Types of Employment Insurance Benefits (8:IV)

A. Regular Benefits

Starting April 7, 2013, EI benefits are calculated using your highest weeks of earnings over the qualifying period (generally 52 weeks): http://www.servicecanada.gc.ca/eng/ei/vbw/index.shtml. (Applies to both Regular (A) and Special Benefits (B)).

Regular EI benefits are payable during the benefit period to a claimant who:

• has had the requisite number of hours of insurable earnings during the qualifying period;
• has had an interruption of earnings from employment;
• is capable of and available for work, has made “reasonable and customary efforts” ; and
• is unable to find suitable employment.

The maximum number of weeks of regular benefits available to a claimant varies according to the claimant’s hours of insurable employment in the qualifying period, and the regional rate of unemployment. See Schedule I, s 12(2) of the EI Act.

B. Special Benefits

This category includes sickness, compassionate care, pregnancy, parental benefits, and benefits for parents caring for a critically ill child (s 12(3)). More than one type of special benefit can be claimed within one benefit period. Similarly, special and regular benefits claims can be combined. However, s 12(6) sets out the maximum for such a combination. If the combination of regular and special benefits adds up to 50 or more weeks of benefits, the total number of weeks that a claimant is entitled to shall not exceed 50 weeks. If the combination adds up to 50 or fewer weeks, the claimant may receive more than the number of weeks he or she is entitled to under special benefits, but not more than 50 weeks in total.

• In some cases, a claimant can receive greater than 50 weeks of special benefits and extend the benefit period beyond the usual 52 weeks while these benefits are being received. Claimants must not have been paid regular benefits during the benefit period, have been paid some combination of special benefits, and not have reached the maximum allowed amount of at least one of the types of special benefits that they have been paid (s 10(13)). In these cases, claimants will be able to receive up to the maximum number of weeks of each type of special benefits that they claimed before the benefit period was extended.

C. Sickness Benefits

1. Entitlement

To qualify for sickness benefits, the claimant must be able to prove that he or she is unable to work due to illness, injury, or quarantine, which normally requires that the claimant obtain a medical certificate. The illness, injury, or quarantine must be that of the claimant personally, not a child or other family member.

a) Major Attachment Claimant

Up to 15 weeks of sickness benefits are payable to a claimant who is incapable of work due to a prescribed illness, injury, or quarantine (s 12(3)). Major attachment claimants can receive sickness benefits even if the illness is the reason for ceasing work.

b) Minor Attachment Claimant

A minor attachment claimant may qualify for up to 15 weeks of sickness benefits where the illness arose after the termination of employment. This is where the minor attachment claimant did not suffer an interruption of earnings due to illness, but whose illness arose after the interruption (s 21(1)). If, due to the illness, the claimant cannot accept work, the claimant may be entitled to receive sickness benefits.

If a minor attachment claimant loses his or her job because of the illness or injury, the claimant will be eligible for regular benefits once recovered and capable of accepting suitable employment, notwithstanding that he or she was ineligible for sickness benefits. In some cases, a claimant who loses previous employment – due to injury for example – may not immediately qualify for regular benefits if he or she is capable of performing other jobs and is actively seeking such employment.

2. Sickness Benefit Rate

The sickness benefit rate is the same as the regular benefit rate and is subject to reduction due to “earnings”, which are allocated to weeks of sickness. In contrast to regular claimants, all “earnings” are deducted (s 21(3)). See Section V.D: Effect of Earnings, above.

Since paid sick leave benefits are regarded as earnings, they are deducted from EI benefits payable. An employee who receives paid sick leave has not suffered an interruption of earnings and therefore is not eligible to establish a claim.

3. Prescribed Illness, Injury or Quarantine

Sickness benefits are only available for a “prescribed illness, injury or quarantine that renders a claimant incapable of performing the functions of his or her regular or usual employment or other suitable employment” (s 40(4)). The onus is on the claimant to prove entitlement. A medical certificate is usually required, and the Commission may also require a claimant to undergo a medical examination at their direction pursuant to s 40(2) of the EI Regulations. In those situations the Commission must pay travel and other expenses for the examination.

D. Compassionate Care Benefits

At the time of writing, Compassionate Care Benefits may be paid upto a maximum of six weeks to a major attachment claimant who has to be absent from work to provide care or support to a gravely ill family member or a person who considers the claimant to be like a family member and is at risk of dying within 26 weeks. As of January 3, 2016, the maximum weeks of benefits will be 26 weeks for anyone whose benefit period begins on or after that date, and the benefit period within which those benefits may be paid will be 52 weeks. Unemployed persons on EI can also apply for this type of benefit.

To be eligible for Compassionate Care Benefits a claimant must apply and show that:

• his or her regular weekly earnings from work have decreased by more than 40 percent; and
• he or she has accumulated 600 insured hours in the last 52 weeks or since the start of his or her last claim

The EI Act’s expanded definition of “family member” includes a claimant’s:

• own child or the child of the spouse or common-law partner;
• wife/husband or common-law partner;
• father/mother or father’s wife/mother’s husband, if parent is remarried;
• common-law partner of father/mother, if there has been no remarriage;
• other relatives; and
• anyone that the gravely ill person considers to be like a family member.

NOTE: Please refer to the HRSDC web site for a comprehensive list of persons included under the term “family member”: http://www.servicecanada.gc.ca/eng/ei/types/compassionate_care.shtml#Definition

To establish a claim for compassionate care benefits in order to care for a gravely ill person who considers you to be like a family member, a signed “Compassionate Care Benefits Attestation” form must be obtained from the gravely ill person or their representative. A claimant will need to provide a medical certificate that indicates that the family member or friend is gravely ill with a significant risk of death within 26 weeks. The benefits will be given regardless of where the family member lives but a claimant will need to meet the same conditions that would apply if that ill person was in Canada.

E. Benefits for Parents of Critically Ill Children

Eligible parents who take leave from work to provide care or support to a child with a life-threatening illness or injury can receive up to 35 weeks of benefits. The benefits must be collected in the 52-week window beginning on the day a medical certificate is issued showing that the child is critically ill or, if the claim is made before the certificate is issued, from the date a specialist medical doctor certifies that the child is critically ill or injured.

As with other special benefits, the claimant must have an interruption of earnings (for special benefits, a 40% reduction in earnings) and have 600 hours in their qualifying period.

These benefits are not available to parents of a child with a chronic illness or condition that is their normal state of health. There must be a significant change from the child’s normal or baseline state of health at the time they are assessed by a specialist medical doctor.

F. Pregnancy Benefits

Like sickness benefits, pregnancy and parental benefits can be distinguished from regular EI benefits, because they are paid even though the applicant is not available for work. Pregnancy benefits are paid to an expectant or newly delivered mother. A mother can be entitled to both pregnancy benefits and parental benefits.

1. Entitlement

A claimant for pregnancy benefits must:

• a) be a major attachment claimant;
• b) prove her pregnancy. This entails furnishing a certificate completed by a physician that sets out the expected date of birth, or providing such other evidence as the Commission may require (s 18(1));

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