Validation.

Yesterday I worked with a client - her name is Heather.  Heather worked for 28 years as a cook in a retirement village.  She was a great cook, and was well liked by her co-workers and the residents of the nursing home.  At "happy-hour" time, Heather would work the bar and enjoyed catching up with her customers at the village.

Heather always struggled with her knees.  She had been on her feet for years and her knees were becoming more problematic.  Her employer tried to accommodate her as best as they could, but the kitchen and the bar are physical and eventually she could no longer continue.  In 2008, she was advised that she needed total knee replacements.  She had both knees replaced in 2008 and 2009.  The pain that she had in her hips and back were thought to have been radiating from her knees, was expected to resolve once she had the knee replacements and she was anxious to have the surgeries in order to get her life back. She was a golfer, enjoyed darts, and was a new grandmother. 

It was clear after the 54 physiotherapy visits after the surgeries, and the acupuncture, and the exercise and weight loss, and the medication, and her beloved Dr. Ho that she was not going to get back to her old job as a cook.  She was restricted by her physicians to 2-3 hours of work - 2 days a week.  She went back to her employer but they couldn't accommodate such a limited capacity to work.  She was broken-hearted and soon became depressed.  This lead to a number of other issues raising their head - more pain - more stress eating - more depression - limited sleep - the never-ending self-recrimination that she was unable to provide an income for her family.  She could not retrain, cooking was all she knew, and she had chosen that profession as in her words "book work never stuck with me"

She applied to Canada Pension Plan three times and was repeatedly denied.  She gave up after each denial as she was told she would get no where with the government.  She went on to have her hip replaced - and her back has serious degeneration due to arthritis.  She fights depression constantly and seeks mental health counselling.  She took injections in her back to see if that would help her pain.  She is on medication and she needs help to sleep.  And yet she continued to be denied.

A medical adjudicator from Canada Pension Plan called Heather and told her because the doctor said that she could work 2-3 hours, 2 days a week that she was indeed capable of working and that she did not qualify for a disability benefit. When Heather said that she could not work at the same level as  I am quoting directly from the file here the medical adjudicator who works for CPP says "Canada Pension Plan disability does not look at the level of earnings she could make, just whether or not she is able to work some type of job."

This statement is in fact misinformation and this case-manager knows that.  The reason why I know that, is because I have been doing this work for twenty years and I recognize the medical adjudicator on file.  The adjudication guidelines talk about what a substantially gainful occupation is - actually there is a policy outlining it - and there are the allowable earnings provision which reflects the fact that some people only have the capacity to work in a limited way - as was the case with Heather.  So this medical adjudicator ignored the guidelines to deny a claim. This misinformation was included in the denial letter, and made up part of the Minister's submission that they included to defend their position to continue to deny this claim right to the hearing date.

Sadly this is not an isolated incident.

Heather and her husband appeared at the Social Security Tribunal hearing and were able to explain how Heather's medical condition has severely impacted their life.  Because Heather could no longer work, her husband was working two jobs in his early seventies to make ends meet.  When Heather was asked by the Tribunal Member if she had anything to say in closing - Heather spoke about how she was misled by the government, how she had paid in to the program for 28 years, how she was reduced to tears by the medical adjudicator who spouted the misinformation, how this decision prevented her from enjoying her life, how she had to scrape by to get Christmas gifts for her grandchildren, how she had always contributed to her family, how she has to use all of her RRSPs in order to survive and now she is left with no retirement funds.  She spoke about the pain that she was experiencing, the fact that she had done everything she could to regain her ability to work, but that she was quite simply disabled.  She said that she finally felt validated that she had the opportunity to speak her piece to the Tribunal Member.

One of the recommendations that I have heard in my work on the CPP Disability Roundtable is that the government is suggesting that there be early intervention in that medical adjudicators contact appellants to speak to clients prior to making a decision.  I am opposed - the reason being - is for the type of situation that actually occurred in this file. Further, these calls are out of the blue, and most people find speaking with the government to be very stressful.  Heather explained she was on the back foot during this call - and was confused and stressed, and as noted "client weepy" by the medical adjudicator.  How about some compassion lady?

I received a call yesterday - from a client who has massive anxiety and panic attacks, PTSD, etc. This client was contacted by CPP out of the Chatham region (this is for the folk who are reading this blog from Gatineau).  When the client sad that she could not speak to the medical adjudicator without her advocate present - the case-manager demanded that she talk to her - and eventually the client hung up.  She phoned my office in a full blown panic attack - had to call her psychiatrist after the call.  I am still getting the details to share as she does not remember the name of who it was that called her - but I will get there and share this information.

Anyway, it is Friday - and happy weekend to you all.  Please if you need help, contact the office as we are here to help.  Our expertise gets results.

 

 

Social Security Tribunal Appeal Time Lines

If you are denied at reconsideration and you find yourself appealing to the General Division of the Social Security Tribunal you are going to be in for a lengthy wait before your appeal is heard.

The average throughput time for an appeal hinges on a variety of contributing factors including the complexity of the appeal - but the majority of the clients will wait 517 DAYS

That is almost seventeen months which is outrageous in my opinion.  Can you imagine that you have made an application to CPP disability - it takes 4 months for a decision - you are denied - then you request an appeal and it takes another 6 months - so you could be waiting over two years before a final decision is rendered.

DCAC has close to 90 percent success rate.  CPP disability denies over 50% of initial applications.  This statistics identify why it is important to get help as soon as you can in the application process to avoid these types of delay and to have a much greater chance of being successful.

 

Review of the Social Security Tribunal

It has been a busy six months with a lot of work to be done here at DCAC Inc.  We continue to be the premier service for individuals who have been denied their CPP disability benefits or who need help with the application process.  We now have 12 staff members across Canada and we continue to grow.

Early this year the KMPG report was released.  This report was commissioned by Minister Duclos in order to review the SST's processes to ensure it met the needs and expectations of Canadians, as well as to assess its fairness and transparency.   The comprehensive report highlighted a number of facts which I will present over the next months, to inform Canadians about what is new and evolving in the Canada Pension Plan disability forum.

I have included several newspaper articles on the DCAC Facebook feed as this is more timely than my ability to blog sometimes!  If you have not liked the DCAC page - you will find a link to it on the website.

I would like to start with a summary of the Key Findings - overall the review found that:

  • The SST was born out of the previous government's initiative to save $25 million dollars and was announced in the Federal Budget without the benefit of any stakeholder engagement.  The SST inherited a large backlog of appeal cases before they had staff, systems, or processes in place.
  • The total cost of the SST is lower than the cost of the four legacy tribunals that were combined.
  • Timelines for appeals are longer than the previous system and the average person waits over 500 days for their appeal to be heard.
  • Examination of the appeal structure and the enabling legislation and regulations that were designed to expedite appeals have had the unintended consequence of slowing down the process and frustrating clients.
  • The public consultations undertaken in order to produce the KPMG report - consistently identified dissatisfaction with the accountability of the SST and more is required to support a transparent, accountable tribunal.
  • The government recognizes that social programs must be designed and delivered with a focus on the client - and the SST currently does not incorporate many of the leading practices of a client-centric organization.

There was unanimous agreement that the goal of the SST appeal system should be to serve vulnerable Canadians through a far, objective, and responsive appeals process and that achieving this goal will require a "resetting of the SST" shifting from a primary orientation to the law - towards a greater orientation to the client.

What does this mean?  Well the findings have illustrated that there needs to be changes to the appeal system - and as I blog over the next while I will share with you my experiences with the SST, with the reconsideration appeal process, and with the application process.  I will provide information about the recommendations of this report and highlight individual cases and how they fit in to the recommendation for changes that have been presented to Minister Duclos.

At this time, there has not been a response from the Minister on this report - and we do not know what recommendations will be followed.  I do have several issues with the current SST appeal system specifically concerning access to justice issues.  A right to appeal is meaningless if an appellant cannot navigate the appeal process - and I will talk about this moving forward.

If you are denied CPP disability and you need help appealing please get in touch with our office.  We will be able to guide you and in most cases achieve a successful result on your behalf.  I am very proud of the work that we do here - so much so - that DCAC has been nominated for two business excellence awards in the customer service category and business of the year for 2018.  As well, March marks DCAC's 20th anniversary so it has been great to be acknowledged.

 

 

 

 

 

 

In the blink of an eye....

Last week we experienced a solar eclipse, something that is a rarity and infrequently happens.  As I had my weekly staff meeting, we got to talking about what can happen in the blink of an eye.

Some disabilities are chronic and occur over a number of years - but sometimes disability happens quite literally in the blink of an eye - a fall off a ladder, being hit by a car, a stroke, a heart attack.  Quite literally in the blink of an eye - a life can be changed.

At DCAC, we have been privileged to help thousands of individuals with disabilties navigate an often frustrating, confusing, and lengthy process of applying for or appealing CPP disability benefits. Our initial focus was to help people who had been denied, however over the last several years, we have been assisting individuals with their CPP disability applications and we are proud to say we have over 85% success rate. 

A Facebook poster asked me why it is necessary for someone to pay for help in order to fill out government forms.  I agree it shouldn't be necessary - but like you go to an expert to fill out your taxes - at DCAC we are experts in case-managing Canada Pension Plan disabilty applications.  The CPP disability denial rate on initial applications is around 55% - our success rate illustrates why it is smart to obtain professional assistance to navigate the waters.

There are individuals who can manage on their own, but there are people who find the process completely overwhelming - those individuals who have brain injury or cognitive deficits - maybe English is their second language - maybe they do not have a great education so the forms are just daunting. 

I feel that it is only a smart idea to get help right from the very beginning of the process.  At DCAC provides value in the following ways:

  • On the website we include a Canada Pension Plan disability Application kit which provides helfpul suggestions on making your application
  • Our staff are experienced - you can see the level of accumulated experience when you read about our team.  We understand the CPP disability legislation
  • We have worked on thousands of cases and we understand how a disability application or appeal should be managed
  • We provide all the service that you need seeing you right through the process - from application to appeal our work together will benefit you by achieving earliery approvals and assisting you to avoid common pitfalls of doing this alone
  • We have all the available technology to support clients across the country - we have representatives across Canada
  • We have years of accumulated contacts within the Canada Pension Plan - and we know who to call when help is needed

At DCAC - we have you covered - call us if you need help.

 

 

 

 

Hello Again!

Thank you all very much for staying in contact with DCAC over the last couple of years.  It has been a very busy time for us all here at DCAC and I now finally have some time to focus on keeping the blog entries current.

I would like to welcome you all to the new website - we hope that you like it and are able to get the information that you need to help you with your CPP disability matters.

My goal for this blog is to keep you updated on what is happening with CPP disability and to provide education and outreach if you are struggling to apply for CPP disabilty, or if you have been denied and need to appeal.

Over the last couple of years, there have been a number of newspaper stories on CPP disability which I would like to share with you all in the hopes that you will be well-informed to deal with the program.

In February 2016, the Auditor General of Canada, released its' findings on the Canada Pension Plan disability program - it was very scathing and a blessing to those of us who work within this system.  Shortly after that report was released, the Minister instructed the reconstitution of the CPP Disability Roundtable and I was fortunate to be offered a seat at this table.  This means, that I am able to speak up on behalf of the Canadians who have to deal with this system - and to offer my opinions on how the program can be more accessible.  From the lengthy and complex application process - to the large denial rate  - there are many good folk who are working towards change.  I am looking forward to sharing some of the information on participation in this process. The Social Security Tribunal has recently been reviewed and we await the findings of the report due in Fall. 

There is much to write about and over the next weeks I will be posting entries that I hope will be informative and interesting.  Thank you for being here.  Allison

 

 

CAUTION - Notice of Readiness Form - CAUTION

If your appeal is at the Social Security Tribunal and you are currently waiting for a hearing - you would have likely received a Notice of Readiness form in the mail. 

Please read this article carefully.

In December 2015, the Social Security Tribunal, decided that they were going to implement the regulations concerning the Notice of Readiness process.  If you have filed an appeal and received an acknowledgment from the Tribunal, you will receive a Notice of Readiness form.

This form will be located in the letter you receive from the Tribunal outlining your next steps in the appeal process.

 It says in the letter  that all parties to the appeal are allowed one year to send to the Tribunal any documents they want the Tribunal to consider.  And they will give you a date in which this 365 day period ends.

However, you are given the option, that if you do not need the one year and want the Tribunal to decide the appeal sooner, you can complete the Notice of Readiness form and send it to the Tribunal.

What is the Social Security Tribunal Notice of Readiness Form?

Well it is a document that is named Notice of Readiness:  Form for the Appellant

This form is very important - as once you complete this form and return it to the Social Security Tribunal  it means that you are stating that there are no more documents you wish to file in support of your appeal.

I know that many people will be keen to get the Appeal heard - and a Tribunal date - but it is a very bad mistake to sign this form without consulting an expert to ensure that you are indeed ready to proceed.  In fact, it is a very big mistake to send this form in before your case is reviewed and your appeal is managed.

If you sign this form it says that you have nothing further to add to your file. 

Sending the Notice of Readiness Form without consulting an expert is a mistake

This is my opinion.  Many people believe that they have submitted what is needed in order to support their Canada Pension Plan disability application - many people assume that because your doctor says your disabled - and because you are disabled - that you will qualify.  Well the recent news stories and the Auditor General's report has unfortunately highlighted that this is probably not the case.  Many people think that they have submitted all that they need to be successful -but in my experience - this is most often not the case.  Many people assume their doctors have submitted what they need, or think that CPP disability have collected what they need - but no. 

Most people have no understanding of the Minimum Qualifying Period or how that impacts an appeal.  There are so many reasons not to sign this form without expert consultation. 

If you sign a Notice of Readiness Form without consultation you could be preventing the opportunity to prepare your for your appeal.  And I like to follow the five p's - Prior Preparation Prevents Piss Poor Performance  (excuse my language).

So don't sign it without knowing for certain that you are prepared and that you have at least had someone look over your case as once you have signed it - well you may have difficulty submitting any more documents that could be critical to your appeal.

Think of it this way - if you have got the Notice of Readiness Form  - and signed it - and then you are diagnosed with another condition or perhaps you have more medical testing - who knows - but these may not be allowed to be submitted in order to support your appeal.

The last kick at the can

If you are a follower of this blog, you will know that the SST General Division appeal is pretty much the last opportunity you will have to submit information in order to support your appeal and it is your best shot to being successful and securing your disability benefits.  If you are denied at the General Division you cannot submit new documents on appeal - see why the you have to be so careful with the Notice of Readiness Form?

Some suggestions to follow

I would review the blog here to learn information about Canada Pension Plan and how to prepare your appeal.  I would make sure that you review all of the information in your file and ensure that all the documents are in there.  I would certainly wait until you receive The Minister's submission as to why they feel you are not entitled to Canada Pension Plan disability - and then review that to see what they find deficient in your case - at least make sure you prepare to respond to that. 

I would review the medical information and make sure that you have submitted everything before the time of the Minimum Qualifying Period and continuously to present.  I would make sure that your doctors have written letters of support - recent letters of support.

I cannot say it enough but I would make sure I had a professional expert review your file to ensure that your appeal documents are ready to go.  Do not leave this to an untrained person - it is a bad foolish thing to do.

Please contact me for further information - I am always happy to help.  We are currently evolving here at DCAC again - and have exciting changes to announce shortly.

 

 

 

 

 

Rants, Road blocks & Rubberstamps

It has been quite a long while since I have been sufficiently annoyed to write a blog entry.

For the most part, since then Minister Kenney pledged to eliminate the backlog at the SST, my year has been spent running from one end of the country to the other, working with clients whose appeals had finally been scheduled.

There were a large number of clients whose files were settled by Canada Pension Plan prior to the hearing.  But for those who did have to attend the Tribunal, I will say that they have been very well managed and the Tribunal Members have really been great ensuring the client has had a very good hearing experience.  Each Member has a differnt style, some more relaxed than others, but the clients had all left the hearings feeling a lot more positive than how they felt going in.  The clients are nervous and I have found the Members do their best to put the client at ease.  At least this is my experience and perspective.

I understand that the Tribunal are very close to completing all of the legacy files that had come over from the old Review Tribunal.  They have really worked hard - and whilst what happened to many clients caught up in the back log mess was very discouraging and frankly just bad - I do want to tip my hat to the staff of the SST.  They seem to be hitting their stride and almost remind me of the Tribunal of days gone by. 

Now let me speak of the road blocks and rubber stamps......

I have always maintained that if CPP disability actually adjudicated the applications they received utilizing the CPP disability adjudication framework - they would not have the large denial rates they seem to maintain year after year.  The Tribunal at one point, said that they had overturned and allowed more than 50% of the appeals they heard - which means that CPP disability - or the government - had got it wrong 50% of the time.

I cannot tell you how these denials so negatively impact the clients - they go without medication - they cannot afford their bills - their families suffer - the doctors getting pissed off because CPP disability do not listen - and it is just negative overall - not to mention how the clients become sicker due to the finanical stress they are put under.

I received a denial letter from CPP disability yesterday - the client had requested a reconsideration of the initial decision on September 4th advising CPP they there was additional information that the client was planning to submit to support his appeal - and today I got a copy of another denial letter dated October 22nd, 2015 denying him again.  THEY DID NOT WAIT FOR ANY INFORMATION THAT THE CLIENT WANTED TO SUBMIT.  FP Winnipeg.

I have sent letters to the CPP Medical Adjudicators - those particularly in CPP Chatham - and advised them that the client was waiting for a copy of their CPP disability file to come from Privacy so that they could prepare their appeal - and to please wait until they have had the opportunity to review this and submit additional infomration - ONLY TO BE DENIED WITHOUT ANY CONSULTATION.

That my friends is RUBBER STAMPING by Canada Pension Plan disability. 

If this rubber stamping did not occur, then the SST would not have such a large number of appeals being received each year. 

 

 

 

Bad time to pick a fight

It has been a while.  I have been very busy.  As you know the mandate came down from then Minister Kenney to wipe out the SST backlog.  The SST has been working hard to put the Tribunal on a more stable footing.

Things were going along fine, until last week.  It is a bad time to pick a fight.

I will further elaborate as things unfold.