, can also be designed to top-up other short-term disability plans.<\/p>\n<p>If the disability is a result of employment-related injury or illness, Johnstone\u2019s Benefits can help you coordinate income replacement through another short-term disability plan, if necessary, while getting this coverage established, as well the appropriate reconciliation and deductions reporting.<\/p>\n<p><strong>Understanding disability plan offsets<\/strong><\/p>\n<p>Insurers apply offsets in their disability plan policies so employees can\u2019t \u2018stack\u2019 benefits while on LTD. Primary offsets typically include workers\u2019 compensation benefits, CPP disability benefits, EI Sickness Benefit, wages or other renumeration from the employer (not SUB benefits). Secondary offsets may include spouse or children\u2019s or spouse\u2019s CPP benefits.<\/p>\n<p><strong>Timing considerations<\/strong><\/p>\n<p>Doctors\u2019 appointments, scheduling medical exams, completing reports required by the insurer(s) all take time. We recommend employees start the disability claim application process as soon as possible. If the employee anticipates a longer-term disability, we recommend they contact us two (2) months prior to the end of the LTD elimination period. This \u201cwaiting\u201d period commonly aligns with the short-term disability plan benefit maximum period \u2013 17, 26 or 52 weeks. Insurance companies have a cut-off date for an application for disability benefits, which are not easily negotiated if missed. This date affects the actual benefit eligibility, as well as eligibility for an approved waiver of premium for the employee\u2019s life insurance.<\/p>\n<p><strong>Waivers of premium<\/strong><\/p>\n<p>Disabled employees are legally eligible for group benefits as long as they are an \u2018employee\u2019, if they continue to pay the insurance premiums they would normally be responsible for. Once employment is terminated, or \u201cfrustrated\u201d, benefits typically end. However, benefits with a \u201cwaiver of premiums\u201d provision \u2013 life insurance, accidental death &amp; disablement, disability insurance, critical illness insurance \u2013 allow continuation of these coverage for a disabled employee provided they deem the employee to meet the definition of \u201cdisabled\u201d. The waivers of premium must be applied for and approved within the insurer(s)\u2019 timeline. AGAIN \u2013 we can help!<\/p>\n<\/div><\/section><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-1935","post","type-post","status-publish","format-standard","hentry","category-news"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\r\n<title>Disabled Employees - Johnstone&#039;s Benefits<\/title>\r\n<meta name=\"description\" content=\"Johnstone&#039;s Benefits provides simple employee insurance benefit programs for large and small business.\" \/>\r\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\r\n<link rel=\"canonical\" href=\"https:\/\/johnstonesbenefits.com\/clients\/ila\/disabled-employees\/\" \/>\r\n<meta property=\"og:locale\" content=\"en_US\" \/>\r\n<meta property=\"og:type\" content=\"article\" \/>\r\n<meta property=\"og:title\" content=\"Disabled Employees - 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