FAQs

Choose a question below. If you require more information on issues and situations of particular interest to you, please feel free to contact us.


Eligibility/Coverage

Q: Do I have to join the D&R Plan?

A: If you meet the eligibility criteria as described in the eligibility information in the Disability & Rehabilitation Coverage section, you must join the D&R Plan as a condition of employment.

Q: If my employment status changes from casual to part-time or full-time, when will I be eligible to join the D&R Plan?

A: You will be eligible as soon as you meet the requirements described in the eligibility information in the Disability & Rehabilitation Coverage section.


Leave of Absence

Q: If I am on an approved sick leave of absence (LOA) and receiving benefits from the Workers Compensation Board or Manitoba Public Insurance, do I have to make premium payments to continue my D&R coverage?

A: Yes, premium payments are required to continue D&R coverage as the LOA will be considered a sick leave. Please refer to the Unpaid Sick Leave of Absence and Prepayment of D&R Premiums section.

Q: If I am participating in an employer-paid Return to Work Program during the Elimination Period, do D&R premiums need to be submitted?

A: Yes, Required Contributions (premiums) must be submitted to HEB Manitoba while you are participating in the Return to Work Program/Work Trial. The Required Contributions are calculated based on the Covered Employee’s Monthly Earnings as of the last day worked.

Q: Can I prepay my premiums to continue my D&R coverage after my planned personal, maternity/parental or educational LOA has started?

A: No, prepayments must be received by HEB Manitoba before the start of your LOA. Premiums can be prepaid with post-dated cheques.

Q: Will I be covered during a work stoppage?

A: You will not be covered unless your union arranges to pay premiums for the group of affected employees prior to the beginning of the work stoppage.

Q: Can I prepay premiums to maintain my own coverage during a work stoppage?

A: No, an individual member of an affected union cannot prepay premiums to maintain individual coverage. Coverage must be maintained for the union group as a whole, as described above.

Q: Will I be covered if I am laid off?

A: If the duration of the layoff is known before the layoff date, and is less than 12 months, you may prepay premiums to continue your coverage.

If the duration of the layoff is not known before the layoff date, your coverage will stop on the pay end date in which your last premium deduction occurs.

Q: If I have maintained my coverage during an approved  LOA, layoff or work stoppage, and become Totally Disabled during this time, when will my 119-day Elimination Period begin?

A: The first day of your Elimination Period will be your Date of Disability.

Q: Should I prepay my D&R premiums beyond the 119-day Elimination Period if a decision regarding my claim has not been made?

A: Yes, there are situations where a D&R claim decision may not be made until after the 119-day Elimination Period. If a decision regarding a claim has not been made prior to the end of the 119-day Elimination Period, D&R premiums must continue to be paid to maintain D&R coverage. If D&R premiums are paid beyond the 119-day Elimination Period and the claim is accepted retroactively, applicable post-dated cheques will be returned, or a D&R premium refund can be arranged by contacting your Claims Specialist.

Q: What if I have prepaid my D&R premiums but return to work sooner than expected?

A: Applicable post-dated cheques will be returned and/or a D&R premium refund can be arranged by contacting your Case Worker.


D&R Benefits

Q: Who is responsible for notifying the D&R Department of my return to work?

A: It is the responsibility of both the member and the Employer to notify the D&R Department of a return to work. It is important to do this as soon as possible to avoid an overpayment of D&R Benefits, which would have to be returned to HEB Manitoba.

Q: If my doctor or I submit a copy of the completed claim application rather than the original, will my claim be adjudicated?

A: No, all original completed claim application forms must be submitted to HEB Manitoba.

Q: What happens if I was approved for D&R Benefits, returned to work, and then had to stop work again due to the same or a related disability?

A: In this situation, you must re-apply for D&R Benefits. HEB Manitoba will assess your claim to determine if your disability is a Recurrent claim. If your claim is approved and:

  • You had stopped working within six months of returning to work, it is considered a continuation of the first period of disability. If your claim is approved as a Recurrent claim, your D&R Benefits will be effective the date of your Recurrent Total Disability. Your benefit amount will be calculated based on your Monthly Earnings as of your last day worked prior to your first period of Total Disability.
  • You had stopped working more than six months after you returned to work, it is considered a new claim.

Note: You must be covered under the D&R Plan to be eligible for D&R Benefits. Please see the Termination of Coverage section for additional information.

Q: I am approved for D&R Benefits and I want to take a vacation. Will this affect my claim?

A: If you are planning a vacation, contact your Claims Specialist in advance to discuss how this may affect your claim and monthly D&R Benefit. If you were referred to a HEB Manitoba Rehabilitation Specialist and participating in an Approved Rehabilitation Program or graduated Return to Work Program, please contact your HEB Manitoba Rehabilitation Specialist in advance.

Q: Will I be eligible for D&R Benefits?

A: To be eligible for D&R Benefits, you must be employed at a Participating Employer in a position that is eligible for coverage under the D&R Plan; prepay your D&R premiums to maintain coverage under the D&R Plan; submit a completed D&R application within the required time frame; and be eligible for benefits based on the definition of Total Disability and other Disability and Rehabilitation Plan Text provisions.

Q: What happens if a wage increase occurs while I’m receiving D&R Benefits?

A: Your monthly D&R Benefits will increase if the effective date of the wage increase is on or before your last day worked. If applicable, a retroactive payment will be made. Your Employer must notify HEB Manitoba, in writing, of the date of the wage change and provide the new rate. If the effective date of the wage increase follows your last day worked, your monthly D&R Benefits will not be adjusted.

Q: What happens to my HEB Manitoba Life Insurance coverage if my D&R claim terminates?

A: If your D&R claim terminates, your premium-free HEB Manitoba Life Insurance coverage will cease.

If your HEB Manitoba Life Insurance coverage ceases, you may apply to convert your Life Insurance and your spouse/common-law partner’s Life Insurance coverage to an individual life insurance policy with Great-West Life. There is a 31-day period following the termination of your coverage in which you are eligible to apply for conversion to an individual life insurance policy with Great-West Life without Evidence of Insurability (maximums may apply). Life Insurance coverage is maintained for you and your spouse/common-law partner during the 31-day period.

To convert your HEB Manitoba Life Insurance, please contact Deborah Capek, Great West-Life representative at (204) 297-6224 for further information. As time restrictions apply, please contact Great-West Life as soon as possible.

Q: What can I do to avoid delays in the D&R claim process?

A: There are a number of steps you can take to assist in avoiding delays in the D&R claim process:

  • Apply early! If you believe your sick leave of absence may be two months or longer, it is important to apply for D&R Benefits. Contact your Employer or HEB Manitoba to begin the D&R application process
  • When you receive your D&R application, ensure that you complete the forms in full, and sign and date each form
  • Ensure that you submit the original completed application to HEB Manitoba
  • Remember to include a copy of a document that proves your age such as birth certificate, baptismal certificate, Canadian passport, or Certificate of Canadian Citizenship with your application
  • Include any additional information that establishes your eligibility for D&R Benefits with your application
  • You do not need to wait for your Physician to complete the Attending Physician’s Statement before submitting your portion of the D&R application. Be sure to follow-up with your Physician to ensure that the medical forms are completed and submitted to HEB Manitoba in a timely manner
  • Have your Physician submit copies of all clinical notes, consult reports and test results related to the medical condition for which you are claiming benefits
  • Submit a void cheque with your D&R application. If you do not have a chequing account, ask your financial institution to provide a document confirming the institution’s number, transit number and account number.

Q: Can my chiropractor complete the Attending Physician’s Statement of my D&R Application?

A: No, HEB Manitoba recognizes that your chiropractor plays an integral role in your healthcare and that your doctor and chiropractor can work collaboratively to provide for your care; however, HEB Manitoba requires medical information that addresses the overall medical health of a member. Therefore, a licensed medical Physician, Registered Nurse (Extended Practice), Nurse Practitioner, medical specialist, or clinical psychologist who has a doctoral degree and whose primary professional activity is treating patients must complete the Attending Physician’s Statement.

Note: The D&R Plan requires that your Physician not be related to you by blood or marriage.

Q: Will my assigned D&R Case Worker, Claims Specialist and/or Rehabilitation Specialist always remain the same?

A: No, to provide you with the most efficient and expedient service, your D&R Case Worker, Claims Specialist and/or Rehabilitation Specialist may change.


Claim Application

Q: Some of the questions on the Member Statement do not seem to apply to my situation; do I still need to complete them?

A: Yes, the information requested on the Member Statement is needed to assess your claim. Please complete all questions fully and to the best of your ability.

Q: Why do I need to provide a void cheque with my application?

A: HEB Manitoba needs the void cheque to set up direct deposit should your claim be approved. If you do not have a chequing account, have your financial institution provide documentation on their letterhead that provides the financial institution number, branch transit number, your account number, and confirmation that the account is in your name.

Q: Who should I contact about the status of my application? 

A: If you require confirmation about the status of your application, or whether all forms have been received, you can contact your Case Worker in the D&R Department. Once HEB Manitoba receives all three parts of the application, you will be notified in writing, and your claim will be transferred to a Claims Specialist.

Q: Who should I contact about the status of my claim? 

A: Contact your Claims Specialist in the D&R Department with any questions regarding your claim. 


Change in Definition Assessment

Q: What do I need to do for the change in definition assessment?

A: You will receive information from your Claims Specialist about the change in definition assessment and what information is required for the assessment. Your Claims Specialist or Rehabilitation Specialist may arrange assessments or testing to assist in adjudicating your claim or to assist with vocational rehabilitation planning.

Q: Will HEB Manitoba find me a job when I am assessed for the change in definition of Total Disability?

A: No, HEB Manitoba will assess whether you are medically able to work in any occupation that could provide you with 66 2/3% of your Monthly Earnings at your Date of Disability if your Date of Disability is January 1, 2009, or later; or 60% of your Monthly Earnings at your Date of Disability if your Date of Disability is June 1, 2005, to December 31, 2008. While HEB Manitoba will identify whether such an occupation exists, the D&R Plan does not require us to actually find you a job.

Q: If the assessment determines that I am Totally Disabled at the change in definition, what will happen to my premium-free HEB Manitoba Healthcare, Dental, and Life Insurance coverage, and my Healthcare Employees’ Pension Plan (HEPP) pension accrual?

A: If the assessment determines that you remain eligible for D&R Benefits, your premium-free coverage will continue. If you participate in HEPP, your pension accrual will also continue.

Q: Who should I call if I have questions about my HEPP Pension?

A: Please contact HEB Manitoba's Member Services at (204) 942-6591 or toll-free at 1-888-842-4233 (outside Winnipeg).

Q: What will happen to my job at the change in definition?

A: If you have questions regarding your employment, please contact your Employer and your union representative (if you are a member of a union).

Q: What will happen to my D&R Benefits if, at the change in definition, I am not Totally Disabled from any occupation?

A: If you are not Totally Disabled, as defined by the D&R Plan, your D&R Benefits will end.

© 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.

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