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Entering a new chapter

by Allison Schmidt 30 March 2013 11:03

This was my last week of Review Tribunals.  I have literally ran from coast to coast these last three months trying to complete as many Review Tribunals and Pension Appeals Board hearings possible.

I have a lot of people to thank especially the staff of the RT and PAB who have been very helpful and accommodating as I have managed the number of appeals scheduled and often had submitted information that was a tad on the late side.

I did not get an opportunity this week to say good bye to those staff who were not hired by the new CPP Social Security Tribunal so this is my way of expressing gratitude for their excellent service over the last fifteen years.

I was told by someone very special in my life who has since passed on "that the good lord works in mysterious ways".

It felt that way this week.  I had my last set of hearings with three very interesting clients - all really quite difficult cases in terms of disability (not straightforward medical diagnoses but complicated) - as well as each one requiring some discussion over legislative tenants - let's just say it wasn't simple fare. 

Blow me down if I did not get a most excellent panel!  The clients were made to feel comfortable - no judgment - and were heard in a compassionate way.  Thank you Tribunal members.

The sun was shining - there was no snow where I was - and I was able to run outside.  Something I have not done since October.  It really was a great week of hearings.

So now as one door closes, we open a new door, with a new chapter starting.

If you have read my blogs recently, you will sense my disquiet about this new CPP Social Security Tribunal.  It remains to be seen how everything evolves - and my anxiety has been about what is going to happen in the future.  However, it is time to walk through this new door and work as hard as I can, to ensure that my clients, as well as people reading this blog, as much information as I can as time rolls along.

I know the legislative tenants have not changed - how a claim is adjudicated has not changed - and they cannot deny everyone!

Monday is the big day folks - so stayed tuned.  To all of the people who have called and left messages I will do my best to return your calls as soon as I can. 

Allison

Appealing a CPP Disability denial - some self-help strategies

by Allison Schmidt 23 March 2013 16:34

I think it is helpful to understand what strategies to employ when you need to appeal a CPP disability denial.  I have been side-tracked with the new CPP Social Security Tribunal and my frustration with the lack of information as you can probably get from my recent blog entries.

I think there is some benefit to cutting and pasting the information that is available on the internet about the CPP disability system in a blog entry - but what I strive to do here - is give actual case examples and situations that I have dealt with in order to provide a better understanding of the CPP procedures and processes.  I think these descriptions of actual cases that I have done, provide situations clients can relate to - as words cut and pasted - are still just words that any one can look for online.

Understanding the complexities of CPP disability takes time and experience. Please ensure your representative has the experience and knowledge to case-manage your application or appeal.  So make sure when you are looking for help that you ask these questions: How many appeals have they done? What is their success rate? Do they have the required licenses to do the work? How long have they been in business?

I wanted to talk about some self-help strategies to increase your chances of success.  Make sure you have done the following:

  • Obtained and reviewed your Canada Pension Plan disability file.  You can get a copy of your file by completing the Personal Information Request form which you will find in the Downloads section of this website.  You will need to send this form in to the CPP regional office who is adjudicating your claim.
  • Understand why CPP Disability are denying your claim.  I have posted a lot of information on the blog about why CPP disability is usually denied - and how to understand the CPP disability language.  If you understand the reasons why CPP disability have denied your claim then you will better understand how to put together your appeal. 
  • Find out what your MQP is?  Minimum Qualifying Dates are extremely important and you need to review your file to see if the medical information that has been submitted provides evidence around the time of the MQP.
  • Once you have reviewed your file, it is important to decide what additional supportive documentation you may need to get and who to get it from.  Make contact with your doctor and any other people you might want to get letters from.  Most doctors charge money to obtain the evidence you need to support your appeal.  It is not helpful to get a doctor to write that your disability is "severe and prolonged".
  • Understand your responsibility to provide information to support your appeal.  Understand how CPP disability is determined. Read through the blogs and the appeals guide on this website.
  • Make sure all the information you have collected will help with your appeal. Sometimes clients get discouraged because their doctors write that they may be able to do "some light work" but keep in mind that the work has to be regular and substantially gainful.  It is a good idea to speak to your doctor about their thoughts on your capacity to work before obtaining a written report.
  • Your written submission should address when you stopped working and why you think you are unable to work in any job because of your disability.  It should discuss if you have tried to return to work and failed due to your medical condition, and if you looked for work, how your disability prevented you from finding a job.  The submission should outline your functional limitations. 

I am going to be away next week working on my final Review Tribunal hearings.  Three complicated but interesting cases. I must say I am very sad that these hearings are coming to an end.

CPP Social Security Tribunal

by Administrator 22 March 2013 12:13

Attention Attention Attention.

Memo To Diane Finley Minister Human Resources Skills Development Canada

What the hell is going on??????

It is March 22nd, 2013.  There are nine days until the appeals system changes to the CPP Social Security Tribunal - and no one - not one single person - can advise me of any information.

Nothing. Squat. Nadar.

When will appeals start to be heard?

Where is the office going to be located?

Who is going to manage my files?

Where are the appeals going to be heard?

How are they going to be heard?

How long are people going to wait to be heard?

Who do I call on April 1st, 2013?

Who is going to staff the place?

When are they going to advise us representatives how to proceed with our clients?

How in heaven's name is this going to be a seamless transition? 

This is nothing but a gosh darn shyte show.

To all my readers please excuse my language but I am just so frustrated with this whole process and angry that good people are being effected by these changes and no one seems to give a hoot.

Please note that I am not talking about the existing staff at the Tribunals  - they are excellent .

 

Hang in there please

by Allison Schmidt 21 March 2013 10:39

I have one more week of appeals out of my office.  I have a lot of phone calls to return and please be patient as it may take a while for me to get back to you.

If you can address your questions to me via email that would help info@dcac.ca as if I am out of the office I can get back to you via email.

If you have been denied, please make sure you send off letters of appeal - so you do not miss your 90 day appeal period.

Again thank you for all of your kind words and emails, I appreciate the feedback and knowing that my work is making a difference and providing some support during a difficult period.

Allison

Tags:

Medical Reports

by Allison Schmidt 21 March 2013 10:10

This blog is about a client I helped let's call her Corrine.

Corrine is in her late 40's and I helped her with a Review Tribunal this week.  Corrine has a mental disability - she is diagnosed with Social Anxiety Disorder, Major Depressive Disorder, Agoraphobia, Cluster C Personality Disorder.  She had worked for 26 years and unfortunately due to frequent absences at her work place - and due to lack of understanding and compassion of her work place and co-workers became the target of work place bullying.  You know what it is like in the work place - a person starts taking time off work due to illness that really cannot be visually seen - or sometimes understood - by coworkers so that person gets labeled as a slacker or a faker - just wanting to get out of work.  Along with the work place bullying - Corrine had several bereavements in a short period of time - she broke down - that was in 2007 and she has not worked since.

Corrine had a MQP or Magic Date of 2010 - remember what the magic date is - based on contributions the point in which you have to be found disabled.

When I received her file from the Feds - there was only medical information in it from 2011 forward.  That is when she applied for disability.  The Feds did not develop the file further even though it was clearly listed in the file that she had been seeing the treating psychiatrist since 2008.  The Feds sent off a letter of denial and said she did not meet the criteria in 2010.  It was not until she was deneid twice that Corrine contacted my office. I got a copy of her file and noted that there was no evidence in the file around her magic date of 2010.

Remember please that if you have a MQP or MAGIC DATE that is in the past - you need to ensure the medical evidence is provided from that time period to support your appeal - the MQP is noted on your denial letter. It is usually found under the CPP Disability rules section after point 2.  It will say something like; "in your case, under the late application provision, you would have to be found disabled by December 2010"  or whatever year it might read.

So back to Corrine.  I got the medical reports from her Psychiatrist - some 70 pages of it.  I submitted it to the Feds to review prior to the hearing - but they continued to maintain their denial so off we went to the hearing.  I was really worried how Corrine was going to manage the hearing - given the disability that she has - and due to the fact that she is prone to rage outbursts - but we were able to get through it with many breaks and lots of emotional breakdowns - thank you to the Panel and the Minister's Rep who were very fair and tolerant.

The whole reason for writing this blog is that Corrine had not seen any of the medical reports that had been submitted in her file - she had no idea of what was written about her.  The point I am trying to make is that there was a lot of information contained in the medical reports that were inaccurate - or on first blush without knowing the context of the conversation present a very different picture of the actual situation.

There were recommendations in the medical reports that were never shared with Corrine - as well there was information in the reports that said she was not following up with treatment.  Yes that is the case, Corrine had missed some appointments - because her family could not afford the gasoline to get to the appointments.  It is a reality folks, people cannot afford to go get the treatment they need because they have been denied disability - and they have no money - or are just squeeking by - this family had two boys, and they are starting to lose everything they have worked for - because they are on one income.

Under the new system, this information is going to be reviewed by a Social Security Tribunal Member - at least two thirds of whom have never sat on a CPP disability Review Tribunal and who knows what type of medical expertise they have - then the appellant is going to have try and explain the contents of the reports - and you are dealing with individuals who do not understand medical terminology or what medical reccomendations mean - these reports that I submitted included different scales and measures - particularly the Global Assessment of Functioning or GAF and if you do not know what these terms mean how are you going to be able to present your case?

Corrine told me she gave up on her appeal for Long-term Disability benefits because she did not have the capacity cognitively and mentally speaking to even "go there" and she would have given up on the CPP disability appeal if I was not there to help her through.  It just seems so unfair to me, that Canadians who have worked and who have paid in to this system are so disadvantaged by the system. 

Corrine I am proud of you - you got through the hearing.  It was really nice to get to know you and your husband.

A late night vent

by Allison Schmidt 18 March 2013 21:19

I had one of those days.  A day when all things seemed to go awry.  I had a couple of hearings go pear shape due to inclement weather, problems with couriered information, and sick appellants. 

I also found out that several people I know at the exisitng Tribunals did not get positions at the new CPP Social Security Tribunal.  I do not understand this - these people have had years of experience and knowledge working with CPP disability - yet for some reason they did not meet the "new" Social Security Tribunal knowledge and requirements. How can that be?

I am also frustrated with the delays - when this new system was announced - we were all assured that the would be a "seamless transition" to this new system.  I do not understand how that is going to happen. The delays and backlogs just seem to be getting longer and worse.  The Social Security Tribunal members have just been announced and as I said before only 10 members have previously sat on the old Review Tribunal panels - there are a few on board - and I mean a few - who have medical experience - so who is going to be making decisions about often complex medical issues to determine whether they are disabled - are they going to be able to read medical terminology?  Oh but they have medical expertise at the new Social Security Tribunal - yes medical experts who used to work for the CPP and HRSDC.  I just do not get the how there is any impartiality there?  It is not my intention to put any disrespect on to the doctors many of whom can be fair and balanced - but I am just saying this lack of impartiality is something I do worry about - and there are the "company" doctors - if you know what I mean.    

I find that lack of information about the new CPP Social Security Tribunal frustrating - people phone me all day asking what this new system is going to be like - and so far there has been no information about the processes - how an appeal is going to be managed, how it is going to be heard, we do not know where this tribunal is even located - well they say in Ottawa but who knows where.  It is March 20th tomorrow - that leaves 11 days.

Well stay turned and get help if you are in the application or appeal process - it is far to important an undertaking to go through without having knowledge of the playing field - that is what I try to do on this blog - and on this website - give as much information as I can.  Call or email me if you need a question answered.

 

Bouquets for the Tribunal Staff

by Allison Schmidt 17 March 2013 12:21

We are heading in to our final two weeks of Review Tribunal and Pension Appeals Board hearings.  The CPP Social Security Tribunal will become in to effect on April 1, 2013.  Change is not easy, and it is going to be a totally new system to get used to in terms of how I am going to present my client's cases.  Thankfully the legislative criteria has not changed of course, you will still have to meet the CPP disability criteria no matter what level of appeal you are at.

I am going to be away working for the next couple of weeks, I have a final eight Review Tribunal hearings to do.

I want to take this opportunity to send my appreciation to the staff of the Review Tribunal and Pension Appeals Board. I would also like to say thank you to the Judges of the PAB as well as the Review Tribunal Panel members. Some are moving on to new positions at the Social Security Tribunal, some are retiring, and some people did not get positions.  My thanks go to you for your support over the last 15 years - for the way that you have all professionally managed the appeal cases, as well as myself.  It has been a great pleasure getting to know you over the years and I wish you all the very best in your new endeavours.

I am feeling the worry of this change - any change, even a possible change for the better, is accompanied with challenges and drawbacks. Like I have said before - keep calm and carry on - and please keep in touch - you know where to find me.

One quick aside to this message - last night I was watching my regular TV shows that I record on my PVR during the week - and I counted at least five times that the Government of Canada advertised its work vision - or whatever economic vision they have for the future.  Instead of paying all this money on advertising how good they are making it for job seekers, and business - why don't they pay their own employees to keep up the levels of acceptable service Canadians need?  Just Saying.

Tags:

General

CPP Disability and Chronic Fatigue Syndrome

by Allison Schmidt 17 March 2013 12:06

When an appellant has a disability condition such as chronic pain, chronic fatigue, or depression, it is difficult to describe the subjective symptoms that one may experience. I am reposting this blog entry as I recently has a client - let's call her Julie, who I was diagnosed with Chronic Fatigue Syndrome after she had surgery for thyroid cancer ( I also would keep this in mind for people who have "chemo brain" after chemotherapy, or if you want to describe any type of chronic fatigue from say Fibromyalgia).

As I said, I recently had a case with a client who has Chronic Fatigue Syndrome.  This client, Julie, was in her late forties and had been unable to work due to her condition for approximately four years.  She had gone through a process of elimination with her physicians and specialists to see if there was an alternative illness causing her chronic fatigue which all came up negative. She had also been through numerous type of treatment both traditional and non - and had spent a large amount of money trying to regain her health.  Unfortunately this has not happened and she is not able to work at all.  Julie was a very accomplished woman - she was a single mother who raised two children, who was also well-educated with a good job and resume to her name.

When I was preparing for Julie's appeal I remembered a client I had in 2010 who had experienced similar symptoms.  He was referred to a Psychiatrist who specialized in Chronic Fatigue Syndrome and Fibromyalgia.

Saying one is simply fatigued does not really describe the condition - and this doctor quoted five variants of fatigue as identified in a recent scholarly article by Jason et al.  I did a google search and found a link to this article http://www.ncbi.nlm.nih.gov/pubmed/20185398?dopt=Abstract

When presenting a chronic fatigue case to an appeal's body I think it is helpful to discuss each of these five variants of fatigue.  These are some of the examples we used in Julie's case -

Post-exertional Fatigue  - the more that Julie did, the longer it takes for her to recover, she has to pace himself with her activities, if she does an activity she has to rest after this activity. I often hear clients say if they do something they will "pay" for it later. I think it is probably better to give examples - like how does one "pay" - increased fatigue, increased pain, would be a more appropriate way to describe this.

Brain Fog Fatigue - Julile described this type of fatigue as being in the "twilight zone" - she was unable to take in information or react to outside stimulus -she talked about how hard it was to her to follow a story line in a book, and how it was difficult to arrange her thoughts.  When she was experiencing this type of fatigue she was unable to focus on anything.

Flu-like Fatigue - Julie described this type of fatigue as that she "just feels ill"

Energy Fatigue - this was described by Julie as her feeling okay and then something happens to "pull the plug" and she feels his energy draining away.  If this happens, her need to rest is immediate.

Wired Fatigue - Julie described this aspect of fatigue as not really making sense to her in that when she seems to get really really tired, she gets "wired" by which she meant she was hyper - and that this was the hardest aspect of her fatigue to manage.

Julie was successful with her appeal and the Review Tribunal Panel considered the following factors - she was credible, she had a strong work history and attachment to the work force, that Julie's evidence at Review Tribunal gave them a clear idea as to the severity of her condition, that the Panel was impressed with Julie's diligence to  find the appropriate diagnosis and treatment (efforts at mitigation) and that she had pursued treatment options that were recommmended by all the physicians to whom she was referred to, that it was not reasonable for her to try alternative employment (Inclima - if evidence of work capacity) and that her symptoms are unpredictable, which would make regular attendance at a place of employment either difficult or impossible - there was no evidence of functional overlay (ie: malingering, secondary gain). 

I hope this helps clients who have any subjective symptoms to understand the importance of trying to quantify these symptoms to help the Panel gain a clear idea of the severity of your condition.  With the changeover to the CPP Social Security Tribunal coming in a few short weeks, it is going to be more important that you are able to describe your functional limitations and use examples to explain how these functional limitations prevent you from working.

 

 

Know your rights.

by Allison Schmidt 16 March 2013 17:24

I see this posted on websites - know your rights.

I do not think knowing your rights is sufficient.  Your need to know information - not only your rights.

You have the right to make an application for CPP disability - you have the right to appeal the decision if you do not agree with it.

But knowing your rights without knowing how an application for disability should be completed, or how an appeal should be presented - is not going to help you much.

And CPP disability know they have the right to deny you. 

 

 

Pull back the curtain please?

by Allison Schmidt 16 March 2013 17:11

It is my goal to help Canadians understand the CPP disability process - I want to pull back the curtain - and help level out the playing field. 

The information I post in these blogs, as well as the information that is included in the CPP application and appeals guide - are based on years of experience of working with Canadians applying for and or appealing the denial of their benefits.

In order to do this well, I employ individuals who also have had their own unique experiences with CPP disability.   I have a lot of information about my employees, who we are, and what we have done.  I pull back the curtain and do not hide behind 1800 numbers, or websites without any addresses or information on fees, or who it is that is actually offering their expertise.

I am happy to announce a new community partner working along side DCAC which I will share in the near future - which I believe will serve my clients well.  I also have some exciting new changes happening with the website - check back frequently.

I received some lovely congratulatory calls yesterday acknowledging my 15 years of service in this business.  It has been a blessing for me to do this work.

Tags:

General

A post to help you understand the CPP disability language.

by Allison Schmidt 16 March 2013 16:23

When clients call my office I ask them why they have been denied CPP disability benefits.  Believe me I get a wide range of answers - some I would not repeat, but mostly people do not know why they have been denied.  They say to me, I have a disability, I have paid in to CPP disability - so why don't I qualify?  I am writing this blog post because I think it might be helpful for people out there to understand the CPP disability language. 

As you know you have to meet three criteria in order to qualify for CPP disability benefits; your disability has to be severe, it has to be prolonged, and you have to have made sufficient contributions in a particular number of years. 

CPP Disability is assessed using an ADJUDICATION FRAMEWORK - this document (you can find it online just google) outlines the policies used to determine medical eligibility of applicants for the CPP Disability benefit.  It became effective in May, 2004.  Now in my opinion this document is not followed very carefully by CPP Disability adjudicators - but it is out there for people to review and can be helpful when putting together your submissions.

The DATE OF APPLICATION is the date that CPP disability application is received by the Feds.  This is important as when there is eligibility for retroactive payments the amount is calculated from this date.  DATE OF ONSET is the date a person is determined to be disabled for CPP disability purposes.  This date can be no more than 15 months prior to the receipt of the application.  Payment begins from the fourth month following this date.

In order to qualify you must be under age 65.  If you have applied for your early retirment at age 60 - there are another set of rules that you may fall under - I have blogged about this previously.

Your disability has to be SEVERE - which means you must have a mental or physical disability that regularly stops you from doing any type of work (full-time, part-time, or seasonal), not just the work you usually do.  The formal definition can be found under Section 42(2)(a) of the CPP legislation.  As well your disability has to be PROLONGED - which is long-continued and of indefinite duration.

There is an ALLOWABLE EARNINGS which is a client's total earnings from all work in a calendar year that is equal to or less than the Disability Basic Exemption.  A CPP disability beneficiary is allowed to earn around $5000 per year without a requirement to report earnings from employment and without being reassessed on earnings from employment alone.  (check with CPP to find out the exact amount).

BENEVOLENT EMPLOYER is someone who will vary the conditions of the job and modify their expectations of the employee, in keeping with his or her limitations.  The demands of the jobs may vary, the main difference being that the performance, output or product expected from the client are considerably less than the usual performace from other employees.  If you read some of my prior blog posts you will see clients that I have worked with who had benevolent employers.

CPP Disability are not supposed to rely on medical diagnoses alone but rather the assessment of  FUNCTIONAL LIMITATIONS.  A functional limitation is an impairment that leads to a less than normal performance for an individual.  The focus of CPP disability is only on those functional limitations that affect the capacity to work.  Question 22 of the CPP disability application is where you would list your functional limitations - think about these carefully - they are very important - on the website is an application guide, review for helpful tips. 

In applying for CPP disability, the applicant has the ONUS OF PROOF.  This means that the person or representative acting on behalf of the person, must provide the necessary documentation to satisfy the Feds that he or she meets the "severe" and "prolonged" criteria. 

The PRIME INDICATOR when determining eligibility for CPP Disability is the medical condition.  This determination is based on the nature of the medical condition, functional limitations, impact of treatment, and medical statements from your health practitioners. 

The CPP disability medical adjudicators must be REASONABLY SATISFIED that is - is it more likely than not this person's disability makes him/her incapable of regularly pursuing any substantially gainful occupation?  If the standard of reasonably satisfied is met -than the application or appeal should be granted. 

SOCIO-ECONOMIC CONDITIONS - the availability of certain types of jobs in a particular location, lack of child care or elder care, family responsibilities, or preferred working hours, factors that exist in society which are outside the context of an individual with a disability are not considered when determining severe and prolonged. 

SUBSTANTIALLY GAINFUL OCCUPATION is an occupation where the remuneration for the work performed reaches a certain benchmark for earnings that likely indicates whether a person is showing regular capacity for work. The SGO is the maximum monthly CPP retirement pension x 12 months. 

Most people are denied because CPP disability will argue that they have the capacity to perform some type of work suitable to your limitations - but remember these definitions  - and it will help you answer questions when the CPP adjudicators do their EARLY CLIENT CONTACT calls.  These are telephone calls made by CPP departmental representatives at the initial application and reconsideration stages.  No less than two attempts to contact the client are to be made for a rapport and decision call.  The rapport call is to inform the client of the process and the required documentation.  The decision call is to explain the reasons for the decision and the appeal rights.  I find that these calls can be very manipulative - if a client does not know the CPP language then often times the adjudicators can manipulate answers of clients which then go on to be used as a reason to deny.  I am not saying someone should fabricate the truth here - but you have to watch what you say.  The adjucators in my opinion (although very nice people) have a job to do - and in my experience - that is to deny benefits.

Understanding the CPP disability language is important - especially now with the CPP SOCIAL SECURITY TRIBUNAL looming in the future - do yourself a favour and get educated on the process and procedures.  Or contact our office and we can help advise you on the lay of the land.

 

CPP Disability denied - No Label?

by Allison Schmidt 15 March 2013 12:28

Okay some time ago I blogged about a gentleman Lyndon.  I have been working with Lyndon now for several months - he has unfortunately been denied twice now and has to go to the Review Tribunal - well Social Security Tribunal.

For the past 14 months, Lyndon has been trying to get a diagnosis.  He has had numerous consultations and objective testing, MRIs and blood work trying to find out what is causing the problems he is having - severe fatigue, issues with memory, forgetting recent events and conversations, sleeping all day, weight loss, muscle weakness, difficulty with walking and balance. When I talk to Lyndon you can hear the problems he is having with speaking even.  I have spoken at length with his wife, who says that his functioning is rapidly declining.

As I said he has been through numerous tests trying to figure out what is happening - they tried to check if he has Multiple Sclerosis, or an infectious process like Lyme's disease, but to date there has been no label.  The last medical report has shipped him off to Psychiatry to see if he has a mood disorder.  Sure Lyndon is frustrated and upset but he says he is not dperessed.  Lyndon's family doctor has sent in multiple reports to the Feds explaining how desperate his situation is becomming and how he is a "shadow" of the man he once was.

Lyndon has 25 years of contributions to Canada Pension Plan.  He is 49 years old - this guy is no slouch.

So why was Lyndon denied CPP disability benefits?  Let me quote the denial letter:

"According to your neurologist's report, no neurological diagnosis could be found for your symptoms at this time.  While it is acknowledged that you have limitations, there is not enough evidence to support that you have a condition that would prevent you from doing all types of work"

"The neurologist's report also indicates that your symptoms may be related to a mood disorder and consideration of a referral to a psychiatrist was recommended. It is reasonable to expect that, if you do have a mood disorder, your condition will improve with appropriate treatment"

Okay - but the neurologist's reports indicated all of the functional impairments that Lyndon was experiencing - and the neurologist said - that although there was no neurological explanation to explain his functional limitations he still has them.  As well, the neurologist says - "although he denies feelings of depression I am WONDERING if he MAY have a mood disorder.  I suggest you consider referring him to a pyschiatrist to assess this POSSIBILITY."

There are two things that worry me about Lyndon's case - firstly - he is off to the Social Security Tribunal - and he has me to case-manage his file.  But there is still no indication what the process will be in terms of hearing this appeal - no idea how long it is going to take - no idea about anything - so this man and his family still sit without funds  - with his wife struggling to make ends meet.  Lyndon had to stop work due to his disability in August 2011.  The other thing that worries me  - is the complete lack of consideration of his functional limtiations and how these prevent him from regularly pursuing a substantially gainful occupation.

Look the neurologist did not appear to think the man had a mood disorder - his family doctor had not picked up on a mood disorder - in my mind it is a last ditch effort and another avenue to rule out.

It is not the MEDICAL LABEL that determines disability  - it is the FUNCTIONAL LIMITATIONS - there are many individuals who have serious medical labels  - like Multiple Sclerosis, Rheumatoid Arthritis, Lupus, etc., who still have the capacity to work within their limitations.

So I believe the adjudication of Lyndon's file and denying him to the point that he now has to appear before the Social Security Tribunal is another way the Federal Government and CPP Disability program are not appropriately applying the rules of the game. 

 

15 years of DCAC Inc

by Allison Schmidt 13 March 2013 16:19

March 15th, 2013 marks my 15 year anniversary of owning and running the Disability Claims Advocacy Clinic.

As the Review Tribunal and Pension Appeals Board are closing - I asked if I was able to quantify by numbers the work that I have done and the results of my work for my clients.

Out of the 460 hearings that I have attended 325 have been allowed or settled prior to the hearing and 135 have been dismissed.

Out of the 135 that have gone on to the Pension Appeals Board, 104 appeals have been allowed or settled prior to the hearing.  This means my success rate is really quite good.

These results do not include all of the reconsiderations and initial applications I have also worked on.

Just wanted to toot my horn and let people know the benefit of working with the Disability Claims Advocacy Clinic and the success and experience we hold.  I would also ask that you keep this in mind when deciding who it is you want to case- manage your appeal.

A reason why I worry about the new CPP Social Security Tribunal

by Allison Schmidt 13 March 2013 15:58

Yesterday I did a Review Tribunal hearing for a lady - let's call her Sal.  Sal is in her late 50's and has been struggling with mental health issues since 2004.  Sal originally stopped working in 2004 and had previously applied for CPP Disability in 2006 been denied two times, initial and reconsideration - then reapplied in 2011 and had again been denied initial and reconsideration and finally made it through to get one of the last slots for a Review Tribunal hearing.

So keep this in mind, Sal had been denied four times by HRSDC.  Now perhaps you might think that obviously the Feds must have been right, after all they had denied her four times - and they must have had valid reasons to do so.  Yeah but of course it is never that simple.  The Feds were relying strongly on the fact that Sal had undergone an assessment requested by a third-party.  This often happens in files, and the third parties are usually agencies who are wanting to terminate a person's benefits - like worker's compensation or motor vehicle insurance - a couple that come to mind.  So one has to consider the source of this information and the motivation for obtaining it.  Often times it is very contradictory to the totality of the information which is what had happened in Sal's case.

Now sorry Sal if you are reading this blog - but after you read this report from the third party - which totally ripped Sal to pieces and made her out to be nothing but a malingerer, faker, and crazy, one would automatically assume that she would not qualify for benefits  - this report was very negative.  However, I have been around enough to know - that the reports never tell the entire story - and I had the opportunity to meet with Sal and quickly decided that the words on this report - did not describe Sal at all.

And you know, when I read the report over and over, I did find that it was not as negative than on first blush.  But with the new CPP Social Security Tribunal, the back log of cases, and the fact that many of the panel members are green (see prior post), it would be very simple to read this report and immediately believe the contents.

It was important that Sal was able to attend the hearing - we were able to present her case - and we were able to review the TOTALITY of the information and not the one negative report.  Had Sal not had the opportunity to have her case "heard" - I think the results would be very unfortunate.

The Feds seemed to be hung up on labels - and given so many years of medical history - there were a lot of labels in the file.  However, no matter how you sliced it - what ever label you wanted to give it - the fact of the matter was that I believed Sal met the legislative criteria - and let me keep you posted as to the results of the hearing.

I would also like to thank Sal's support people, Dianne and Mavis for also attending the hearing!  It was a pleasure meeting you all.

 

CPP Social Security Tribunal

by Allison Schmidt 13 March 2013 15:47

Well finally.  It's about time we have some information.  I note today that HRSDC has announced the CPP Social Security Chair and members.  Here is the link for the announcement. 

http://www.newswire.ca/en/story/1128779/government-of-canada-announces-murielle-brazeau-as-new-social-security-tribunal-chairperson

The only thing I would like to say about this announcement is that there are only 10 CPP Social Security Tribunal members who have had any experience with Canada Pension Plan disability benefits acting as prior Review Tribunal members, and that Ontario and Quebec are heavily represented with members, I find that unfortunate.  The reason I say this - in my opinion - it takes some time for Members to become what like to call "seasoned" in issues surrounding people with disabilities.  When new parties are elected to power, I cringe, as in the past that means my "old seasoned" panel members would be changed and "new green" panel members would be appointed - and it would take some time before these members became knowledgable about the issues.  However, I am keeping an open mind as I have been told the new members will have advisors working for them - however, the advisors previously worked for HRSDC!

Now let's keep waiting to find out how this appeal body is going to operate.  I hope they have some news for us by the time April 1, 2013 rolls around.

 

CPP Disability - what is "Any Occupation?"

by Allison Schmidt 01 March 2013 07:35

The fourth word in the CPP legislation considered under capacity to work is "Any".  "Any" refers to an occupation in which a person might reasonably be expected to be employed because of his or her skills, education and training.  It may also refer to the capacity to acquire the necessary skills, education or training in the short-term whether on the job or otherwise given the person's limitations and restrictions.

The determination of "any" occupations also considers the personal characteristics of the applicant - age, education, and experience.

On most CPP Disability denial letters, the Feds state, that while they acknowledge you have limitations, you should be able to do some kind of work within your limitations.  What they are arguing here, is that you still have residual capacity to do some type of work, therefore, you are not disabled from "any" occupation.  An example I just had, was Blanche.  Blanche is 60, she is a very sophisticated lady who worked the majority of her career in high-end retail, in a posh boutique. Blanche had been trying to work and manage severe migraines for the last 10 years until the pain overtook her life, and she was no longer able to work The Feds had argued that she had the residual capacity to work - albiet in a low-stress environment (good luck finding that). So the question for the Panel, was did Blanche have the capacity or "any" occupation given her age, education, and experience, also considering her functional limitations due to her disability.

In Blanche's appeal, my submission was, that she was unable to do any kind of retail work and that had been her life-long career.  Would it be reasonable for Blanche to consider retraining in to another position? This is unlikely - she has chronic severe migraines, despite trying all types of treatment she could not manage them, and retraining would not be something that would happen in the short term.  Her capacity to do her household activities was greatly effected and limited by pain.  She was unable to focus or concentrate due to pain.  Retraining is not really an option given her age either.

Retraining must be considered as a means to support an individual's work capacity for those in their most active years of working career, or for older workers where there is a demonstrated suitability.  In Blanche's case there was no suitability. 

Sometimes, people call me and say that they could not do their own work anymore.  They say that they were making $20 an hour at their own work, and what do the Feds expect them to do? Work at a fast food place for minimum wage - yes I am sorry folks but that is indeed what they expect you to do - if you have the capacity to do so with your functional limitations.  If you have the capacity to do some type of work - then you will be expected to have "tested that capacity".  An example is, say you're a trades person and you have worked in the trade for most of your working years.  You started in your late teens, and now by your early 50s your body is pretty banged up with arthritis and you cannot do the physical trade anymore.  The argument will then become, are you capable of retraining and acquiring skills? And are you capable of doing some other type of work? For example, working in a hardware store, or working in an automotive store, or supervising a work site?  But you have to remember that this work has to be "substantially gainful" which is another word in the definition that I will tackle in another blog post.

CPP Social Security Tribunal

by Allison Schmidt 01 March 2013 07:28

It is March 1st, 2013.  We have a total of 30 days before the new CPP Social Security Tribunal takes effect.  Despite numerous calls and attempts at getting information about this new tribunal and the processes, there is still no word on what to expect.  As far as I know, the Social Security Tribunal members have not been appointed, therefore they have not been trained.  They government is still decide on who it will be choosing to staff the Social Security Tribunal.  Again, how this is all going to be a seamless transition, and have no effect on appellants waiting for hearings is a tough sell by the Feds.  I think people waiting for appeals are going to be waiting a lot longer.  I cannot predict what April 1, 2013 is going to look like - but I know it's no April fool's joke that we are in for a difficult time.  It is like the great wall of China surrounding this new tribunal.

 

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