Digest of Benefit Entitlement Principles Chapter 11 - Section 1

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11.1.0 Benefits of a specific type

The Employment Insurance (EI) program combines several income protection measures adapted to a variety of forms of unemployment that might arise during an insured person's working lifeFootnote 1. While the EI Act does not contain a specific term designating the type of benefits paid in case of inability to work by reason of illness, injury or quarantine, the term "sickness benefits" is commonly used. Thus, it has been provided that a person who becomes incapable of work by reason of illness, injury or quarantine may receive sickness benefits. The statement of the principle in the case of sickness benefits is found in Section 18(1)(b) of the ActFootnote 2 which states:

18.(1) A claimant is not entitled to be paid benefits for a working day in a benefit period for which the claimant fails to prove that on that day the claimant was

  1. …;
  2. unable to work because of a prescribed illness, injury or quarantine, and that the claimant would otherwise be available for work …;

On reading these few lines, we are already forewarned that sickness benefits are not paid to all claimants or in all circumstances. Instead, they are subject to entitlement conditions and to provisions concerning payment, which will be explained as the chapter proceeds.

11.1.1 Who can receive sickness benefits while unable to work

These legislative provisions apply to every insured person who is unable to work by reason of illness, injury or quarantine, with some exceptions. There are specific provisions for those who work in the fishing industryFootnote 3, are self-employedFootnote 4 and for those who are employed under a work-sharing agreement or who are attending a training course or participating in any other employment activity to which they have been referred by the authority designated by the Commission. In the latter three cases, a person is deemed to be unemployed, capable of and available for workFootnote 5.

The Act also provides for the making of claims for benefits by, and for the payment of benefits to, any person or agency on behalf of deceased or incapacitated persons or persons with mental disabilitiesFootnote 6.

11.1.2 Qualifying conditions

Regardless of the type of benefits being claimed, an insured person must meet the qualifying conditions for the specific benefits claimedFootnote 7. With respect to sickness benefits, the qualifying conditions stipulate that the claimant must be major attached, that is have accumulated a minimum of 600 hours of insurable employment during the qualifying periodFootnote 8 and must have an interruption of earnings from employmentFootnote 9.

See section 11.4 for specific conditions applicable to minor attached claimants.

It should be noted that in situations where a claimant has accumulated a violation on a previous claim, the claimant will require more than 600 hours of insurable employment during the qualifying period to be eligible for these benefits. Violations range from minor to subsequent with a related increase in the number of hours required to qualify for benefitsFootnote 10.

Individuals who are unemployed and already receiving EI benefits can also apply and be entitled to sickness benefits.

Sickness benefits are also accessible to self-employed persons who have voluntarily registered into the EI programFootnote 11.

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