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Weekly Indemnity |
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General
A Member is eligible for all benefits except Weekly Indemnity
after satisfying the normal qualifying conditions of the Plan. A
Member does not become eligible for Weekly Indemnity coverage
until the first day of the second month after the Member has
worked, and the Plan has received contributions, for 1,000 hours
of work with a participating employer.
The Weekly Indemnity benefit provides,
from the first claim submitted, a
maximum of 26 weeks of benefit. Once
the 26-week maximum has been reached, either through
one claim or a series of shorter claims, the entitlement
to benefits thereafter will be limited to a total
of 20 weeks. Once the 20-week maximum has been
reached, either through one claim or a series of shorter
claims, the entitlement to benefits will be limited
to a total of 13 weeks. Once a Member has claimed
the final 13 weeks (59 weeks total) he/she is no
longer eligible for Weekly Indemnity benefits.
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How
a claim is made for non-occupational
Weekly Indemnity Benefits
The following steps must be taken as soon as possible
after becoming “disabled” (unable to work):
- Obtain an E.I. Claims Kit from a Post Office
or the Employment Office.** The physician's report must be
completed and a copy sent to the Administration Office in
order that they may provide the Member with Disability
Credits. See Disability
Credits.
- If the Member is not eligible for E.I. sick
benefits, khe/she must obtain a claim form from the Administration Office as
he/she is entitled to submit a claim to the Ironworkers’ Weekly Indemnity Plan,
provided a copy of the E.I. rejection letter accompanies the
claim. Claimants must be under the care of a Physician and be
treated in person during the period claimed for.
- Complete the front of the claim form.
- The attending physician must complete the Physician’s
Statement on the back of the same form. If there is any charge for completing
this form, it is the claimant's responsibility.
- the claim should be presented within 30 days
unless special circumstances prevent such.
** A Member claiming for a non-occupational
accident may commence benefits from the 1st day of the accident through to
recovery or to the maximum weeks of claim, whichever occurs first at
$435.00 per
week. However, the Member must make an application to E.I. at the time of the
accident in order that benefits would commence with E.I. on the 15th day. The initial
2 weeks would be paid under the Health & Welfare Plan at
$435.00 per week.
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On what basis are the Weekly Indemnity Benefits
of $435.00 per week paid?
Claim cheques are mailed to the Member’s
home address at the end of each
7-day period on the basis of $62.14
per day up to a maximum of $435 per week, provided the Member is not eligible for
E.I. sick benefits, including Saturdays and Sundays.
Benefit payment commences on the 1st day of
a non-occupational accident or the 15th day of a sickness.
If hospitalized prior to the 15th day of disability,
benefits commence on the 1st day of hospitalization,
provided the Member is not eligible for E.I.
sick benefits during that period.
All substance abuse claims will be paid a maximum WI
benefit of 6 weeks, provided they are in a rehabilitation
centre and remain there for the full course
of treatment.
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Is it necessary
to consult a Physician in
person before making a claim for Weekly Indemnity Benefits?
Yes. The Physician’s report is required to
establish the record of the Member's inability to work and regular medical attendance will be
required for the duration of the claim.
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Will further medical reports be required?
Yes, depending on the nature of the illness and
in addition, it may be requested to have an independent medical
examination by the Plan’s Physician.
Members returning to work, must be cleared in writing to do so
by their physician.
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Limitations and Exclusions – Weekly Indemnity
Benefits
The Plan does not pay weekly benefits for:
- any injury or sickness:
- covered by E.I. sick benefits;
- covered by any Workers’ Compensation or
Occupational Disease Law;
- covered by the Insurance Corporation of
British Columbia;
- arising from or sustained in the course of
any occupation or employment for compensation, profit, or gain;
- any pregnancy related illness during a period
for which the claimant:
- is entitled to receive benefits from the
Employment Insurance Commission; or
- is entitled to pregnancy leave of absence by
reason of Provincial or Federal stature, or any greater period of leave
as granted by your employer by way of contract or agreement, verbal or
written.
- any Member who is in receipt of Canada Pension Plan Disability benefits
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