Vice President’s Message

It has been a difficult year with this global pandemic and, as front-line workers, there has been no time to take a break. Nobody wants to be unhealthy, but if the situation arises, we have an insurance plan every member should know about.

So, what is LTD?

The long-term disability (LTD) benefit is an insurance policy. There is no reason for someone not to apply for LTD, providing they are off work, on disability or modified duties for more than six months uninterrupted. That would include anyone already in the process or approved for WSIB. If a member does not apply within a year, Manulife will consider the claim closed.

To qualify for LTD, a member must be under the age of 65. If the member is between the age of 60-65, they could not qualify if they had accumulated 25 years or more of pensionable TFS service at age 60. An employee who reaches 25 years of pensionable TFS service AFTER age 60 will not be affected by this provision.

Most LTD plans range from 50% to 80% of an employee’s annual salary. The City of Toronto’s LTD plan with Local 3888 pays seventy-five percent (75%) of an employee’s basic salary, including any benefit paid under any pension plan, insurance plan and/or Workplace Safety and Insurance Act. The monthly amount of LTD is based on gross earnings, not net; so, a member’s take-home pay on LTD (short-term) is similar to a member not on disability. When approved for LTD, payments are paid monthly through the insurance provider instead of bi-weekly by the City of Toronto. A common myth suggests that people on LTD from ten years ago make the same wages as members’ income today. I wish this were true, but it is not. Unfortunately, our plan does not allow for the cost-of-living indexing.

How is the annual rate of pay for LTD benefits determined?

LTD benefits are determined by the date of the disability.

Date of Disability: The date of disability is identified by the last day worked before the six months, uninterrupted qualifying period.

When a member gets approved for LTD, there are no increases from that date. In other words, if someone went off on disability ten years ago, they would be receiving 75% of the current salary they were making at the time. A first-class firefighter made $80,000 ten years ago. If they are still off on LTD today, that would be their date of disability amount. Unless the member returns to work, there is no way to increase their pension, salary and other increments while on LTD.

Is the member on LTD still able to use their benefits?

The City of Toronto provides employees who are in receipt of long-term disability plan benefits benefit coverage under the Extended Health Care, Group Life Insurance and Dental Plans. Under this plan, the City shall pay one hundred percent (100%) of the premiums.

What is a qualifying period?

Qualifying Period: To qualify for LTD, it takes six months of uninterrupted time. During the six (6) month qualifying period, the employee is subject to participating in the Modified Work Program Policy, which will not interrupt the qualifying period to qualify for LTD. Generally, a member will receive a package in the mail after three months. If they do not receive a package, please contact the Association. When calculating the long-term disability benefit referred to in clause 16.06(a), above, the employee’s basic salary shall take into account changes in salary, if any, that occurred during the “qualifying period” if the employee was a participant in the Modified Work Program at the time that the salary change(s) took effect. A member who has applied for the long-term disability benefit, but who has exhausted their sick pay credits before the conclusion of the six (6) month qualifying period, may use any vacation entitlement or lieu time owing as sick credits. In that case, the vacation or lieu time will be treated as sick pay credits, and the provisions of this Article and Article 14 of the Collective Agreement will apply.

What are the different parts of the LTD package?

The LTD package has three sections: • Employer’s Statement: The employer confirms the date of disability and timelines and delivers information directly to Manulife. The member never receives this package. • The Physician’s Statement: The member’s family doctor or specialist should fill out the physician’s statement. It is important to note that when someone applies for LTD, it isn’t like

WSIB. The medical treatment provided should be holistic, taking into account all ailments. For example, a member may have a mental health issue, but is off due to a shoulder replacement. The member should report all their pertinent medical history on the forms. • The Member’s Statement: The member provides information regarding the claim, history, and a personal perspective of the symptoms and conditions.

VICE PRESIDENT’S MESSAGE CONTINUED...

This portion of the process looks pretty daunting. However, the member’s statement supports the information provided by the physician’s statement. It is important to include all treating healthcare providers. I tell members not to downplay their conditions. No one wants to be unhealthy; sometimes we are, and that is why this exists.

What other forms are included in the LTD package?

• Notice of Competition Form: The

City of Toronto is required to provide promotional competition notification in the workplace. If a member on LTD wishes to receive a copy of the notice for competition in which they may be eligible to participate, they should complete this form. • Consent to Releasing Information

Form: This form provides members with the opportunity to share their personal medical information with Employee Health for the City of

Toronto. All medical information provided to Manulife is protected and cannot be shared with the City of Toronto unless this form is signed. There is no reason to fill out this form, and it doesn’t affect qualification. Where this form is relevant is during the return-towork phase. If a member has questions, they should contact the Association. • Use of Available Credits Elections

Form: When a member receives LTD, the member may receive Long Term

Disability payments from the carrier and cease participating in the Modified

Work Program or utilize sick credits before receiving Long Term Disability payments. If the member chooses to use sick credits, they will be required to provide a return-to-work form. Once a member is receiving LTD-paid benefits from the provider, that requirement will no longer exist. • Workplace Safety Insurance Board

(WSIB) Assignment of Benefits

Form: LTD payments are directly offset by all other income sources, including any WSIB benefits or pension payments. Should a member be denied

WSIB benefits and subsequently approved later through an appeal, they will have to repay Manulife Financial any LTD payments received for this period. In addition, if you were receiving

WSIB advances/top-up from the City of

Toronto for a denied WSIB claim, they will be required to pay any advances/ top-up back to the City of Toronto from your LTD payments. This form is required to be completed and submitted. • CPP Wavier: Information about the

Canada Pension Plan (CPP) disability benefit is available online at www. servicecanada.gc.ca or via phone at 1-800-277-9914. If a member’s claim is approved, their LTD benefit will be subject to the statutory deductions of

Income Tax, CPP and EI. If the members are approved for CPP disability benefits, the CPP contributions are waived and will not be deducted from your monthly LTD benefit. • Information about the OMERS

Disability Benefits: An OMERs

Disability Waiver of Contribution

Benefit allows a member to continue to accrue credited service towards their pension without paying contributions (no member cost), as if they are still working. If approved for the disability waiver, the OMERS Plan covers the member’s contributions and the employer’s contributions during your disability.

What do Own Occupation and Any Occupation mean?

After the six months qualification period for the LTD is completed, the clock starts ticking regardless of being approved for LTD or not. Qualifications for coverage will be based on the following:

Own Occupation: Normal occupation: the regular occupation, job or work (apart from any temporary assignment) member was performing at the time he/ she became totally disabled by the condition which prevented them from working and led to a claim being made under this plan. The own occupation period is only for two years.

Any Occupation: any other occupations, jobs or work: (a) for which they are, or become, qualified by his/her education or training or experience, considered collectively or separately; and (b) for which the current monthly earnings are 75% or more of the current monthly earnings for the employee’s normal occupation. In any occupation phase, there are no time limits.

What if I am denied for LTD?

Expedited Process for Appeals:

There are times where members submit claims for LTD, and the claim is denied. Often this is because there wasn’t enough medical information provided, all the paperwork wasn’t completed fully or because of timeline issues. Our Collective Agreement has specific language that outlines a process to deal with appeals. Please contact the Association for support if a claim is denied.

Long-term disability can be confusing and may be a benefit that most of us will never use in our careers. But, if the time comes where it is an option, there is no reason not to apply. LTD is your insurance policy.

Kevin McCarthy, Vice President Toronto Professional Fire Fighters’ Association I.A.F.F. Local 3888