Long-term disability benefits provide financial help should you become disabled for an extended period of time. If you are eligible for benefits, you will receive a percentage of your income while you are on long-term disability leave.

For a summary of your long-term disability coverage, refer to the Benefits At-a-Glance section. There you will find information on benefits payable in the event you become disabled.

For a list of long-term disability exclusions, see the Exclusions section.

The plan will pay monthly long-term disability (LTD) benefits to you if you are considered totally disabled. These benefits are taxable.

Your benefit amount will increase annually to take into account the rising cost of living. Although a disability can put your life on hold, the cost of living keeps on growing. That’s why the PSGIP currently increases benefits on January 1 of each year after your first full calendar year of total disability. This increase is equal to the annual increase in the Consumer Price Index, to a maximum of 3% per year.

If you become disabled as a result of an accident, you may also be eligible for a permanent total disability benefit under your AD&D insurance. See the AD&D insurance section for more information.

Your Benefits and Pension During Periods of Disability

The continuation of your benefits while on long-term disability leave depends on the benefit and your employment group. Certain benefits could be continued without premium payments. Johnson Inc. will provide you with details at the time of your application for coverage.

While you are receiving long-term disability benefits, an additional percentage of your earnings will be paid on your behalf to cover your contributions to the pension plan – the Civil Service Superannuation Fund.

When Will Benefits Begin?

LTD benefits will begin after the qualifying period has been satisfied, which is the later of:

• the date your accumulated sick leave credits have expired, or
• four months of continuous total disability.

You must, however, still be totally disabled at that time.

When Will Benefits End?

LTD benefits continue until the earliest of the following dates:

• when you cease to be disabled,
• when you fail to submit to a requested physical examination and/or mental evaluation,
• when you fail to provide satisfactory written proof of continuance of disability,
• when you are no longer receiving regular and ongoing care of a physician,
• when you refuse to enter into (or stop participating in) any rehabilitation program that the insurer considers to be appropriate,
• for approved claims that:
• Begin on or after January 1, 2019: when you reach age 62 (if your sick leave benefits end after your 61st birthday, monthly income payments will continue beyond age 62 until a total of 12 monthly payments have been made or your disability ceases),
• Began between February 1, 1998 and December 31, 2018: when you reach age 60 (if your sick leave benefits end after your 59th birthday, monthly income payments will continue beyond age 60 until a total of 12 monthly payments have been made or your disability ceases),
• Began before February 1, 1998: when you reach age 65,
• when you reach age 62 (if your sick leave benefits end after your 61st birthday, monthly income payments will continue beyond age 62 until a total of 12 monthly payments have been made or your disability ceases). Employees disabled before February 1, 1998 will continue to receive benefits on approved claims until age 65,
• when you are incarcerated in a prison or mental institution by authority of a criminal court,
• when you refuse to complete and return a Reimbursement Agreement/Direction form, provided by Canada Life, form or comply with the terms of a signed Reimbursement Agreement/Direction form, when requested, in accordance with the provisions under third-party liability, or
• when you die.

Note: LTD benefits may extend beyond your termination date provided you became disabled while you were still insured. Benefits will continue to be paid according to the contract provisions regardless of the subsequent termination of the group policy. Canada Life reserves the right to request proof of the continuance of total disability and to have you submit to an examination by Canada Life’s medical advisors when requested.

In the Case of a Reoccurring Disability

Rehabilitative Programs

If you have been disabled for the waiting period or longer and engaged in a rehabilitative program approved by the insurer, you will continue to receive LTD benefits.

However, the monthly LTD benefit will be reduced by 50% of the amount, if any, of remuneration you earn for the work performed during the rehabilitation period. This reduction applies provided that, while on rehabilitative employment, your income from all sources outlined in the Other sources of income section is not greater than 100% of earnings before your disability.

LTD benefits will end when your rehabilitative income equals 75% or more of the current monthly earnings for your normal occupation.

This rehabilitative income will continue until the earliest of the following dates:

• the date your rehabilitative employment ends,
• no later than 24 months after the rehabilitative employment began,
• the date the rehabilitative employment is no longer approved, or
• your 60th birthday.

Other Sources of Income

LTD benefits are designed to give you a reasonable level of income without equalling or exceeding your normal pay. For this reason, the benefit you receive from the plan will be reduced by income from any of the following sources:

• disability benefits payable under the Canada or Quebec Pension Plan (C/QPP), excluding C/QPP benefits for dependents,
• earnings or payments from any employer,
• disability benefits payable under any other group, association or franchise insurance plan,
• disability and income replacement benefits payable under any government plan (excluding employment insurance (EI) benefits),
• retirement benefits provided by an employer,
• income replacement indemnity payable under any automobile insurance plan, and
• earnings recovered through a legally enforceable cause of action against some other person or corporation.

There is a further reduction of your benefit if the total of the long-term disability benefit, the income from all sources outlined above and the public pension plan benefits payable to you on behalf of another member of your family exceeds 85% of your monthly earnings before you became disabled. If it does, your benefit is reduced by the excess amount.

Should you not be eligible for LTD benefits due to this benefit integration, contributions to your employer’s pension plan will still be made on your behalf.

Note: Your monthly LTD benefit will not be reduced by disability benefits payable under the C/QPP until your C/QPP benefits are determined. However, when you submit your LTD claim, you must sign an agreement to reimburse the insurer. Otherwise, C/QPP benefits that have not been determined by the time your benefit is payable will be estimated and deducted from your monthly benefit. Adjustments to correct such payments will be made after the award has been determined.

Third-Party Liability

If you have a cause of action against a third party for income lost as a result of your disability, the LTD will be payable as specified. However, before payments begin, you must complete a Reimbursement Agreement/Direction form, provided by Canada Life, agreeing to reimburse the insurer. The amount to be reimbursed will not exceed the amount of LTD benefits paid by the insurer. Full details concerning terms and calculation of reimbursement are as set out in the agreement.

No LTD benefit will be payable for any period of total disability:

• during which you are not under the care of a doctor,
• during the time you are on a maternity leave agreed upon by you and your employer,
• during which you fail to undergo medical, psychiatric, psychological, educational and/or vocational exams by examiners selected by the insurer,
• during which you are incarcerated in a prison or mental institution by authority of a criminal court,
• as a result of drug or alcohol use or the use of any hallucinogen unless in an approved rehabilitation program or due to an organic disease,
• resulting from intentionally self-inflicted injuries or attempted suicide while sane or insane,
• resulting from war, declared or undeclared, insurrection, rebellion, participation in a riot, or active duty in the armed forces of any country,
• resulting from the commission of or an attempt to commit a criminal offense,
• due to a condition for which you were treated or attended by a physician, or for which prescription drugs or medicines were taken within a six-month period prior to the effective date of your insurance. This limitation will not apply after you have performed all the duties of your regular occupation on a regularly scheduled basis for a 24-month period after your effective date, or
• for any period in which you are entitled to benefits under any Workers' Compensation Act.

If you must hold a government permit or license to perform your duties, you will not be considered totally disabled solely because your permit or license has been withdrawn or removed.