Personal Long-Term Illness Leave

Submitted to ESA Leave Consultation on May 6, 2024 via email to ESA-Leave-Consultation@ontario. PDF available here.

The Decent Work and Health Network (DWHN) is an organization representing health care providers, public health professionals, health policy experts, and communities across Ontario. Our province-wide network recognizes that improved working conditions are a critical pathway to better health outcomes. We have been providing health-related feedback and analysis on labour policies since 2014.

Our members regularly help patients navigate the financial hardships associated with long-term sickness or injury, in particular for those who are engaged in low wage and/or precarious work. We also have health worker members with first hand experience of these systems. We are putting forward four recommendations as described below.

1. Personal long-term illness leave under the ESA must be at least 27 weeks

We believe that when workers access the federal Employment Insurance (EI) sickness benefit, their ongoing employment should be protected under Ontario’s Employment Standards Act (ESA). This improvement would align employment protection with the 26 weeks benefit period plus 1 week waiting period of federal EI sickness benefits.

As it exists today, access to the federal EI Sickness Benefit without job protection serves as a disincentive to taking time off to adequately recover from serious medical illness or injury. Working while ill/injured is linked to longer absences later and/or increased presenteeism (attending work while feeling ill or sick). In both instances, long-term health, productivity, and safety are threatened or compromised, both for the individual and others in the workplace.

2. Decrease administrative burden on healthcare by aligning the evidentiary standard and required documentation for personal long-term, job-protected leave with federal EI sickness benefit requirements.

As you are no doubt aware, administrative load is a significant concern for family and emergency physicians, the cohort of healthcare workers most often providing workers with documentation for medical leaves. A streamlined evidentiary and documentation standard would avoid confusion and unnecessary administrative burden on health care workers involved in providing documentation. Moreover, this change would also reduce the confusion created by multiple standards for workers, employers, and businesses or organizations.

3. Remove the proposed length of service requirement

Illness or injury can occur at any time and without warning. Both employees and employers have an interest in ensuring an adequate period of recovery before returning to work. Proceeding with a medical leave is a serious decision that is best made between a worker and their healthcare provider. As such, access to job protection should not have arbitrary conditions that are unrelated to health needs.

4. Implement ten employer-paid sick days Finally, we suggest amending the ESA to include ten (10) employer paid sick days.

Reforms related to the ESA and medical leave cannot neglect short-term absences. The Decent Work and Health Network has long called for 10 employer paid sick days, with an additional mandated allotment during public health emergencies. These are critical to not only protect individual workers’ health, but to prevent the spread of infectious disease, facilitate access to medical care, and care for dependents including sick children or ailing parents who may require periodic care.

Sincerely,

Danyaal Raza, MD MPH
Family Physician, Unity Health Toronto, St. Michaels Hospital
Assistant Professor, University of Toronto

Edward Xie, MD MSc
Emergency Physician, University Health Network
Assistant Professor, University of Toronto

Monika Dutt, MD, MBA, MPH
Public Health and Family Physician
Health Policy PhD student, McMaster University

On behalf of the Decent Work and Health Network