Administrative Change to the Rehabilitation Income Calculation under the Disability Insurance (DI) Plan - Effective November 1, 2013
To: Compensation Managers, Heads of Human Resources, Participating Separate Employers
The purpose of this Notice is to provide information regarding an administrative change to the way rehabilitation benefits are calculated under the Disability Insurance (DI) Plan administered by Sun Life Financial.
This change was implemented to streamline administrative processes, increase accountability and reduce overpayment situations. This approach is also consistent with industry standards and will serve to align with the Public Service Management Insurance Plan (PSMIP).
Currently, DI rehabilitation benefits are calculated when an employee participates in a Gradual Return to Work Plan. This process involves estimating employee earnings based on the expected return to work schedule and then projecting a monthly DI benefit payable to the employee based on this estimate.
Frequently, there can be changes in the planned return to work such as, a modification to the schedule, an absence from work, or other reasons that may alter the amount of the estimated earnings. Once Sun Life is notified of the actual earnings, a re-calculation is prepared which can result in payment adjustments; usually an overpayment.
If an overpayment is incurred, the employee is then asked to reimburse Sun Life. The recovery of overpaid benefits is administratively difficult since the employee has likely returned to work and is no longer in active claim status with Sun Life.
Effective , Sun Life will now hold the rehabilitation payment for the month in which the Gradual Return to Work plan begins, until confirmation of earnings is received from the employer.
Given the new process, it is imperative that the employer forward confirmation of the gross rehabilitation earnings for the period specified, as soon as they are available. If the earnings are not received, Sun Life will diligently follow- up with the employer via email or telephone.
Once Sun Life receives the earnings information from the employer, the monthly rehabilitation benefits will be calculated within 48 hours and the employee will be notified. Since the calculation will be based on actual earnings reported by the employer, the incidence of under or overpayments is expected to be significantly reduced.
Should you have any questions regarding this notice, please contact the Pensions and Benefits Sector.
Assistant Deputy Minister
Pensions and Benefits Sector
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