Canada Disability Insurance: New Medical Form for Claims

Canada’s federal public service is implementing a standardized medical form for disability insurance claims, a change intended to reduce administrative burden on physicians. The new “Initial Medical Statement for Disability Insurance” replaces three separate questionnaires previously used for musculoskeletal disorders, mental health conditions, and other health issues.

The shift, announced Tuesday, is being implemented by the Canadian Insurance Providers Association and is consistent with industry-wide changes, according to a notice to federal employees. Sun Life, which administers the federal government’s disability insurance plan, will accept claims submitted using the older questionnaires, ensuring a transition period for both employees and medical practitioners.

The Disability Insurance (DI) plan provides long-term disability benefits to eligible federal public servants, including members of designated groups, who become totally disabled and unable to work. Employees can apply for DI benefits once their illness or disability is expected to last beyond a 13-week waiting period, or after exhausting their sick leave credits, whichever comes last.

Prior to the change, physicians completing disability claims had to select from one of three specific questionnaires. The consolidation aims to streamline the process for doctors, reducing the time and effort required to provide necessary medical information.

Employees seeking disability benefits through their employer or a plan sponsor should continue to use the existing forms designed for employer-sponsored plans. Those with coverage directly through Canada Life should utilize the “Liberté de choisir” forms. Canada Life provides an online option for completing an “Initial Claimant Statement” via DocuSign, but still requires physicians to complete and return the new Initial Medical Statement for Disability Insurance.

The online form, or a downloadable and printable version, is available on Sun Life’s website. Completed paper forms, along with any accompanying medical documentation, can be submitted by mail, email, or fax, with specific submission details outlined on the Initial Claimant Statement form.

Federal departments’ payroll heads can direct questions to the Sector of Employee Relations and Total Compensation. Members of the plan, or their physicians, with questions or concerns regarding the disability claim process can contact Sun Life directly at 1-800-361-5875.