Digest of Benefit Entitlement Principles Chapter 12 - Section 3

12.3.0  Maternity benefits as part of special benefits

Maternity benefits, together with the following types of EI benefits, are known collectively as special benefits, and have specific requirements for payment, as well as limits to the number of weeks that can be paid:

• parental benefits (to care for a new born or a child placed for the purpose of adoption) (Digest 13.1.0; Digest 13.1.2)
• sickness benefits (in case of illness, injury, or quarantine) (Digest 11.2.0; Digest 11.3.0)
• compassionate care benefits (to care for a seriously ill family member with a significant risk of death within 26 weeks) (Digest 23.1.0; Digest 23.2.1), and
• family caregiver benefits for children or adults (to care for or support a critically ill family member) (Digest 22.1.0; Digest 22.2.1)

The number of weeks of special benefits that can be paid is not linked to the unemployment rate, as it is for regular benefits, but rather, the maximum for each type is set out in the legislation. These parameters are explained in the following section.

12.3.1  Limits to the number of weeks of special benefits payable

Each type of special benefits has an individual maximum number of weeks that can be paid in one benefit period [EIA 12(3)]. The individual maximums are:

• 15 weeks for maternity benefits
• 35 weeks for standard parental benefits or 61 weeks for extended parental benefits
• 26^{Footnote 1} weeks for sickness benefits
• 26 weeks for compassionate care benefits
• 35 weeks for family caregiver benefits to care for a child, and
• 15 weeks for family caregiver benefits to care for an adult

Special benefits may be paid in any combination during a benefit period, provided the claimant proves entitlement for each type of benefits claimed.

A maximum of 50 weeks of benefits can be paid when regular and special benefits are combined. The only exception to this is when regular benefits and extended parental benefits were paid in the initial benefit period. Refer to Chapter 13 – Parental benefits, for more information on combining regular and extended parental benefits, and the maximum number of weeks that can be paid under these circumstances.

Generally, a maximum of 50 weeks of special benefits may be paid when different types of special benefits are combined [EIA 12(5)]. The benefit period may be extended to allow a maximum of 102 weeks of combined special benefits to be paid if all of the following conditions are met [EIA 10(13)]:

• no regular benefits have been paid during the initial benefit period
• more than one type of special benefits was paid; and, for at least 1 of the special benefits already paid, the applicable maximum number of weeks payable has not been paid, and
• the combined maximum number of weeks that could be paid for all types of special benefits requested, is greater than 50

If a specific type of special benefits was not paid during the initial benefit period, it cannot be paid during the extended benefit period.

The initial benefit period ends on the earlier of:

• when 50 weeks of special benefits have been paid; or
• the benefit period start date plus 51 weeks, plus any weeks of extension due to work-sharing or for one of the following reasons, is reached
  1. confined in a jail, penitentiary or other similar institution and was not found guilty of the offence for which the claimant was being held, or any other offence arising out of the same transaction
  2. in receipt of earnings paid because of the complete severance of the claimant’s relationship with their former employer
  3. in receipt of workers’ compensation payments for an illness or injury, or
  4. in receipt of payments under a provincial law based on having ceased to work because continuing to work would have resulted in danger to the claimant, her unborn child, or a child whom she was breast-feeding

It is important to note that for the purpose of the extension of the benefit period, when reference is made to benefits paid for a pregnancy or caring for a child, this also refers to provincial benefits that have been paid to the claimant for the same reasons [EIR 76.19(1); Québec Parental Insurance Plan (QPIP)]. This means that QPIP benefits can be used to extend the EI benefit period to allow the claimant to receive the maximum number of weeks of special benefits to which they are entitled under the EI Act, other than maternity or parental [EIA 10(13)].

A claimant who does not qualify for regular benefits under the EI Act, but qualifies for special benefits because of the regulatory exception, can only receive special benefits, in their benefit period (EIA 7; EIR 93).

The limit to the number of weeks of special benefits payable also includes benefits paid under the QPIP. According to a specific regulatory provision, each week of benefits paid under the QPIP is considered as a week for which benefits are paid under the EI program. As such, weeks of QPIP paid are taken into consideration in calculating the overall maximum number of weeks of EI maternity or parental benefits to be paid in a benefit period. As well, these weeks are taken into account to determine the maximum number of weeks of EI benefits, if any, to be paid for a birth or an adoption (EIR 76.19(1); QPIP).

12.3.2  Sickness benefits within the maternity period

A claimant who is pregnant may request and be entitled to sickness benefits during the maternity period (EIA 22(2)). Although pregnancy and childbirth are not considered illnesses, complications with respect to either may be. To receive sickness benefits, the person must obtain, at their own expense, a medical certificate that attests to the incapacity, the start date, the probable duration of the incapacity and is signed by a medical doctor or other medical professional (Digest 11.2.2).

Once qualifying conditions are met, this claim is dealt with according to the principles applicable to any person requesting sickness benefits, with one exception for minor attached claimants (Digest 11.1.0). This exception provides that claimants who do not have the required number of hours (600) to establish a claim for maternity benefits, but had sufficient hours to establish a claim for regular benefits (420-599), are not required to prove incapacity for the actual day of the child's birth and for the 14 calendar days immediately following the child's birth. The birth itself is considered adequate proof of incapacity and the claimant may be paid sickness benefits for this period. Normally this issue will only arise when the claimant is collecting regular benefits during their maternity window.

In all cases, the claimant must still demonstrate that they would be otherwise available for work for each day they are requesting sickness benefits during the maternity period.

It is not uncommon for a claimant to request sickness benefits for a period immediately prior to starting their maternity leave. In these cases, sickness benefits may be payable, provided the claimant can demonstrate that, were it not for their illness, they would have continued to work, or would have been available for work. The start date of maternity benefits for claimants who request sickness benefits prior to maternity, will be as follows:

• where there is an indication that the claimant would have continued to work until the week in which the expected date of birth falls (EDC - expected date of confinement), sickness benefits will be allowed until the week prior to EDC. Maternity benefits would begin as of the week of EDC, even if the child is born later
• where the actual date the child is born is prior to the EDC, sickness benefits will be allowed until the week prior to the week the child was born (ADC – actual date of confinement). Maternity benefits would begin as of the ADC
• where the claimant had made arrangements with their employer to start maternity leave on a specific date, sickness benefits will be allowed until the week prior to the week in which the pre-arranged maternity leave was to begin. Maternity benefits would be paid as of the week the claimant intended to start maternity leave, even if the child is born later
• where the ADC is prior to the week the claimant had intended to start maternity leave, sickness benefits will be allowed until the week prior to the ADC. Maternity benefits would begin as of the ADC

A pregnancy that is terminated within the first 19 weeks is considered an illness for the purposes of the act and must be treated as such (EIR 40(5)). Entitlement to benefits in this situation would be considered pursuant to the provisions for sickness benefits, rather than those for maternity benefits.

[ August 2021 ]