Assessing Your Claim for the Change in Definition of Total Disability

Your Claims Specialist will assess your claim based on the change in definition of Total Disability. In order to determine eligibility based on the change in definition of Total Disability, HEB Manitoba will:

  • Review medical evidence from your treating Physician(s) and other healthcare professionals
  • Evaluate information regarding your work history, education, experience and transferable skills
  • Compare earnings for identified alternative occupations for which you could earn 66 2/3% or more of your Monthly Earnings at your Date of Disability. If your Date of Disability is prior to January 1, 2009, earnings for identified alternative occupations for which you could earn 60% or more of your Monthly Earnings at your Date of Disability will be compared
  • Review any other income replacement benefits that you are receiving and the reasons the benefits were awarded (if applicable).

Note: The Any Occupation assessment determines whether you are able to perform the duties of an alternative occupation that meets the stated earnings criteria. HEB Manitoba is not required to assist you to become employed in an alternative occupation.

Your Claims Specialist or Rehabilitation Specialist may request additional medical information from your Physician(s). It is your responsibility to prove your continued right to Disability & Rehabilitation Benefits and, if requested, to ensure that your Physician submits the information within 60 days of the request. Where fees apply, HEB Manitoba is prepared to contribute to a maximum of $50 for requested medical information. You are responsible for paying any additional fees your Physician charges.

In addition, you may be required to provide additional information regarding your:

  • Medical condition
  • Activities of daily living, and
  • Education, work experience, transferable skills and training.

We would be pleased to review any additional information you provide in support of your claim.

HEB Manitoba will make a decision using the above information. You will be informed of the status of your claim once the assessment has been completed.

HEB Manitoba reserves the right to have a medical examination of a Covered Employee performed by a medical practitioner designated by HEB Manitoba. HEB Manitoba will cover the cost of an Independent Medical Examination.

© 2017 HEB Manitoba

 

Disclaimer - This website provides a basic overview of the Healthcare Employees' Pension Plan (HEPP) and the Healthcare Employees' Benefits Plan (HEBP) (collectively the HEB Manitoba Pension and Benefit Plans). Not all employers participate in all Plans. Please check your eligibility for benefits with your employer.

HEB Manitoba is a name notation registered by the Healthcare Employees’ Pension Plan – Manitoba and the Healthcare Employees’ Benefits Plan – Manitoba and under which each of their respective undertakings is carried out.

The information on this website is for convenience of reference only and has no official sanction. View our full disclaimer here.