A steward needs to know the following basic information about the LTD Plan. Please share it with your members, in particular anyone who can’t work because of illness or injury.
Both are available at www.sgeu.org/content/long-term-disability.
Once a member is accepted to receive benefits, they have access to staff of the LTD Plan, including vocational rehabilitation counselors. The steward’s role is greatly diminished, unless and until the member returns to work.
Stewards need to understand that the employer and the union have a legal obligation to disabled workers (called the duty to accommodate). When a disabled employee’s doctor determines that they are able to return to work, the employer is required to bring that employee back, with any necessary modifications to tasks, equipment, or work schedule identified by the doctor, unless it causes the employer an undue hardship. And the union is required to co-operate and remove unnecessary barriers to the return to work.
Conflict can arise in the workplace if co-workers do not understand why there are changes in the workplace. For example, the disabled employee may not have to do the same duties or work as many hours or days as they did before. The steward’s role is to educate the rest of the workplace before the disabled employee’s return to minimize backlash and to address any bad behaviour or harassment that occurs after the return to work.
SGEU’s vocational rehabilitation counselors will work out the details of a disabled employee’s return to work. If you, the steward, see that the employer is violating the terms of that return-to-work agreement, have the member get in touch immediately with their voc rehab counselor or AAA. Finally, stewards can document any violations (or non-violation and help the disabled member grieve if necessary.
What if the member’s claim is denied or terminated?
A member’s claim can be denied if the medical evidence doesn’t support the disability or illness. Benefits can be suspended if the member doesn’t follow the proper process or doesn’t act on requests from the Plan. Or a claim can be terminated according to the rules listed in the Plan Text.
If a member’s claim is rejected, they can appeal within 30 days as outlined in Article 4 of the LTD Plan Text [link]. SGEU’s LTD Claimant Advocates will assist and can be reached at 1-800-667-5221. All reasonable costs of the appeal process are covered by the Plan. The appeal process is designed to be streamlined and accessible to members.
What happens if and when the member is able to return to work?
If and when the member’s doctor(s) determines that it is possible to return to work, even on a part-time basis, this is what happens:
a) The doctor provides a letter stating that the member can return to work and outlining any limitations on work duties or length of the work day or work week.
b) The employer reviews the letter and the work that needs to be performed in the workplace, and considers what accommodations it can make to address the medical restrictions.
c) The employer meets with the member and union representatives (including the member’s vocational rehabilitation counselors) to make an offer, which specifies the duties and any accommodations.
d) The member reviews the offer with their doctor, to make sure it meets any limitations, and with their vocational rehabilitation counselor, whose priority is to see the member returned to their previous job or a job in the same workplace.
e) Once all parties agree to a return-to-work program, the member returns to work, keeping their doctor and the employer informed of any difficulties or improvements. If the return-to-work is part-time, LTD benefits continue but are reduced accordingly.
f) A permanent return to work may require temporary or permanent changes to the workplace and/or to the duties that the member performs.
What happens if the member returns to work and becomes disabled again?
A member who returns to work after a period on LTD benefits may become eligible for benefits again if:
a) They become disabled due to a recurrence of the same disability or illness within one year of returning to work; or
b) They experience an unrelated disability or illness within one month of returning to work; and
c) They provide medical documentation to support the disability.
For other frequently asked questions, see the LTD Plan Guide at /public/files/aboutLTD/Long Term Disability Plan Guide.pdf