A negative Review Tribunal decision

In January I wrote a blog about a hearing that I had attended and I was complaining about the vibe in the hearing room. I had strongly felt that the client was going to be denied - based strictly on the panel that had convened to hear that appeal.

An this week I got the decision and sure enough it was dismissed.

You cannot win every appeal - I understand that - and if the decisions are evenly written and reasons are well thought out - I have no problem taking a denial - you have a different interpretation on the information that is fine - no complaints and that is why there are various levels of appeals.

However, this decision I am going to describe to you. The client has appeal rights thank goodness.

This client - let's call him James.

James is middle aged. He has several diagnoses - including systemic arthritis as well bowel disease due to adhesions from previous surgeries - and chronic pain and fatigue due to these conditions. He has been under specialist treatment since 2002 - so now ten years on.

He has an MQP of December 2008- remember that is the magic date - the date he needs to be found disabled.

He could not work in a competitive work force due to his disability - so he decided to do a home based business - which continued to grow - but soon he could not keep up with the demands because of his disability.

He bought equipment to help him manage the business but eventually he had to turn business away - he continues to earn around $200 per month as that is his capacity.

He has pain in his knees, hips, back, he has adhesions on his abdominal wall which leads to significant bowel issues. He also has chronic fatigue due to his systemic arthritis.

He was prescribed medical marijuana to manage his pain as well as other medications to manage the degeneration of his joints.

The analysis of the Panel and the reason for the denial.......

The Panel agrees that James has ongoing "problems" related to his medical condition. No significant increase in his symptoms from Jan 2002 to October 2007 - note this is one year before the MQP - and the doctor does not give an opinion as to whether the condition is disabling - note these where consultation reports from one doctor to another.

There is little medical evidence regarding the bowel issue- really??? Well James had been referred to several specialists as well as surgeons to see if they can do anything to help - all doctors say no. That if there is surgery it could make the situation of the adhesions worse - and James did not mention this pain enough to his doctor - yet he has been prescribed medical marijuana by the doctor who notes "for ONCE I am comfortable with this as a means of CHRONIC PAIN management" and the doctor also notes in evidence - that mobility is seriously impacted 8/10 - that the paitent is in pain sitting, standing, and lying down.

The medical conditions do not individually or collectively appear to disable him and that he is intelligent and articulate - and that he has not made attempts at employment - okay????? As explained he has been trying to operate within his functional capacity for many years.

So yeah there are pages of medical reports from specialists - his doctor characterizes his medical condition as severe.

There is no discussion about productivity - there is no discussion about how pain interferes with his day to day functiioning - there is no discussion about how this client cannot regularly attend at a place of employment - there is no discussion about his excellent work history. There is no discussion about his efforts at mitigation.

And one last thing that James mentioned to me when I called to see if I could put his story on the blog was - that the hearing was in the mid morning - the hearing took about an hour - and after the hearing James and I sat in the lobby and I was telling him about my negative feelings - less than ten minutes later the Panel left the hearing room and went to the restaurant to eat lunch - so James said to me - how much time was spent deliberating and discussing the file - he was not at confident that his case was given its due - and you know what I tend to agree.

Anyway just wanted to update you.

Still learning after all this time.

This week marks my 14th year of running the clinic.

I was so vain as to think that I really understood the procedures and the CPP program well - and you know I do - but there appears situtations to me that I really do not have any idea how to answer people's questions.

I ask them have they phoned the 1-800 number - you know "Service Canada" - and they laugh at me. They tell me that they receive different information depending on the time they call - and then it is an insufferable amount of holding time before you are connected - well I suppose we cannot complain too much - I mean some of the 1-800 numbers I call are off shore and at least "Service Canada" remains in Canada - but any way I digress!

Okay so I have some pretty good contacts within the department - well I thought I did - because I have sent several emails to CPP managers, as well as called CPP regional officers - only to be told to phone the 1-800 number! Yeah okay....

Anyway I am back to trying to wade through enormous amounts of procedures to find policy and answers to questions that half the time I think do not exist - or maybe they exist in one region but not another.

So my recourse is the Freedom Of Information Act, then I have things in black and white and concrete answers to my questions that do not forget relate to Canadians in the public - not cause I am out of a whim trying to find information for my own jollies.

Maybe the Feds are pissed at me cause I am "outing" them - and hello to all you bureaucrats who are reading the blog.

So yes there are clients that appear that have unique situations that I am very interested in finding out the answers - and I often get ideas for the blog from CPP recipients - so thanks and keep them coming. I will try and find out the answers to your questions the answers that you are advised to get from "Service Canada".

CPP and the dangling carrot.

I received a phone call this week from a clergyman - let's call him Cameron. Cameron had just turned 60. He could no longer work as a clergyman a position he had held for 30 years or more due to multiple disabilities both physical and mental. Cameron had applied for CPP disability at 59. He was denied because the Feds said whilst they recognise that he has limitations he was still suitable for some type of work. No surprise this is the standard denial vernacular.

So why I am calling this the dangling carrot......

The Feds go on to say and I am paraphrasing, well you cannot have your disability benefit but, because you will be turning 60 in whatever length of time that is - or if you are already 60 - we are delighted to advise you that you can collect you CPP early retirement benefits. Just sign here, withdraw the disability application, and there you have it we will put you on these benefits and just forget the CPP disability. We will even recognise the date of your appliation to CPP early retirement benefits as if that is the date you applied for early retirement benefits (note I am being a tad sarcastic).

This is the dangling carrot......

The CPP early retirement benefit payment is significantly lower that what you would collect on a CPP disability benefit - so the Feds have saved themselves a lot of money. It is my opinion that the Feds are also playing on people's emotions and desperation of the fear and financial implications of not having a monthly income. In Cameron's case I have seen the medical reports and the doctors have all supported that he is not capable of doing any work quite clearly.

I have seen this situation occur over and over again. Most people understand what the dangling carrot is - and the smart people of Canada are on to it.

I would also like to make note of one more thing. I have seen a lot of write ups lately from financial planners talking about taking early retirement from CPP. It is their perogative to give financial information but I get frustrated that not one of the financial planners mention that if you take early retirment one of the implications is the window of eligibility to access CPP disability benefits. I have talked at great length about this in previous blog entries.

I would like to thank everyone who contacts me about the blog. I am happy that the information it contains is helpful. Have a good week. Allison