OCA Loss of Time Benefits

Members Only

If while eligible for benefits you become disabled due to a non-occupational accident or injury, you can receive weekly payments of $200 (less any applicable taxes) from the Fund while you recover.

To be eligible for and receive these benefits, you must:

  • Be under the continuous care of a physician; and
  • Complete and submit a Loss of Time Claim Form.
    • Your employer must complete their portion of the form confirming the date you last worked.
    • Your physician, such as a doctor of medicine (M.D.), doctor of osteopathy (D.O.) or doctor of podiatric medicine (D.P.M.), must indicate the diagnosis, dates of disability, and the date he or she was first consulted for the disability. Please note that a disability certified by a D.P.M. for more than six (6) weeks is subject to review.

Loss of time benefits will be payable to you:

  • On the first day of a disability which is due to an accident; or
  • On the eighth day of a disability which is due to sickness.
IMPORTANT! No disabilities, including those resulting from accidents, will be considered as beginning more than three days prior to the date you first received treatment by a physician.

Maximum Benefit

The maximum number of weeks for the loss of time benefits is 26 weeks per disability.

If you are on a loss of time leave, return to work, and go on another leave for the same accident or sickness within 14 days, your leave will be considered as one continuous period for purposes of determining the maximum number of weeks during which the benefit is payable.

However, if you have a second period of disability that is not related to the prior accident or sickness, and if you have completed at least one day of active work between the two periods, then the second period will be a new period for purposes of determining the maximum number of weeks during which the benefit is payable.

Benefit Payments

You do not have to wait until you return to work to file for your loss of time benefits. Once a fully completed Loss of Time Claim Form has been received by the Fund Office, you will receive a check for a period of time to be determined by the Administrative Manager, according to your disability and the information on the claim form.

The Fund will also send you a Report on Continued Disability form. If you are still disabled, you should submit this form, completed by you, by your employer confirming that you have not returned to work, and by your physician confirming that you are still disabled. Additional benefits will then be determined, and you will receive another check and another Report of Continued Disability form to file if you are still disabled. This process is repeated until you are able to return to work or have received the maximum benefits payable for the period of disability.

Benefit Exclusions and Limitations

Loss of Time benefits are not payable for:

  • Any period of disability during which you are not under the regular care of a physician; or
  • Any disability due to sickness which is covered by a Workers' Compensation Act or similar legislation, or due to injury arising out of or in the course of any employment for wage or profit.