Entitlement To LTD
Unionized employees are typically entitled to various benefits, including Long Term Disability coverage. These benefits are usually provided by an outside insurance company, such as Sun Life, Manulife, or Great-West Life. When an employee submits a claim to the insurer for LTD, it is the insurer that decides whether the employee qualifies for benefits or not, not the employer.
When Disputes Arise
Often Long Term Disability claims are improperly denied.
Even though the employer had absolutely no input into rejecting the claim, collective bargaining agreements sometimes prohibit the employee from commencing a lawsuit against the insurer for the improper denial. Instead, the dispute must proceed by way of the union grievance and arbitration process.
The theory behind this counter-intuitive approach is that the entitlement to Long Term Disability benefits arises from the collective bargaining agreement, and all disputes regarding the CBA must be arbitrated in accordance with grievance process.
The courts in Ontario and other jurisdictions have created a patchwork of cases outlining in what circumstances unionized employees can and cannot bring a lawsuit for denied LTD claims. These cases are complicated, but it essentially comes down to the precise wording of the collective bargaining agreement. If the CBA addresses Long Term Disability benefits in any detail, the employee might not be able to bring a lawsuit against the LTD insurer. Instead, he or she would have to proceed through the union grievance and arbitration process.
This can be problematic, because unions are often not well equipped to effectively fight the Long Term Disability insurer. Unions are usually good at addressing employment related issues, but may not have the resources a Long Term Disability lawyer has that are required to take on a billion dollar insurance company in a very specialized area of law.
Avoiding The Issue
There are several possible ways of avoiding being stuck with union representation. First, ask a Long Term Disability lawyer to carefully review your CBA.
If there is no reference to Long Term Disability benefits in the CBA, then you are probably able retain a LTD lawyer. If there is reference to LTD in the CBA, but it only states who is responsible for paying the premiums, you are again probably okay to retain a Long Term Disability lawyer of your choosing.
If, however, the CBA does go into detail regarding Long Term Disability benefits, such as the benefit amount, the test of disability, the waiting period, etc., you may be limited to the available union resources. There may still may be legal arguments that will allow you to retain a lawyer to commence a claim outside the grievance process, despite the CBA. This is particularly true if your union refuses to help, or if you are no longer a member of the union.
Contact A LTD Lawyer, For Free
It is therefore important that you contact a Long Term Disability lawyer for advice.
Michael Jordan regularly advises clients on this issue without fee and without obligation. Do not hesitate to contact Micheal regarding your situation.