E.I. Sickness Benefits – An Overview [video]

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This lecture provides an overview of employment insurance sickness benefits and covers topics such as eligibility criteria, amount and duration of these benefits.

This lecture is taught by Amer Mushtaq, LL.B., M. Engineering , B.Sc. (Hons.), who is the Principal and Founder of Formative LLP.   Through his YouTube channel, YouCounsel, Amer shares practical advice from his years of legal experience to help anyone access justice and achieve their goals.  Subscribe today to learn more.

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Welcome everyone this is Amer Mushtaq from You Counsel. In our previous lecture, we talked about employment insurance benefits in general, we explained to you some of the types of employment insurance benefits that are available, and then we talked specifically about regular benefits that you get after your employment has ended. Today, we’ll talk about sickness benefits. A lot of people are not familiar with sickness benefits, the eligibility criteria, the duration, the amount, so, we’ll cover those topics in today’s lecture.

We begin with our usual disclaimer that this course is not legal advice, so, if you have any specific questions you must contact a lawyer, or a paralegal, or the Law Society of Upper Canada and in this case you can contact Service Canada, for more information about your entitlement to Employment Insurance Benefits and Sickness Benefits.

We’ll explain to you fundamentally what are sickness benefits. We’ll talk about some other types of E.I. benefits just basically telling you what are the other types. We’ll explain to you the eligibility criteria for sickness benefits, some discussion about E.I. Sickness Benefits versus short-term disability benefits, if those are benefits that are available to you in your workplace. When to apply for E.I. Sickness Benefits, how much benefits to you get and for how long, and where to apply.

Employment Insurance Benefits for Sickness is also a government program and it provides temporary financial assistance for people who are unable to work because of sickness, injury, or quarantine. They are quarantined because of any medical issues and those are the three situations in which you may be entitled to Employment Insurance Sickness Benefits.

Some of the other types of Employment Insurance Benefits we have talked about briefly in the previous lecture, irregular benefits, sickness that we’re discussing today, maternity, parental benefits, and if it’s compassionate care, parents of critically ill or injured children, fishing, and developmental program benefits.

Let’s jump into the eligibility criteria for sickness benefits, the first condition as in all Employment Insurance Benefits is that you were employed in an insurable employment. And what is an insurable employment? It is easy to determine, you can look at your pay stub, and you will see that there is a deduction for E.I. Employment Insurance that indicates that you are working an employment that is insurable and the limited remittances are being sent to CRA. on this account. If you are unclear, you can contact your employer to make sure that you are in insurable employment. If you are self employed, you should know whether you are registered with employment insurance or not and making payments for the E.I.

Second part for the eligibility, is that you must meet specific criteria for sickness benefits, usually a doctor’s certificate that indicates that you are unable to work, and indicates the duration for which you may not be able to work is usually sufficient. You must obtain, before applying for sickness benefits, you must obtain a doctor’s certificate and keep it handy. It is not required to be submitted as part of the application but the Service Canada people may ask you to provide them a copy or to provide the original certificate. So, you must have it before you apply for your sickness benefits.

Third, eligibility requirement is that your weekly earnings, your normal weekly earnings have been reduced by more than 40%. Obviously, if you are unable to work at all then your income is gone down to zero, but there may be other circumstances where you may be partially working for a few hours here and there and so, your earnings has dropped significantly more than 40% and that is another condition you must meet to apply for sickness benefits.

And finally, you must have accumulated at least 600 hours of insurable employment during the qualifying period, that’s important. So, you have you are in insurable employment, you have accumulated 600 hours of insurable employment during the qualifying period. And we have explained what is a qualifying period in our previous lecture. But briefly speaking, a qualifying period is within the last 52 weeks, so, you must have 600 insurable employment hours within the last 52 weeks. But if you had applied previously for another E.I. benefit during the 52-week’s period and then the qualifying period is the period from the commencement of your previous benefits to the commencement or the application of the new benefits. So, 600 hours are required.

A quick discussion about E.I. Sickness Benefits versus Short-Term Disability Benefits Plan. You may be employed with a company that have their own group benefits plan through a third party insurer or by themselves and it may have Short-Term Disability Benefit, Long-Term Disability Benefits, medical benefits etcetera.

So, if you are unclear you must contact your human resources and find out whether you have a benefit plan that covers Short-Term Disability Benefits. You should also find out what is the available period for those Short-Term Disability Benefits. Most often, the Short-Term Disability Benefits are about three months, sometimes about six months. So, I have not seen a Short-Term Disability Benefits plan which is less than three months, it is possible but normally three months to six months is sort of, the general range. So, find out what is the duration of the available Short-Term Disability Benefits plan.

The requirement for Short-Term Disability Benefits plan, under the insured maybe different than the requirements under the E.I., so you need qualify separately if you are applying for Short-Term Disability Benefits plan. You should also contend the benefits amount, how much money will you get under Short-Term Disability Benefits plan. And then you may also need to consider your future medical needs if you have to go, if your circumstances, medical circumstances are such that you expect to be on long-term disability benefits later on, then you may need to consider as well because you may have to go on a Short-Term Disability Benefits plan first and then be eligible for a Long-Term Disability Benefits plan. So, it all depends upon what are the terms and conditions of the group benefits plan that your employer has negotiated with the insurer, so, you need to find that out either from your human resources or get the contact information of the third party insurer and then contact them and obtain that information.

So, the lesson or the item that you want to keep in mind with respect to E.I. Sickness Benefits and Short-Term Disability Benefits is that if your employer does provide Short-Term Disability Benefits, then ideally, you want to apply for Short-Term Disability Benefits and not E.I. Sickness Benefits. Based upon another factor that you want to keep in mind is that these benefits may be deductible, so, if you apply for E.I. Sickness Benefits and you have Short-Term Disability Benefits then those Short-Term Disability Benefits may be deducted. So, you want to make sure that you are clear about the availability of Short-Term Disability Benefits and your employment. If you don’t have an option to apply for Short-Term Disability Benefits, then of course, you can apply for sickness benefits under the E.I. program.

How much money do you get? It is not based on your needs, it’s not based on your financial obligations, and it is calculated on the basis of 55% of your average insurable weekly earning. So, the maximum amount you can get is $543 per week at present time. This may change if the legislation changes, but at this point, $543 gross income per week is the maximum amount. And if you’re making about $50,000 plus then you get $543 per week, but if your income is less then this amount will be less.

There is a one week waiting period, consider it a deductible period, in which you don’t get any sickness benefits, and the first payment of your sickness benefits you receive it within 28 days after you have completed your application. So, you have filed your application and all other documents that maybe required, they’ve all been submitted to E.I., and within 28 days of that, you will get your first payment.

Remember that all E.I. benefits are taxable income, so, the money you get, taxes are deducted and then you get that payment. Duration of sickness benefits is 15 weeks maximum, so, if for any reason you are ill for longer than 15 weeks you will not get any more benefits from the E.I. system.

When and where to apply? As I mentioned earlier, there’s a seven days waiting period but you must apply immediately, do not delay the application process. And if your record of employment has not been issued yet, you should still apply for it so that you’re application is in the system and it is being processed. You can apply online or by attending a Service Canada office near your home or near your place. Here are the two websites, one is for the application, the online application and the other one is general information about different kinds of benefits. I will put these links in the description below this video and by all means you can click on there and go to these websites.

I hope this gives you a brief sense of what are E.I. sickness benefits eligibility criteria and amount. And if you have any questions about any of the things that we have talked about today, by all means send us an e-mail or contact us and we look forward to seeing you in the next lecture. Thank you for watching.

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