From: ADENEKAN BAYO

Sent: Mon, 25 May 2026 16:28:27 +0000

To: HOLAND MARK; mark holand

Ce: Employee Benefits (BCRTC); BCRTC Payroll

Subject: LTD Forms - Holand M. (£21987)

Attachments: CL LTD Attending Physician Statement (M5445 - 51296)-FINAL.pdf, FAQ

WCB_LTD Pension Deeming.pdf, LTD Employee Statement (M7413).pdf

Hi Mark,
| hope you’re well.

I’m emailing to provide you with the application forms for Canada Life LTD which comes
into effect for individuals who are off and will pass the 26 week mark. Please see
attached FAQ for further details.

There is a lot of information included here, so please give me a call back so we can
discuss this process in greater detail.

As part of the claim process your group plan requires you to notify Canada Life of your
disability within a certain timeframe after you become injured in the workplace. As you
have been absent from work since February 2, 2026 due to injury, this email is being
sent to provide the necessary forms and notify you of your responsibility to:

e Notify Canada Life of your injury;
e Apply for LTD benefits through Canada Life

Because the application process can take time, the necessary forms are sent out well
in advance of the 26-week cutoff. We strongly recommend submitting your Canada
Life LTD claim early to allow sufficient time for adjudication.

You will need to submit the following forms in order to apply for Long Term Disability
benefits:

Submit to Canada Life: Va

1. LTD Employee Statement — (completed by employee) Provides Canada Life with
general information about you and your medical details and provides Canada Life with
notice of your disability claim; Group LTD plan number: 51296

2. LTD Attending Physician Statement (APS) — (completed by physician) Your doctor will
need to provide us with medical information about how your condition(s) prevent you
from working.

Employee Benefits (CC’d) will submit an employer statement to Canada life on your
behalf.

Your physician may also submit the APS to Canada Life by Fax: 1-844-816-1038

000229