Wood Buffalo In Solidarity

Canadian Union of Public Employees Local 1505


Initial Attending Physician Statement only

Employee Statement

  1. As per the collective agreement, if you have been or will be absent from the workplace “beyond 7 consecutive days” you need to apply for short-term disability through Desjardins.  (You pay 100% of this benefit on each pay cheque).
  1. The Employer needs a doctor’s note that excuses your absence.  It should not include diagnosis (what’s wrong with you) just prognosis (how long you will be absent).  Send to health@rmwb.ca with a copy to admin@cupe1505.ca.
  1. Print off the Desjardins Initial Attending Physician Statement Form and get your doctor to fill it out.
  1. Print off the Desjardins Employee Statement and fill it out with your banking information. 
  1. These two forms (4&5) get submitted to Desjardins at www.DesjardinsLifeInsurance.com/Send

We strongly suggest you submit them yourself (or get help from a steward to submit them).

  1. Also you will need to fill out the “Benefits Continuation during Leave Request” form and send to benefits@rmwb.ca with a cc to admin@cupe1505.ca.

If you need assistance, please contact the chief shop steward Nikki Peddle (chiefshopsteward@cupe1505.ca) and she can assign a steward to help you.

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