No benefits are payable for:
- any day on which you are not under the care of a legally qualified physician or surgeon; no period of care shall be considered to have started until you have been seen and treated personally by a physician or surgeon;
- any day you are performing work of any kind, anywhere, for compensation or profit;
- any period of disability resulting from aesthetic or cosmetic treatments;
- during any leave of absence (including Maternity/Paternity Leave);
- the period of illness or injury for which benefits ought to be payable from Employment Insurance Sickness Benefit;
any day you are receiving Disability Benefits, Early Retirement, or Retirement benefits under any Employer or Union sponsored pension plan; - any day you are entitled to receive reimbursement under any Workplace Safety and Insurance law or similar legislation;
- any injury caused or contributed to by a Motor Vehicle Accident which occurs in Ontario or Quebec;
- any portion of a period of disability resulting from substance abuse, including alcoholism and drug addiction, unless you are participating in a recognized substance withdrawal program;
- any disability resulting from intentionally self-inflicted injuries, whether you are sane or insane;
- any disability resulting from voluntary participation in war, riot, rebellion or insurrection;
- the portion of a period of disability during which you are imprisoned in a penal institution or confined in a hospital or similar institution as a result of criminal proceedings;
- disability which commences on or after the date a strike begins, subject to any provincial Employment or Labour Standards Act. However, you can fulfill your Qualifying Disability Period during a strike.
The Trust Fund does not reimburse any physician charges associated with the completion of claim forms.