What do I do now that my Canada Pension Plan disability (CPP-D) benefits application has been denied? How can I successfully obtain CPP-D benefits? These are common questions, which we have heard from a number of clients, who have come to us with respect to their CPP-D benefits applications.
What are CPP-D BENEFITS?
The CPP-D benefit is a monthly payment, payable to eligible individuals who are unable to work for a long-term or indefinite period, due to a mental or physical condition.
Disability alone will not make you eligible for CPP-D benefits. You must also (1) be under the age of 65; and (2) have made sufficient contributions to the CPP.
Although the above criteria to qualify for CPP-D benefits may seem simple to meet, in reality, the application process can end up being complicated and drawn out, particularly if your initial application is denied. A 2016 audit of CPP-D Benefits found that nearly 60% of initial CPP-D applications were denied. At the reconsideration level, approximately 65% of reconsiderations were denied.
Having an experienced lawyer help you with your CPP-D benefits application and appeals can facilitate the CPP-D benefits process.
Commonly Cited Reasons for Denial of CPP Benefits
- Injury is not sufficiently severe and prolonged
- Insufficient contributions
- Inadequate medical documentation
- Applying for CPP-D late or appealing a decision late
Your CPP-D Benefit Application was Denied? Next Steps: The Appeal Process
If your CPP-D benefit application is denied, you can appeal the denial in three successive stages.
- The Reconsideration Request
The first stage is the reconsideration. You must request the reconsideration within 90 days of the date that you receive your decision letter denying your initial CPP-D benefits application.
In your reconsideration, you must prepare a written request, which includes reasons as to why you disagree with the initial denial of your CPP-D benefits application.
You can provide new information that you think will advance the case for your application. For example, medical records, and letters from medical professionals responding to the reasons why your application was denied, can help persuade a decision-maker to overturn a denial of a CPP-D benefits application.
It is crucial that your reconsideration request address the reasons why your initial CPP-D application was denied.
- Appeal to the Social Security Tribunal – General Division
If your reconsideration request is denied, you can further appeal to the General Division of the Social Security Tribunal (SST). You must submit a Notice of Appeal within 90 days after you receive the denial of the reconsideration request, and have one year from the date that you submit your Notice of Appeal, to submit additional required material.
This stage of the appeal requires you to submit arguments, backed by evidence, on why the General Division should agree to allow your CPP-D benefits application.
This appeal stage also consists of a hearing. This is an opportunity to address why your CPP-D benefits application should be allowed. You can bring in witnesses, such as a family member or medical expert, to testify at the hearing. The decision-maker will also have the opportunity to ask you questions, so it is best to be well prepared. If you are using a lawyer, your lawyer can help you prepare for this process and go before the SST member with you.
- Appeal to the SST – Appeals Division
If the SST General Division denies your appeal, you can submit a final appeal to the SST Appeals Division. You will need to submit an Application Requesting Leave to Appeal form to the SST Appeals Division within 90 days of receiving the SST General Division decision.
The SST Appeals Division will not review all appeals submitted for review. If the SST Appeals Division grants permission to hear your appeal, you again must submit arguments and will likely have a hearing.
An Experienced Lawyer Can Smooth the CPP-D Benefits Process
Applying for CPP disability benefits, and appealing denied CPP disability benefit decisions, can be a long and complicated process. The lawyers at Landy Marr Kats LLP can help you navigate this process. We have successfully helped our clients overturn CPP-D benefits denials and can help facilitate the CPP-D benefit application process for you.