Half of Canadians denied CPP disability benefits are successful on appeal

June 21, 2017, Kitchener, Ontario

Posted by: Robert Deutschmann, Personal Injury Lawyer

It appears that there are some problems in the CPP disability pension approvals process. In February 2016, Auditor General of Canada Michael Ferguson released a report on the $4 billion program.

His report found that while the department met service standards for assessing initial and reconsideration applications for disability benefits, it didn’t meet the guidelines for faster decisions on applicants with terminal illness and grave conditions. The report also found that a very high proportion of decision were overturned on appeal. In 2014-15 fully 35% decisions were overturned by the department on reconsideration, and 67% of appeals were overturned at the tribunal or even before the tribunal decision. It appears that there was no analysis internally of why so many decisions were overturned.

These rates of decision reversals are concerning to anyone involved in long term disability law, and to the individuals applying for benefits. It appears the department has no quality assurance program, nor are decisions made consistently across the country. The initial applications process was also found to be overly complex, and lengthy requiring a large number of paper forms to be completed. The application totals some 42 pages and can take months to complete. The form for terminally ill patients has been shortened to 11 pages.

It is no wonder that so many Canadians are forced to hire lawyers or other professionals in order to simply apply for benefits, let alone to help the through the appeals process and tribunal phases of the process. It is unreasonable to see so many cases being overturned, and the numbers leave professionals to wonder how there can be so many errors in the initial decisions. Possible reasons are that the staff reviewing the very lengthy applications are under pressure to meet timelines, and are not reviewing the entire files. The department says that another reason for high rates of appeal include the fact that often extra information is required, or there are changes to the medical information.

On review though, it appears that many files initially denied are then approved with not changes to the application itself and no additional information being required.

The department has indicated that a quality assurance framework will be established, and the paper application is being changed this year, with a web based application coming in 2019. Changes have also been made to assure that applicants with terminal illness are having their file handles within five days of receipt, and for applicants with grave conditions are being adjudicated within 30 days.

If you are having trouble with your applications for long term disability benefits or CPP disability benefits please call our office. The initial consultation is always free.

About Deutschmann Law

Deutschmann Law serves South-Western Ontario with offices in Kitchener-Waterloo, Cambridge, Woodstock, Brantford, Stratford and Ayr. The law practice of Robert Deutschmann focuses almost exclusively in personal injury and disability insurance matters. For more information, please visit www.deutschmannlaw.com or call us at 1-519-742-7774.

It is important that you review your accident benefit file with one of our experienced personal injury / car accident lawyers to ensure that you obtain access to all your benefits which include, but are limited to, things like physiotherapy, income replacement benefits, vocational retraining and home modifications.