Life changes

Disability benefits

OMERS provides two different disability benefits if you meet the applicable definition of totally disabled under the terms of the OMERS Plan: a disability waiver and a disability pension.

Disability benefitsClaiming disability benefitsRehabilitation programI am terminally ill

If you are an OMERS member and 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.

Members must provide all relevant medical and other required information to be eligible for and continue to receive disability benefits. This requires that members advise OMERS of changes in their eligibility (i.e., if you return to work with an OMERS employer, work for any non-OMERS employer or become self-employed, you must notify us immediately.). If you are returning to work with your OMERS employer on an OMERS-approved rehabilitation program that is temporary in nature, you may continue to be eligible for a disability waiver during this transition period.

Notes:

  • In the event that a member’s disability occurred prior to them enrolling in the OMERS Plan, they may still be able to qualify for the disability waiver once they become a member but the disability elimination period and deemed contributory earnings will look different than described below. Reach out to our Member Experience team for more information.

  • 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?

Disability waiver

While on a disability waiver, you continue to accumulate credited service in 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 earnings 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 be totally disabled as 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 or early retirement pension (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 your normal retirement age (NRA)

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.

Note

You are not required to submit supporting documentation prior to receiving your disability package. In the event you have provided sufficient medical documentation to OMERS prior to the end of the disability elimination period, only a completed election form will be requested from you. If you require additional information about the disability pension at this stage, call our OMERS Member Experience team.

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.

NOTE

If you are deemed totally and permanently disabled, you will be given the option of continuing on a disability waiver or you can elect a disability pension. OMERS will contact you with additional details if you qualify for a disability pension.

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.

If you are receiving any disability benefits through OMERS and return to work (with an OMERS employer, any non-OMERS employer or become self-employed), you must contact OMERS Member Experience. If you are returning to work with your OMERS employer on an OMERS-approved rehabilitation plan that is temporary in nature, you may continue to be eligible for a disability waiver during this transition period.

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.

For more information, visit our Frequently Asked Questions page for commonly asked questions about the application process for OMERS disability benefits.

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 the commuted value (CV) of 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, your beneficiary or estate. To apply for the shortened life expectancy benefit, call OMERS Member Experience team.

NOTE

If you have an eligible spouse, applicable legislation requires that they provide their written consent for you to withdraw the shortened life expectancy benefit. Survivor benefits are a key feature of the OMERS Plan and part of our commitment to providing a secure future for members and their survivors. For more information regarding survivor benefits, see the Survivor Benefits page.

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