Archived – Digest of Benefit Entitlement Principles Chapter 1- Basic Concepts – section 1.1.5

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The Digest of Entitlement Principles, (the digest), contains the principles applied by the Employment Insurance (EI) Commission (the Commission) when providing information and guidance on legislative and regulatory requirements.  These principles are also applied when making decisions on claims for EI benefits under the EI Act (the act) and its Regulations (the regulations).

The digest is a reference tool for all users and is intended for readers who have a general understanding of the act and regulations.  As such, legal terms have been avoided as much as possible. Individuals seeking a less technical overview may prefer to first review the relevant webpages on these topics on the Government of Canada website. The Commission attempts to ensure this information remains accurate and is updated regularly; however, it is not a substitute for the legislation.

1.1.0 Authority

The Employment Insurance (EI) program is under the jurisdiction of the federal government. The current legislation is known as the Employment Insurance Act (the act). This act allows for the making of regulations to the legislation, with approval of the Governor in Council.

The regulatory provisions are referred to as the Employment Insurance Regulations (EI Regulations) (EI Act 5(4)(5)(6); EI Act 24; EI Act 54), Employment Insurance (Collection of Premiums) Regulations (EI Act Part IV; EI Act 152), and National Employment Service Regulations (EI Act 60).

NOTE: The Justice Laws Website provides an official consolidation, and up to date version, of the EI Act and Regulations.

1.1.1 Summary

The EI program, which is insurance-based, is designed to protect individuals who have lost their job for reasons outside their control, while they look for new employment or upgrade their skills. It may also help unemployed individuals across the country find employment. The EI program also provides temporary financial assistance to workers who are sick, pregnant, caring for a newborn or newly adopted child, or caring for a family member who has a serious medical condition.

The EI program marked its 75th year in 2015, having been implemented in 1940. The last major reform occurred in 1996. At that time, the program introduced changes to better reflect its primary objective of promoting employment, and to better emphasize that access to the program is linked to significant work attachment.

1.1.2 Roles and responsibilities

Employment and Social Development Canada (ESDC) is the department of the Government of Canada responsible for developing, managing and delivering programs and services. The Minister of Employment and Social Development is responsible for the EI act, except for PART IV - Insurable Earnings and Collection of Premiums, and PART VII - Benefit Repayment.

The Canada Revenue Agency is responsible for resolving any questions pertaining to the insurability of employment or earnings (Part IV), and for the collection of EI premiums (Part VII).

Service Canada is a federal institution that is part of ESDC. Service Canada oversees all legislative provisions of the act, including the determination of benefit eligibility and entitlement, and issues EI benefits (Part I) directly to EI claimants. Its role is to provide timely and accurate EI benefit payments and services, and to support EI claimants through each stage of the service delivery process. It strives to accurately and efficiently provide benefit information, respond to enquiries, assist employers, process claims and provide the means to request a formal reconsideration of a decision, or to appeal decisions.

Provinces and territories deliver the majority of Employment Benefits and National Employment Services (Part II). These benefits and services are delivered through Labour Market Development Agreements (LMDA) funded by the Government of Canada. Through these agreements, Government of Canada funding enables provinces and territories to design, deliver and manage skills and employment programs for unemployed individuals, particularly for those who are eligible for EI benefits.

The Canada Employment Insurance Commission (CEIC) is a departmental corporation of ESDC. It plays a key role in administering the EI program, including the making of regulations, with the approval of the Governor-in-Council, and reviewing, as well as approving, policies related to the EI program administration and delivery. In addition to its role in EI premium rate setting, the CEIC produces the annual EI Monitoring and Assessment Report.

The Social Security Tribunal of Canada (SST) is an independent administrative body composed of a General Division and Appeal Division, that makes decisions on appeals related to the Act.

1.1.3 EI premiums & Insurable Employment

All workers employed in insurable employment are required to pay EI premiums. The fact that a worker can or cannot qualify for EI benefits is not a criterion to determine whether EI premiums are payable, as it is the employment, and not the individual that is insured.

The fundamental requirement for an employment to be insurable is that there is an employer-employee relationship; i.e. the person is not self-employed. CRA holds the responsibility for making decisions as to whether an employment is insurable or not, and whether EI premiums are payable with respect to that employment.

1.1.4 Purpose of Employment Insurance benefits

As previously stated, Part I of the EI program provides temporary income support to workers who have lost their job for reasons outside their control, while they look for new employment or upgrade their skills. EI Part I also provides temporary financial assistance to workers who are sick, pregnant, caring for a newborn or newly adopted child, or caring for a family member who has a serious medical condition.

The purpose of Part II of the EI Act is to provide employment assistance to eligible insured participants, through various programs and services.

1.1.5 Types of Employment Insurance benefits

There are a number of types of EI benefits available:

Regular benefits are available to individuals who lose their jobs for reasons outside their control and who are available for and actively seeking employment.

Special benefits are available to insured workers and self-employed individuals who are too sick to work, are pregnant or have recently given birth, are providing care to a newborn or newly adopted child, or who must be away from work temporarily to provide care or support to a family member with a serious medical condition. Special benefits include:

  • Maternity benefits: for biological mothers who are pregnant or have given birth. These benefits cover the period surrounding the child's birth (up to 15 weeks).
  • Parental benefits: for any legal parent to care for their newborn or newly adopted child or children. One parent can receive these benefits, or they can share benefits between them (up to 35 weeks of standard parental benefits or 61 weeks of extended parental benefits).
  • Sickness benefits: for people who cannot work due to injury, illness, or the need to be isolated in quarantine because they may be carrying a disease (up to 15 weeks).
  • Compassionate Care benefits: for people who must be away from work temporarily to provide care or support to a family member who is gravely ill with a significant risk of death within 26 weeks. One family member can receive these benefits, or they can be shared between several family members (up to 26 weeks).
  • Family Caregiver benefits: for family members who must be away from work temporarily to care for or support a critically ill or injured family member. One family member can receive these benefits or they can be shared between several family members (up to 35 weeks for caring for a child; up to 15 weeks for caring for an adult).

In certain circumstances various types of special benefits may be combined up to a maximum of 102 weeks of benefits within a maximum 104 week benefit period.

Fishing benefits – are for eligible self-employed fishers who do not meet the eligibility requirements for EI regular benefits in their region.

Job creation partnerships, work sharing, training benefits: for clients participating in developmental programs.

1.1.6 Requirement to apply for benefits

An insured person who wishes to receive benefits must first indicate their intention by making a claim and proving they meet the conditions necessary to establish a benefit period. The filing of an initial claim is the first requirement to be met and it is an essential requirement by which the Commission can begin the process of determining whether a claimant is entitled to benefits (EI Act 48).

The payment of EI benefits is not based on the personal needs or financial obligations of an individual. Equally, the fact that one has paid premiums into the EI fund does not by itself provide a right to receive benefits. It is rather the right to apply for benefits that an insured person may exercise, as would be the case with an insurance policy to which one has subscribed. Eligibility and entitlement depend on meeting the various conditions established by the legislation.

1.1.7 Who can receive benefits?

Under the act, all workers may be able to access the EI program if they are an insured worker; that is they must have paid into the EI account and have worked in insurable employment.

Workers unable to work because they are temporarily unemployed, sick, pregnant, caring for a newborn or newly adopted child, or providing support to a seriously ill family member, may receive temporary financial assistance if they meet specific qualifying and entitlement conditions.

Under separate provisions of the act, self-employed workers, (those who work for themselves), may be entitled to EI special benefits if they are registered for access to the EI program. Detailed information regarding entitlement to benefits for self-employed workers is available in Chapter 24 of this digest.

1.1.7.1 Foreign Workers

Foreign workers employed in insurable employment are required to pay EI premiums, as it is the employment that is insured and not the individual. However, foreign workers are exempt from EI premiums when they remain covered under an EI program in their country while working temporarily in Canada.

Foreign workers, as with any other worker, can receive regular benefits, provided they meet eligibility and entitlement conditions, while in Canada.

They may also be entitled to receive EI maternity, parental, compassionate care or family caregiver benefits after they leave Canada, as long as their social insurance number has not expired (EI Regulation 55(4)). These types of benefits can be paid outside of Canada, as there is no requirement to show availability for work.

Foreign workers, as well as any other worker, may also receive sickness benefits, but only while in Canada. In order to receive sickness benefits all individuals must show that, were it not for their illness, they would be available for work in Canada.

Foreign workers who are allowed to remain in Canada after their work permit expires, and have applied to extend the work permit before it expired, may receive benefits pending receipt of the new work permit. Those who obtain permanent residency status have full rights to receive EI regular or special benefits, provided they meet all of the qualifying and entitlement conditions for the type of benefits requested.

1.1.8 Notification of a decision

Upon receipt of an initial claim the Commission will review the claim and all related information, and make a decision as to whether the claimant is entitled to receive benefits. The claimant will then be notified of the decision. Notification may be in the form of a formal decision letter, or by way of the payment of benefits.

Claimants who disagree with a decision have the right to request a reconsideration of that decision (EI Act 112(1)). A formal request for reconsideration provides a claimant with a review of the decision without having to go through a formal appeal process with an independent decision-making body. Following this review, the EI Commission either changes or reaffirms the decision regarding the issue in question and notifies the claimant of that decision.

Claimants who disagree with the decision made following a request for reconsideration have the right to appeal that decision to the Social Security Tribunal (SST) General Division (EI Act 113).

If the claimant or the Commission is dissatisfied with the decision reached by the SST’s General Division, they may submit an appeal to the Appeal Division of the SST.

[October 2018]

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