Eligibility for D&R Benefits
You are eligible to commence and to continue receiving D&R Benefits if, during the 119-day Elimination Period and the subsequent 20 months, you are deemed Totally Disabled by reason of a medical condition certified by a Physician, and are:
- Under the Regular Care of a Physician
- Unable to perform the Material and Substantial Duties of your Regular Occupation, and
- Not engaged in any occupation for wage or profit, except as permitted while participating in a HEB Manitoba Approved Rehabilitation Program.
The foregoing shall not prevent a Covered Employee from participating in a Return to Work Program as defined by the D&R Plan.
After the Elimination Period and the subsequent 20 months, the definition of Totally Disabled changes. At this time, your claim will be reassessed to determine if you are eligible to continue receiving D&R Benefits.
To be eligible for continued D&R Benefits after the Elimination Period and the subsequent 20 months, you must be Totally Disabled by reason of a medical condition certified by a Physician, and:
- Under the Regular Care of a Physician, and
- Unable to perform the Material and Substantial Duties of your Regular Occupation or the duties of some other occupation for which you are reasonably suited by education, training or experience, which would provide you with earnings equal to, or greater than, 66 2/3% of your Monthly Earnings at your Date of Disability
OR
- Able to perform the Material and Substantial Duties of your Regular Occupation or the duties of some other occupation, but you can provide medical certification that your disability is the result of a medical condition which is of such a character that common care and prudence require you to desist from doing any work for wage or profit, and
- Not engaged in any occupation for wage or profit, except as permitted while participating in a HEB Manitoba Approved Rehabilitation Program.
Note: D&R premiums must be paid to HEB Manitoba up to the date you are eligible to receive D&R Benefits. If premiums are not paid, your coverage will terminate and you will not be entitled to D&R Benefits.