Issue With a Friend. Fracture Costs

[Saudamini]

So one of my friends entered Canada in Jan 2017 and works in big bank in Toronto. She did have employer insurance which do not cover out - patient costs. So there are two issues with her.

She got a fracture in foot and was not able to walk, hence she took sick leave (she was entitled for 10 days at max), but she has to be in day cover for more than 4 weeks, so her employer gave her next 2 weeks without pay. Now she has been given extended bed rest, so her employer has given other 4 weeks of leave without pay? I am just wondering is this allowed? Can't they give work from home to her? Is there any Government assistance for people on sick leave?

Given her situation, her foot fracture was identified as "Jones Fracture" . She has been asked to get surgery, however, given its not emergency, hospitals have given her surgery date in end of April. Would going to different hospital help? Private surgery costs more than >$9,000. Again it is out patient non-invasive surgery, so it won't be covered by her employer (that what is told to her!)

She obviously can't go without pay anymore. She has mortgage for home and car. It's been more than six weeks and she saved good amount of money which is being drained by buying prescription medications, and using ambulance service ($300).

Last option she has got is to travel to India and get surgery done within $2000 and come back to Canada. Could you please let me know, I am searching a lot for her, however, not able to get any solution or answer. Anyone with fracture can tell me. Her parents are also in India, who will travel if no other option is there.

 

[Copingwithlife]

Has she looked into long term disability with her employer ?
Sick leave paid under Employment Insurance ? How long has she worked for the bank ? You said your friend landed back in 2017, when exactly did she start working for the bank ? Landing and starting working are two totally different things . She has to have worked so many hours to be eligible for sick leave from EI .
Is she an actual employee or on contract ? If she’s on contract then she would not have paid EI premiums, hence not eligible for EI sick leave

 

[Saudamini]

Has she looked into long term disability with her employer ?
Sick leave paid under Employment Insurance ? How long has she worked for the bank ? You said your friend landed back in 2017, when exactly did she start working for the bank ? Landing and starting working are two totally different things . She has to have worked so many hours to be eligible for sick leave from EI .
Is she an actual employee or on contract ? If she’s on contract then she would not have paid EI premiums, hence not eligible for EI sick leave

She is working since May 2017.

May 2017 - April 2019: Bank A
May 2019 - Present: Bank B. She has worked 40 hrs per week since May 2019

She can get at max $563 per week for sick leave from EI (correct me if I am wrong), but there are so many documents required and she is afraid that if she takes sick leave from EI, she wont able to sponsor her parents. Would that be an issue?

Also, sick leave from EI is giving at max $563 per week; she was obviously making close $1800 per week. She has more than $2,000 in mortgage payments towards house, car and multiple insurances per month.

Can't employer give Work From Home. She used to work mostly on laptop (individual contributor), can't she push her employer for WFH option. Multiple companies give that. Her employer is refusing citing reasons like her presence is required. They have recently got person on contract to do her job whom they are paying almost 2 times her hourly/rate.

She is like she can go unpaid for next 2-3 months, get surgery in India ($2000) and return in Feb end ($2000 to and fro from Canada to India), rather paying $8000-9000 in private surgery in Canada. Would her surgery in India be reimbursed including her travel? Why there is so much wait in first place as this is just out-patient non-invasive surgery. She is obviously depressed and anxious that this is eating all her savings from last 2.5 years and its not much she hardly saved $12,000-14,000. She took money from her parents for 1st 2 BHK she bought included some of her savings as well. This is very disturbing!

I cant even help her. I am travelling in last week of Jan

 

[21Goose]

She is working since May 2017.

May 2017 - April 2019: Bank A
May 2019 - Present: Bank B. She has worked 40 hrs per week since May 2019

She can get at max $563 per week for sick leave from EI (correct me if I am wrong), but there are so many documents required and she is afraid that if she takes sick leave from EI, she wont able to sponsor her parents. Would that be an issue?

Also, sick leave from EI is giving at max $563 per week; she was obviously making close $1800 per week. She has more than $2,000 in mortgage payments towards house, car and multiple insurances per month.

Can't employer give Work From Home. She used to work mostly on laptop (individual contributor), can't she push her employer for WFH option. Multiple companies give that. Her employer is refusing citing reasons like her presence is required. They have recently got person on contract to do her job whom they are paying almost 2 times her hourly/rate.

She is like she can go unpaid for next 2-3 months, get surgery in India ($2000) and return in Feb end ($2000 to and fro from Canada to India), rather paying $8000-9000 in private surgery in Canada. Would her surgery in India be reimbursed including her travel? Why there is so much wait in first place as this is just out-patient non-invasive surgery. She is obviously depressed and anxious that this is eating all her savings from last 2.5 years and its not much she hardly saved $12,000-14,000. She took money from her parents for 1st 2 BHK she bought included some of her savings as well. This is very disturbing!

I cant even help her. I am travelling in last week of Jan

1. EI/LTD is not welfare and will not affect any sponsorship applications. Your friend needs to use the options available to her. That's why she paid the premiums..
2. You cannot force a company to give you WFH. They cannot simply fire her (which they aren't), but they are within their rights to refuse WFH options.

 

[Copingwithlife]

She is working since May 2017.

May 2017 - April 2019: Bank A
May 2019 - Present: Bank B. She has worked 40 hrs per week since May 2019

She can get at max $563 per week for sick leave from EI (correct me if I am wrong), but there are so many documents required and she is afraid that if she takes sick leave from EI, she wont able to sponsor her parents. Would that be an issue?

Also, sick leave from EI is giving at max $563 per week; she was obviously making close $1800 per week. She has more than $2,000 in mortgage payments towards house, car and multiple insurances per month.

Can't employer give Work From Home. She used to work mostly on laptop (individual contributor), can't she push her employer for WFH option. Multiple companies give that. Her employer is refusing citing reasons like her presence is required. They have recently got person on contract to do her job whom they are paying almost 2 times her hourly/rate.

She is like she can go unpaid for next 2-3 months, get surgery in India ($2000) and return in Feb end ($2000 to and fro from Canada to India), rather paying $8000-9000 in private surgery in Canada. Would her surgery in India be reimbursed including her travel? Why there is so much wait in first place as this is just out-patient non-invasive surgery. She is obviously depressed and anxious that this is eating all her savings from last 2.5 years and its not much she hardly saved $12,000-14,000. She took money from her parents for 1st 2 BHK she bought included some of her savings as well. This is very disturbing!

I cant even help her. I am travelling in last week of Jan

To be eligible for EI sickness benefits, you must have accumulated at least 600 hours of insurable employment in your qualifying period.
So she would require 600 insurable hours from when she left the bank sick. The qualifying period is one year back from when she left work , HOWEVER if she left bank A from quitting , then her insurable hours start from May 2019, up till when she went off sick . If she didn’t accrue 600 hours , no EI benefits . Is she quit from bank A, I’d request the claim be sent off to adjudication
Whether she can work from home is her employers call , that’s not mandated by law
Her employer issues a ROE, with the reason employment stopped do to sick reasons . They’ll calculate the insurable hours . It’s typically issued electronically, so the ESDC receives it fast . You can apply for benefits , however it’s strongly recommended you get a doctors note to support your claim . If you don’t have enough hours after applying the system will auto deny it , versus automatically approving
Btw, she should of had a ROE issued automatically by the HR. And she MUST have 600 hours , not 595, not 599, but 600. There’s no appeal if she’s short
Note ; the maximum benefit paid for EI is legislated, whether or not it covers your bills is not relevant. As I say, something is better then nothing
Note ; You asked whether her airfare to India and medical costs overseas would be reimbursed... by who ?
Contact the mpp regarding healthcare wait times
Good luck

 

[Saudamini]

To be eligible for EI sickness benefits, you must have accumulated at least 600 hours of insurable employment in your qualifying period.
So she would require 600 insurable hours from when she left the bank sick. The qualifying period is one year back from when she left work , HOWEVER if she left bank A from quitting , then her insurable hours start from May 2019, up till when she went off sick . If she didn’t accrue 600 hours , no EI benefits . Is she quit from bank A, I’d request the claim be sent off to adjudication
Whether she can work from home is her employers call , that’s not mandated by law
Her employer issues a ROE, with the reason employment stopped do to sick reasons . They’ll calculate the insurable hours . It’s typically issued electronically, so the ESDC receives it fast . You can apply for benefits , however it’s strongly recommended you get a doctors note to support your claim . If you don’t have enough hours after applying the system will auto deny it , versus automatically approving
Btw, she should of had a ROE issued automatically by the HR. And she MUST have 600 hours , not 595, not 599, but 600. There’s no appeal if she’s short
Note ; the maximum benefit paid for EI is legislated, whether or not it covers your bills is not relevant. As I say, something is better then nothing
Note ; You asked whether her airfare to India and medical costs overseas would be reimbursed... by who ?
Contact the mpp regarding healthcare wait times
Good luck

Thanks I have told her. She has 640 hours incurred, so EI benefits she will get. I have told ROE and ESDC are required

Can employer insurance cover her cost of medical treatment abroad? Its better than waiting till April end and be on EI benefits and EI benefits will also be given maximum for 15 weeks.

 

[Copingwithlife]

Thanks I have told her. She has 640 hours incurred, so EI benefits she will get. I have told ROE and ESDC are required

Can employer insurance cover her cost of medical treatment abroad? Its better than waiting till April end and be on EI benefits and EI benefits will also be given maximum for 15 weeks.

It’s extremely important that she applied for EI sick benefits ASAP
Delaying applying can affect the claim
All she needs is a doctors note stating she’s off work due to illness with the expected date of return explicitly in the note
And she wants to keep a copy of that note and give the original to ESDC
The ESDC can request that note from up too six years from when the claim finishes
No note, the claimant may have to repay the benefits
She’d have to contact the employers benefit provider to see if over seas treatment would be repaid

 

[scylla]

So one of my friends entered Canada in Jan 2017 and works in big bank in Toronto. She did have employer insurance which do not cover out - patient costs. So there are two issues with her.

She got a fracture in foot and was not able to walk, hence she took sick leave (she was entitled for 10 days at max), but she has to be in day cover for more than 4 weeks, so her employer gave her next 2 weeks without pay. Now she has been given extended bed rest, so her employer has given other 4 weeks of leave without pay? I am just wondering is this allowed? Can't they give work from home to her? Is there any Government assistance for people on sick leave?

Given her situation, her foot fracture was identified as "Jones Fracture" . She has been asked to get surgery, however, given its not emergency, hospitals have given her surgery date in end of April. Would going to different hospital help? Private surgery costs more than >$9,000. Again it is out patient non-invasive surgery, so it won't be covered by her employer (that what is told to her!)

She obviously can't go without pay anymore. She has mortgage for home and car. It's been more than six weeks and she saved good amount of money which is being drained by buying prescription medications, and using ambulance service ($300).

Last option she has got is to travel to India and get surgery done within $2000 and come back to Canada. Could you please let me know, I am searching a lot for her, however, not able to get any solution or answer. Anyone with fracture can tell me. Her parents are also in India, who will travel if no other option is there.

I'm assuming your friend is a full time employee rather than contractor. If she is a full time employee, what has happened doesn't make sense. She should be on short term disability rather than leave without pay. Has she looked into this with her company?

If she is a contractor, that is a different matter since benefits are not the same.

You cannot force an employer to let her work from home.

 

[Saudamini]

It’s extremely important that she applied for EI sick benefits ASAP
Delaying applying can affect the claim
All she needs is a doctors note stating she’s off work due to illness with the expected date of return explicitly in the note
And she wants to keep a copy of that note and give the original to ESDC
The ESDC can request that note from up too six years from when the claim finishes
No note, the claimant may have to repay the benefits
She’d have to contact the employers benefit provider to see if over seas treatment would be repaid

She has started the process EI sick benefits

What you mean by claimant have to repay the benefits?

She has asked for overseas treatment cover, however, he employer said Insurance is in addition to OHIP. Its not replacement of OHIP.

I'll tell her to contact local MPP. This is preposterous, that for simple surgery she has to wait for so long and given she has been paying taxes since May 2017 for 2.5 years. She is already spending on Vitamin D injections and Calcium, Protein Capsules every 2 weeks. I don't understand it was said healthcare is free (there should be caveat only for emergency), do simple surgery wait times are 16 weeks!

What about EI benefits after 15 weeks?

I shall be taking Vitamin D and Calcium and Protein capsules for her from India

 

[Saudamini]

I'm assuming your friend is a full time employee rather than contractor. If she is a full time employee, what has happened doesn't make sense. She should be on short term disability rather than leave without pay. Has she looked into this with her company?

If she is a contractor, that is a different matter since benefits are not the same.

You cannot force an employer to let her work from home.

She is full time employee. There is no short-term disability coverage by employer, HR advised her to apply for Employment Insurance (EI) sickness benefits, but she thought given she has to sponsor her parents and it could affect her sponsoring the parents which I explained to her is not true.

 

[scylla]

She is full time employee. There is no short-term disability coverage by employer, HR advised her to apply for Employment Insurance (EI) sickness benefits, but she thought given she has to sponsor her parents and it could affect her sponsoring the parents which I explained to her is not true.

Does she work for one of the big five banks?

 

[Saudamini]

Does she work for one of the big five banks?

Yes she started as contractor and then converted to full time employee

 

[Saudamini]

Does she work for one of the big five banks?

Do you think they have it and just not aware, her full time agreement says this " You will be able to participate in the Company's Medical, Dental and Vision Plans as described in the Company Benefit Summary upon completion of 60 days of full time employment" she has completed 60 days on Nov 1

 

[scylla]

Yes she started as contractor and then converted to full time employee

This story makes zero sense. All of the big five have short term disability benefits.

 

[scylla]

Do you think they have it and just not aware, her full time agreement says this " You will be able to participate in the Company's Medical, Dental and Vision Plans as described in the Company Benefit Summary upon completion of 60 days of full time employment" she has completed 60 days on Nov 1

I have no idea. She needs to speak with HR and call the benefits hotline.

This isn't something any of us here can help you with. We don't have access to her employment records, or benefits coverage or personal information. There are resources available to support her at her company - she needs to use them.