Disability Insurance (DI) plan claims process

Date: June 18, 2019

This notice is to inform you of changes to the Disability Insurance (DI) plan claims process and the launch of a new Sun Life DI plan webpage.

DI claim forms

In an effort to improve the claims application process, changes have been made to the DI claim forms and process.

There are now four claim forms that must be completed and submitted to Sun Life in order for a DI claim to be processed.

The Employer’s Statement (TBS/SCT 330-303E) has been divided into two forms:

  1. the Employer’s Statement (Immediate Supervisor or Manager)(4841-E), to be completed by the employee’s immediate supervisor or manager
  2. the Employer’s Statement (Compensation Advisor)(4811-E), to be completed by the employee’s departmental compensation advisor or the Public Service Pay Centre

The Employee’s Statement (TBS/SCT 330-302E) and Employee’s Medical Information and Attending Physician’s Questionnaire (TBS/SCT 330-304E) DI claim forms have been revised with housekeeping changes such as the revision of instructions and deletion of duplicate or unnecessary questions. Also, three Attending Physician’s Questionnaires have been made available to best describe the medical condition.

  1. the Employee’s Statement (490L-M-12500-E), to be completed by the employee
  2. the Attending Physician’s Questionnaire (490L-P-12500-GEN-E General condition, 490L-P-12500-MHC-E Mental health condition, or 490L-P-12500-MSK-E Musculoskeletal condition), to be completed by the attending physician. Just one questionnaire that best describes the medical condition is to be completed and sent to Sun Life.

New DI claim process

Effective immediately, all four DI claim forms are to be used when submitting a claim to Sun Life as per the process below.

When an employee’s illness or disability is expected to be prolonged beyond the 13-week elimination period or they have exhausted their sick leave balance, whichever comes later:

The employee:

  1. should immediately advise their immediate supervisor or manager of their intent to apply for Disability Insurance benefits.
  2. complete the Employee’s Statement (490L-M-12500-E).
  3. have their physician to complete the appropriate Attending Physician’s Questionnaire (490L-P-12500-GEN-E, 490L-P-12500-MHC-E, or 490L-P-12500-MSK-E).
  4. send both forms, the Employee’s Statement (490L-M-12500-E) and the Attending Physician’s Questionnaire (490L-P-12500-GEN-E, 490L-P-12500-MHC-E, or 490L-P-12500-MSK-E) to Sun Life, as per the instructions on the forms.

The employee’s immediate supervisor or manager must:

  1. complete the Employer’s Statement (Immediate Supervisor or Manager)(4841-E).
  2. send the completed and signed copy along with the employee’s current work description to Sun Life, as per the instructions on the form.
  3. submit a Pay Action Request (PAR) and a copy of their completed form to the Public Service Pay Centre, requesting the Pay Centre complete and send the Employer’s Statement (Compensation Advisor)(4811-E) to Sun Life. See the Submit a pay action request page on Canada.ca for instructions.

Note: Supervisors/ Managers that have departmental compensation services should contact their departmental compensation office to initiate the submission of the Employer’s Statement (Compensation Advisor)(4811-E) to Sun Life. In these cases no PAR is needed.

The Pay Centre or departmental compensation advisor will:

  1. receive the PAR and a copy of the Employer’s Statement (Immediate Supervisor or Manager(4841-E).
  2. complete the Employer’s Statement (Compensation Advisor)(4811-E).
  3. send the completed Employer’s Statement (Compensation Advisor)(4811-E) form to Sun Life.

Once Sun Life receives the four completed forms, the claim will be processed.

New DI plan webpage

To facilitate the new DI claims process, assist claimants with the completion of the claim package and house the new claim forms, Sun Life has launched a new webpage, www.sunlife.ca/DI, for plan members. The  webpage houses:

  • the  DI claim forms
  • the Employee DI claim guide
  • the Manager / supervisor’s DI plan guide
  • additional resources

Enquiries

Chiefs of Compensation at the corporate level may contact the Pensions and Benefits Sector at pbs-spas@tbs-sct.gc.ca.

At any time during the DI claim process, employees can contact Sun Life for more information.

Marie-Chantal Girard
Assistant Deputy Minister
Pensions and Benefits Sector

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