Digest of Benefit Entitlement Principles Chapter 12 - Section 3
12.3.0 Maternity benefits as a part of special benefits
Maternity benefits, together with parental benefits (to care for a new born or a child placed for the purpose of adoption), sickness benefits (in case of illness, injury, or quarantine), compassionate care (to care for a seriously ill family member with a significant risk of death within 26 weeks) and family caregiver benefits (to care for or support a critically ill family member) are known collectively as special benefits and have specific requirements for paymentFootnote 1 as well as limits to the number of weeks payable.
Entitlement to special benefits is not limited by the unemployment rate, but rather, the maximum number of weeks for which special benefits may be paid has been set by legislation. These parameters are explained in the following section.
[ October 2013 ]
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 periodFootnote 2. The individual maximums are: 15 weeks for maternity benefits; 35 weeks for standard parental benefits or 61 weeks for extended parental benefits; 15 weeks for sickness benefits; 26 weeks for compassionate care benefits; 35 weeks for family caregiver benefits for children and 15 weeks for family caregiver benefits for adults.
Special benefits may be paid in any combination during a benefit period provided the claimant proves entitlement for each type of benefit.
A maximum of 50 weeks of benefits can be paid when regular and special benefits are combined. The only exception 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.
A maximum of 102 weeks of combined special benefits can be paid in an extended benefit periodFootnote 3 if:
- No regular benefits have been paid during the initial benefit period; and
- More than one type of special benefits was paid; and at least one of these special benefits was paid for fewer than the applicable maximum number of weeks payable for these special benefits, and
- The maximum total number of weeks payable for the 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
- Benefit period start date plus 51 weeks plus any weeks of extension due to work-sharing or for one of the following reasons
- 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;
- In receipt of earnings paid because of the complete severance of their relationship with their former employer;
- In receipt of workers’ compensation payments for an illness or injury;
- In receipt of payments under a provincial law on the basis of 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 benefits period, when reference is made to “benefits paid for a pregnancy or caring for a child”, this also refers to the provincial benefits that have been paid to the claimant for the same reasonsFootnote 4. This means that Québec Parental Insurance Plan benefits can be used to extend the EI benefit periodFootnote 5 to allow the claimant to receive the maximum number of special benefits weeks under the EI Act, other than maternity or parental, to which he/she is entitled.
A claimant who does not qualify for regular benefits under the EI ActFootnote 6 but qualifies for special benefits because of the regulatory exceptionFootnote 7, can only receive special benefits in their benefit period.
The limit to the number of weeks of special benefits payable also include benefits paid under the Québec Parental Insurance Plan. According to a specific regulatory provisionFootnote 8, each week of Québec Parental Insurance Plan benefits paid is considered as a week for which benefits are paid under the EI program, and is taken into consideration in calculating the overall maximum number of weeks of EI maternity or parental benefits to be paid per benefit period, and the maximum number of weeks of EI benefits to be paid regarding a birth or an adoption.
[ October 2013 ]
12.3.2 Sickness benefits within the maternity period
A woman who is pregnant may request and be entitled to sickness benefits during the maternity periodFootnote 9. Although pregnancy and childbirth are not considered to be 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 signed by a doctor or other medical practitionerFootnote 10.
Once qualifying conditions are met, this claim is dealt with according to the principles applicable to any person requesting sickness benefitsFootnote 11 with one exception. That exception is that these claimants are not required to prove incapacity for the actual day of the child's birth and for the fourteen calendar days immediately following the child's birth. The birth itself is considered to be adequate proof and the claimant may be paid sickness benefit for this period. Normally this issue will arise only when the claimant is collecting regular benefits during her maternity window.
A pregnancy that is terminated within the first 19 weeks is considered an illness for the purposes of the ActFootnote 12 and must be treated as such. The claim in this case, would be considered for sickness benefits rather than maternity benefits
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