Disability Benefits

Overview

OMERS provides two different disability benefits if you meet the applicable definition oftotally disabledTooltipunder the terms of the OMERS Plan: (1) a disability waiver and (2) a disability pension.

If you are unable to work for more than four months and meet the eligibility requirements, you may be eligible for one of the two types of OMERS disability benefits as early as the first day of the fifth month following the start date of your injury or illness, provided you are still employed with your OMERS employer. The waiting period before eligibility is referred to as the disability elimination period.

The following sections summarize the type of disability benefits offered to OMERS members, the application process and the requirements while receiving an OMERS disability benefit. You can also refer to the Member Handbook for more information.

Notes:

• Exclusions apply in the case of a disability waiver and a disability pension. For example, to qualify for either benefit, a disability cannot have resulted from a willful self-inflicted injury, committing (or attempting to commit) an offence under the Criminal Code or working in an unlawful occupation.

• OMERS also offers a shortened life expectancy benefit to terminally ill members. For more information see the section below.

What disability benefits does OMERS offer?

OMERS provides two disability benefits to eligible members: (1) a disability waiver of contributions (also called a “disability waiver”) and (2) a disability pension.

1. Disability waiver

While on a disability waiver, you continue to accumulate credited serviceTooltipin the OMERS Plan as if you were still working. The OMERS Plan covers the contributions you and your employer would have made if you were not on a disability leave.

Deemed contributory earnings

While you’re working, you pay OMERS Plan contributions on your regular and recurring “contributory” earnings in each pay period, excluding additional amounts such as overtime pay and also excluding most one-time payments and lump-sum payments. When you end membership in the OMERS Plan, these same contributory earnings are used to calculate your pension benefit (i.e., the “best five” earnings in the OMERS pension formula).

During a disability waiver period, your contributory earningsTooltip are deemed based on the annual rate of contributory earnings that were used to determine the last contributions you made to the OMERS Plan. Generally, the deemed contributory earnings equal the annual rate of contributory earnings you were receiving prior to your disability leave. If you contributed to the OMERS Plan during part of your disability leave, the annual rate of contributory earnings that were used to determine your last contributions to the OMERS Plan prior to the disability waiver starting will be used as your deemed contributory earnings during your disability waiver. The deemed contributory earnings are used to calculate your pension and are eligible to be increased annually by the lower of the annual increase in the Average Industrial Wage (AIW) or the Consumer Price Index (CPI).

Disability waiver start and end dates

To qualify for a disability waiver, you must betotally disabledTooltipas defined by the OMERS Plan. If you qualify, the disability waiver can begin as early as the first day of the fifth month after you become totally disabled.

The disability waiver benefit continues until one of the following events occurs:

• you are no longer totally disabled;

• you begin receiving an OMERS disability orearly retirementTooltippension (the latter is only available if you terminate employment with your OMERS employer);

• you return to work with your OMERS employer or another employer (unless you are on an OMERS-approved rehabilitation program);

• you terminate employment with your OMERS employer prior to your early retirement birthday (55th birthday if you have a normal retirement age of 65, or 50th birthday if you have a normal retirement age of 60) and elect to transfer your benefit from the OMERS Plan; or

• you reach yournormal retirement age (NRA)Tooltip
  

2. Disability pension

If you becometotally and permanently disabledTooltipas defined by the OMERS Plan, you can begin a disability pension. Your disability pension is an unreduced pension calculated using the OMERS pension formula.

You can find the formula in the How your pension grows section of the Member Handbook.

Maximum disability pension

The maximum OMERS disability pension that you can receive is 85% of the monthlycontributory earningsTooltipthat you last received from your OMERS employer.

If you are receiving Workplace Safety and Insurance Board (WSIB) benefits, this amount will also be counted towards the maximum disability pension you can receive. In this case, your combined monthly WSIB benefit and disability pension from the OMERS Plan cannot exceed 85% of the monthly contributory earnings that you last received from your employer.

If you exceed these limits, your OMERS disability pension will be reduced until you reach your normal retirement age. If you are receiving WSIB benefits and the WSIB benefit changes before your normal retirement date (for reasons other than inflation adjustments), you are required to contact OMERS with the updated amount.

Disability pension start and end dates

The disability pension begins on the later of:

• the first day of the fifth month after you become totally and permanently disabled; or

• the first of the month following the month you elect a disability pension, if you have been on a disability waiver.

If you are on a disability waiver immediately before an OMERS disability pension, the waiver benefit ends when your pension begins and you will no longer accrue credited service in the OMERS Plan.

The disability pension continues until the earliest of one of the following events occurs:

• you no longer meet the definition of totally and permanently disabled;

• you return to work with your OMERS employer or another employer (other than on an OMERS-approved rehabilitation program);

• you begin an early retirement pension (this is only available if you terminate employment with your OMERS employer); or

• you reach yournormal retirement age (NRA)Tooltipand your disability pension becomes an OMERS normal retirement pension.

Members must provide all relevant medical and other information to be eligible to continue to receive disability benefits and advise OMERS of changes in their eligibility.

If you qualify for both the disability waiver and disability pension, the best option for you will depend on your personal circumstances. You may also wish to speak to your employer about any other benefits or leave questions that you have.

What to expect when claiming disability benefits

The following outlines the disability benefits administration process. Read each section to see how it applies to you.

• Disability elimination period
  For a member to be eligible for a disability benefit, the member must be wholly prevented from performing their job due to a disability for a period of at least four months (this can be a mental or physical incapacity). This period is referred to as the disability elimination period.

• Disability leave reporting
  Your OMERS employer will report your disability-related leave to OMERS on your behalf after your disability elimination period has passed (i.e., the reporting will generally occur around the first of the fifth month from the date of your disability). This will start the disability benefit application process.

• OMERS will send you a disability package

  The package includes:

  • An overview of OMERS disability benefits

  • Disability options election form to be completed by you and returned to OMERS. This election form captures your decision to proceed or not proceed with a disability waiver; and

  • A request for Medical report - OMERS total disability benefits (Form 147) to be completed by your doctor should you wish to apply for the disability waiver. OMERS will also accept copies of similar medical forms or reports completed by your doctor that describe your condition. OMERS is not responsible for any costs associated with completing the medical forms.

• You make your election
  You may apply for the disability waiver by providing OMERS with your completed election form and medical documentation. Upon receipt, our physician will determine whether you qualify for disability benefits and OMERS will communicate the outcome.

• Medical verification process
  OMERS is required to ensure that benefits are administered in accordance with the OMERS Plan terms. Accordingly, OMERS conducts regular reviews of all members receiving disability benefits and will request updated medical documents from you. For a verification review, OMERS will ask you to confirm your employment and continued disability status. OMERS will generally request additional information every 12 months from your disability date while you are approved for a disability waiver and every 24 months if you are permanently approved for a disability waiver or a disability pension. It is your responsibility to inform OMERS if your disability status changes at any time, including in between review periods.

Is a rehabilitation program part of OMERS disability benefits?

You may be eligible to continue receiving a disability waiver benefit if you have returned to work with your OMERS employer as part of a temporary rehabilitation program approved by OMERS.

What is a rehabilitation program?
Your OMERS employer will define the terms of a rehabilitation program for you, subject to your circumstances. Based on the information provided by your employer, OMERS will determine if the rehabilitation program is approved.

If approved, you will continue to be eligible for the OMERS disability waiver benefit. A rehabilitation program should be reported to OMERS by your employer if:

• You return to work, either for reduced or modified work duties after being on a disability leave or while on disability waiver; or

• You work under an arrangement with your OMERS employer that transitions you from reduced or modified work duties to your normal work duties or to a new position (either full-time or part-time).

How long can an OMERS-approved rehabilitation program be?
For OMERS purposes, a rehabilitation program is generally the transitional period between a member's total disability leave ending and a return to normal duties or to a new permanent occupation (either full-time or part-time). OMERS would expect that this transition period would only span weeks or months, and not years.

In some cases, a member may change their employment status permanently and begin a new job or a job with a permanent accommodation. In these cases, the disability waiver would end.

What does OMERS require to administer your disability benefits while you are on a rehabilitation program?
Your employer will notify OMERS when you start working on a rehabilitation program and will provide a next scheduled review date and/or expected return to work date. OMERS will review the rehabilitation program details and any additional medical documents received and determine whether the rehabilitation program is approved.

If the rehabilitation program is approved, you will not make contributions to the OMERS Plan during the period of the program. Your employer will be required to certify your progress during the rehabilitation program at a pre-set follow-up date in order for OMERS to determine if you continue to qualify for the disability waiver.

If at any stage you return to regular duties or a new permanent accommodation and stop your rehabilitation program, your employer must inform OMERS. This will end the disability waiver and your employer will resume deducting contributions from the contributory earnings you receive in each pay period.

If the rehabilitation program is not approved, your employer must either deduct contributions from your contributory earnings and send them to OMERS or report a leave period.

I am terminally ill. What options are available to me?

If, because of an illness or other condition, your life expectancy is less than two years, you may be able to withdraw thecommuted valueTooltipof your pension plus any applicable refund of contributions, in cash, less applicable tax withholdings. Once you receive this shortened life expectancy benefit, no further benefit is payable from the OMERS Plan to you, your survivors, yourbeneficiaryTooltipor estate. To apply for the shortened life expectancy benefit, call our Member Experience team.