OFF WORK DUE TO ILLNESS OR INJURY: Insurance Benefits Available
A sudden injury or illness can turn your life upside down, especially if it causes disability from work. Coping with the injury or illness itself is challenging, but when compounded with the financial strain of being unable to work, the burden can feel overwhelming. Do you know what income loss benefits may be available to you if you are unable to work? To assist you during this difficult time, we’ve compiled the following essential information as your guide.
EMPLOYMENT INSURANCE (EI) SICKNESS BENEFITS
If you are off work due to an illness or injury, you may be eligible for EI Sickness Benefits. EI sickness benefits can provide up to 26 weeks of financial assistance if you can’t work for medical reasons, which includes illness, injury, quarantine, or any medical condition that prevents you from working.
If your regular weekly earnings decreased by more than 40% for at least one week, you should consider applying for EI benefits. You must have accumulated 600 insured hours of work in the 52 weeks before the start of your claim or since the start of your last claim (whichever is shorter), and you must get a doctor to complete a medical certificate showing that you are unable to work for medical reasons and approximately how long.
If you qualify for EI Sickness Benefits, you could receive 55% of your earnings, to a maximum of $668 per week. You can receive EI Sickness Benefits for a maximum of 26 weeks.
You can find out more information and apply online for EI benefits here: https://www.canada.ca/en/services/benefits/ei/ei-sickness.html.
Note that some other insurance benefits (Section B Weekly Indemnity benefits, for example) will require you to apply for EI Sickness benefits and will deduct the amount you are receiving from EI.
SHORT-TERM AND LONG-TERM DISABILITY BENEFITS
You may have short-term and/or long-term disability benefits available through your employer. Talk to your Human Resources department about what benefits you enrolled in. Each disability policy is different with respect to eligibility requirements and payment amounts, however all insurance policies are governed by legislation (in Nova Scotia, Insurance Act, RSNS c 231, s 1).
SECTION B – LOSS OF INCOME BENEFITS (Automobile Insurance Benefits)
If your injury is due to a car accident, you may be entitled to Section B Accident Benefits Weekly Indemnity Benefits through your car insurance company. If you meet the eligibility criteria, these benefits are available to you whether or not you are at fault for the accident.
If you are off work (disabled from work) for 7 days or more (this does not have to be 7 consecutive days) within the first 30 days after your accident and as a result of your injuries sustained in the accident, you should talk to your Section B adjuster about a claim for Weekly Indemnity benefits. You will need to have your employer complete a form confirming your salary and your time off work. You will also need a doctor to confirm you are unable to work due to injuries caused by the car accident.
You may be entitled to Weekly Indemnity benefits even if you were not working at the time of the accident. If you are disabled from work after the accident, make a claim and/or talk to a lawyer about what coverage you might be entitled to.
If you qualify for Weekly Indemnity benefits, you could receive 80% of your average weekly wage, to a maximum of $250 per week, for as long as you remain disabled. If you meet the initial criteria (off work for 7 days out of the first 30), and you return to work after 7 days but later are placed off again due to your injuries from the accident, you should ask that your Weekly Indemnity benefits be reinstated.
WORKERS’ COMPENSATION BENEFITS
If you were injured at work, you may be entitled to Workers’ Compensation Benefits. The Workers’ Compensation Board (WCB) providers workplace injury insurance to workers and employers in Nova Scotia pursuant to the Workers’ Compensation Act, 1994-95, c.10, s.1. Employers who conduct business in a ‘mandator industry’ (e.g., hotels, restaurants, supermarkets, fishing, trucking, construction and other manufacturing) must register if they have three or more workers at one time. If a worker is injured on the job, the injury must be reported.
WCB provides temporary and long-term income replacement benefits to injured workers as well as medical benefits, permanent impairment, death and survivor benefits where applicable. If you qualify for earnings replacement benefits, you could receive 75% of your earnings loss for the first 26 weeks and 85% of your earnings loss after 26 weeks, for as long as you are medically unable to return to work up to age 65. If you are still disabled at age 65, you will receive 5% of your total benefit paid as an annuity.
CANADA PENSION PLAN – DISABILITY BENEFITS (CPP-D)
If your injury or illness which is causing disability from work is severe and prolonged, you may be entitled to Canada Pension Plan disability (CPP-D) benefits. CPP-D can provide monthly financial assistance while you remain unable to work.
If you have a mental or physical disability that regularly stops you from doing any type of substantially gainful work and that is long-term and of indefinite duration, or is likely to result in death, you should consider applying for CPP-D benefits. You must have contributed enough to the Canada Pension Plan and you will be required to complete an application form and have your doctor complete a detailed medical certificate.
If you are over age 65 and are already receiving the monthly CPP retirement pension, you may be eligible for the post-retirement CPP-D benefit. You must meet the criteria and have been receiving the CPP retirement pension for more than 15 months or become disabled after starting to receive the retirement pension.
If you qualify for CPP-D benefits, you could receive a monthly amount between $583.32 and $1,606.78 (2024 amounts), based on how much you paid in the Canada Pension Plan while you worked.
You can find out more information and apply online for CPP-D benefits here: https://www.canada.ca/en/services/benefits/publicpensions/cpp/cpp-disability-benefit.html.
Note that some other insurance benefits (many long-term disability insurers, for example) will require you to apply for CPP-D benefits if you are off work for more than 2 years, and will deduct the amount of benefits you receive from CPP-D.
INCOME ASSISTANCE
If you are unable to work, you may be eligible to receive Income Assistance (IA) benefits. These benefits are often called benefits “of last resort” because all income from other sources will be considered when evaluating your eligibility for IA. The IA program helps you when you are not able to support yourself or your family. Depending on your situation, you may get money for your basic needs or help with other special needs.
You can find out more information and apply online for IA benefits here: https://novascotia.ca/coms/employment/income_assistance/index.html
TAX CREDITS AND BENEFITS FOR DISABLED PERSONS
There are tax credits and deductions available for persons with disabilities, their supporting family members, and their caregivers, including:
You can find out more information and apply online here: https://www.canada.ca/en/revenue-agency/services/tax/individuals/segments/tax-credits-deductions-persons-disabilities.html
CREDIT PROTECTION INSURANCE BENEFITS
You may have other insurance available on specific financial products, such as loan protector insurance on loans, lines of credit or credit cards, or mortgage insurance. Inquire with your bank to find out what protections you may have in place.
ACCIDENTAL DEATH & DISMEMBERMENT
If you suffered an injury in an accident that caused death or a specific serious injury*, such as paralysis, the loss of a limb, eyesight, hearing or speech, you may be covered under Accidental Death and Dismemberment (AD&D) insurance (often sold with life insurance). Inquire with your insurance agent and/or employer to find out if you have this coverage.
COMPENSATION FROM AT-FAULT PARTY (Personal Injury Claims)
If you were injured due to the fault of another person or company, such as in a car accident or slip and fall, you may have a valid claim against the at-fault party. A personal injury claim can include claims for compensation for pain and suffering, lost wages, diminished ability to perform housekeeping duties, medical costs and out-of-pocket expenses.
Sometimes, insurance companies will incorrectly deny a claim for income replacement benefits. If you have questions about a personal injury claim, insurance or any other coverage after an injury or illness, please do not hesitate to contact us. We offer free consultations in most cases, with no obligation to retain our services moving forward.
Carter Simpson has prepared this document for information only. It is not legal advice. You should consult Carter Simpson about your unique circumstances before acting on this information. Carter Simpson excludes all liability for anything contained in this document and any use you make of it.