Northern Exposure

Disability benefits claimant abandoned job

by Shane Todd

Disability claims management is never easy. It is particularly difficult when employees refuse to provide enough medical information to substantiate their absence and entitlement to benefits, while also refusing to return to work. The decision in Betts v. IBM Canada Ltd., 2015 ONSC 5298, provides guidance to employers dealing with such cases. It confirms that failing to comply with the terms of a disability plan or to return to work may constitute job abandonment.

What happened in this case

Anthony Betts worked for IBM for 15 years. He stopped reporting to work because of depression. Manulife, IBM’s disability plan and attendance management program administrator, wrote to Betts to request information from his treating physician. It sought substantiation of his claim. Betts missed the deadline to submit the medical information. Around this same time, without telling IBM, Betts moved from New Brunswick, where he was employed, to Ontario to live with his fiancee.

Manulife denied Betts’ claim for disability benefits. IBM wrote to Betts to explain he could either return to work or submit the necessary medical information to support his claim. The letter further explained that if he did not submit the information he would be deemed to have abandoned his claim for disability benefits.

Over the next seven months, IBM sent another four letters to Betts. Each of the letters explained Betts’ options in the face of his noncompliance with the disability benefit plan’s terms. His failure to provide the requested information continued even when filing deadlines were extended. The last four letters all warned Betts if he did not return to work or submit the requested medical documentation, he would be deemed to have abandoned or resigned his employment.

Finally, in June 2014, after Betts failed to submit medical information for his final appeal and failed to return to work, IBM ended Betts’ employment. They said that he had abandoned his job or resigned. Betts sued IBM for wrongful dismissal.

What the court decided

The court dismissed the lawsuit because it concluded Betts had clearly indicated his intention to abandon or resign his employment by:

• Failing to report to work for eight months;
• Failing to follow the disability plan policies and procedures;
• Failing to heed five clear written warnings about the consequences of those failures; and
• Selling his home in New Brunswick and moving to Ontario to live with his fiancee.

The fact that Betts was suffering from depression did not excuse him from complying with the disability plan. There was no evidence that he was medically unable to comply. Betts was familiar with the plan’s requirements, having made a prior claim.

The court said that an employee suffering from a medical condition is “not immune” from being found to have abandoned employment. The failure to follow the requirements of a disability plan can justify dismissal in the appropriate case. The court rejected the argument that there was—outside of human rights law and beyond the disability benefits plan—a further, independent duty to accommodate that required IBM to retain a physician to assess the truth of Betts’ claims. The court said it was difficult to imagine what more IBM could have done.

What you should take away

An employer is legally entitled to information confirming that an employee’s absence from work is medically necessary. Where, over a long period of time, an employee refuses to provide that information, comply with the disability plan, or return to work, the employee may be found to have abandoned employment.

In assessing whether an employee has indeed abandoned a job, the court will look for objective factors demonstrating an employee’s intention. For example, long-term noncompliance with the disability plan, failing to report to work for a long time, ignoring clear and simple warnings of the consequences of doing so, and moving away.

While the court said there was no independent duty to accommodate Betts with respect to his disability claim, that must be read in the larger context of the case. Betts filed but withdrew a claim for damages under the Human Rights Code, so there was no alleged failure to accommodate his disability in employment at issue.

Employers do of course have a duty to accommodate disabilities to the point of undue hardship. If the duty to accommodate is triggered, an employer may need to take additional steps to accommodate, which may arguably include tolerating the failure to return to work or 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 employees. Employees should be informed of the consequences of failing to follow the disability claims process. Where an employee refuses to return to work and noncompliance with the plan continues (and is not caused by the disability itself), an employer may be justified in terminating for job abandonment.