CAF Long Term Disability Insurance

Frequently Asked Questions

• What does "total disability/totally disabled" mean?
  It means that you have been released from the CAF and that there is clear and objective medical evidence, which confirms that you are incapacitated by a medically determinable physical or mental impairment, which is preventing you from performing any and every duty of any substantially gainful occupation or employment for which you are reasonably qualified by education, training or experience. 
• Am I covered if my injury or medical condition is not attributable to military service?
  In most instances, the LTD plan covers you 24/7* and provides an income replacement benefit regardless of whether you are injured in the line of duty or not. 
    
  *Refer to question “How do I know if I have LTD coverage?” 
• What is my contribution to the LTD?

  Regular Force: 

  Treasury Board of Canada (TBC) pays 100% of the premiums for claims involving service-related injuries and illnesses. However, for claims involving non service-related injuries and illnesses, TBC pays 85% of the total premiums while Regular Force personnel pay the remaining 15%; total contribution of the member is 0.356% of monthly salary. 

  Reserve Force: 

  The TBC pays 100% of the premiums for an established deemed basic salary of $2,700 per month for Primary Reserve Class A or B service of less than 180 days. You may submit an application form to SISIP Financial to increase your coverage from $2,700, to either $3,700 or $4,700 per month, determined by an income test. Once the increase in coverage is approved, you must pay the additional premiums. Additional premiums are: LTD Optional of $3,700/month with a monthly premium of $35.59, and LTD Optional of $4,700/month with a monthly premium of $71.18. For Primary Reserve Class B service of more than 180 days or Reserve Force members on Class C service, the TBC pays 100% of the premiums and you are covered for each period of service. 
• What are the benefits under the LTD?

  (For the purpose of benefit calculation, the minimum salary shall be equal to Corporal-basic). 

  Regular Force and Class C Reserve Force: 

  The LTD benefits for the Regular Force equal 75% of salary on release, less other relevant sources of income*. 
  For Class C Reserve Force the LTD benefits equal 75% of monthly salary, applicable at the time the illness or injury occurred, less other relevant sources of income*. 

  Primary Reserve Force on Class A and B Service: 

  LTD coverage and resulting benefits are based on the class of Reserve service at time of injury or illness. For Primary reservists on Class A or B service of 180 days or less, the LTD benefits, when added to income from other relevant sources**, equals 75% of a deemed monthly basic salary of $2,700 or 75% of your additional optional coverage if purchased. 
  
  For Primary reservists on Class B service of more than 180 days, the LTD benefits equal 75% of your monthly salary applicable at the time the injury or illness occurred, less other relevant sources of income**. 
    
  * Other relevant sources of income include: 

  • The Canadian Forces Superannuation Act (CFSA) benefits; 

  • The primary benefits under the Canada Pension Plan (CPP) or the Quebec Pension Plan (QPP); and 

  • Any employment income. 

  ** For the Primary Reserve Force on Class A or B service, other relevant sources of income include all of the  above and, in addition, benefits payable under: 

  • LTD coverage provided through another employer; 

  • Other disability employment plans, such as workers compensation; 

  • An automobile insurance; 

  • An employee pension plan; and 

  • The Government Employee Compensation Act (GECA). 

  Please note that once the Insurer approves your claim, you are paid the full amount of the LTD benefits up front, minus the known offsets, with the understanding that any subsequent awards received under the CPP/QPP and any retroactive payments, as of the start date of payment of benefits, will have to be reimbursed to the Insurer. If applicable, your monthly benefits may be adjusted, thereby offsetting those payments going forward.  

• How do I know if I have LTD coverage?

  Regular Force: 

  • If you joined the CAF on or after April 1, 1982, coverage is automatic. 

  • If you joined the CAF prior to April 1, 1982, you had to apply for LTD coverage and, if you are covered, it is indicated on your pay statement. 

   Reserve Force: 

  • If you are a primary reservist on Class A or B reserve service of 180 days or less, coverage is automatic for each period for which you are "on duty". "On duty" means that you are authorized and entitled to pay during the performance of primary reserve service. 

  • If you are a primary reservist on Class B reserve service of more than 180 days or a reservist on Class C, coverage is automatic for each period of service and is deemed to be twenty-four hours per day, seven days a week. 

• What is the process if I am released medically (3a or 3b at the time of release) from the CAF?

  • SISIP Financial is notified of your medical release; 

  • SISIP Financial verifies your eligibility and informs Manulife; 

  • Your local Case Manager will give you the LTD claim package; and 

  • Once all forms are received by Manulife, you are informed of the decision. 

  NOTE: Contact SISIP Financial Head Office/Customer Service at 1-800-267-6681 if you have not had any contact at least 60 days before your date of release 

• Can I submit a claim if I select a voluntary or any other type of release?
  Yes. However, you must submit your claim within 120 days after your effective date of release and you must qualify as "totally disabled". 
• When do I start receiving LTD benefits?
  Your CAF LTD benefits will commence once Manulife has received your final release information directly from NDHQ.  This information is sent to Manulife by SISIP Financial approximately 4-6 weeks following your effective date of release.  Once your final release information has been received, Manulife will contact you to process the approval of your claim.  Your entitlement to CAF LTD benefits will be calculated retroactively to the day following your date of release. 
• For how long can I receive LTD benefits?
  Once approved, your initial benefits terminate 24 months after your effective date of release. Medical reviews will be conducted at 12 and 18 months to determine your eligibility for continued benefits beyond the initial 24-month period. As long as you qualify as" totally disabled", you may be eligible for continued benefits up to your 65th birthday. 
    
  If you are released for reasons other than medical and you qualify as "totally disabled" you can receive benefits. Medical reviews are conducted once per year. You may also be eligible for continued benefits up to your 65th birthday, as long as you qualify as "totally disabled". 
• What are the limitations and exclusions of my LTD plan?

  No coverage is provided if total disability results from any of the following: 

  • The injury was sustained as a result of participation in the commission of a criminal offence; 

  • The injury was self-inflicted or you attempted self destruction, unless medical evidence establishes that the injuries are related to a mental health illness; 

  • The total disability has begun during the first twelve months of coverage from injuries or sickness for which you consulted a physician during the six-month period immediately preceding the date you became insured under this Policy; or 

  • Former members of the Regular Force who are annuitants and serving as Primary Reserve members on Class B service of more than 180 days are not covered during their mandatory period of break in service. 

• Is there an accidental dismemberment clause within LTD?
  Yes. Under specific circumstances, you may receive the same benefits as for LTD for up to three years. The length of the benefit is determined depending on the severity of the dismemberment. The accidental dismemberment must be non-attributable to military service, must occur within 365 days of an accident, and you must be released from the CAF within three years of the date of the accident. There is no provision for a lump sum payment for accidental dismemberment in the LTD policy. 
    
  If you suffer an accidental dismemberment or loss of sight, hearing, or speech, attributable to military service, you may submit a claim under the Accidental Dismemberment Insurance Plan (ADIP). 
    
  Please note that in the case of conflict between the information on this page and the insurance contract Policy No. 901102, the terms of the English contract will prevail. The documents posted on this website are provided for reference purposes only and shall not be considered to be definitive. 
• Who has the governance of the LTD insurance plan?
  CAF Long Term Disability Insurance (CAF LTD) is a group insurance plan for CAF personnel sponsored by the Treasury Board of Canada. The Chief of the Defence staff (CDS) and the Deputy Minister of the Department of National Defence (DND) are the co-policy holders, SISIP Financial is the administrator and Manulife is the insurer. 
• Are the LTD benefits taxable?
  Note: the information provided in this section is for basic reference purposes only and is not intended to be tax advice. Please consult either the Canada Revenue Agency or Revenue Québec directly for more detailed information.
  
  Yes, your CAF LTD benefit is taxable as it is a wage-loss replacement benefit that is partially or fully paid by the CAF.
  
  Please click this link for more information on wage-loss replacement benefits.
  
  Manulife will issue the appropriate tax slips, depending on your province of residence, Federal T4A and Provincial (QC) RL-1, each taxation year that you receive LTD benefits.
  
  Should you require additional tax related information, please contact your CAF LTD Case Manager, or the Canada Revenue Agency and/or Revenue Québec directly.
  
  Regular Force
  For those who qualify for CAF LTD benefits based on a release from the Regular Force:

  • During the first year you become a claimant, Manulife will provide a letter which indicates the total portion of LTD premiums you paid during your military career;
  • Store this letter in a safe place as you will need to include it with your tax return;
  • In accordance with the Canadian Income Tax Act, the amount of your individual LTD premium contributions may be deducted from the total income received under a wage loss replacement benefit.

  Primary Reserve Force
  For those who qualify for CAF LTD based on a release from the Primary Reserve Force:

  • Unless you paid premiums for optional Reserve Force CAF LTD coverage under SISIP Policy 901102, no letter summarizing premiums is produced as your premiums were fully paid by the Canadian Armed Forces;
  • If you paid for optional Reserve Force CAF LTD, during the first year you become a claimant, Manulife will provide a letter which indicates the total portion of LTD premiums you paid during your military career;
  • Store this letter in a safe place as you will need to include it with your tax return.
• What if I wish to submit an appeal?
  There are two levels of appeal. For more information, please read the appeal process.