Disability claims management is a complex problem that many employers find difficult to deal with. It is especially difficult when employees refuse to provide enough medical information to prove their absence and entitlement to benefits while refusing to return to work. The Betts v. IBM Canada Ltd. decision, 2015 ONSC 5298 (PDF) provides guidance to employers dealing with this difficult issue. It affirms that failure to comply with the provisions of a disability plan or return to work can result in leaving the job.
What happened in this case?
Mr. Betts worked for IBM for 15 years. He stopped calling for work because of depression. Manulife, IBM’s disability plans and attendance management program administrator, wrote to Betts to request information from his attending physician. It sought the justification for its assertion. Betts missed the deadline for submitting the medical information. Around the same time, Betts moved from New Brunswick, where he was employed, to Ontario to live with his fiancée without telling IBM.
Manulife denied Bett’s claim to disability benefits. IBM wrote to Betts to explain that he could either return to work or submit the necessary medical information to support his claim. The letter also stated that if he had not provided the information, he would have given up his disability benefit.
Over the next 7 months, IBM sent Betts another four letters. Each of the letters explained Betts’ options in light of his failure to comply with the provisions of the disability insurance plan. His failure to provide the requested information continued even after the registration deadlines were extended. The last four letters warned Betts all that if he did not return to work or provided the requested medical records, it was believed that he had left or resigned from his job. Eventually, IBM terminated Betts’ employment in June 2014 after Betts failed to submit medical information for his final calling and failed to return to work. They said he quit his job or resigned. Betts sued IBM for wrongful dismissal.
What the court decided
The court dismissed the lawsuit because it concluded that Betts had clearly stated his intention to quit or leave his employment relationship by:
- Not reported for work for 8 months;
- Failure to comply with Disability Plan policies and procedures;
- Failure to follow five clear written warnings about the consequences of these errors; and,
- Sell his home in New Brunswick and move to Ontario to live with his fiancée.
The fact that Betts was suffering from depression did not excuse him for following the disability plan. There was no evidence that he was medically incapable of meeting the requirements. Betts was familiar with the plan’s requirements after previously filing a claim.
The court said that an employee suffering from an illness is “not immune” if found to have left their job. Failure to meet the requirements of a disability plan can justify dismissal in the appropriate case. The court rejected the argument that there was another independent duty of adjustment, outside of human rights law and beyond the disability insurance plan, that required IBM to hire a doctor to assess the truth of Betts’ claims. The court said it was hard to see what more IBM could have done.
What to take with you
An employer has a legal right to information confirming that an employee’s absence from work is medically necessary. If an employee refuses to provide this information for an extended period of time, to adhere to the disability plan, or to return to work, it can be determined that they have left their job. In assessing whether an employee has actually quit his job, the court will look for objective factors that substantiate an employee’s intention. For example, long-term non-compliance with the disability plan, failure to report to work for a long time, ignoring clear and simple warnings of the consequences and moving away.
While the court said there is no independent duty to house Betts in relation to his disability claim, this needs to be read in the larger context of the case. Betts filed a human rights claim for damages but withdrew it so that there was no alleged violation of his disability in the employment in question. Employers are of course obliged to accommodate disabilities up to an unreasonable emergency. If the placement requirement is triggered, an employer may need to take additional steps to make the placement possible. This could potentially include tolerating non-return to work or the inability to provide medical information if caused by a disability such as depression.
Employers in a similar situation should be proactive and send clear and simple letters to guide workers. You should be informed of the consequences of non-compliance with the disability entitlement. If an employee refuses to return to work and the non-compliance with the plan persists (and is not caused by the disability itself), an employer may be entitled to terminate the contract.