Disability Claim not honored if suspended


#1

All the paperwork to receive short term disability was filled by my doctor but the employer sent me for a medical expertise with a doctor of their choice. Even though the doctor corroborated with my doctor I never received any benefits. The reason given by the employer was that when the employee is suspended so are their benefits. Is this correct? I was denied the therapy and medication needed to improve.


#2

Most policies say no benefits for temporary lay off or work or leave of absence-can you apply for EI for the time period-you usually have 5 weeks to start the claim-but I would file immediately
How long was your suspension for? I believe you could argue that you should be covered for any period that did not overlap the suspension.
Did your employer warn or advise you that you would not have benefits prior to the suspension? The fact the employer sent you to their doctor implies they did not. You maybe able to claim against your employer.
Are you unionized?.
Was the suspension justified or was it due to your medical condition?


#3

You have a duty to mitigate and not having the funds to get medication and treatment may go against you. You must comply with treatment except if you can show it would not be effective or you exhausted all resources to find a way to comply


#4

The employer never told me about me losing my benefits before and it took her about 2 months of me enquiring why I wasn’t receiving my benefits to write this. I was not giving a form to apply for my Unemployment because she stated I was still under employ. The request for disability benefits and suspension happened around the same time.


#5

No I am not unionized. The employer claims it was justified I deny this and am taking them to court.


#6

Then your employer is negligent -you have a very strong argument/case against your employer on the benefits advice. Advising against EI and not letting you know about your benefits and you relied on that.
Not sure how long you were suspended for-but if your claim was longer than the suspension -you should have coverage for those weeks. Not sure if you are represented but depending on the amount you could go small claims against both?


#7

I am not quite sure what you mean by saying your employment was suspended? We you laid off? Fired? On unpaid sick leave?

The issue in these case is WHEN your disability arose. If your disability or illness arose while you were covered under the policy and when you were “actively at work” then you would have a valid claim. You must have been actively at work at time disability arose and perhaps this is the problem in your situation. You should seek legal advice from a disability lawyer.


David Brannen

Disability Lawyer with Resolute Legal

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