Executive Summary: Key Legal and Evidentiary Issues

• Interpretation of subsection 21(3) of the Employment Insurance Act regarding exceptions to the benefit deduction calculation under subsection 19(2) was the central legal question.

• The Social Security Tribunal – Appeal Division erroneously applied subsection 21(3), ignoring the provision's requirement that the plan in question be one for which the employer obtained a premium reduction under subsection 69(1).

• Jean-Marc Joseph received weekly CNESST indemnities of $627, which exceeded his employment insurance benefits of $518, leading to the Appeal Division's finding that he was entitled to an extension of his benefit period.

• Evidence confirmed the employer was not enrolled in the premium reduction program contemplated by subsection 69(1) of the Act.

• CNESST, being a provincial body, does not qualify as a plan covered by subsection 69(1), which explicitly refers to plans other than those established under provincial law.

• The Federal Court of Appeal found the Appeal Division's decision unreasonable and remitted the matter for redetermination in accordance with the Act.

Background and facts of the case

This case involves Jean-Marc Joseph, a claimant who received employment insurance (EI) benefits while also receiving workers' compensation indemnities from the Commission des normes, de l'équité, de la santé et de la sécurité au travail (CNESST). Joseph's weekly CNESST indemnities amounted to $627, while his EI benefits were $518 per week. Under the Employment Insurance Act (the "Act"), EI benefits are generally payable for a period not exceeding 52 weeks; however, this period may be extended up to a maximum of 104 weeks if the claimant can establish that he was not entitled to the benefits he received during a prior period because he was receiving compensation for a workplace accident or occupational disease.

The statutory framework

To establish that he was not entitled to benefits, a claimant must demonstrate that the benefit amount would be reduced to zero (or less) after deducting the workplace injury compensation. Subsection 19(2) of the Act specifies how this deduction is calculated: it is the sum of (1) half of the other earnings received up to an amount representing 90% of the weekly insurable earnings, and (2) the entirety of any amount exceeding 90% of the weekly insurable earnings. However, this deduction rule is subject to exceptions, particularly the one set out in subsection 21(3) of the Act. That provision states that when benefits are payable due to illness, injury, or quarantine, any allowances, money, or other benefits payable to the claimant under a plan that covers insured persons employed by an employer whose premium has been reduced under regulations made pursuant to subsection 69(1) shall be deducted from those benefits.

The Appeal Division's decision and the dispute

The Social Security Tribunal – Appeal Division, relying on subsection 21(3), concluded that Joseph was not entitled to EI benefits under paragraph 10(10)(c) of the Act because the CNESST indemnities he received exceeded his EI benefits. As a result, the Appeal Division found Joseph eligible for a prolongation of his benefit period for the number of weeks during which he was receiving indemnities for a workplace accident. The Attorney General of Canada challenged this conclusion through a judicial review application, arguing that the Appeal Division committed a reviewable error in its interpretation of subsection 21(3) of the Act. Specifically, the Attorney General contended that the Appeal Division ignored the final portion of the provision, which provides for its application solely in the context of benefits received under the premium reduction program.

The employer's non-participation and the nature of the CNESST

The evidence before the Court established that Joseph's employer was not enrolled in the premium reduction program under subsection 69(1). Furthermore, the indemnity in question was paid not by an employer but by the CNESST, which is not a plan covered by subsection 69(1). That provision explicitly refers to a plan other than a plan established under a provincial law, which means a provincial body such as the CNESST falls outside its scope entirely.

The ruling and outcome

The Federal Court of Appeal, composed of Chief Justice de Montigny, Justice Leblanc, and Justice Pamel, granted the Attorney General's application for judicial review. The Court found that the Appeal Division's decision was not justified in light of the applicable law and therefore could not be characterized as reasonable. The matter was remitted back to the Appeal Division to be dealt with in accordance with the Act. The successful party was the Attorney General of Canada (the applicant). No specific monetary amount was awarded, as the relief granted was procedural in nature — the case was sent back for redetermination rather than resulting in a final monetary judgment.