CPP Disability Benefit Time Lines

I have had several messages concerning the time lines at Canada Pension Plan.  I am not talking about the horrendus delays at the Social Security Tribunal, but rather the adjudication and processing times at Canada Pension Plan disability. 

These timelines are for adjudication on initial applications as well as time lines for adjudication on reconsideration appeals.

I confirmed with Service Canada today that the time lines are 26 weeks.  That means it is taking over six months for a decision on a CPP disability application or appeal.

 

Okay so I know from the Freedom of Information requests that I have made that the denial rate on initial is around 62%.  That means that it is going to take over six months for 6 out of 10 of you to be told that you are denied.  And of those people who go on to appeal, it is going to take another six months before you receive a decision on the appeal - and if you are denied again  - well then you are at the Social Security Tribunal.

From the information that I have read and have here in my office, there is a memorandum that notes that the Social Security Tribunal does not expect to be able to manage this backlog until 2017.  In fact I quote from a Memorandum to the Minister of Employment and Social Development from the Social Security Tribunal dated February 2014 states "Based on the early assumptions, the transferred inventory and newly acquired inventory (the backlog) would be eliminated at the earliest by 2017."

So there you go folks.   Please get help with your applications and your reconsideration appeals.  This is no joke. 

Please contact the office if you need help.

Downward Spiral

Today I have had six phone calls from clients wanting to know when their appeals will be heard.  I have had another 5 emails asking why the department has not responded to any of the additional information that we have submitted.

In the mail I received more stupid denials from CPP disability (review my previous blogs).

I am waiting for files from CPP so that I can help clients manage their appeals - I am not receiving them in a timely fashion and the Feds are denying before the client has any time to submit additional documents.

I just feel this is a downward spiral - it is almost like the government wants to deny these claims knowing full well that the wait for an appeal is so long - that these people are either bankrupt and then they have no choice but to go on welfare.

This system is causing individuals to go without treatment - making them sicker - forcing them in to seperation or divorce - either due to depression or stress - or so that they can obtain some kind of provincial disability support.  There are kids that are suffering because of this  - and these people have paid in to the program - why is it so hard for them to get something they are entitled to receive - if the money is not there to pay the folk - then where is it?  No insurance company would ever get away with this type of practice. They hold them accountable - they have appeal processes that allow for redress if there is an error.  That is supposed to be what is available for individuals who are denied CPP - so why are they not getting the appeals - how is a three year process to get an appeal acceptable?

I have sent emails to the Information Line and received no information in fact I have not received a response and when I do get a response the file is pending.  The Social Security Tribunal is so insular that I cannot even talk to a live person - or any person for that matter - to find out more details - and when they give us conference calls - we are told snottily to write a letter - I cannot tell you how many letters I have written.  Perhaps I should start posting them all on this blog. 

Look it really is not that hard - start hearing cases - start moving the backlog - start hiring members - rehire the Review Tribunal members - do something.  How are 9000 appeals going to be heard by 26 members?  How is that fair, accessible, or efficient?

I feel like I am airing dirty laundry but I just have no other release or way to let any one know what is happening here in this office every single day.

I really think it is a disgrace - the gentleman who phoned me today working and paid in to CPP from 1971 until 2010 - that is 39 years of contributions.  He is 61 years of age.  He has never taken a nickle in EI benefits.  He first applied in July 2011.  Despite sending in so much supportive medical information - we still have not even had this acknowledged - either by the Social Security Tribunal or Canada Pension Plan.  He is just sitting waiting for a decision or appeal that never seems to occur.

Please get help with your CPP Application or if you are denied your appeal for Reconsideration.

Canada Pension Plan Disability Benefits denials continue to discourage

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. 

 

Riding on the CPP Disability Denial train.

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?

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Confirmation that only EI appeals being heard

I had heard through the grape vine from the various people who are in the know - or who know someone who is in the know - that the only appeals that the Social Security Tribunal are hearing and processing are those related to Unemployment Insurance.  As you know, the Social Security Tribunal contains all four of the prior HRSDC tribunals - and Unemployment Insurance and Canada Pension Plan were the two streams the Social Security Tribunal are mandated to hear.

So again, I have just received confirmation that the only appeals being heard are EI appeals and I guess Summary Dismissals - which you can read about on this blog.  I know there were some Appeals Divisions hearings being heard - but the difference between those hearings and those that are waiting at the General Division is the Notice of Readiness process.

So review my blog entry about Mike and wonder how this government can get away with doing this to people who are disabled. 

Please to all the Feds who are reading this blog - if I am incorrect with my information I would really appreciate a phone call if anything needs correction that I have posted here.

 

Consequences of CPP Disability delayed..

So far this week there have been several calls and emails to my office asking me when the client's appeal will be heard by the Social Security Tribunal.  I have no answers to give them.  In this blog entry I would like to highlight the cost to the client due to these delays. 

I have been helping a gentleman let's call him Mike.  Mike is a farmer who had an impressive record of earnings over 30 years of contributions to CPP.  He is 59 years old and due to a life time of smoking and dust exposure, Mike now has severe Chronic Obstructive Pulmonary Disease.  Mike could no longer farm so he took on lighter work as a meat cutter.  He has no additional education or training other than high school. He could no longer work due to his disability in February 2012 and applied for CPP Disability in March 2012.  Mike was denied twice - at initial and also at reconsideration and was now waiting for a hearing at the Social Security Tribunal.  I met Mike as he had contacted his local MP office and they then contacted me to see if I could help - as by this time Mike was reliant on oxygen. Mike had unfortunately racked up $30.000 in credit card debt trying to manage to keep himself and pay his rent, he had also now found himself on the Provincial disability role because he exhausted all of his credit.  I met Mike and he told me he wanted to die - I am not exaggerating. It is very difficult for me to hear this and to tell this man that he has to keep positive and that it will all work out okay. 

So I took his file, I requested some additional information from his specialist, and took the time to prepare a written case overview to explain how Mike would meet the CPP legislative tenants for disability.

The next time Mike called me, he was again in crisis. He had run out of his medication and unfortunately this drug was not covered by the Province.  He had not been taking his medication for weeks.  He was again crying and gasping for breath.  It took me a long time to calm him and I was able to get in touch with his respirologist to explain what was happening - thankfully his doctor agreed to provide him with the medication free of charge.

Then last week Mike phoned me to say that the CPP Disability has phoned and miraculously decided after 18 months that finally he did meet the criteria and he was disabled - but that he would have an onset of disability one year after he actually applied - yes they were screwing him out of a year's backpay because he was not on oxygen until March of this year.  So Mike who has struggled to keep his head above water, to do the honourable thing and pay his credit card bills - which he had relied upon to keep him for the 18 months it has taken CPP to decide he is finally disabled - has now resulted in him getting four months of retro payments out of them.

So I went to see Mike yesterday to talk to him about his options.  Mike again was crying and telling me that he has to do what he never dreamed of doing - declaring bankruptcy. This morning my email box is full of people wondering why it is taking so long to get an appeal.

Okay I have no idea how to illuminate these issues other than to hope someone somewhere is reading this blog.  If you need help call the office.  Allison

 

CPP disability denied and you need to request Reconsideration

If you have been denied CPP disability and you need to request a reconsideration, this has to be done before your 90 day appeal period expires.  I would send off a letter of appeal stating the following:

I do not agree with your decision to deny my CPP disability benefits.  I am disabled according to the legislative criteria and I wish to request a reconsideration.

Additional information to support my appeal may be forthcoming and I request that your office contact me to discuss this appeal prior to making a decision to ensure that I have had the opportunity to submit all the information I can to support my reconsideration appeal.

Make sure you put your Social Security Number on this letter and if possible I would send this letter in some traceable way - registered, express post etc. or I would drop it off to a Service Canada office and get receipt that you submitted this appeal letter.  Within a month you should receive a letter from CPP disability acknowledging that they have received your appeal. Make sure you watch out for this - and if you have not received a letter check in to it.

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 suggest that given the state of the new appeal process at the Social Security Tribunal and the delays it appears many appellants will be facing, I strongly suggest that if you have been denied your CPP disability benefits that you get some professional advice to put together your reconsideration appeal in the hopes that you avoid any further delay.

Speaking of the CPP Social Security Tribunal, this week (I know it is only Wednesday) has been frustrating.  I have got calls from people who have submitted their appeals to the Social Security Tribunal in June or before and their appeals have not been acknowledged.  I cannot understand why it takes three months for this new tribunal to acknowledge receipt of an appeal - also there are many files that I am waiting for case books from the Social Security Tribunal and it is taking months - how can appeals be prepared without the information I need to work on the file?  I just think the right hand does not know what the left is doing.  I am not slagging the staff - it is not their fault.  I am simply stating that this system as it currently stands is not working too well and something needs to change - more staff, more training, more efficiency -something.

Have a good week.

 

CPP Disability Denial Rates

I have had the opportunity to have some time off over the summer.  When I returned to the office, I received a response to my request that I submitted under the Access to Information Act concerning CPP Disability.

The first question I asked was about the actual Canada Pension Plan Disability denial rates.

In 2009 - 2010

69,214 CPP disability applications were received and 41,584 CPP Disabiity applications were denied at initial - that is a 60% denial rate.

In 2010 - 2011

73,179 CPP disability applications were received and 39,160 CPP Disability applications were denied at initial - that is a 53% denial rate.

In 2011 - 2012

69,294 CPP disability applications were received and 40, 563 CPP Disability applications were denied at initial - that is a 58 % denial rate.

In 2012 - 2013

69,002 CPP disability applications were received and 42,883 CPP Disability applications were denied at initial - that is a 62% denial rate.


So let's first discuss the denial rate for 2012 - 2013.  I fail to understand how any disability insurance company (and you can compare CPP Disability to an insurance company - you pay in premiums to cover you for a benefit) can possibly get away with a 62 percent denial rate.  It is astonishing to me  - I have been doing this for 15 years and this is the highest denial rate that I have seen.  Yet if you look at the figures in terms of applications received, they are declining, so you would assume that the denial rate would also decline rather than increase.  My thoughts are that given the files that I have reviewed that little is being done in terms of development and given the attitude of some of the adjudicators I have spoken with lately at CPP disability, I would have to conclude that things are very negative.

The average adjudication times for initial CPP applications  for each region are as follows:

National Region:  87 days

Atlantic Region:  76 days

Ontario Region:  98 days

West Region:  77 days

 

The average length of time that an appellant has to wait in each area until a appeal is received at reconsideration are as follows:

National Region:  88 days

Atlantic Region:  108 days

Ontario Region:  88 days

West Region:  78 days

 

I would also like to note about the non existent service that is being provided by the SERVICE CANADA 1-800-277-9914 line.  I have called repeatedly trying to help people obtain information on their appeal or application status.  When I make my way through all the recorded messages and I finally press to connect to a live person - I am told there is no one there to SERVE me at SERVICE CANADA and I am hung up on.  I have had so many complaints about this telephone line - so I do not know how the government can get away with providing nothing to people who need to know important information about the status of the application or appeal.

I used to be able to contact some of the CPP Disability staff directly - however, according to recent correspondence, that option has now been closed to me.  Not sure why? Must have been too much work for the CPP adjudicators to provide service to clients - but I digress. Anyway, if the Feds who read this blog might be able to pass these messages on to their Management.  Look, I am critical but it with reason. 

I would be interested in hearing your experiences with Canada Pension Plan disabiity - especially if you have been denied.  Please email me or call the office at 1-877-793-3222

Twice today - CPP Early Retirement benefits.

Twice today I have had calls and enquiries about the denial of CPP disability benefits based on the 15 month rule.

I have spoken about this at great length in the blog.  Basically in order to switch over from a CPP early retirement benefit to a CPP disabiity benefit, you have to have been receving your CPP retirement benefit for less than 15 months.

However, CPP legislation does not allow a person to receive both an early Retirement pension and Disability benefits at the same time. 

Not only is there the 15 month rule, but taking your early retirement benefits also changes your Minimum Qualifying Period Date.  If you recall this is a magic date in which you have to be found disabled by.  And if you apply for CPP early retirement benefit, your MQP becomes the month before you start collecting the benefit. 

For example, Billy.  He started taking his CPP early retirement benefits when he turned 60 in December 2011.  He was struggling to keep up at work and slowly down and thought that if he worked less hours his aches and pains would go away.  Unfortunately Billy was not too keen on going to the doctors.  So Billy took his CPP early retirement.  His Minimum Qualifying Period date becomes November 2011.  He stays on working until April 2012 when he has a stroke.  He does not qualify for CPP disability no matter how disabled he is - because he was not disabled at his Minimum Qualifying Date of November 2011 the month before he took his early retirement benefit. 

I just got off the phone explaining this to Billy when I got an email from a lady whose husband is in the same position.

There is very little education about the implications of taking your CPP early retirement benefit.  Even though financially it might be helpful, it is very important to understand what happens to your coverage for disability should you take these benefits.  And it is important to understand that disability tends to increase with age.  Those over 60 need to proceed with caution.