Long Term Disability Benefits Regulation

(Consolidated up to 218/2022) ALBERTA REGULATION 176/78 Legislative Assembly Act LONG TERM DISABILITY BENEFITS REGULATION 1 In this Regulation, (a) “benefit” means money paid under section 7; (b) “member” means (i) a member of the Executive Council or a former member of the Executive Council, (ii) the leader of His Majesty’s loyal opposition or a former leader of His Majesty’s loyal opposition, or (iii) a Member of the Legislative Assembly; (c) “public service plan” means the Long Term Disability Income Continuance Plan Regulation , as amended under the Public Service Act ; (d) “salary” means salary as defined in the Members of the Legislative Assembly Pension Plan Act . AR 176/78 s1;228/83;420/86;218/2022 2 This Regulation shall be administered by the employee designated as the administrator of the public service plan. AR 176/78 s2 3 The adjudicator shall be the adjudicator appointed under the public service plan. AR 176/78 s3 4 Repealed AR 374/83 s2. 5 (1) A member is eligible to receive a benefit under this Regulation if (a) repealed AR 374/83 s3, (b) he has been (i) a member of the Executive Council, (ii) the leader of His Majesty’s loyal opposition, or (iii) a member of the Legislative Assembly for an aggregate period of 3 consecutive months immediately before applying for a benefit. (2) Notwithstanding subsection (1), a member who is 65 years of age or older is not eligible to receive a benefit under this Regulation. (3) Subject to subsection (4), benefits authorized pursuant to subsection (1) may be continued for not more than the maximum benefit period as stated in section 9 during any one period of disability and benefits shall cease at the cessation of the disability as determined by the adjudicator. (4) A member who throughout the 24 month period has suffered from a total disability preventing him from performing his regular duties, is eligible for benefits for a period ending (a) 24 months from the date the benefits commence or from the date he resumed his duties as a member, whichever is earlier, or (b) at such time, being later than the end of that 24 month period, as the adjudicator, on the recommendation of the administrator, decides. AR 176/78 s5;228/83;347/83;218/2022 6 (1) A member may be paid a benefit if, in the opinion of the adjudicator, the member is (a) totally disabled mentally or physically, and (b) as a result of that disability, no longer holds office as a member of the Executive Council or ceases to be the leader of His Majesty’s loyal opposition. (2) No benefits shall be payable under this Regulation in respect of any of the following: (a) injuries suffered as a result of an act of war; (b) intentionally self‑inflicted injury or illness; (c) illness due to alcoholism or drug addiction, except if the member is participating in a recognized therapeutic program to correct his addiction and is under the continuous care of a licensed physician; (d) illness due to nervous and mental disorders, unless (i) the member is under the continuous care of a licensed medical specialist in this area, or (ii) the member (A) has been under the care of a licensed medical specialist in this area, and (B) is under the continuous care of a licensed physician to whom the employee was referred by that specialist; (e) illness due in whole or in part to pregnancy except for the following complications: (i) extra‑uterine pregnancy; (ii) toxemia of pregnancy, including eclampsia and pre‑eclampsia; (iii) pyelites of pregnancy; (iv) hydatideform mole; (v) post‑partum depression; (vi) placentomas; (vii) Sheehan’s post‑partum pituitary necrosis; (f) an injury or illness sustained before the member became covered under this Regulation; (g) injuries that are attributable solely to the serious and wilful misconduct of the member. (3) Subsection (2)(f) does not apply if the member completes 5 consecutive years of coverage under the plan under this Regulation, provided that he has not been absent due to the pre‑coverage injury or illness during those 5 years. AR 176/78 s6;228/83;218/2022 7 (1) A member may be paid each month 70% of 1/12 of the salary he received at the time at which he became disabled. (2) The benefit paid under subsection (1) shall not exceed the maximum benefit payable to an employee under the public service plan. AR 176/78 s7 8 Repealed AR 228/83 s5. 9 A benefit payable under this Regulation terminates on the earliest of the following dates: (a) the date of his 65th birthday; (b) the date the member resumes his duties as a member; (c) the date of his death. AR 176/78 s9;228/83 10 If a member (a) continues as a member of the Legislative Assembly, or (b) becomes employed in any capacity during the period in which he is receiving a benefit, the benefit shall be adjusted pursuant to section 12. AR 176/78 s10 11 (1) If a member has received benefits for a period of not less than 24 months and in the opinion of the adjudicator that member is capable of (a) engaging in an occupation, or (b) being employed for remuneration or profit, in a position for which he is reasonably suited as a result of his education, training or experience, the administrator shall terminate the benefits to that member. (2) If a member whose benefits have been terminated under subsection (1), is a member of the Legislative Assembly, engages in an occupation for remuneration of profit, or is employed for remuneration or profit, he shall be paid a benefit adjusted pursuant to section 12. AR 176/78 s11 12 (1) In this section “earnings” include (a) remuneration or profit from an occupation or employment, and (b) an indemnity allowance paid under section 33 of the Legislative Assembly Act . (2) The monthly benefit amount to which a member is entitled under section 7(1) shall be reduced as follows: (a) by the amount of disability benefit entitlement, excluding children’s benefits, under the Canada Pension Plan at the date of disablement; (b) by the amount of entitlement under the M.L.A. Compensation Act ; (c) by the amount of benefits payable from any other group disability plan provided for the benefit of members; (d) in the case of a member who is receiving income under a recognized rehabilitation employment program in an amount that is less than the member’s pre‑disability salary, by 50% of the income received from that program, except that where the combination of reduced benefits and income equal an amount in excess of the pre‑disability salary, the benefits shall be further reduced so that combined benefits and income do not exceed the pre‑disability salary; (e) by the amount of earnings received from employment or self‑employment, other than a rehabilitation employment program recognized by the administrator. (3), (4) Repealed 228/83 s7. AR 176/78 s12;228/83;196/2006 13 If a member becomes totally disabled as a result of injury or illness, and (a) the member received a benefit that terminated, (b) the injury or illness is, in the opinion of the administrator, a recurrence of the injury or illness as a result of which the member received benefits that terminated, and (c) the member is not 65 years of age or older, the member may receive a benefit under this Regulation. AR 176/78 s13 14 (1) If the adjudicator has ruled that a member is not eligible for benefits or that benefits are to cease under this Regulation, (a) the administrator may request that the adjudicator review the claim, or (b) the member may request that the adjudicator review the claim and the member may, at his expense, have his personal physician make representation on his behalf. (2) On receipt of a request for review pursuant to subsection (1), the adjudicator shall conduct a review taking into account any representation by the member’s personal physician, or new information as may be available, and render his decision, which is final and not subject to further review. (3) A request for a review pursuant to subsection (1) must be received by the adjudicator within 60 days after the date the member is notified that he is not eligible for benefits or that his benefits are to cease. AR 176/78 s14;228/83 15 The administrator or the adjudicator may require a member to submit to a medical examination by a physician appointed by the administrator or the adjudicator before a benefit is paid or at any time during which a benefit is being paid to the member under this Regulation. AR 176/78 s15