Digest of Benefit Entitlement Principles Chapter 16 - Section 1
Claims for unemployment benefits are filed by the thousands every day throughout Canada. To achieve the result aimed at by the Employment Insurance legislation, there is an obvious need to process these claims quickly so that benefit can be made available to claimants when they are in need of it. An important administrative body as is the Employment and Social Development Canada (ESDC), in an effort to achieve the desired result, requires certain rules which must be strictly adhered to which will enable it to process the claims in an orderly manner. To be effective, these rules must apply in the great majority of cases. As a consequence, every Canadian has a duty to comply with the rules or at least make proper enquiries at the proper time to facilitate the administration of the plan.
Delays in filing claims are not an uncommon occurrence in employment insurance matters. The Act and Regulations provide for time limits on the filing of claims and it is incumbent upon claimants to take such steps as are necessary to make sure they are conforming to the statutory requirements. It is only in exceptional circumstances that failure to file within prescribed delays may be waived. The claim procedure is spelled out in the following provisions.
16.2.0 Claim required - Section 48 of the Act
- No benefit period shall be established for a person unless the person makes an initial claim for benefit in accordance with section 50 and the regulations and proves that the person is qualified to receive benefits.
- No benefit period shall be established unless the claimant supplies information in the form and manner directed by the Commission, giving the claimant's employment circumstances and the circumstances pertaining to any interruption of earnings, and such other information as the Commission may require.
- On receiving an initial claim for benefit, the Commission shall decide whether the claimant is qualified to receive benefits and notify the claimant of its decision.
16.3.0 Proof required – Section 49 of the Act
- A person is not entitled to receive benefits for a week of unemployment until the person makes a claim for benefits for that week in accordance with section 50 and the regulations and proves that:
- the person meets the requirements for receiving benefits; and
- no circumstances or conditions exist that have the effect of disentitling or disqualifying the person from receiving benefits.
- The Commission shall give the benefit of doubt to the claimant on the issue of whether any circumstances or conditions exist that have the effect of disqualifying the claimant under section 30 or disentitling the claimant under section 31, 32, and 33, if the evidence on each side of the issue is equally balanced.
- On receiving a claim for benefits, the Commission shall decide whether benefits are payable to the claimant for that week and notify the claimant of its decision.
16.4.0 Entitlement to benefits – Section 50 of the Act
- A claimant who fails to fulfill or comply with a condition or requirement under this section is not entitled to receive benefits for as long as the condition or requirement is not fulfilled or complied with.
- A claim for benefits shall be made in the manner directed at the office of the Commission that serves the area in which the claimant resides, or at such other place as is prescribed or directed by the Commission.
- A claim for benefits shall be made by completing a form supplied or approved by the Commission, in the manner set out in instructions of the Commission.
- A claim for benefits for a week of unemployment in a benefit period shall be made within the prescribed time.
- The Commission may at any time require a claimant to provide additional information about their claim for benefits.
- The Commission may require a claimant or group or class of claimants to be at a suitable place at a suitable time in order to make a claim for benefits in person or to provide additional information about a claim.
- For the purpose of proving that a claimant is available for work, the Commission may require the claimant to register for employment at an agency administered by the Government of Canada or a provincial government and to report to the agency at such reasonable times as the Commission or agency directs.
- For the purpose of proving that a claimant is available for work and unable to obtain suitable employment, the Commission may require the claimant to prove that the claimant is making reasonable and customary efforts to obtain suitable employment.
- A claimant shall provide the mailing address of their normal place of residence unless otherwise permitted by the Commission.
- The Commission may waive or vary any of the conditions and requirements of this section or the regulations whenever in its opinion the circumstances warrant the waiver or variation for the benefit of a claimant or a class or group of claimants.
16.5.0 Definitions: prescribed – Subsection 2(1) of the Act
- In this Act, "prescribed" means prescribed by the regulations or determined in accordance with rules prescribed by the regulations.
16.6.0 Regulations – Paragraph 54(y) of the Act
The Commission may, with the approval of the Governor in Council, make regulations prescribing the information and evidence to be provided by the claimant to prove
- inability to work because of illness, injury or quarantine, or
- pregnancy or the expected date of confinement;
16.7.0 Claim for benefits – Section 26 of the Regulations
- Subject to subsection (2), a claim for benefits for a week of unemployment in a benefit period shall be made by a claimant within three weeks after the week for which benefits are claimed.
- Where a claimant has not made a claim for benefits for four or more consecutive weeks, the first claim for benefits after that period for a week of unemployment shall be made within one week after the week for which benefits are claimed.
16.8.0 Documents sent by mail – Subsection 134(2) of the Act
- For the purposes of this Act and the regulations and any proceedings under them, a document appearing to be a certificate of the Commission or a person authorized by the Commission to the effect that a notice, request, demand or other document was sent by mail is evidence that the notice, request, demand or other document was received by the addressee in the ordinary course of the mails.
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