seven-o-seven seven-o-seven REPORTER - CAW Local 707

Sickness And Accident
Benefits
Benefit Representative’s Report
By Mark Sciberras
Our year over year Group Wage Loss Insurance utilization
costs continue to increase. The company continues to
ask why. While the company has not personally asked, it
seems to be concerned about the health of the workforce in
Oakville – just the costs; for if it was concerned about our
health, it might take into consideration the average age of the
worker in Oakville. Very few of us are under 30 years old as
we have not had a new hire since 2003. It may reconsider its
decision to reduce break times and vacation, stop increasing
workloads and attempt to create a more positive working environment
that would decrease Group Wage Loss Insurance
claims; but to do this would require more manpower and
that would increase the company’s costs. Unfortunately, at
present, it seems it can’t get past the immediate costs for if
the company was a little more concerned about the
long term overall health of its workforce, it might
find that it could decrease the amount of group
wage loss claims, which is something we should
want.
If the company was serious about our health, it
would have continued to fund a wellness program
that was slow to start but had great potential. It
would attempt to create better gradual return to work programs
for those with personal injuries or illnesses, e.g. accommodate
alternative work schedules. Currently it seems
the company’s only solution to decrease costs is to have
Great West Life Assurance Company scrutinize more claims
than ever, especially those related to mental health.
While I have stated this previously it is worth repeating.
To ensure you are eligible for S&A benefits while unable to
work due to illness or injury and your claim does not end up
a statistic in one of its cost cutting measures, ensure your
S&A application is completed properly. On your application,
make sure you sign in the two necessary spots and include
direct deposit information or a void cheque. This is the only
way payment can be made as the Ford Motor Company and
Great West Life Assurance do not share your banking information.
Make sure your fully completed S&A application is
passed on to the First Aid Department in a timely manner at
least a month from the commencement of your disability.
While off on Group Wage Loss Insurance, speak to your
doctor about a treatment plan. To qualify for benefits, not
only do you have to be unable to perform your job and have
a clear diagnosis, but you are required to have a treatment
program that is followed, e.g. an individual with a diagnosis
of clinical depression might have a treatment program of
medication and weekly counselling. If you are not engaged
in some type of physician-prescribed regular treatment program,
our Group Wage Loss Benefits could be denied. Also
ensure the doctor completes the form correctly. It should have
Page 18 – July – September 2011
at the very minimum, a medical
diagnosis, the date the symptoms
first appeared, the first medical
attention you sought within five
days of the commencement of your
disability, a regular treatment plan,
the date you were first unable to do
your job due to illness or injury and
the approximate or return to work date. A completed application
done right the first time is the best way to ensure your
claim for benefits is not delayed and withstands the scrutiny
of insurance adjudicators at Great West Life Assurance and
allow you to focus on what is most important – your treatment,
recovery and hopefully a quick return to work.
If the company was serious
about our health, it would have
continued to fund a wellness program.
Sickness and accident Benefits are commonly not paid
for:
c Workplace Conflict – If you are in a conflict with your
supervisor or co-worker, insurance companies traditionally
do not view this as a disability.
c Stress – Insurance companies view it as an everyday part
of life; not a clear medical diagnosis or a disability. To be
eligible for benefits, you must instead have an illness with
a clear medical diagnosis, treatment plan with restrictions
and limitations that prevent you from performing your job.
c Death or a serious illness of a family member – This is
not viewed as an illness to you. Instead it is viewed as a
“life event” by insurance companies unless you are unable
to work because of your own illness with a clear medical
diagnosis, treatment plan with restrictions and limitations
that prevent you from performing your job.
Benefit Information
For updated negotiated benefit information, visit our
CAW Local 707 website at www.local707caw.ca. Once on
our home page, click “Representatives” and then click on
“Benefits”. Visit Green Shield’s website at www.greenshield.ca
to sign up for “Online Plan Member Services”.
This provides you with instant access to important benefit
plan information.
Fraternally,
Mark Sciberras
Local 707 CAW Benefit Representative