Appropriate Available Treatment. The Proof must be given upon the Plan's request and at the Employee's expense. In determining whether the Employee is Disabled, the Plan will not consider employment factors including, but not limited to, interpersonal conflict in the workplace, recession, job obsolescence, paycuts, job sharing and loss of a professional or occupational license or certification. For purposes of determining Disability, the Injury must occur and Disability must begin while the Employee is a participant of this Plan. The Weekly Benefit will not:
1. exceed the Employee's Amount of Benefits; or
2. be paid for longer than the Maximum Benefit Period. The Amount of Benefits and the Maximum Benefit Period are shown in the Plan Specifications. To figure the amount of Weekly Benefit:
1. Take the lesser of:
a. the Employee's Basic Weekly Earnings multiplied by the benefit percentage shown in the Plan Specifications; or
b. the Maximum Weekly Benefit shown in the Plan Specifications; and then
2. Deduct Other Income Benefits and Other Income Earnings, (shown in the Other Income Benefits and Other Income Earnings provision of this Plan), from this amount. When the Plan receives Proof that an Employee is Partially Disabled and has experienced a loss of earnings due to Injury or Sickness and requires the Regular Attendance of a Physician, he may be eligible to receive a loss of earnings Weekly Benefit, subject to any other provisions of this Plan. To be eligible to receive Partial Disability benefits, the Employee may be employed in his Own Occupation or another occupation, must satisfy the Elimination Period, and must be earning between 20.00% and 80.00% of his Basic Weekly Earnings. A Weekly Benefit will be paid for the period of Partial Disability if the Employee gives to the Plan Proof of continued:
1. Partial Disability;
2. Regular Attendance of a Physician; and
Appropriate Available Treatment. The Proof must be given upon Xxxxxxx’s request, on behalf of the Sponsor, and at the Covered Person's expense. In determining whether the Covered Person is Partially Disabled, Xxxxxxx, on behalf of the Sponsor, will not consider employment factors including, but not limited to, interpersonal conflict in the workplace, recession, job obsolescence, paycuts, job sharing and loss of a professional or occupational license or certification. For purposes of determining Partial Disability, the Injury must occur and Partial Disability must begin while the Employee is covered under this plan. To figure the Amount of Weekly Benefit the formula (A divided by B) x C will be used.
A = The Covered Person's Basic Weekly Earnings minus the Covered Person's earnings received while he is Partially Disabled. This figure represents the amount of lost earnings. B = The Covered Person's Basic Weekly Earnings. C = The Weekly Benefit as figured in the Disability provision of this plan plus the Covered Person’s earnings received while he is Partially Disabled ( not including adjustments under the Cost of Living Adjustment Benefit, if included). On the first anniversary of benefit payments and each anniversary thereafter, for the purpose of calculating the benefit, the term "Basic Weekly Earnings" is increased annually by 7%. The Weekly Benefit payable will not be more than the Disability benefit otherwise payable under this plan.
1. The amount for which the Covered Person is eligible under:
a. any benefit payable under Workers' or Workmen’s Compensation law;
b. any work loss provision in mandatory “No-Fault” auto coverage; or
c. any other governmental program or coverage required or provided by statute (including any amount attributable to the Covered Person's family).
2. any amount the Covered Person receives from any unemployment benefits; or
3. any amount of Disability and/or Retirement Benefits under the United States Social Security Act, the Canada Pension Plan, the Quebec Pension Plan, or any similar plan or act, which:
a. the Covered Person receives or is eligible to receive; and
b. his spouse, child or children receives or are eligible to receive because of his Disability; or
c. his spouse, child or children receives or are eligible to receive because of his eligibility for Retirement Benefits.
Appropriate Available Treatment. The Proof must be given upon the Plan’s request and at the Employee's expense. In determining whether the Employee is Partially Disabled, the Plan will not consider employment factors including, but not limited to, interpersonal conflict in the workplace, recession, job obsolescence, paycuts, job sharing and loss of a professional or occupational license or certification. For purposes of determining Partial Disability, the Injury must occur and Partial Disability must begin while the Employee is a participant of this Plan. The work incentive benefit will be an amount equal to the Employee's Basic Weekly Earnings multiplied by the benefit percentage shown in the Plan Specifications, without any reductions from earnings. The work incentive benefit will only be reduced, if the Weekly Benefit payable plus any earnings exceed 100% of the Employee's Basic Weekly Earnings. If the combined total is more, the Weekly Benefit will be reduced by the excess amount so that the Weekly Benefit plus the Employee's earnings does not exceed 100% of his Basic Weekly Earnings. The Weekly Benefit payable will not be more than the Disability benefit otherwise payable under this Plan.
Appropriate Available Treatment. The Proof must be given upon the Plan’s request and at the Employee's expense. In determining whether the Employee is Partially Disabled, the Plan will not consider employment factors including, but not limited to, interpersonal conflict in the workplace, recession, job obsolescence, paycuts, job sharing and loss of a professional or occupational license or certification. For purposes of determining Partial Disability, the Injury must occur and Partial Disability must begin while the Employee is a participant of this Plan. The work incentive benefit will be an amount equal to the Employee's Basic Weekly Earnings multiplied by the benefit percentage shown in the Plan Specifications, without any reductions from earnings. The work incentive benefit will only be reduced, if the Weekly Benefit payable plus any earnings exceed 100% of the Employee's Basic Weekly Earnings. If the combined total is more, the Weekly Benefit will be reduced by the excess amount so that the Weekly Benefit plus the Employee's earnings does not exceed 100% of his Basic Weekly Earnings. The Weekly Benefit payable will not be more than the Disability benefit otherwise payable under this Plan. An increased Weekly Benefit will be paid while an Employee is fully participating in a Rehabilitation Program. The Plan must first approve the Rehabilitation Program in writing before an Employee can be considered for this benefit. If the Plan does not approve a Rehabilitation Program, the regular Disability benefit will be payable provided the Employee is Disabled under the terms of this Plan. To be eligible for a Rehabilitation Incentive Benefit, the Employee must:
1. be Disabled and receiving benefits under this Plan; and
2. be fully participating in a Rehabilitation Program approved by the Plan.
