Know your rights under the Nova Scotia Public Service Long Term Disability Plan.
Plan benefits are owed to employees who meet the test for disability. The test for disability under the Nova Scotia Public Service Long Term Disability Plan changes based on the passage of time since the onset of the disability. There are two main time periods to bear in mind: own occupation and any occupation.
Your right to receive compensation
Benefits are owed only for those who meet the test for disability, and only after the Elimination Period has been satisfied. The Elimination Period is a waiting time applied to your claim for disability benefits. Under the Nova Scotia Public Service Long Term Disability Plan. The plan text states:
when illness or injury results in the disability of an employee, the employee shall be eligible for benefits from the first day following the elimination period;
The Elimination period for full-time employees is 100 days of lost work due to the complete inability to perform the regular duties of his/her occupation due to illness or injury. The days must be consecutive, though there are a few exceptions related to return to work efforts.Benefits will then be paid back to the date of disability
Your rights under the Own Occupation test
The plan defines disability as follows:
"disability"/"disabled" means the complete inability of an employee, because of illness or injury, to perform the regular duties of his/her occupation during the applicable elimination period and the next 24 months of any period of disability...
Simply put, if you can't do your own job, you will be paid benefits for your inability to complete that job for up to 24 months so long as the disability continued during that period of time. The test will change to the Any Occupation test on the 25 month.
Your rights under the Any Occupation test
At month 25, a new test for disability benefits will apply. Your rights under the plan allow for continued benefits only if you meet the much wider test for disability on an "any occupation" basis:
...Thereafter, an employee remains disabled if he/she is unable to engage in any occupation for remuneration or profit for which the employee is or may become fit through education, training, experience or rehabilitation, which occupation pays not less than 75% of the current rate of the position, class and step he/she held prior to disability;
In our experience, the two most contentious issues at play during the 'any occupation' period are
- whether the other occupation is actually one that the employee is or may become fit to perform through education, training, experience or rehabilitation
- whether the other occupation can actually be expected to earn 75% of the pre-disability income.
Be sure to do a careful review of your claim if the insurance company suggests that you have no right to benefits because of the change of definition to the 'any occupation' test.
Has your right to benefits been denied?
Be sure to contact us right away for a free case review. Ideally, we are providing you with our opinion before the second appeal to Manulife. If this appeal has already happened in your case, please be sure to let us know right away. Time limits apply to your claim and timely notice to complete the final appeal must be made. Jeff Mitchell is an experienced Long Term Disability Benefits Lawyer who has successfully advanced his client's interests before the Nova Scotia Public Service Trust Fund. To book your free consultation, call toll-free: 1-855-670-1345 or 902-702-3452. Prefer to email? Email Jeff at firstname.lastname@example.org.