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Limitation periods for long-term disability (LTD) claims
Applying for long-term disability (LTD) benefits can feel like a game of cat and mouse, in which the insurer repeatedly invites claimants to appeal the denial of benefits internally. Often these internal appeals are met with further denials. What many claimants may not realize is that, while these internal appeals and denials are occurring, the time limit to bring a court action continues to run.
In Ontario, most long-term disability (LTD) policies give you two years to sue the insurer, and a few provide even less time. This time limit is known as a “limitation period”, and you may be unable to claim lost benefits in court if you permit that period to expire.
Long-term disability (LTD) limitation periods: when does the clock start?
One important question is what event actually triggers the running of the limitation period. While it is impossible to predict in the abstract, the law in Ontario since December 2014 is that the two-year timeframe (or, more rarely, the one-year timeframe) begins to run the moment you receive an “unequivocal denial” of your claim.
In other words, the clock will start to run when the insurer clearly denies your claim. The fact that the insurer invites you to pursue an internal appeal does not mean that the limitation period is not running. Once your claim has been clearly denied, the lawsuit clock starts ticking, and the time limit is likely not restarted by bringing an internal appeal.
Consult a disability lawyer soon after the initial denial
The take-away from the law on limitation periods in long-term disability (LTD) claims is that you should take action quickly after your claim is first denied. Even if you are still pursuing internal appeals, do not assume they prolong your right to sue, because the opposite is likely true.
A disability lawyer with expertise in long-term disability benefits can provide you with specialized advice, including on the issue of whether your claim has been clearly denied and your time limit for suing the insurer has started. So once you’ve received that first denial, contact a lawyer for a consultation to decide whether you should commence an action, and to learn about what other legal options might be available to you.
We are here to help navigate the LTD application process. Consult one of our experienced Long Term Disability lawyers at Raven, Cameron, Ballantyne and Yazbeck LLP if you are considering making a claim for disability benefits or if your claim for benefits has been denied.
[This article is for informational purposes only and does not constitute legal advice, which cannot be given without consideration of your individual circumstances.]
David Yazbeck Named as an Advisor to FOLKRUM
David Yazbeck has been named an Advisor to FOLKRUM, Ottawa’s community music venue. FOLKRUM is an independent, not-for-profit organization working toward the creation of a creativity hub and music facility to serve Ottawa, Outaouais, the valley and surrounding areas.
Federal Court of Appeal Overhauls Unjust Dismissal Law under the Canada Labour Code
The Federal Court of Appeal recently issued a decision overhauling the state of federal employment law. In Wilson v Atomic Energy of Canada Ltd, 2015 FCA 17, the Court rejected the generally accepted approach to unjust dismissal complaints under the Canada Labour Code (“Code”), which applies to workers who are employed in federally regulated industries. The decision in Wilson has profound implications for non-unionized federally regulated employees. Mr. Wilson is currently seeking leave to appeal the Federal Court of Appeal’s decision to the Supreme Court of Canada.
Background on termination of employment of unionized and non-unionized employees
Unionized workers can only be dismissed with just cause
For most unionized workers, terms and conditions of employment are governed by collective agreements which include a requirement that the employer only terminate an employee where there is just cause for dismissal. Just cause is a high threshold for an employer to meet and provides substantial protection for unionized workers.
Non-unionized federal workers cannot be dismissed “unjustly”
Section 240 of the Code provides non-unionized federal workers with the right to make “unjust dismissal” complaints, provided they have been employed for at least 12 months and they allege that they have been dismissed “unjustly”. The Code also provides statutory remedies for federal workers who are dismissed unjustly, including reinstatement to employment, which are not available to non-unionized provincial workers.
Non-unionized provincial workers can be dismissed without cause
At common law, non-unionized employees who work for provincially regulated employers – the vast majority of employers in Canada – can be dismissed without cause provided that employers provide reasonable notice of termination, or pay in lieu or reasonable notice. A dismissal that is both without cause and without reasonable notice is a wrongful dismissal. Read more about termination in the provincial sphere here.
The Pre-Wilson Approach to Unjust Dismissal Complaints under the Code
Prior to Wilson, there was an established line of cases holding that federal employers could only dismiss employees for cause, similar to the just cause protections provided for in collective agreements. Leading employment law scholars, Innis Christie and Geoffrey England, have explained that the Code’s unjust dismissal provisions were intended to:
“provide the non-unionized employee with substantially similar protections against unjust discharge as the unionized employee enjoys under a collective agreement.”
However, Code adjudicators have disagreed on this point and there are conflicting decisions on whether the Code permits dismissals on a without cause basis. As Code adjudicators are bound by decisions of the Federal Court of Appeal, Wilson settles the disagreement, unless the Supreme Court of Canada grants leave to appeal and weighs in on the issue.
Wilson v Atomic Energy of Canada Ltd
A Code adjudicator determined that AECL had violated the Code by terminating Wilson on a without cause basis. AECL applied for judicial review of this decision at the Federal Court, and the Federal Court overturned the adjudicator’s decision. Mr. Wilson appealed the Federal Court’s decision to the Federal Court of Appeal.
A dismissal without cause is not “unjust”
In Wilson, the Federal Court of Appeal concluded that:
- a dismissal without cause is not automatically unjust under the Code;
- this is consistent with the common law of employment, which allows for dismissal without cause so long as the reasonable notice requirement is met; and
- the Code cannot be interpreted as giving non-unionized employees a “right to the job” or attempting to place unionized and non-unionized employees in the same position.
Code adjudicators must determine if a dismissal is “unjust” in all of the circumstances
The Court also explained the role of Code adjudicators in unjust dismissal complaints:
- it is up to Code adjudicators to look into the circumstances of each case to determine if the dismissal was “unjust”; and
- adjudicators do not have “free rein” to find a dismissal unjust on any basis, although the fact that an employer has paid an employee severance pay does not preclude a finding that the dismissal was unjust.
However, beyond commenting that “unjust” is a term that “sits alongside and gathers much, if not all, of its meaning from well-established common law and arbitral cases concerning dismissal”, the Court declined to interpret the meaning of “unjust”. It will now be up to Code adjudicators to determine the meaning of “unjust” through the development of case law.
Supreme Court will decide whether to weigh in on this dramatic change for federal employees
The Federal Court of Appeal’s decision marks a major departure from an established line of cases, and creates considerable uncertainty in the law going forward. The Federal Court of Appeal left open the meaning of “unjust”, the very basis for section 240 complaints, which may now make it more difficult for a worker to assess the merits of an unjust dismissal complaint. Mr. Wilson’s leave application will thus be closely followed by federal workers and their advocates, who undoubtedly hope the Supreme Court will intervene on this important issue.
Some of the questions that may be raised, if the appeal is heard by the Supreme Court, include:
- What, if any, differences are there between a common law wrongful termination and an unjust dismissal under the Code?
- Is it contrary to the policy reasons for section 240 of the Code to permit terminations “without cause”?
- Will reinstatement remain available as a remedy for unjust dismissal complaints under the Code, if employers are now permitted to terminate without cause? If so, under what circumstances will it be ordered?
It is hoped that an appeal before the Supreme Court will bring clarity to these issues, and resolve them in a manner that is consistent with the protections Parliament intended to afford to federally regulated employees.
[This article is for informational purposes only and does not constitute legal advice, which cannot be given without consideration of your individual circumstances.]
RavenLaw Lawyers Participate in University of Ottawa Labour Arbitration Course
This month, Andrew Astritis and Wassim Garzouzi participated in an upper-year labour arbitration course at the University of Ottawa Law School. Andrew and Wassim enjoyed serving as panelists for the year-end labour arbitration moot and providing students with comments and feedback on their presentations.
RavenLaw Proud to Support the Ten Oaks Project Bowl-a-Thon
RavenLaw was proud to support this year’s Ten Oaks Project Camp Bowl-a-Thon. This annual event helps bring much-needed funds to the Ten Oaks Project organization and connects children and youth from LGBTQ+identities, families and communities with their supporters. This year’s event surpassed the $40,000 fundraising goal.
The Ten Oaks Project engages and connects children and youth from LGBTQ+ communities through programs and activities rooted in play.
RavenLaw Partnering with MESH Ottawa for Presentation on Disability Insurance Issues
On May 12, 2015, RavenLaw lawyers Raphaëlle Laframboise-Carignan, Morgan Rowe and Dayna Steinfeld will be participating in a panel discussion on disability insurance issues as part of an International Myalgic Encephalomyelitis/ Fibromyalgia (ME/FM) Awareness Day event hosted by MESH Ottawa. Topics of discussion will include the duty to accommodate, Canada Pension Plan Disability, and short-term and long-term disability benefits. The panel will also feature Margaret Parlor, President of the National ME/FM Action Network, who will provide facts and background on Fibromyalgia and Chronic Fatigue Syndrome.
More information about the event, including how to register, can be found here.
Arbitrator finds Hospital Sick Leave Policy Discriminatory
In a recent arbitration decision, Ontario Public Service Employees Union, Local 464 v Ottawa Hospital, Arbitrator Mary Ellen Cummings found that the Ottawa Hospital’s application of its short-term sick leave benefits discriminated against employees with chronic disabilities, contrary to the Human Rights Code. The collective agreement language at issue in the case is common throughout most of the hospital sector in Ontario, and this decision sets an important precedent for how absences due to chronic illnesses must be handled in the province.
Background
The case related to sick leave benefits under the Hospitals of Ontario Disability Income Plan (“HOODIP”). Under HOODIP, employees have up to 15 weeks of short-term sick pay benefits for each period of absence. Article 16.03 in the Collective Agreement states: “No sick pay benefit is payable under HOODIP for the first fifteen hours of absence for the sixth and subsequent period(s) of absence in the same fiscal year”. The Ottawa Hospital applied this rule such that any absences separated by three weeks or more were treated as distinct “periods of absence”, even if the absences were all due to the same chronic illness. The Ontario Public Service Employees Union filed a policy grievance against the Hospital, arguing that this interpretation of “period of absence” discriminated against employees who have chronic illnesses that periodically reoccur (e.g. migraines, Crohn’s Disease).
Arbitrator’s Decision
The Arbitrator found that the use of a three-week gap to identify distinct periods of absence had an adverse impact on employees with chronic illnesses compared to other employees receiving sick leave benefits. Employees with frequent, short absences due to a chronic illness will reach their sixth and subsequent “period of absence” more quickly than other employees, due to the nature of their disability. Treating these absences as a “new ailment”, simply because they were separated by three weeks, failed to address the circumstances of employees with chronic illnesses.
Arbitrator Cummings further found that this discrimination was not justified as reasonable and bona fide. She rejected the Hospital’s argument that it would be too onerous to determine whether absences were due to a chronic disability, holding: “looking at the individual needs of employees with disabilities and determining to what extent accommodation is required is the minimum required of all employers under the Code.”
The grievance was allowed, and the Hospital was directed to stop counting absences separated by more than three weeks as a distinct period of absence when the employee has a chronic illness. The Arbitrator further directed the employer to look at absences of employees with chronic illnesses and determine whether the employee can be accommodated, and if so how. She emphasized that accommodation may take many possible forms, and so a single remedy would be inappropriate.
This Award sets an important precedent, not only for collective agreements in the hospital sector with similar language, but also more broadly for treatment of employees’ absences when they are due to a chronic, recurring illness. Arbitrator Cummings’ decision provides strong confirmation that there is not a ‘one size fits all’ approach to managing employees’ attendance, and employers must look at each individual’s circumstances and needs.
The Union was represented by Wassim Garzouzi and Amanda Montague-Reinholdt from Raven, Cameron, Ballantyne & Yazbeck LLP/s.r.l.
David Yazbeck Speaking on Whistleblowers
On May 13, David Yazbeck will be speaking at the Lancaster House Halifax Human Rights and Labour Law Conference. David is participating in a panel called “Don’t Shoot the Messenger: Dealing with whistleblowers in the modern workplace”. The panel will examine whistleblower legislation, discuss human rights protections, and explore the issue of reprisals.
Canadian Human Rights Tribunal Issues Important Decision on Human Rights Remedies
On May 7, the Canadian Human Rights Tribunal issued an important decision granting over $310,000 in remedies for discriminatory practices engaged in by the Canada Border Services Agency in violation of sections 7 and 10 of the Canadian Human Rights Act. In an earlier decision, the Tribunal found that the complainant, Levan Turner, was discriminated against by CBSA on the basis of his race, colour, and perceived disability of obesity.
In the remedial decision, the Tribunal found that CBSA wilfully deprived Mr. Turner of employment opportunities, conduct which was deliberate, driven by prejudice and permeated with an ulterior motive to deny Mr. Turner an opportunity to continue being employed with CBSA.
The Tribunal ordered that CBSA compensate Mr. Turner for his lost wages over a ten-year period, anticipated lost wages for the years 2015 to 2019, $15,000 for pain and suffering, and an additional $15,000 compensation arising from CBSA’s wilful discrimination.
Mr. Turner was represented by David Yazbeck of RavenLaw.