Experience Counts - Choose wisely

I am now entering my 17th year of case-management work for individuals who are applying for or have been denied Canada Pension Plan disability benefits.

It was recently suggested that people like myself, were "taking advantage" of people with disabilities because we charge a fee for the services that we provide and that most people could do this work for themselves for free.

Some agencies have suggested that they know the proper terminology that needs to be used in order to get results, or that they were experienced in directing doctors on what words to use in medical reports in order to get results.  As well, that the CPP disability adjudicators need to see the "proper" words in order to be approved.

There are also some agencies who feel they have the capacity to do this work with little or no experience.

It takes a very long while of working within this system to know how to manage applications and appeals.  Before you decide or who it is you are going to get to help you with this process, please ensure that you have done your homework and determined that the service provider you engage has the necessary experience to help you.  You should ask any agency or service provider what there experience is in the system, how many appeals and applications they have completed, and how many appeals they have attended and what their success rate is.  You should ask them how they plan to approach the management of your file, and how they are going to engage your medical health practitioners.  You should ask them if they have any experience dealing with your medical condition, and if they have, how have they managed this appeal.  Ask them how many years they have been working in this system and what can they offer to help you through the process.

The government and constituency offices who suggest that service providers are taking advantage of people with disabilities well that could not be further from the truth and perhaps those haters should remember that it is their own political party that are taking advantage by not approving the applications and appeals and continuing to maintain a 60% denial rate.  If the government adjudicated these applications appropriately, why would a service to help be needed?   Best to not throw stones.

This process is very complex and it is best not to try and manage this alone.  Saying that people could do this alone - well it is true - but it is not smart. Especially now with the new appeal system and the significant delays I would caution most people to get help with this process.

I would also like to say that having doctors use the "proper terminology' is not the greatest way to manage a medical report - if a letter states that a client's disability is "severe and prolonged" I feel that this provides little help to the overall application or appeal.

Also the information on this website and posted on this blog is copyrighted.  If you would like to use this information in your literature or websites please contact my office.

I would like to wish all the followers of this blog a Merry Christmas.  It has been a challenging year but it is my hope that 2015 brings some welcome changes to the CPP disability landscape.  Take care. Allison

 

Ask for an inperson hearing at the Social Security Tribunal

http://www.winnipegfreepress.com/canada/fewer-in-person-hearings-being-heard-by-social-security-tribunal--286276871.html

It has been statistically shown that appellants are more successful in their appeals if they have an in-person hearing rather than a hearing held over the phone or by video-conference.

I think what is missing from this article, is also the level of experience of the Tribunal Member.  I know this spokesperson from the SST continues to espouse how trained and proficient the tribunal members are, but in my experience any new tribunal members lack what I call "seasoning" which is in my opinion, a detriment to the appeal process.  I hope that the new hires to the tribunal will include many more of these "seasoned" and experience members who do not require "mentorship".

As well, it is noted by Richard Beaulne spokesman for the SST - that the type to hearing held had NO BEARING on the final decision.  I can tell you right now Sir, that is a load of rubbish.  Your statistics do not support your statement. 

You say that "Members make their decisions following a complete analysis of the evidence, submissions and applicable legsilative provisions presented by the parties."  HOW CAN THE MEMBERS MAKE A COMPLETE ANALYSIS OF THE EVIDENCE WITHOUT HEARING FROM THE APPELLANT?  ARE YOU TELLING ME THAT A TELEPHONE CALL IS AN APPROPRIATE WAY TO DO THIS? The statistics your office provides seems to illustrate that there is a significantly high number of denials when a Member holds a hearing by telephone compared to the in-person hearing.  Why is that?

If you had bothered to review the previous Pension Appeals Board cases that discuss the importance of being able to receive and consider the information provided by an appellant in person - you would soon realize how ridiculous your statements are.

So listen up people......  If you are told that your hearing is to be via teleconference - then you say NO you want to have an in-person hearing - so the totality of the information concerning your appeal can be assessed by a Tribunal Member. 

If this request is denied, please contact my office and I will pass your information on to some legal professionals who are developing a challenge concerning your right to chose the type of hearing you are given and the denial of the principals of natural justice. 

I will also tell you that most of these disability cases are complex - and the contents of a CPP disability file - NEVER - contains the totality of the information.  The CPP decision makers are required to consider the TOTALITY of the information - and how do you get that without hearing from an appellant.  I am just reading a letter that was sent to CPP Disability and this is what they write "I don't understand how somebody in your office who I have never seen, spoken too or been treated by apparently has this supernatural ability to know what I am or am not capable of doing based entirely on a couple of forms consisting of questions and answers and notes.  This person has the power over my life to decide on whether I should be or shouldn't be receiving a benefit for which I have paid into all of working life."  Note that this client is now stuck in the Social Security Tribunal line up due to the denial of his disability benefits by Canada Pension Plan.

Speaking to this point, it is noted in this newspaper article that the Feds pledged to "improve and rigourously monitor departmental processes, including reconsideration to minimize the number of cases proceeding to appeal."  YEAH RIGHT.  This week has been at least five denials where the Feds did not even wait for the client to submit the additional information before they chose to deny the claim.  One denial occurred a mere 37 days after the client submitted a reconsideration - and how is that not rubber stamping?  This was despite the client advising the CPP that they had additional information to submit.

On the last statistics received by my office, it is noted that the Ontario region had a 62% denial rate.  And according to the information in previous newspaper articles this is one of the highest denial rates in the world.

MP Jinny Sims says that government cannot be "insensitive"  I would like to say that it is not insensitivity but rather abuse of people with disabilities who have paid in to the CPP for years and who continue to deny their applications without following their own adjudication guidelines.

 

 

 

 

 

 

Backlogged by Design

http://www.ctvnews.ca/politics/harper-pco-approved-15-month-hiring-process-for-social-security-tribunal-1.2152053

 

Seriously - who puts a 15 month hiring process in place for an appeal tribunal that is going to open in 6 months?  I wonder if any thought was given to the numerous Canadian people whose lives are in turmoil while they wait for an appeal by the PMO as well as the "boys in short pants" boneheads who thought that this appeal system would be more efficient, fair, and transparent.  '

Minister Kenney blames the rigourous hiring process for the delays - yet he knew that there was a huge back log coming down the pipes and did not start hiring until six months before the tribunal opened knowing that the rigourous hiring process would take 15 months.  It just stinks. 

I feel extremely bad for the Chairperson and the staff at the SST who were some how supposed to manage this screw up on behalf of the bureaucrats.  Must have been real cushy gig for the rigourously-appointed newly-hired tribunal members getting their six figure salary while Canadians with disbailities suffered?   

 

 

 

 

 

Letter to the Editor

The backlog of disability claims with the Social Security Tribunal is not caused by the SST; the tribunal only examines appeals which have been referred to it after those applications for a disability pension have been refused by two medical adjudicators working for Employment and Social Development Canada.

The disability pension system is part of the Canada Pension Plan; all working Canadians pay into it, and anyone who becomes disabled under the legal definition qualifies for a pension until age 65.

The applicant sends in completed forms to ESDC. His or her doctor likewise submits forms. After several weeks a decision is made by a medical adjudicator. If the MA turns down the request, the applicant may apply for “reconsideration,” wherein a second adjudicator takes a look at more forms. It is only after the second MA denies the application that one may appeal to the SST. The tribunal is backlogged due to the extremely high refusal rate by the adjudicators at ESDC.

Over 60 per cent of applicants are turned down right away. Why such a high rate? How would you feel if you found out your private insurance company refused most claims? Perhaps a few applicants don’t meet the criteria, but it surely cannot be 60 per cent. Those people do, after all, have the approbation of their personal doctor.

A large number of the applicants are later accepted at reconsideration. Furthermore, most appellants with the SST are successful. So why were they not accepted upon initial application with ESDC?

Since the entire procedure is difficult, frustrating and time-consuming, the process of fighting for a disability pension is not for the faint-of-heart.

After many years of bureaucratic combat with the soul-less vortex of federal government, I can seriously state that the medical adjudicators with Employment and Social Development Canada are uniformly failing in their responsibilities. They lack adequate medical expertise. They fail to apply their own Adjudication Framework guidelines. They do not follow the laws of the Canada Pension Plan Act, nor the precedents set by the Federal Court with regard to that Act. And the Social Security Tribunal is left trying to cope with the result of the profound failure of ESDC’s medical adjudicators to do their jobs properly.

Meanwhile, sick, suffering and dying Canadians are dealt a sentence of deep poverty because the program into which they have paid during their entire lives is ignoring them.

Craig Schindler

Cardston

 

 

What a disgrace.

http://www.winnipegfreepress.com/canada/social-security-officials-were-idle-in-tribunals-early-months-says-official-284908491.html

 

I have been calling the appalling treatment dished out to Canadians with disabilities by this government a national disgrace for months now - and all of these news articles only illustrate why.

 

I personally know how this is affecting people who have worked hard only to be the recipients of this utter calamity that they Feds have called the Social Security Tribunal.

 

It is quite clear from the people who have spoken out, that there may indeed be a strong motive for denying Canadians the benefits they may be entitled to - because they have PAID in to this system for their working lives.  And but for a stroke of miserable misfortune, they find themselves begging - while the fat cats espouse how wonderful they are for Canada. 

 

But for the grace go I........

 

I hope that all of the 11,000 who are waiting - and it is likely more now - given the people phoning and the stupid denials I received this week (one said the lady should have better posture and then she could work) there is no doubt that this backlog will continue to grow.  This is just as much a Canada Pension Disability problem as it is a Social Security Tribunal problem.  Like Mr. Prince said - if they fix the front end - maybe the back end would do better.  And Minister Kenney is also responsible for that as well.  As Minister Kenney and his bureaucrats sit there and say that they now have a hundred members to hear 11,000 appeals - how is that going to help?  That is at this rate 1100 appeals per person - and further how are you going to staff the government so that the Ministry can look at these existing files to make sure that they have the opportunity to make submissions on their position - perhaps reversing their ridiculous decisions to deny? I just do not understand.

 

This week I have been inundated with phone calls and email messages, I have received offers of help from so many people, I have been offered help with legal support, volunteers have offered to help, old panel members and Federal Court judges have sat with me,  and Mr. Rabot.  Thank you Sir, I tip my hat.  To Ms. Goodman and the people who spoke out in the papers thank you. 

 

Allison

 

 

 

 

Of course the backlogs could have been avoided

You know I really think that the Minister needs to get his facts straight.  

To the people who were in the lastest newspaper article published today, I thank you for speaking out.  

I wonder who will come forward tomorrow?  There are those out there who believe that this delay was by design so that the government could balance the budget.  Think of the fact that 11,000 people (the backlog grows daily) are waiting for appeals to be heard - does anyone have any idea how much money the Feds are saving by not paying these people their benefits? Not to mention the benefit payable to their children? And the back pay that is owed to them?  My guess is hundreds of millions. 

If there is interest I believe a lawyer should look at coming after the government for punitive damages for those people who have lost so much while these dicks have done this using money that people have contributed out of their working incomes.  If there is any interest please contact me and I will help any way that I can.  

It is an absolute shame. 

I would also like to say that this is not the staff at the Social Security Tribunal who have caused this problem - for the most part they have worked very hard to manage what has been dealt to them and my hat goes off to what they have done to try and get this all going smoothly - to the new Commissioner of the Social Security Tribunal - hang in there. 

 

CPP Disability amoung the highest rejection rates in World

http://www.huffingtonpost.ca/2014/12/03/cpp-disability-benefits-denied_n_6257988.html

 

If there was not such a high denial rate by Canada Pension Plan disability then there may not be 11,000 appeals waiting to be heard.  When I opened my mail yesterday, I received two letters from CPP disability Chatham office who had denied individual's requests for reconsideration, despite letters on file from myself and client noting that there was additional information we were waiting to receive from the client's medical practitioners and asking for some time to submit this information.  Further, there was notice on file asking CPP adjudicator to call before making a decision. 

It says in the letter:

"A letter was sent from Service Canada to your physician on March 25, 2014 that acknowledged receipt of a medical report, however, the physician stated there was supporting evidence; however there was no documentation attached.  He has not sent in further information and in the letter from your representative on August 25th, they state that additional information is forthcoming.  To date, no further information has been received by Service Canada."

This person was denied and is now in the SST backlog - yet not one person from Service Canada called the client or my office to ask where the information is?  If they had bothered to do so, they would note that the information had been received and on its way.

So why Service Canada?????  There are many good adjudicators who work with the clients to ensure that all the information is sent in.  It is the client's responsibility to ensure that they proivde the information - but BLB RN in Chatham a phone call would have saved this client being stuck in appeal.  You could have called.

 

 

Story Response

Thank you for all your emails and phone calls - it has been a surprise to me how many people have contacted me and offered their support, offers of help, ideas on how to proceed, and all the professionals of various stripes who have stepped forward to offer their assistance.  Thank you to those who have offered their opinions and ideas on challenges that may be applicable.

What I would like to say is that I just want to help these people navigate their way through this appeal system.  Plain and simple.  I have worked for 15 years with the prior system and had an excellent relationship with the staff and the management - same goes with the adjudicators at Canada Pension Plan disability.  Although we were on opposing sides - our goals were to make sure that the appellant had an opportunity to have the best appeal that they can to get to get the correct result - win or lose - at least the appellant had a chance to tell their story. 

I would like just to get on with my work.  I would like to be left alone to do my work.  I would just like to get this backlog sorted so that the Canadian people can stop hurting.  Let's focus on what is important and that is the people who are suffering.