Common use of Eligibility for Benefits Clause in Contracts

Eligibility for Benefits. A member will not be eligible to receive Long Term Disability benefits until their Income Protection benefits have expired. 2.03.01 The City shall administer the Long Term Disability Plan. A member's eligibility for Long Term Disability benefits, including their ability to perform alternative employment shall be determined by the Plan Adjudicator. The costs of the Plan Adjudicator shall be borne by the Long Term Disability Plan. The Plan Adjudicator shall be appointed by the City. 2.03.02 In the event of a dispute based on medical evidence between the member and the Plan Adjudicator concerning such member's eligibility for Long Term Disability benefits, the same shall be settled by referring the dispute to a hearing with a review panel comprised of the Plan Adjudicator, the physician representing the member and an independent physician selected jointly by the City and the Union. If the City and the Union cannot agree upon the selection of an independent physician within 60 calendar days, the process outlined in the Duty to Accommodate Framework Agreement (Procedures for Obtaining Expert Opinions, Selection of Agencies) shall be used to select the independent physician. The hearing shall be chaired by a representative of the City of Edmonton and both the Union and Plan Adjudicator shall have the opportunity to make submissions at the hearing. The decision of the majority of the review panel members or the independent physician shall be final and binding on the member, the City, and the Union. The City appointed chairman shall not be a voting participant in the decision making process of the review panel. The cost of the review panel or the independent physician shall be borne by the Long Term Disability Plan. The decision must be consistent with the provisions of Part II, 10.02 –

Eligibility for Benefits. A member will not be eligible to receive Long Term Disability benefits until their Income Protection benefits have expired. 2.03.01 The City shall administer the Long Term Disability Plan. A member's eligibility for Long Term Disability benefits, including their ability to perform alternative employment shall be determined by the Plan Adjudicator. The costs of the Plan Adjudicator shall be borne by the Long Term Disability Plan. The Plan Adjudicator shall be appointed by the City. 2.03.02 . In the event of a dispute based on medical evidence between the member and the Plan Adjudicator concerning such member's eligibility for Long Term Disability benefits, the same shall be settled by referring the dispute to a hearing with a review panel comprised of the Plan Adjudicator, the physician representing the member and an independent physician selected jointly by the City and the Union. Alternatively, the Union may choose to have the dispute referred to a hearing with a single independent physician selected jointly by the City and the Union. If the City and the Union cannot agree upon the selection of an independent physician within 60 thirty (30) calendar days, the process outlined in the Duty to Accommodate Framework Agreement (Procedures for Obtaining obtaining Expert Opinions, Selection of Agencies) shall be used to select the independent physician. The hearing shall be chaired by a representative of the City of Edmonton and both the Union and the Plan Adjudicator shall have the opportunity to make submissions at the hearing. The decision of the majority of the review panel members or the independent physician shall be final and binding on the member, the City, City and the Union. The City City-appointed chairman shall not be a voting participant in the decision decision-making process of the review panel. The cost of the review panel or the independent physician shall be borne by the Long Term Disability Plan. The decision of the review panel must be consistent with the provisions of Part II, 10.02 II Article 8.02 –

Eligibility for Benefits. ‌ * A member will not be eligible to receive Long Term Disability benefits until their Income Protection benefits have expired. 2.03.01 The City shall administer the Long Term Disability Plan. A member's eligibility for Long Term Disability benefits, including their ability to perform alternative employment shall be determined by the Plan Adjudicator. The costs of the Plan Adjudicator shall be borne by the Long Term Disability Plan. The Plan Adjudicator shall be appointed by the City. 2.03.02 . In the event of a dispute based on medical evidence between the member and the Plan Adjudicator concerning such member's eligibility for Long Term Disability benefits, the same shall be settled by referring the dispute to a hearing with a review panel comprised of the Plan Adjudicator, the physician representing the member and an independent physician selected jointly by the City and the Union. Alternatively, the Union may choose to have the dispute referred to a hearing with a single independent physician selected jointly by the City and the Union. If the City and the Union cannot agree upon the selection of an independent physician within 60 thirty (30) calendar days, the process outlined in the Duty to Accommodate Framework Agreement (Procedures for Obtaining obtaining Expert Opinions, Selection of Agencies) shall be used to select the independent physician. The hearing shall be chaired by a representative of the City of Edmonton and both the Union and the Plan Adjudicator shall have the opportunity to make submissions at the hearing. The decision of the majority of the review panel members or the independent physician shall be final and binding on the member, the City, City and the Union. The City City-appointed chairman shall not be a voting participant in the decision decision-making process of the review panel. The cost of the review panel or the independent physician shall be borne by the Long Term Disability Plan. The decision of the review panel must be consistent with the provisions of Part II, 10.02 II Article 8.02 –

Eligibility for Benefits. ‌ A member will not be eligible to receive Long Term Disability benefits until their Income Protection benefits have expired. 2.03.01 The City shall administer the Long Term Disability Plan. A member's eligibility for Long Term Disability benefits, including their ability to perform alternative employment shall be determined by the Plan Adjudicator. The costs of the Plan Adjudicator shall be borne by the Long Term Disability Plan. The Plan Adjudicator shall be appointed by the City. 2.03.02 . In the event of a dispute based on medical evidence between the member and the Plan Adjudicator concerning such member's eligibility for Long Term Disability benefits, the same shall be settled by referring the dispute to a hearing with a review panel comprised of the Plan Adjudicator, the physician representing the member and an independent physician selected jointly by the City and the Union. Alternatively, the Union may choose to have the dispute referred to a hearing with a single independent physician selected jointly by the City and the Union. If the City and the Union cannot agree upon the selection of an independent physician within 60 thirty (30) calendar days, the process outlined in the Duty to Accommodate Framework Agreement (Procedures for Obtaining obtaining Expert Opinions, Selection of Agencies) shall be used to select the independent physician. The hearing shall be chaired by a representative of the City of Edmonton and both the Union and the Plan Adjudicator shall have the opportunity to make submissions at the hearing. The decision of the majority of the review panel members or the independent physician shall be final and binding on the member, the City, City and the Union. The City City-appointed chairman shall not be a voting participant in the decision decision-making process of the review panel. The cost of the review panel or the independent physician shall be borne by the Long Term Disability Plan. The decision must be consistent with the provisions of Part II, 10.02 –.

Eligibility for Benefits. ‌ * A member will not be eligible to receive Long Term Disability benefits until their Income Protection benefits have expired. 2.03.01 The City shall administer the Long Term Disability Plan. A member's eligibility for Long Term Disability benefits, including their ability to perform alternative employment shall be determined by the Plan Adjudicator. The costs of the Plan Adjudicator shall be borne by the Long Term Disability Plan. The Plan Adjudicator shall be appointed by the City. 2.03.02 In the event of a dispute based on medical evidence between the member and the Plan Adjudicator concerning such member's eligibility for Long Term Disability benefits, the same shall be settled by referring the dispute to a hearing with a review panel comprised of the Plan Adjudicator, the physician representing the member and an independent physician selected jointly by the City and the Union. If the City and the Union cannot agree upon the selection of an independent physician within 60 calendar days, the process outlined in the Duty to Accommodate Framework Agreement (Procedures for Obtaining Expert Opinions, Selection of Agencies) shall be used to select the independent physician. The hearing shall be chaired by a representative of the City of Edmonton and both the Union and Plan Adjudicator shall have the opportunity to make submissions at the hearing. The decision of the majority of the review panel members or the independent physician shall be final and binding on the member, the City, and the Union. The City appointed chairman shall not be a voting participant in the decision making process of the review panel. The cost of the review panel or the independent physician shall be borne by the Long Term Disability Plan. The decision must be consistent with the provisions of Part II, 10.02 –