Ultimate Guide to EI Sick Benefits [+video]

I wrote The Ultimate Guide to EI Sickness Benefits for people who need to apply for EI sickness benefits after going on sick leave from work.

This Guide is a starting point for learning more about EI Sickness benefits and will supplement the information you can find on the official government website. As long as you have your doctor’s support, EI sickness is a straightforward program that you can easily navigate on your own.

Because you are reading this article, I know you are already on the right track to having your benefits approved.

If you have questions about this Guide, or any disability claim issue, call our support team toll free at (888)-732-0470.

Keep on learning and I wish you all the best with your journey.

— David Brannen, disability lawyer & founder, Resolute Legal

Contents

What are EI sick benefits?

EI sickness benefits are a type of temporary income replacement benefit. They get paid to people who are unable to work because of injury or illness. EI sickness benefits are paid by the federal government through the Employment Insurance program.

To qualify for EI sickness payments, your income must be reduced by at least forty percent because of your illness or disability; you must be employed by a qualified employer; and you must have already earned 600 hours of insurable employment.

If you get approved, then the payment amount is normally 55 percent of your average insurable weekly earnings. You can get up to a maximum of $638 per week. And, you can receive EI sickness payments for up to fifteen weeks.

Requirements for EI sick benefits

To be eligible to get EI sickness benefits, you must meet the following criteria:

You are employed
Your weekly employment income has been reduced by more than forty percent
You have accumulated 600 hours of insurable employment during the qualifying period
You meet the medical requirements.

The qualifying period is whichever of these is shorter: either the 52-week period leading up to the date of your EI sickness claim, or the time since you last made a claim for EI payments.

EI sick benefits calculator

You won’t know exactly how much you will get until Service Canada processes your application for EI sickness benefits. Generally speaking, it will be 55% of your average insurable weekly earnings, up to a maximum amount.

Currently, the maximum EI sickness payment is $562 per week. This is based on an income of $53,100 or more. These are based on 2019 rates and are subject to change each year as they are adjusted for inflation.

You may be entitled to a higher benefit amount — called the family supplement — if you have children and your net family income is below $25,921.

How Service Canada calculates your benefit amount

When determining your average insurable weekly earnings, Service Canada will look at your “best weeks” during the 52 weeks leading up to your last day worked. These will be your highest-earning 14 to 22 weeks, depending on the unemployment rates of your region in Canada.

Your best weeks are the ones where you earned the most money. This includes tips, gratuities and commissions.

There is a one-week waiting period before benefits start. In other words, you aren’t paid for the first week you are off sick. Payments would start at the beginning of week two. This waiting period can be waived if you receive sick pay for that week, or benefits from another source.

Family Supplement

Your EI sickness payment may be higher if you qualify for the family supplement. To qualify for the family supplement, your net family income must be below $25,921 (2019); you must have a dependent child; and you or your spouse must be receiving the Child Tax Benefit. The family supplement cannot increase your payment higher than the maximum weekly payment, which is $562 (2019).

How to apply for EI sick benefits

You can apply for EI sickness Benefits online at home, or by using a public computer at your local Service Canada office. The application is made up of three parts:

A form that you fill out
A medical certificate signed by your doctor, which confirms how long you will be unable to work due to illness or injury
A Record of Employment (ROE) from each employer

To apply for EI sickness benefits you will need the following information:

Your Social Insurance Number (SIN)
Your mother’s maiden name
Current mailing address
Your complete banking information
Names and addresses of all employers you have worked for in the last 52 weeks
Dates of employment with each employer over the last 52 weeks
Reasons for leaving each of the employers.

Click here to apply online through the Service Canada website.

Appealing a denial of EI sick benefits

You have the right to appeal any decision regarding your EI sickness benefits. There are three levels of appeal:

Service Canada Reconsideration Appeal
Social Security Tribunal (General Division)
Social Security Tribunal (Appeal Division)

Reconsideration Appeal

If your application for EI sickness benefits is denied, you have the right to request a reconsideration appeal. You have a 30-day deadline to request a reconsideration appeal. You request the appeal by submitting a “Request for Reconsideration of an Employment Insurance (EI) Decision” form either online or in person at any Service Canada centre (Download).

If Service Canada denies your reconsideration appeal, then you have the right to appeal that decision to the Social Security Tribunal (General Division). You do this by filing a “Notice of Appeal – Employment Insurance – General Division” form (Download).

If the Social Security Tribunal (General Division) denies your appeal, then you can appeal to the Social Security Tribunal (Appeals Division). You do this by filing an “Application to the Appeal Division – Employment Insurance” form (Download).

After approval of EI sick benefits

If your application is approved for EI sickness benefits, you will receive payments within 28 days from the date they received your completed application.

Bi-Weeky Reports

Once approved, you must submit reports to Service Canada every two weeks. You submit these reports online using a 4-digit code (given to you by Service Canada), or by calling the EI Telephone Reporting Service at 1-800-531-7555.

Do not submit your report before the due date or it will not count.

When doing a report, you will have to update Service Canada on the following information. You have to let them know if you:

started a full-time job
traveled outside of Canada
worked or received earnings, including self-employment earnings
attended school or a training course
were ready, willing, and capable of working each day
received or will receive money other than that which you have already reported.

Payment of Benefits

You can receive EI payments by direct deposit into your bank account or by a cheque in the mail. Direct deposit is the best option because it eliminates the risk that your payments will be disrupted either by getting lost in the mail or work stoppages by Canada Post — we have seen both happen.

EI sick benefits forms

There is no paper form for the EI sickness benefits application. You must apply online using your own computer or the public computers at any Service Canada office.

However, there are other forms you can download and fill out for certain situations:

Medical Certificate for Employment Insurance Sickness Benefits INS5140 (2017-06-22) (Download)
Consent to Disclose and/or use personal EI information INS3124 (2017-06-22) (Download)
Request for Reconsideration of an Employment Insurance (EI) Decision INS5210 (2017-06-22)(Download)
Notice of Appeal – Employment Insurance – General Division (Download)
Application to the Appeal Division – Employment Insurance (Download)

EI sick benefits: Answers to Frequently Asked Questions

How long is the approval process for EI sick benefits?

If your claim is approved, then you should receive your first payment within 28 days from the date Service Canada received all your application forms and information.

EI sick benefits and short-term disability

EI sickness payments are a type of disability income of last resort. This means you can’t receive EI sickness payment if you are already receiving disability income from your employer or through a disability insurance policy or plan. If you receive EI sickness benefits, you might also get approved for retroactive short-term disability insurance payments. In that case, you will need to reimburse the EI sickness program out of those retroactive funds.

Are EI sick benefits taxable?

Yes, EI sickness benefits are taxable. Both federal and provincial income taxes get deducted from your payments.

How long is the EI sick benefits waiting period?

There is a one-week waiting period for EI sickness benefits. You won’t receive benefits for the first week you are on sick leave. You should still apply for benefits immediately — you don’t have to wait a week to apply.

Can I work while on EI sick benefits?

Yes, you can earn some income while receiving EI sickness benefits — as long as you report it to Service Canada. You can keep 50 cents of every dollar you earn, up to the point where you are earning 90% of the weekly insurable earnings used to calculate your EI sickness benefit. Once you reach 90%, Service Canada will start deducting your income dollar-for-dollar.

How long can I collect EI sick benefits?

You can collect EI sickness benefits for a maximum of 15 weeks. If you have received the full 15 weeks, you cannot extend sickness benefits any longer and might want to consider applying for other benefits if you are still unable to work.

What type of income can be deducted from EI sick payments?

The following income will be deducted from your EI sickness payments:

employment income (including self-employment)
workers compensation payments made for lost wages
short- or long-term disability payments
motor vehicle accident payments for lost income
retirement income from private or public pension plans.

What type of income is not deducted from EI sick payments?

They following sources of income are not deductible from EI sickness payments:

CPP disability payments
survivor or dependent benefits
workers compensation payments not related to wage loss
payments for pain and suffering
sickness payments from supplemental unemployment plans
sickness or loss of income payments under a private insurance policy
retroactive increases in your salary.

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