Description of Benefits

Long Term Disability (LTD) benefits are wage replacement benefits, which provide you a monthly income if you become so totally disabled by an accidental bodily injury or disease while covered under this plan and under the age of 65 that you can no longer work for your living. Long Term Disability coverage covers you for those total disabilities that last beyond the period covered by the Short Term Weekly Wage Replacement Plan. This benefit applies to active Members under age 65. It does not apply to Dependents, working Members age 65 or older, or Retirees.

Definition of Total Disability:

You will be considered "totally disabled" during the first 24 months in which you receive Long Term Disability benefits if you unable, solely because of disease or accidental bodily injury, to work at your own occupation. Your own occupation means the type of work in which you were engaged and is not limited to the actual job you were performing prior to the start of a period of total disability. After this 24 month period, and during the same period of disability, you are totally disabled only if you are incapacitated to the extent that solely because of a disease or accidental bodily injury, you are unable to work at any occupation or employment for which you are, or may reasonably become, qualified by education, training or experience. Such disability must result from a medically determinable physical or mental impairment.

Maximum Period of Payment

You will be eligible for your first income payment from the Trust Fund after you have completed the qualifying period, which is the first 26 weeks of a period of total disability, or the duration of the Weekly Wage Replacement benefit, whichever is greater. However, you will not receive an income payment if you reach age 65 before you complete the qualifying period.

After completing the qualifying period, you will be eligible for income payments during the continuance of a period of total disability up to age 65.

A period of total disability is considered to cease:

• When you commence work at a reasonable occupation;
• When you fail to furnish proof of the continuance of total disability or refuse to be examined by a Physician;
• When you cease to be under the care of a Physician;
• The date of your death.

Amount of Monthly Income

The Long Term Disability benefit will be payable monthly in the amount of $1,500, subject to the All Source Maximum and Rehabilitation provisions described below. The benefit is taxable however no tax will be withheld from your monthly payments. You will receive a T4 for all paid amounts by the end of February of the following year.

All Source Maximum

In no event can your total monthly income from all sources exceed 75% of your pre-disability earnings. If your monthly payments under the Long Term Disability benefit together with any other income to which you may be entitled under any other group disability program or pension plan, exceed in the aggregate, 75% of your normal earnings; payments under this LTD benefit will be reduced so that your monthly payments together with all other disability payments or compensations, will not exceed 75% of your earnings as of the date your disability commenced.

Your monthly benefit shall not be further reduced by a government plan or cost of living adjustment which may be given after the date on which this LTD benefit first becomes payable.

Rehabilitation Provision

If you recover sufficiently to work again at any occupation, you may be able to do so without jeopardizing your total disability status. However, in order to remain eligible for income benefits from the Trust Fund, the Insurance Company must approve such work as a rehabilitation program, in writing.

This approval may be withdrawn if it is determined by the Insurance Company that you are not participating in the program to the extent previously agreed to.

Any of the following may be eligible for consideration as a rehabilitation program:

• Your regular occupation on a part-time basis;
• A formal vocational training program;
• Any other training program deemed suitable by the Insurer.

If you commence work under an approved rehabilitation program, you will regain a portion of the income you lost when you became totally disabled. Working under an Approved Rehabilitative Program is to your advantage as you will receive a greater total income than if you had not made the effort to rehabilitate yourself. Your gross benefit will be reduced by 50% of any earnings under the rehabilitation program, subject to the All Source Maximum.

A rehabilitation program may be in effect for up to 24 months.

Subrogation

If you are entitled to recover compensation for loss of income from a third party as a result of the incident which caused or contributed to the disability, for which benefits are paid or payable, the Insurer will be subrogated to all the rights of your recovery for loss of income, to the extent of the sum of benefits paid or payable by the Insurer. You shall execute such documents as required by the Insurer.

In the event that you can provide proof to the Insurer that you have not recovered full compensation for loss of income, the Insurer shall determine the proportion of damages actually recovered and share pro rata in that amount.

Should you choose to settle the matter prior to judicial determination, you should understand that the sum reached in settlement would be deemed to be full compensation for loss of income, and the Insurer’s right of subrogation will apply.

The term compensation shall include any lump sum or periodic payments which you receive or are entitled to receive on account of past, present or future loss of income.

Continuous Period of Disability

If you become disabled from the same or related causes within 6 months after return to active work, it will be considered one continuous period of disability. If you have returned to active work for one full day and become disabled from different and unrelated causes, it will be considered a new period of disability.

Exclusions and Limitations

No benefits are payable:

• For the portion of a period of disability during which you are not under treatment by a legally qualified physician, or a specialist qualified in the treatment of disabilities due to nervous, mental or emotional disease or disorder, or in the treatment of disabilities due to drug addiction or alcoholism;
• For any portion of a period of disability during which the member is receiving treatment by a therapist unless such treatment is recommended by a physician deemed appropriate by the Insurer;
• For a disability resulting from injury or disease which occurred while the Member is on active duty in the armed forces of any country, or while participating in a riot, insurrection, rebellion or civil commotion;
• For a disability resulting from participation in the commission of a criminal offence;
• For a disability resulting from intentionally self-inflicted injuries or illness while sane or insane;
• For any portion of a period of disability resulting from substance abuse, including alcoholism and drug addiction, unless you are participating in a recognized substance withdrawal program;
• An illness or injury caused or contributed to by a Motor Vehicle Accident that occurs in Ontario or Quebec;
• During any leave of absence (including Maternity Leave);
• For the portion of disability during which you are imprisoned in a penal institution or confined in a hospital or similar institution as a result of criminal proceedings; or
• For a disability which commences on or after the date a strike begins, subject to any provincial Employment or Labour Standards Act. However, you can fulfill your Qualifying Disability Period during a strike.

Canadian Residency Required

No benefits are payable if the member resides outside Canada for any period exceeding 90 consecutive days or a total of 180 days in any 365-day period unless the member:

• has previously notified and received approval in writing from the Insurer, or
• remains under the regular care of a licensed physician deemed appropriate by the Insurer, and
• proof of the ongoing disability can be determined on evidence satisfactory to the Insurer in English or French within 90 days of request.

Extended Insurance

If your Long Term Disability insurance terminates during a period of total disability, the Insurer continues to be liable as though the provision remained in force. If a recurrence of disability occurs within 6 continuous months after termination of this benefit, the Insurer shall continue to pay your benefits but only for the remainder of the original maximum benefit period. Such disability must have been caused by an accident or sickness that occurred before termination. The Insurer shall not be liable for benefits after termination of either the contract or Long Term Disability Income benefit once a replacing Insurer is bound contractually or as a matter of law.

Termination of Coverage

Your eligibility for Long Term Disability terminates the earlier of your retirement or attainment of age 65.