SECTION I - General provisions
Eligibility
In the event of death, illness or accident, a resident shall benefit from the plans described below after one (1) month of continuous service.
Definition
For the purposes of this article, “dependant” means the resident’s spouse or dependent child or a person with a functional disability as defined hereinafter:
Spouse
- spouse: as defined in Article 1.07
Nevertheless, dissolution or annulment of the marriage or civil union, or a de facto separation of over three (3) months’ duration in the case of a common- law union, shall result in the loss of this status of spouse. A married person or a person joined in a civil union who does not cohabit with his spouse may designate that person as his spouse to the insurer. He may also designate another person in lieu of the legal spouse if that person meets the definition of spouse set out in Article 1.07.
Dependant child
- dependent child: as defined in Article 1.07
Person with functional disability
- person with a functional disability: a single person of full age who has a functional disability defined in the Regulation respecting the basic prescription drug insurance plan which arose before he was eighteen (18) years old, who receives no benefits under a last-resort assistance plan pursuant to the Individual and Family Assistance Act (CQLR, c. A-13.1.1), is domiciled at the resident’s home and with respect to whom the resident would exercise parental authority if the person were a minor.
Disability
Definition of disability
Disability is defined as a state of incapacity resulting from an illness or from an accident or a complication of a pregnancy, from a tubal ligation, a vasectomy or similar cases relating to family planning or an organ or bone marrow donation, requiring medical care and rendering the resident totally incapable of performing the normal duties of his position.
Disability period
A period of disability shall be any continuous period of disability or a series of successive periods separated by less than fifteen (15) days of effective full- time work or availability for full-time work, unless the resident establishes to the satisfaction of the establishment or its representative that a subsequent period is attributable to an illness or to an accident completely unrelated to the cause of the previous disability.
Non-insured cases
A period of disability resulting from illness or injury voluntarily caused by the resident himself or that has been caused by alcoholism or use of recreational drugs or that follows active participation in a riot or insurrection, or criminal acts or service in the Armed Forces shall not be recognized as a period of disability for the purposes of this Agreement.
Nevertheless, a period of disability resulting from alcoholism or drug addiction or a suicide attempt during which the resident receives medical treatment or care with a view to rehabilitation shall be recognized as a period of disability
EDSC abatement
In compensation for the establishment’s contribution to the insurance benefits outlined hereinafter, the total abatement granted by ESDC in the case of a registered plan shall be acquired by the establishment.
Effective date
The provisions of the present article shall apply as of the effective date of this Agreement, except for residents who are on disability at that date, who remain subject to the provisions in force before that date until their return to work.
Function of Federation Insurance Committee
The Federation Insurance Committee shall be responsible for establishing the basic health insurance plan and the optional life insurance, health insurance and salary insurance plans, which shall be an integral part of the insurance contract.
The insurance contract shall be taken out with an insurance company having its head office in Quebec.
The optional plans which may be instituted shall be life insurance, health insurance, dental insurance and salary insurance plans.
Contributions to the optional plans shall be entirely at residents’ expense. The rules for participation shall be established in accordance with the terms of the insurance contract.
The contract shall provide that the Minister may obtain from the insurer any statistical compilation or statement that may be helpful and relevant which the insurer provides to the Federation Insurance Committee.
The Minister shall receive a copy of the specifications, the list of tendering insurance companies, and a copy of the contract. Any amendment to the contract shall be brought to the attention of the Minister; any amendment to the contract concerning administration of the plans shall be subject to agreement between the negotiating parties. Any change in premiums shall not take effect until at least sixty (60) days following written notice to the Minister.
The Minister, the Federation and the Association québécoise d’établissements de santé et de services sociaux (AQESSS) shall meet as required to attempt to resolve difficulties associated with administration of the basic health insurance plan and the optional plans.
Establishment’s obligations
The establishment shall perform the work required to establish and apply the basic health insurance plan and the optional plans in accordance with the wording of the contract effected between the insurer and the Federation Insurance Committee. The establishment shall co-operate in any campaign concerning insurance plans. In particular, it shall perform the following operations:
- information to residents;
- registration and withdrawal of residents;
- transmittal to the insurer of applications for insurance and relevant information for updating of the resident’s file by the insurer;
- transmittal to the insurer of applications for discontinuance of insurance coverage;
- collection of the contributions required and forwarding to the insurer of premiums deducted or, where applicable, received from residents;
- delivery to residents of insurance and claim application forms, newsletters, brochures, insurance certificates or other material supplied by the insurer;
- transmittal of the information normally required from the establishment by the insurer for settlement of certain benefit claims.
The waiting period with respect to the salary insurance plan shall not be less than twenty-four (24) months, and the benefit net of tax shall not exceed eighty percent (80%) of the salary net of tax, including benefits which the resident may receive from any other source, notably pursuant to the Act respecting the Quebec Pension Plan, the Automobile Insurance Act, the Act respecting industrial accidents and occupational diseases and the different legislation concerning retirement plans; this maximum shall not be interpreted as imposing a limit identical to the benefits which the resident may receive from other sources.
SECTION II - Basic life insurance plan
Life insurance
Residents shall be entitled to six thousand four hundred dollars ($6,400) in life insurance. The establishment shall pay one hundred percent (100%) of the cost of the life insurance.
Interpretation
This life insurance is over and above the supplementary insurance plan provided for hereafter.
SECTION III - Basic health insurance plan
Interpretation
The basic health insurance plan is explained in the documentation made available to you by your insurer, La Capitale. You may obtain copies of this material by contacting the Federation or from La Capitale’s Website at www.lacapitale.com/collectif/fmrq/en/index.html.
Health insurance plan coverage
The basic plan, in accordance with the terms and conditions of the contract, shall cover all drugs sold by a licensed pharmacist or a duly authorized physician, upon a prescription from a physician or dentist, as well as, if the insurance contract so stipulates, hospitalization expenses not exceeding the cost of a private or semi-private room without limit as to the number of days, ambulance transportation, hospital and medical expenses not otherwise recoverable when the insured resident is temporarily outside Quebec and his condition requires hospitalization outside Quebec, the cost of purchasing an artificial limb owing to a loss sustained while covered by this insurance, or other supplies or services prescribed by the attending physician and necessary for the treatment of the illness.
Employer’s contribution
The establishment’s contribution to the basic health insurance plan for each resident shall not exceed the least of :
- in the case of a resident insured along with his dependants: Biweekly pay: $5.97;
- n the case of an individually insured resident: Biweekly pay: $2.39;
- an amount equal to twice the contribution paid by the resident for the benefits provided by the basic plan.
The establishment shall maintain this contribution for any unpaid leave of no more than twenty-eight (28) days
The insurance contract shall provide for a waiver of the establishment’s contribution effective from the one hundred and fifth (105th) week of a resident’s disability.
Participation in basic plan
Participation in the basic health insurance plan shall be mandatory.
A resident may, however, by giving prior written notice to his establishment, refuse or cease to be a participant in the basic health insurance plan, provided he establishes that he is insured under another group insurance plan or, if the contract so permits, in the general drug insurance plan provided by the Régie de l’assurance maladie du Québec (RAMQ).
The resident benefiting from unpaid leave of more than twenty-eight (28) days shall continue to participate in the basic health insurance plan. He shall be solely responsible for his own and the establishment’s contributions. For optional plans, the applicable rules are those set out in the insurance contract.
Interpretation
Note that under the Act respecting prescription drug insurance, CQLR c. A-29.01, participation in the group drug insurance plan offered is mandatory.
The resident who has refused or ceased to participate in the basic health insurance plan may participate in it once again in accordance with the conditions set out in the contract.
SECTION IV - Salary insurance
Disability insurance grace period
Subject to the provisions of this article, for any period of disability during which he is absent from work, a resident shall be entitled:
Duration of disability insurance
a) to payment of a benefit equivalent to the salary which he would have received had he been at work, up to the limit of the lesser of the number of sick days accumulated to his credit or five (5) working days. Nevertheless, if a resident has to be absent from work owing to a disability without having accumulated a sufficient number of days to cover the first five (5) working days of absence, he may use, in advance, the days he will accumulate until June 30 of the current year. Nevertheless, in the event of departure before the end of the year, he shall reimburse the establishment, out of his last paycheque, at the current rate at the time of his departure, for the sick days taken in advance and not yet accumulated;
Period of rehabilitation
b) to a benefit of an amount equal to eighty percent (80%) of his salary from the sixth (6th) working day, for up to one hundred and four (104) weeks; For the purposes of calculating the benefit, the salary used shall be the salary the resident would receive if working, including any supplements for chief residents and assistant chief residents.
c) beginning in the eighth (8th) week of disability as defined in Article 28.03, a resident receiving salary insurance benefits may, at his request and upon recommendation from his attending physician, undergo one or more periods of rehabilitation, within a period of no more than three (3) consecutive months. This rehabilitation, which may take the form of a return to a part-time work schedule, is possible after agreement with the faculty of medicine concerned and provided that it enables the resident to carry out all the usual duties relating to his position, with the exception of call duty. Throughout the rehabilitation period, the resident shall continue to be covered by the salary insurance plan.
At the end of the three (3) month period, the establishment and the resident may agree, upon recommendation from the attending physician, to extend this period for no more than three (3) consecutive months.
The resident may terminate his rehabilitation period prior to the end of the agreed-upon period on presentation of a medical certificate from his attending physician.
When he is undergoing rehabilitation, the resident shall be entitled, on the one hand, to his salary for the proportion of time worked and, on the other hand, to the benefit applicable to him for the proportion of time not worked.
The rehabilitation period shall not interrupt the disability period or extend the salary insurance benefit period, whether full or reduced, beyond one hundred and four (104) weeks of benefits for this disability.
At the end of the rehabilitation period, the resident may resume his position if he is no longer disabled. If his disability persists, the resident shall continue to receive his benefit as long as he is eligible therefor.
Interpretation
- The first five days of sick leave are paid at 100% of your salary and deducted from your bank of sick days provided for in Article 28.24, which totals 9.6 days per year.
- From the sixth day to the 104th week, you are paid at 80% of your salary. Note that this amount is calculated on the gross salary, excluding call and teaching premiums. You will receive a cheque from your establishment.
- After the 104th week, you will be paid at 80% of your salary, insofar as your situation meets the definition of long-term disability, but by your insurer, La Capitale, under the supplementary insurance plan. In that case, your benefit calculation includes call and teaching premiums, so you should see a slight increase in your benefits. Please note that this portion of sick leave is explained in the reference material from the insurer, which you can obtain by contacting the Federation.
To apply for sick leave, you must provide the establishment with a medical certificate including a diagnosis, treatment, and scheduled date of return or appointment. This certificate must be handed in at your establishment’s Health and Safety office. You are not required to give it to the Teaching Office, since this document has to remain confidential. Furthermore, your University can ask you to provide a medical certificate, i.e., a document signed by your attending physician indicating that you are unable to be in residency owing to sickness, along with the duration of this absence. The diagnosis does not have to be indicated on this document.
Also, from the 8th week of sick leave onward, you can obtain a period of rehabilitation that can take the form of a part-time return to work. To that end, you must submit to the establishment a medical certificate detailing the parameters of the return to work, e.g., the frequency of the return to work, duties or movements to be avoided, distribution of working days per week, etc. You must also discuss it with your program director, in order to ensure a smooth return conducive to the continuation of training in the context of part-time work. Note that the University is not free to refuse such a return. At most, it can decide that a rotation performed part-time will be a rotation that does not count toward the residency program. Progressive return to work is a form of accommodation associated with a handicap (temporary or permanent), and this right is a “fundamental right” protected by the Charter of Human Rights and Freedoms. Neither the establishment nor the University could deny you this right unless “undue hardship” were involved—which they would be responsible for demonstrating. If in doubt, get in touch with the Federation.
During the part-time rehabilitation period, the establishment will pay your work days at your usual salary, while the other days will be deemed sick days, and therefore paid at 80% of your salary.
If a statutory holiday occurs during sick leave of less than 12 months, the establishment pays the difference between the benefit and your salary. So you will receive your full salary for that day (Art. 23.04).
The salary insurance allowances shall be reduced by the initial amount of all disability allowances payable under the Quebec Automobile Insurance Act, the Act respecting the Quebec Pension Plan, the Act respecting industrial accidents and occupational diseases, and the different legislation respecting pension plans, regardless of any subsequent increases resulting from indexation clauses. More specifically, the following provisions shall apply:
QPP allowance
a) in the event the disability qualifies for allowances payable under the Act respecting the Quebec Pension Plan or the different legislation on pension plans, salary insurance benefits shall be reduced by those disability benefits;
Quebec automobile insurance allowance
- for the period stipulated in subparagraph a) of Article 28.15, if the resident has sick days in reserve, the establishment shall pay the resident, as applicable, the difference between his net salary 1 and the benefits payable by the SAAQ. The accumulated sick day bank shall be reduced in proportion to the amount thus paid out;
- for the period stipulated in subparagraph b) of Article 28.15, the resident shall receive, as applicable, the difference between eighty-five percent (85%) of his net salary and the benefits payable by the SAAQ;
Occupational health and safety allowance
- the establishment shall pay the resident ninety percent (90%) of his net salary1 until the consolidation of his injury, without exceeding one hundred and four (104) weeks from the beginning of his period of disability;
- in the event his injury is consolidated prior to the one hundred and fourth (104th) week following the beginning of his period of continuous absence due to an employment injury, the salary insurance plan provided for in Article 28.15 shall apply if the resident, as a result of the said injury, is still disabled as defined in Article 28.03, and in this event, the date of the beginning of such absence is considered to be the date of the beginning of the disability for the purposes of the salary insurance plan;
- the benefits paid out by the CNESST for the same period are to be collected by the establishment, up to and including the amounts referred to in i) and ii).
Disability that occurred at another employer
No salary insurance benefits shall be paid for a disability covered by the Act respecting industrial accidents and occupational diseases when the employment injury leading to entitlement thereto occurred on the premises of another employer. In that case, the resident shall be required to notify the establishment of such an event and of the fact that he is receiving an income replacement allowance. In the event the CNESST ceases to pay the allowance under the Act respecting industrial accidents and occupational diseases pursuant to an employment injury that occurred on the premises of another employer, however, the salary insurance plan referred to in Article 28.15 shall apply if the resident is still disabled as defined in Article 28.03, and in such cases, the date of the beginning of such absence is deemed to be the date of the beginning of the disability for the purposes of administration of the salary insurance plan.
To receive the benefits referred to in Article 28.15 and this article, a resident shall inform the establishment of the amount of weekly benefits payable under any legislation.
Interpretation
The amount of your salary insurance benefits is reduced in proportion to the amounts of benefits received under the Automobile Insurance Act, CQLR c. A-25, Act respecting the Quebec Pension Plan, CQLR c. R-9, or Act respecting industrial accidents and occupational diseases, CQLR c. A 3.001.
The amount of the allowance shall be divided, where applicable, at the rate of one-fifth (1/5) of the amount provided for a complete week, per work day of disability, during the normal work week.
Payment of allowances and supporting documents
Payment of allowances payable either as sick leave or as salary insurance shall be made directly by the establishment in which the resident performs his duties at the time of his departure on sick leave, subject to presentation by the resident of supporting documents that could reasonably be required. The establishment shall continue to pay said benefits to the resident, regardless of the anticipated duration of his employment at the establishment. The resident shall be entitled to reimbursement of the fee charged by the physician for any request for additional medical information required by the establishment.
Interpretation
You will receive your salary insurance benefits from the establishment which was paying you on your first day of sick leave, regardless of the duration of your absence and the entries on your training card.
As a guide, supporting documents which could reasonably be demanded include:
- medical certificate including diagnosis, treatments, and date of anticipated return or of next appointment;
- statement of salary replacement benefits paid by the SAAQ or any agency other than a private insurer.
It is up to the establishment to determine the nature of the supporting documents required and the circumstances in which they are required. But the establishment may not demand such supporting documents in an abusive, discriminatory or arbitrary manner. It must take into account the context of the absence. So, if you are rarely absent and contact the establishment to advise it that you are off sick for the day, it could be abusive for the establishment to require a medical certificate. After a few consecutive days’ absence, the establishment could then be justified in querying the grounds for the absence.
Verification of absence
Regardless of the duration of the absence, whether it be paid or not and whether or not there be an insurance contract to guarantee the risk, the establishment or the insurer or the government body that the employer has chosen to represent it for that purpose may verify the reason for the absence and monitor both the nature and the duration of the disability.
Interpretation
It must be pointed out that the establishment may verify the grounds for your absence and monitor both the nature and the duration of the disability. To this end, the establishment may require you to meet with a physician of its choice. The establishment is also entitled to demand a medical certificate produced by your attending physician that specifies the diagnosis, treatment, and nature of the disability. But this must be done reasonably and with respect for your rights, including your right to integrity, dignity, protection of personal information and privacy. So the establishment cannot monitor your absences in an unreasonable, even abusive manner.
Notice to employer
In order to permit this verification, the resident shall advise the establishment without delay when he cannot report for work due to illness and promptly submit the required supporting documents contemplated in Article 28.18; the establishment or its representative may require a statement from the resident or his attending physician except in the case where, owing to circumstances, no doctor has been consulted; he may likewise have the resident examined with respect to any absence. The fee for the examination shall not be charged to the resident.
Interpretation
When taking sick leave, you must inform the staff physician supervising you on the day of the absence, so he can take the necessary steps to organize the day’s work.
It is also good practice to inform the chief resident or his assistant, in the event you were on call. In fact, the latter has to ensure a replacement for your call duty, as far as possible and in compliance with the collective agreement, since it is not your responsibility to find a replacement when you are sick, but rather to give notice of such a need.
Also, if the absence is longer-term, your establishment’s Health and Safety Office will be responsible for managing absences on sick leave. So it is important to send them your medical certificate (diagnosis, treatment, duration of absence) as soon as possible. Finally, some university regulations stipulate that you must also inform your program director and the Office of the Associate Dean.
Note that any monitoring measure carried out by the employer has to be in compliance with your rights.
Finally, it is possible that specific rules may be in effect in your establishment. Find out about these, with regard to the notice you have to provide.
False statement
The verification may be made on a random basis, or as needed, when, taking into account the accumulation of absences, the establishment deems this appropriate. In the event the resident has made a false statement, or the reason for the absence is other than illness of the resident, the establishment may take the appropriate disciplinary measures.
Evidence
If on account of the nature of his illness or injuries, the resident has not been able to advise the establishment without delay or submit the necessary proofs promptly, he shall do so as soon as possible.
Interpretation
You are required to submit supporting documents as soon as possible, and, in case of extended absence, to follow up periodically with the Health and Safety Office, at their request. The Health and Safety Office often requires a standard form, which your physician will have to complete. In special cases, the nature of your illness or injuries may mean your condition prevents you from providing such follow-up. In such a case, you should contact the Federation.
Resident’s recourse
When payment of benefit is refused by reason of presumed non-existence or termination of disability, the resident may appeal the decision in accordance with the grievance procedure.
Bank of sick days
At the end of each month of paid service, the resident shall be credited with 0.80 working days of sick leave. For the purposes of this article, any authorized absence of more than thirty (30) days shall interrupt the accumulation of sick days, while any authorized absence of thirty (30) days or less shall not interrupt the accumulation of sick days.
Any continuous period of disability of more than twelve (12) months shall interrupt the accumulation of annual vacation days.
Leave for personnal reason
The resident may use three (3) of the sick days provided for in the first subparagraph for personal reasons. The resident shall take this leave separately, and advise the establishment at least twenty-four (24) hours in advance. The establishment shall not deny the leave without valid grounds.
Interpretation
You are therefore entitled to a maximum of 9.6 days’ sick leave for a full year of residency, i.e., 0.80 days per month worked. Moreover, three of these days can be used for personal reasons, i.e., without having to provide justification. The latter three days cannot, however, be taken consecutively.
You continue to accumulate vacation time if your sick leave is less than 12 months in duration. Beyond that period, you can no longer accumulate vacation days, until you return to work. On the other hand, study leave and conference days are prorated downward in proportion to the number of days worked in the year.
Sick days not taken during the year are payable on the first paycheque of July the following year.
Payment of accumulated sick leave
The resident who has not used up all the sick days to which he is entitled under Article 28.24 shall receive, by July 15 of each year at the latest, payment for the unused days accumulated as at June 30 of each year. Payment shall be made on the following July 15 or within a period of fifteen (15) days of his departure, whichever comes first.
Such sick days to which the resident is entitled shall be paid to him in full by the establishment where he is in training at the time of his departure.
Effective July 1, 2018, the Régie shall pay yearly the sum of one hundred thousand dollars ($100,000) to the Quebec Physicians’ Health Program (QPHP) on behalf of the Federation. The purpose of this contribution is to set up stable, ongoing funding to ensure the maintenance and continuity of the services offered to physicians, residents and medical students by the Quebec Physicians’ Health Program.