(Sections 4.03 and 6.01 of the Transfused
and Hemophiliac HCV Plans)
GENERAL ELIGIBILITY CRITERIA
(top)
1. An Approved HCV Infected Person at Disease
Level 3 or higher who normally performed household
duties in his/her home who delivers proof satisfactory
to the Administrator that his/her infection caused
his/her inability to perform these household duties
shall be eligible for compensation for loss of
services.
2. The Dependants of an eligible HCV Infected
Person who has died, who were ordinarily resident
with him/her at the time of his/her death, shall
be eligible for compensation for loss of services.
3. The maximum payable for loss of services in
the home under either Plan is $240 per week calculated
as 20 hours of lost service at $12 per hour (indexed
from 1999 dollars).
4. An HCV Infected Person may not recover both
loss of income and loss of services compensation
for the same period of time. Similarly, Dependants
may not recover both loss of support and loss
of services for the same period of time.
5. An HCV Infected Person may recover loss of
services while continuing to work or in lieu of
loss of income if it is financially advantageous
and he/she satisfies the other eligibility criteria.
6. A claim for loss of income will cease at the
end of the calendar year that the HCV Infected
Person reaches age 65. At that time he/she may
commence receiving loss of services, if he/she
satisfies the other eligibility criteria. Similarly,
a claim for loss of support will cease at the
end of the calendar year that the deceased HCV
Infected Person would have reached age 65. Dependants
may commence receiving loss of services subsequent
to the end of the calendar year of death, if the
other eligibility and entitlement criteria are
satisfied.
7. HCV Infected Persons aged 12 years and older
may recover loss of services if they satisfy the
other eligibility criteria.
ENTITLEMENT OF LIVING HCV INFECTED PERSONS
(top)
8. Past loss of services will be paid to an eligible
living HCV Infected Person, back to the date of
his/her HCV disability.
9. Loss of services (subject to any change as
a result of a re-evaluation of the person's medical
condition) will be payable to an eligible living
HCV Infected Person until the date of his/her
death.
CALCULATION OF PAYMENT FOR LIVING HCV INFECTED
PERSONS (top)
10. The Tran 2/Hemo 2 and Gen 12 Forms will provide
the Administrator with a percentage disability
estimate by the physician together with the number
of hours the eligible HCV Infected Person states
he/she can no longer perform services in the home.
Entitlement to loss of services, subject to the
provisions of paragraphs 11, 12 and 13 below,
will be calculated in accordance with the following:
a. if the physician indicates that the person
is 60% or more disabled, then the person will
be entitled to the number of hours of work in
the home which they are no longer able to do multiplied
by $12 per hour or $240 per week, whichever is
less;
b. if the physician indicates that the person
is 30% or more disabled but less than 60% disabled,
then the person will be entitled to the number
of hours of work in the home which they are no
longer able to do multiplied by $12 per hour or
$120 per week, whichever is less; or
c. if the physician indicates that the person
is less than 30% disabled, then the person will
be entitled to the number of hours of work in
the home which they are no longer able to do multiplied
by $12 per hour or $60 per week, whichever is
less.
11. A person who qualifies at level 6 will be
presumed to be entitled to the maximum of $240
per week in loss of services unless the information
on Gen 12 indicates less than 20 hours of services
per week have been lost.
12. The payments set out in paragraph 10 are
presumptive only. A claimant may provide information,
satisfactory to the Administrator, that because
of his/her personal circumstances he/she should
be entitled to a payment greater than the payment
calculated under paragraph 10, up to a maximum
of $240 per week.
13. The Administrator reserves the right to reassess
the entitlement of claimants to loss of services
and, in particular, may each year ask for an updated
Gen 12 and Tran 2/Hemo 2 Form.
ENTITLEMENT OF DEPENDANTS OF DECEASED HCV
INFECTED PERSONS (top)
14. Where the eligible deceased HCV Infected
Person died after January 1, 1999, past loss of
services will be paid back to the date of his/her
HCV disability to the extent loss of services
or loss of income was not already paid to the
HCV Infected Person prior to his/her death. Any
amount owing for loss of services up to the date
of death will be payable to the Estate. Any amount
owing for loss of services after the date of death
will be payable to the Dependant(s).
15. Where the eligible deceased HCV Infected
Person died before January 1, 1999, past loss
of services will be paid back to the date of death.
The monies owing for loss for services will be
payable to the Dependant(s).
16. The Administrator will use the most current
Canada Life Tables to calculate a notional life
expectancy of the deceased HCV Infected Person
without reduction for any pre-existing ailment
or illness (including HCV) to determine the maximum
period loss of services may be payable.
17. Loss of services will be paid to Dependants
for the calculated life expectancy of the deceased
HCV Infected Person, so long as the Spouse who
is a Dependant remains alive or there is a Child
who is a Dependant who continues to qualify for
payments. Loss of services payments will cease
upon the death of the Spouse who is a Dependant
unless there is a Child who continues to qualify
for payments as a Dependant.
18. Where the Dependant claiming is a Child,
the loss of services will be presumed to continue
until his/her 25th birthday unless the Child provides
evidence satisfactory to the Administrator that
some other period of loss is appropriate.
19. The Dependant(s) claiming loss of services
will be advised at the time of the processing
of the claim the maximum period that loss of services
could be paid in the circumstances of their cases.
CALCULATION OF PAYMENT FOR DEPENDANTS OF
DECEASED HCV INFECTED PERSONS (top)
20. Those Dependants who qualify to receive loss
of services will be presumed to be entitled collectively
to receive the maximum $240 per week unless the
information on the Gen 12 Form indicates less
than 20 hours of services of the deceased HCV
Infected Person per week have been lost.
ALLOCATIONS AND PAYMENTS FOR DEPENDANTS OF
DECEASED HCV INFECTED PERSONS (top)
21. Where one or more Dependant(s) is a Child
who is still a minor or a mentally incompetent
adult, both the allocation of the loss of services
payments and their payment is governed by the
provisions of the Court Approved Protocol - Claims
Where One or More Family Member and/or Dependant
Is a Minor or a Mentally Incompetent Adult.
