How to Properly Complete a Salary Insurance Form to Continue Receiving Indemnities

Your medical data is confidential. Therefore medical forms and documents should not be provided to departments.

Contrary to what many employees believe, the first two years (104 weeks) of salary insurance indemnities is compensated by the employer and not the union group insurance.

When you fall on Salary Insurance in order to continue to receive the salary insurance indemnities you are required to get a Salary Insurance* form completed by your treating physician.

* – After 5 days for a full time employee.
* – After 7 calendar days for a part-time employee from the date of the invalidity. (The 7 days are counted from the first scheduled work shift following the invalidity)

The salary insurance form must include, a diagnosis, a treatment (rest, medication, referral, physio, etc) and a follow up appointment date with the treating physician.

You must ensure the MUHC Occupational Health and Safety ‘attendance agent’ assigned to your file receives the completed form. Your medical data is confidential. Therefore medical forms and documents should not be provided to departments.

It is best practice to contact your local health and safety union delegate to assist with your file, and they will forward all documents to the employer and provide you with a confirmation. Also, it is recommended to contact your union before signing any authorization forms.

The Salary Insurance form is found online at the MUHC Intranet, Human Resources or your local union office.

Doctors may charge a fee to complete the form. Fees are established by your doctor and are not reimbursed through the group insurance plan.

Read More:
How and Where to Submit Your SSQ Group Insurance Claims
Three Important Points Staff Should Know Regarding Work Accidents and Incidents