Lupus Canada Advokit

Employment Insurance Benefits

If illness or disability makes you unable to work and you have paid into the Employment Insurance account, you may be eligible for Employment Insurance sickness benefits.

Employment Insurance (EI) is a Federal program, also administered through Social Development Canada (SDC). These benefits are available to individuals who have lost their jobs through no fault of their own (that is, not being fired or quit), cannot find work, but have contributed to the EI program. It is a "contribution-tested" program, which means that any money you have in the bank or any assets - like a house, a cottage or boat - are not considered when determining your eligibility. There are two EI benefits programs - regular benefits and special benefits, which include maternity, paternity leaves, compassionate care and sickness benefits.

Applications for EI sickness benefits include a basic EI application form, a special benefits form to specifically apply for EI sickness benefits and a medical form to be completed by the applicant's doctor, confirming the medical condition and the fact that it prevents the applicant from working. Information and applications for these benefits are available at any local Social Development Canada (SDC) office. Check your local telephone directory to local the HRDC office closest to you.

You need to return the application and medical form to your local SDC office along with your Record of Employment (ROE), provided by your employer. The ROE lists your insurable earnings and the hours you have worked over the last 52 weeks or since your first day of work, whichever is shorter. If you have had more than one employer within the last 52 weeks you must attach all of your ROEs to your application, as they will be required to calculate your claim for benefits. You will also need to provide and/or show your Social Insurance Number (SIN) when submitting your application.

In order to be eligible for the sickness benefit, a person must have worked at least 600 hours during the previous 52 weeks or since your last claim. You may be eligible for up to a maximum payment of 15 weeks of financial benefits at 55% of your income, to a maximum of $413.00 per week. If you are in a low-income family (a net income of less than $25,921.00 per year) with children, and you receive the Canada Child Tax Benefit (CCTB), you could be eligible to receive a higher benefit rate. In this case your increase will automatically be added to your EI cheque.

Your EI sickness benefits will automatically end after 15 weeks of sickness benefits have been paid out or when you reach the date your doctor stated that you would be ready to return to work.

If they have all the required information and if you qualify for benefits, your payment will usually be issued within four weeks of the start date of your claim. If you do not qualify, you will receive a letter explaining the reason(s) why your claim for benefits has been denied.

The first two weeks of your claim are a waiting period, and you are not paid for that period. This is like a deductible for any kind of insurance. Any earnings made during the two-week waiting period will be deducted from the first three weeks of payable benefits.

In some instances, the two-week waiting period may be waived or deferred, but only under certain circumstances, including for example:

• If you get paid sick leave from your employer following your last day worked, the waiting period may be waived;
• If you receive group insurance payments, you can serve the two-week waiting period during the last two weeks that these payments are being paid.

After the two week waiting period, you could be paid for a maximum of 15 weeks, or shorter if your doctor indicates on the medical that you can return to work sooner.

If you are having problems completing your EI application, you have the right to receive help. If you disagree with an EI-related decision, you have the right to appeal that decision. You may want to talk with an EI staff member about this, to assure that all details of your case have been given, including any new information not previously presented and as well, to ask questions to clarify concerns you may have regarding the decision.

If you decide to appeal, write to your local SDC office explaining what decision you are appealing and why. Your letter must be sent within 30 days of receiving the decision letter and include your name, address and telephone number; your Social Insurance Number (SIN); what decision(s) you are contesting and your reasons for appealing; if you want to attend the hearing; if you want your hearing in French or English; if someone will represent you at the hearing, include that person's name and address. Don't forget to sign and date your letter.

For further information on the Appeals process, contact your Employment Insurance office or see their brochure entitled Employment Insurance: Appealing a Decision, available at their office.

For more information about EI programs you can contact your local SDC office (check for a listing in the blue pages of your telephone directory), contact your local MP's office or visit their web site at www.sdc.gc.ca and look under EI benefits.