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Notice of Readiness - why it's flawed

by Allison Schmidt 27 March 2014 09:41

A client is appearing by video conference before the new Social Security Tribunal next week.

He has been waiting for an opportunity to present the case since 2012 and has finally got a meeting.

He has been dealing with many various symptoms such as weakness, numbness, pain, issues with vision, balance, faigue, etc. for years.  He has had numerous diagnoses and labels assigned to these symptoms.

The beginning of March he had an health incident which led to him receiving an MRI report.  The MRI results came in last week and the MRI results show he has lesions like those found with MS.

Now, this is significant objective information and is an integral piece of the puzzle almost an answer to the symptoms he has been experiencing for years.

What's the problem?

Because the hearing has been scheduled I contact the Social Security Tribunal to find out how I can submit this important piece of medical information.  This is the response that I have received:


You should submit the new information to use immediately (fax or email) being sure to include an explanation as to why you feel it should be accepted.  It will be up to the Member to decide if the new information is accepted.

Okay, I strongly feel that an appellant should be able to submit all the information to help support their appeal - this is his onus - his responsibility - to establish that he meets the criteria for disability - yet a Tribunal Member can decide if additional information can be accepted?  I have said all along that disability is fluid, things change quite often, new answers come to the fore front, new tests reveal new diagnoses, disability gets worse, new doctors come on board, mental health declines, new drugs are tried, there are so many things that can happen.

Yet this Social Security Tribunal feels that I have to ask a Member if they will accept information to help support an appellant's case?  I just do not think that is right. I do not feel that this impartial, arms-length appeal body should be able to decide whether or not pertinent information should be accepted. How is that giving an appellant an opportunity to fully present their appeal?  It worries me because this is a one kick at the can appeal  and if you are prevented by some Notice of Readiness document then how can that person prepare for the ups and downs of the Canadian medical system and the unpredictability of disability?

Okay I will let you know how this all transpires but it is certainly food for thought to keep in mind as you prepare for your appeal.

 

Canada Pension Plan Disability Benefits denials continue to discourage

by Allison Schmidt 24 March 2014 14:42

I was not going to blog today. 

However, on Friday I got another ridiculous denial from CPP disability - when I say ridiculous what I mean is - how can any body in their right mind determine based on the medical information that has been filed that they do not meet the criteria of disability? -type of ridiculous.

This client has been hoping, that given the medical support that was submitted, that the CPP disability would agree that she meets the criteria and an appeal to the Social Security Tribunal would not be necessary.  All weekend I have asked myself "what is wrong with these people?" because I just cannot grasp how an adjudicator could write such utter rubbish and continue to deny the appeal.  And what I mean by utter rubbish - sentences taken out of context - the totality of the information not included, reliance on dated medical reports, using outdated Pension Appeals Board cases to support their condition, it goes on and on.  I certainly would not do anything like that if I was writing a submission to defend my position but then I had a moment - these CPP adjudicators do not have to defend their decisions and submissions. They do not have to stand there and explain how they came to their determination - everything is on paper - and like an internet bully who hides behind the anonymity of their posts - so do these adjudicators.  It is almost like it is just another file off their desk. In reality, clients are only numbers and their personal situations I assume are irrelevent and inconsequential to the adjudicators who write these submissions and take their pay cheques.

I have had lots of calls today with people who are discouraged and I understand that they must be - they are broke, sick, disabled, unable to pay their bills, their lives as they knew it cease to exist and they are then facing long and unreasonable waits to get an appeal.

I had always expected the high denial rates from CPP disability - I should know better that to wonder what is going on - but I had hope that if a person made it through dealing with the government adjudicators - they would at least have a chance to have a fair hearing at the Review Tribunal - and approximately 50 percent of the CPP denial decisions were overturned.

I should not be surprised that there would be a reasonable and fair adjudication by CPP disability now that there is a new appeal system.  I just had faith that the tribunal members would make the right decision.  Now it is taking so long to get an appeal - all of these people are really suffering and becomming discouraged which is only making them sicker.

I will never understand how the CPP adjudicators can deny these cases especially when so much time and effort has gone in to presenting the best submission with all the information as well as relying on their own adjudication guidelines and previous decisions and legislative tenants. They still deny - even when all the facts point to the opposite.  These are human beings - not just a file to get off your desk. 

 

Rest In Peace Mr. S.

by Allison Schmidt 21 March 2014 13:13

So to top off my week I got word today that Mr. S. client who has been waiting for an Social Security Tribunal passes away as a result of his disability on March 16th, 2014.  Mr. S. applied for CPP disability in May 2012.  He had a complicated case I am not going to deny this - but it was one of those cases where paper documents do not show the totality of this man's disability - nor his story - which was complex and frankly very sad, due to mental illness, addiction, and a host of other problems.  CPP also denied him because he worked after his MQP - but as I have said before, the Feds deny you because they say you have not tried to work in order to test your capacity - and when you do try - they say you are not disabled because you worked.

Anyway, rest in peace Mr. S. It was a pleasure knowing you and you have a wonderful daughter and family who will continue to pursue your fight.

Notice of Readiness for Legacy Cases

by Allison Schmidt 21 March 2014 08:50

I said that I would advise what I know about the Notice of Readiness process for thos people who are legacy cases at the Social Security Tribunal.  A legacy case - is one that was previously lodged with the Office of the Commissioner of Review Tribunals that was not heard prior to the changeover to the Social Security Tribunal.

I had requested extensions on some of these cases because I am having trouble getting some of the medical information from doctors - as well some clients have medical appointments and tests that are occuring after the March 31 2014 deadline.

So here are the reasons for granting the request for extension from the Vice-chairperson of the Social Security Tribunal:

 

"This appeal was deemed filed with the Social Security Tribunal on April 1, 2013 but the Appellant was not notified of the 365 day period until the acknowledgment letter from the Tribunal was sent on May 21, 2013.  The Vice-chairperson grants an extension of time to file additional documents or submissions to a date 365 days after the date of the SST acknowledgment letter."

 

So I would say that for all of the people who received letters fromthe SST on May 21, 2013 (the date the SST sent letters to those cases from the Review Tribunal) that they have until May 20th, 2014 to submit documents.

 

My opinion is this whole Notice of Readiness issue is ill thought anyway given all of the reasons I have submitted in earlier blogs.  My question is though - if there are going to be significant delays and it takes months to get an appeal - what about all the current medical that could be submitted prior to the date of hearing.  If it is going to take a year for example to get a hearing and the only way you can get a hearing is to sign the Notice of Readiness then that is a year of medical information that is missing from your file - and that is old information that the Tribunal member is relying on.  I would tell a client going for an appeal to make sure they had all the current medical to submit (you know their onus to establish disability).  If you are waiting for 12 months or more to get a hearing then there is no opportunity to provide recent medical to support your case.

I do not know if this is the "new approach" that I spoke of in my last blog- but even if it is - how is this going to reduce the large volume of back logged appeals that is only going to continue to grow in my opinion.

How about this for a "new approach"?  CPP disability actually approve the claims they should rightly be approving. That would do wonders to alleviating the back log - has any one from the government thought about that?

 

Tags:

Social Security Tribunal Delays.

by Allison Schmidt 20 March 2014 16:07

This is the email that I sent to the Chair of the Social Security Tribunal:

 

Dear Madam Chair.

 

It is now March 10th and I have three weeks until the deadline for the legacy cases.

I have submitted documents back in September and October going forward complete with signed Notice of Readiness and yet I have not received any acknowledgement or Minister's Explanation on what the case will be for the other side, leaving me little time to fix any deficiencies or collect any additional documentation before the deadline expires.

 

I have clients who are literally losing their homes, claiming bankruptcy and who are phoning me weekly to find out the status of their appeal.  I cannot tell them anything - and when I reach out to the staff I am told the file is being processed. What does this mean?

 

May I please kindly ask, what the strategy is for hearing all of these legacy cases?  At least then I can tell my clients and let people know what we can all expect after the expiry of the March 31 deadline.  Is there some sort of plan to handle all of these cases?  What happens when I have had no documents from the department?  Are they even receiving the cases so that they can respond to all of the work and additional documents that have been submitted on the clients behalf?

 

We have all been patient while this transition year has gone by but I think it is time that we all get some clear answers and direction as to what to expect next.  If I can tell the clients that their appeals will be heard in three months or six months - at least i can tell them something.

 

I do not feel that this tribunal is meeting its mandate.  Especially when getting a document or an idea of when the appeal is going to be heard is not at all forthcoming.

 

Please can you advise how this overwhelming back log of appeals is going to be managed? 

 

Thank you.

 

Mrs. Allison Schmidt

DCAC Inc.

 

This is the response from the Social Security Tribunal:

 

 

Dear Ms. Schmidt,

 

Your email of March 10th addressed to Murielle Brazeau regarding the Income Security Section process has been forwarded to me for response.

 

As you know, the majority of appeals initially filed with the OCRT will be deemed ready to proceed as of April 1, 2014.  In preparation for this, the Social Security Tribunal has been working on an approach to deal with this large inventory so that it may continue to process cases transferred from the OCRT fairly and as efficiently as possible.

 

On or around April 1, 2014 the Tribunal will send a letter to all Appellants whose appeals were transferred from the OCRT, as well as to their representatives, to inform them about this new approach that will be implemented to administer the appeals.  More detailed information about this process will also be available on our website.

 

We understand how difficult it is for representatives to advise their clients in this transition period and as such we have decided to hold a teleconference with yourself and other representatives where we will present the process and answer any questions.

 

Please be assured that the Tribunal is taking this very seriously and we are committed to processing this important caseload as efficiently and effectively as possible. 

 

We will be in touch with you shortly.

 

What is the new approach?

I have asked for a response and my stomach is turning because I cannot fathom what the possible "new approach" the Social Security Tribunal has in mind to manage the volume of cases and delays.  Surely after the last year of transtion they would have recognized what was coming down the pipes and now they only realize that they need a new approach?  Oh boy. Before this system was put in place by the government, and all of these people were left to languish in a new appeal system left to wait and wait and go bankrupt - now 10 days before these people will finally be able to have their cases heard - they say there will be a "new approach"

Discouraged, upset, frustrated, and dismayed for Canadians who wound up in this system.  I hope the new approach will help you all out and so now we all wait until we get another letter advising us what is next in this process.

 

 

 

 

PLEASE GET HELP IF YOU ARE DENIED CPP DISABILITY BENEFITS.

 

 

Tags:

Riding on the CPP Disability Denial train.

by Allison Schmidt 20 March 2014 14:57

I am so very disgusted. 

This week I finally have got some submissions from CPP disability arguing why the client still does not meet the legislative provisions of CPP disability. 

These clients are going before the Social Security Tribunal they have come over from the old Review Tribunal and have had to have their documents prepared by the March 31 deadline (which seems to have changed but I will address that later).

So this client - let's call her Shelley - I wonder if I have written about her before, but she is a young woman, a woman who had a heart attack in 2004 in which she coded.  She survived but since that incident is no longer the lady she once was.  Here are her functional limitations taken directly from her CPP disability application.

-          Sitting/standing – one to two hours of sitting at a desk her legs and ankles are all cramped and numb.  After half hour swelling, numbness, pain and dizziness occurs and blood pressure drops.

-          Hearing – comprehension is poor.

-          Walking – at Cardis Rehab she could walk for 10 minutes before her leg cramped, went numb and shortness of breath was hard to control.

-          Speaking – talking is fine but processing what she wants to say is difficult.  She has trouble finding the right words.

-          Lifting/carrying – no more than 5 pounds for a very short distance.

-          Remembering – short term memory is poor; long term memory is fuzzy at times.

-          Concentrating – after five minutes she fights sleep and can’t recall what task she is doing.

-          Bending – at times gets dizzy when she bends down.

-          Sleeping – she wakes at times because she has stopped breathing.  She has to cough her way back to breathing.  Since her heart attacks the first and second one, she wakes up at 3am and is not able to go back to sleep.  She explains it doesn’t matter what time she goes to sleep.  If she happens to get a full night sleep, she still has a hard time staying awake during the day.

-          Breathing – she has asthma.  When she does too much or walks too fast she is short of breath and is very exhausted.

-          Driving – is limited to less than an hour due to exhaustion, especially in the winter.

-          Household maintenance – after 15 minutes of shopping she becomes very weak and tired and needs to rest.  Cleaning and cooking she can do for about 10 to 15 minutes then requires rest for 15 to 30 minutes.

-          She does not have access to public transportation where she lives.


Her family doctor had mentioned in his medical report that he had noticed that she appeared to have cognitive deficits he noted that after her heart attack that she "struggled to do the work and suffered severe chest pains primarily caused by the stress she experienced to meet the deadlines.  Her short term memory was not fucntioning and routine tasks and procedures had become almost impossible."


This mid forty year old woman was unable to complete her own CPP application and her mother writes that due to her problems with comprehension and expressing herself that she had to help her complete the application.

T    The doctor notes that she had two major heart attacks in 2004 and 2011 - and that her condition was "permanent with no hope of improvement" and he goes on to say that "she is unable to perform any kind of work as she cannot walk great distances, nor stand for any prolonged period of time."

She tried to go back to work after her first heart attack from March 15 - March 30, 2005 and she was let go because she was unable to do the work.  She tried again in May 2006 to May 2007 but she was laid off because she was falling asleep at her desk. She tried again in October 2008 to May 2009 and was fired because she could not get the work done because of her "bad memory" and because she could not recall procedures under stress.  Her final attempt was in February 2012 when she tried to be self-employed with two clients but she could not concentrate or recall information and was only able to manage two pay-roll cycles.

Because Shelley had noted all of these  issues she was experiencing in terms of her memory and concentration I thought this need to be quantified objectively so I arranged for her to have a neuropsychological assessment with a trained professional.  It was a day long assessment in which Shelley and her family were interviewed.  The final results of this assessment said that there was " A pattern of CLEAR AND SIGNIFICANT objective deficits in cognitive function.  Deficits were particularly noted in the areas of attention, information processing speed and memory.  The overall pattern of the findings are consistent with acquired impariments in cognitive functioning that are out of keeping with Shelley's age and estimated pre-morbid level of intellectual functioning.  The deficits in cognitive functioning that were found ARE CONSISTENT with acquired cerebral dysfunction and are in-line with those seen in individuals with significant coronary disease and cardiac arrest...The findins are consistent with the report of every day functioning and are also of SUFFICIENT SEVERITY to translate in to significant performance-related deficits and it is my opinion that as a result, Shelley is unable to function in a competitive work environment"


After this report was received her family was relieved in a way to find out that the problems Shelley had been having since 2004 could finally be explained.  An 18 page submission was prepared providing details using the documents on file to support her appeal. 

These are the reasons I have received from the CPP Disability to deny her appeal:

Shelley continues to be overweight and to smoke and that she bears the responsibility to engage in activities to improve her medical condition.

That her medication is causing her memory and fatigue problems.

That the neuropsychological assessment happened after the MQP therefore it could not be considered.

That Shelley is non-compliant because she has not lost weight

She could do sedentary work.

That even though the medical report said that she "coded" after her heart attack there was no other documentation suggesting this occured and that she did not suffer any type of cognitive problem as a result of her CARDIAC ARREST

That she was employed gainfully after her 2004 cardiac arrest.

 

Okay the overweight argument - if you read the file you will note that she cannot exercise because she is short of breath of exertion as well she is unable to walk for longer than 10 minutes and despite her best efforts has not been able to lose weight - really CPP?  Smoking  yeah not a good thing but not a reason to deny a claim.

The SEVERE DEFICITS are noted by a well respected journal published trained expert to be as a result of her hypoxic brain injuiry due to cardiac arrest - she lost oxygen to her brain people - she coded - she had cardiac arrest - what the CPP people reading?  How arrogant to say that the memory deficits are a result of medication  - when a trained professional clearly states that is not the case - and further the argument that the neuropsych assessment happened after the MQP so it is not valid - the genesis of the disability was in 2004 she has not been the same since - she has a son who is going without - she has parents who have to help her financially - she is on welfare - she is unable to manage her home. 

She is non -compliant they say because she has not lost weight. 

She worked they say after her cardiac arrest in 2004 - I have explained what happened with her work attempts - she should be lauded for trying to attempt to work given the significance of her disability - can you imagine what it would be like to not be able to provide for your son one day and then not be able to despite how hard you try?

I am sorry I do not usually get so wound up over the CPP denials but this case has really upset me.  I cannot believe the blantant disregard for the information on file that has been evidenced by the submission of the CPP medical adjudicator.  To continue to deny this woman depsite all of the information to the contrary it is obvious to me - that this government could give a rat's ass about paying people the benefit they are entitled to after paying in to this system.  I have also mentioned how many of the submissions that I have put in to the Social Security Tribunal for clients that are legacy cases.  Despite solid medical evidence and strong support for their cases, CPP continue to submit the same denial submissions, wiith the same denial reasons, riding the same denial train.  When you look at the CPP Adjudication Framework - I believe that it is fair for me to say - that CPP Disability are deliberately flouting the policy and procedures and are only instructed to deny these cases - how else could you explain the denial that I have just described?

S

 

 

 

 

 

An

 

H

 


 


 

Social Security Tribunal - When will you get an appeal?

by Allison Schmidt 18 March 2014 09:28

I have had several emails this week asking me what will happen after the 365 days expire on March 31, 2014 for the legacy appeal cases that came over to the new Social Security Tribunal from the old Review Tribunal.

Many people have asked me when they can expect that their appeals will be heard.

On March 10, 2014 I emailed the Chair of the Social Security Tribunal to ask what the strategy would be in terms of what the Social Security Tribunal will be in terms of managing this large volume of appeals - to date I have not got a response but as soon as I do I will post this information on the blog.

What I do know is that I have sent in many appeals with Notice of Readiness signed and I have not got any response from the Minister in terms of their position.  The expiry is coming up so am I to assume that they are not going to add their position?

I also know that I have sent in appeals in September 2013 and I have not had any indication when an appeal will be held.

So the short answer to when you will get an appeal - well who knows and I am hoping once I hear back from Madam Chair at the Social Security Tribunal that we will be able to have some answers.

If you are not prepared and have not submitted all of your appeal information you will need to request an Extension of time to submit the Notice of Readiness to the Social Security Tribunal.  You will need to provide reasons why you are requesting an extension.  I have been able to request extensions on files in which I have asked for additional medical and I have yet received this from the doctor.  Frankly I  think this whole Notice of Readiness process is flawed because disability is fluid and Appellants who have forward MQPS should be able to continue to submit information, also I do not feel that anyone should be prevented from providing information which will help support their appeal. 

I have noticed that the Minister's Explanation of Decision are pretty much identical in most cases - except for the name change - but basically they argue the same points everytime - you would think that they would be more creative with denials - but perhaps they have no other way but to follow the denial script.  When I have some time after this deadline expires, I will write about the Explanation and how to address these points.

Any questions please call or email, and as soon as I hear what the strategy is for the SST hearing these appeals I will advise.

 

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