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Health Management - Leave & Disability - Applying for S & A benefits

Human Resources

Health
Management

Health Management

Applying For S & A benefits

S & A is a short term disability wage loss benefit for absences due to accident or illness. Employees and supervisors should read the MEBAC agreement for specific information pertaining to this benefit.

The process for applying for S & A benefits includes:

  1. Once an employee knows they are going to be away longer than five consecutive business days, get an Attending Physician’s Statement as soon as possible. For IAFF Local 255 members, use Attending Physician's Statement FD1355 for absences longer than five consecutive working days or four consecutive working days if on a platoon schedule. The information a doctor includes on that form is used by Homewood Health to adjudicate the application. The City’s Extended Health Services Benefits has some coverage for the cost of getting an Attending Physician’s Statement completed.
  2. The doctor should fax the completed Attending Physician’s Statement directly to Homewood Health 1-866-460-4645. The quicker Homewood Health receives the form, the sooner it will be able to adjudicate the application and minimise any interruption in pay for the employee.
  3. Sickness and accident (S&A) is a short term disability wage loss benefit. It is for absences due to non-work-related illness or injury up to 119 calendar days. For absences after five consecutive work days, employees need to provide an Attending Physician Statement APS X427 to support their absence. For firefighters on platoon schedule, this documentation is needed after four consecutive work days to support their absence. For IAFF Local 255 members, use Attending Physician's Statement FD1355 for absences after five consecutive work days or after four consecutive work days if on a platoon schedule. The APS X427 or the FD1355 is submitted to Homewood Health via fax 1-866-460-4645.
  4. As soon as Homewood Health gets an employee’s APS, a case file will be opened. A Homewood Health representative will be assigned the claim to adjudicate.
  5. The case manager will tell both the employee and his or her supervisor if the claim is approved.
  6. If the claim has been approved, Homewood Health will continue to manage the case. If it has been denied, employees can explore other options.

S & A denied or terminated

Appealing the decision

If an employee disagrees with a decision by Homewood Health to deny or terminate their S&A claim for medical or non-medical reasons, they have 30 days from the date of notification that the claim is denied or terminated to appeal the decision.

The appeal process is outlined in the MEBAC agreement.

Other leave options

If S & A is denied or terminated and the employee appeals, they generally will go on a Leave of Absence for medical reasons until a decision is made about the appeal.

Returning to work

If S&A is denied or terminated and the employee DOES NOT appeal, the employee has to return to work.

Who can help?

Human Resources

403-268-5800

Homewood Health

Direct Tel: 403-705-2024
Toll Free: 1-800-472-4904
Fax: 1-866-460-4645
www.homewoodhealth.com



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