Sudden STD pay suspension by TPA without cause

This STD situation is super weird and confusing don’t know what to make of it.

  • Extremely large international company, Alberta
  • Employed for 9 years
  • Started STD February 27 with 7 days paid sick leave (shift work 7 on 7 off).
  • Approximately 92 days on paid STD when letters sent June 5 & 6 suspending pay claiming leave not medically supported.
  • STD managed by a third party administrator while still paid directly from employer.
  • First direct contact with employer was June 5 notifying pay suspension.
  • TPA (OSI) accusations of refusal to return to work and letter is forcing an appeal process looking to be disguised as a information fishing expedition. Information requested for the appeal was not requested previously. Triple ***** in appeal guide say “…must provide a copy of your treating physicians clinical chart notes from the onset of your absence”. I assume they did not request these because they must pay for them?
  • Appeal dates and demands are unreasonable or impossible to complete, and seem to coincide with the 112 days that LTD would start.
  • LTD to start after 119 days with RBC Insurer but not applied for as instructed to deal with STD TPA.
  • TPA only communicated with doctors directly from consent form signed in the beginning giving them access to everything they want from doctors etc. If they have access to unlimited information already why are they asking for more in a forced appeal? Appeal is with TPA only and does not include employer involvement.


  1. Can an employer suspend pay suddenly without notice or just cause while on STD or medical leave? We even asked the employer for the accrued vacation pay which would cover 2 months. The only place in any of their policies that say suspended pay is in the D&A policies or if there was a workplace incident.
  2. Employer suspended pay saying “unpaid leave of absence” without the reason for the absence. The leave of absence is a job protected ground for unpaid leave and eligible for EI benefits…!!! Do we apply for EI or no?
  3. The TPA is implying, accusing, and vilifying the employee of wrongdoing, not participating and refusing to cooperate in the policy procedures and program. Their accusations, false claims, and detrimental decisions are shared with us suddenly and without notice. Even the Employer HR department that issued the pay suspension letter had no idea.

In your opinion what angle/game do you think we are dealing with here? They are trying to make it look like he is quitting by lying about his refusal to go to work therefore justifying a termination?!?! Obviously LTD is not an rightful option now either.

Should we revoke the consent letter right away now that they are forcing an appeal (appeal is done by their own INTERNAL appeal committee hahaha seriously what a joke)?

Should we file a complaint with the Human Rights Tribunal immediately?

They say when submitting our appeal all this new information not required before is required and includes our specific reasons as to why we disagree with the non-support of STD?

Also one big concern is the statement that is STD is denied we must pay back all the STD paid, is that from the date it starts or the date its denied via letter (91 days later)?

Thank you I appreciate all opinions comments and leads!

I can’t follow what you wrote right now (my concentration sucks right now).
Contact Resolute for a free consult:

You can explain the whole situation to them.

  1. In writing request a full and complete copy of your claim file. an example:

To (Insurer name, Case manager name and Privacy officer for Insurer)

I have provided and consented to you contacting my Doctor.
I do not understand the suspension of my benefits.
This is not helping me at all.

Please send me a full and complete copy of my claim file.
If documents are withheld please explain why.


Your name.

If you private message me I will provide you with the email addy’s for your Insurer if needed.

Apply for EI-sickness. Worth a try–if you get back your benefits-you would pay EI back.

Ask for an extension of the appeal in writing-see if they will grant it based on waiting for the claim file.

Get a good sleep–shake off the emotions and accusations against the Insurer. You and your spouse have
to remain cooperative, polite and act in the utmost good faith.

If your spouse is off with any form of mental illness/depression he needs his Doc to refer to a psychiatrist to review meds and provide options.

If they are pushing him back to work then he either needs to try or he has to have a Doctor saying in writing that he is unable to work. He can protect his job by having a doctor write that he needs to be absent from work.

Is there a Union involved?

Unpaid leave of absence just means he is off work without pay. If his employer has a doctors note saying he needs to be off–no issue yet.

Don’t poke the bear yet. Maybe you can provide more information and they will back down.
You should apply for long term.

I am not a lawyer. You may want to lawyer up in the near future.
This is not personal–it is business for them.