15 years of DCAC Inc

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

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

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 Social Security Tribunal

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.

 

CPP Social Security Tribunal - Give us some information.

I am experiencing a great deal of frustration. 

There are no answers.

Every time I phone to find out about the new Social Security Tribunal I am told no one knows when the new hearings are going to be available.  If you have not been scheduled for a hearing by March 2013 you are going to be heard under the new Social Security Tribunal system. That is all I know for sure.

There is still no news regarding whether the members who are going to hear the appeals are hired - or even staff to manage the rather large number of appeals currently waiting to be heard - are hired.

No one seems to know anything.

A great number of Canadians, who are waiting for Review Tribunal hearings, have just had all of their personal information compromised by HRSDC - the government department who has decided that they are going to foist this new tribunal on to Canadians. And maybe because of this massive breach of privacy - they are expecting answers regarding their appeals.  They are starting to contact the existing appeal's bodies and unfortunately they are not getting the answers they require - basically everyone is told - there is a new system starting April 1, 2013 - but we cannot tell you when and for that matter, how your appeal is going to be heard.  I have provided information on the blog here about the different types of appeals that the new system will use - but apparently it is up to "The Member" and not the client to determine how the appeal will be heard. Which is completely inappropriate - it is the person's application - why should someone else get to determine the type of appeal they get to have?  One of the only things that has not be assessed by CPP Disability when they are denying all the claims - is the subjective evidence of the appellant - this is a critical and integral part of any appeal - how can paper information describe the experience one has when dealing with disability like pain or mood - every situation is different - paper information does not give the added dimension that a face to face gives.

I would like to highlight that this is not the existing staff who are at the appeals bodies fault that there are no answers - that is squarely on the shoulders of the bureaucrats at HRSDC.  Perhaps I should get the phone number of the Director of the change over, put it on this blog,  and ask her and her assistants to start taking calls from people who are waiting for appeals?  Maybe then there would be some understanding about how frustrated people are and how badly they are hurting.  Come on Danika - people are losing their homes - people are going bankrupt - people who are sick are getting sicker. A grown man called me today in tears of desperation because he cannot find the money to keep his home - he has five children - he has worked all his life - and I am not exagerating.  He is waiting for an appeal and has been told "they don't know when he will be heard".   Maybe if that starts happening, we will finally get some answers.   And I do not mean 1-800-277-9914 because you cannot get through and they do not have any information either.  I would like a "real number" that can give my clients and myself, as well as everyone still waiting in the system - or the 6 out of 10 people that CPP deny - the opportunity to understand what is going to happen with something so significant as an appeal to hear whether their disability benefits will be allowed.

Clients are getting tired of getting no information - don't they deserve more than "we don't know?"  I am getting calls everyday from frantic people no knowing what is going to happen to them - not understanding how something so important can be drastically changed mid-stream.  If you applied under one system - what right do people have to change the rules mid stream - even Air Canada does not do that - they honour what was existing if they change their policies.  Clients are given a whole lot of government speak on the website stating nothing is going to change and that it is going to be fair and equitable - and I sure hope so. But?

I would think that the Human Resources Social Development Canada has a requirement to provide everyone who is waiting for an appeal, and the people who work within the system, a phone number to call so we can find out what is going to happen - and how on earth this monumental task of switching four appeals bodies in to one is possibly going to be managed and manageable? And how is they are going to provide Canadians with a "seamless transition" as promised.  I really think whoever it was that came up with idea of doing this to save money is so very misguided and obviously have no idea what is happening to people are in the real world.

I know the Feds from Ottawa read this blog so how about it? Give us a number so we can call and find out what is going on here.  What we all can expect from this new system and when people are going to get their appeals heard - and how they are going to clear the large back logs with only 35 members to hear appeals.  If I am wrong with anything I am blogging about - let's hear from my Federal friends - call me and correct my information - you know where to find me.  Send me an email - let me know so I can post here on my blog for everyone to read.  I will gladly do that - and gladly stand corrected.

So many clients are calling wanting answers - these are appeals to determine a pension - an income for a family - a benefit that people are entitled to that have often been unfairly denied.  I wonder how the Bureaucrats would feel if this were happening in their family and what they would do if they were told - "I don't know when your appeal will be heard."

 

 

 

CPP Social Security Tribunal

The new Social Security Tribunal will begin operating on April 1, 2013.  For those of you who read my blog, this will come as no surprise.  However, I think it is important to give an overview on how this important change is going to impact individuals who are applying for and/or appealing the denial of the Canada Pension Plan disability benefits.

The existing system goes as follows; you make your initial application to CPP for disability benefits, and if you are denied you are entitled to request a Reconsideration of this decision.  The Reconsideration is done by HRSDC - technically in house by another staff member - and if you are denied at this level of appeal, you could request a Review Tribunal.  This was an arms length appeal body and your case was heard - in person - by three panel members who determined whether you met the legislative criteria - in other words - if the decision of the Federal government was wrong.  If you were denied, you then had another level of appeal called the Pension Appeals Board who with their permission or leave - set aside the decision of the Review Tribunal granting you a fresh opportunity for the facts and evidence to be considered.  So basically you had two opportunities to convince an arms-length appeal body, that the government had got the decision wrong.

Under the new Social Security Tribunal - there is two levels of appeal - there is the General Division and the Appeals Division.  The difference is - that the General Division is your only opportunity to present all the information you can to support your case - this means medical reports, facts about your situation, any evidence really to convince the Social Security Tribunal member, that you are disabled according to the CPP disability rules. 

The decisions made by the General Divison of the Social Security Tribunal are going to be more difficult to appeal to the Appeals Division and an appeal will only be granted for specific issues that are legalistic and quite technical. There will be no chance for a person to present new evidence (medical reports etc) at this appeal level.  This is going to cause so many problems - for example - if you have a current Minimum Qualifying Period date in the future and the General Division decision says you are not disabled when they decide your appeal - then from what I understand you will be prevented from submitting additional medical information that might not have been available at the time of the General Division appeal because it simply was not available to you.  Or what happens if you are still doctoring? Are you going to have to wait for an appeal before the General Division when all of your medical is available - how realistic is that? Many of my clients continue to seek second opinions or consultations to clinics that may take years to get - chronic pain clinics for example - it does not mean they are not disabled because they are waiting for an medical appointment. 

So the decisions of the General Division are going to be much more significant and leaving this appeal to an individual who is uneducated or unaware of the lay of the land or the rules of the CPP "game" - should not be considered.

I strongly urge anyone going through this process from the CPP Application, to the Reconsideration Appeal and beyond - to get professional assistance with the process.

Securing a disability pension is far to important an undertaking, for yourself, for your family, for your finanical wellbeing to go through this process without professional help and advice.   

 

Social Security Tribunal Regulations

The regulations for the new Social Security Tribunal were finally posted in the Gazette. I am reviewing the regulations to determine how best to help my clients who will find themselves included in the new system with the changeover April 1, 2013.

Some of the changes to the current appeals system include the following:

The General Division must dismiss an appeal if it is satisfied that the appeal has no "reasonable chance of success" (summary dismissal).  Otherwise, the General Division must decide the appeal based on further evidence and subbmissions presented by the parties.   Before dismissing an appeal the General Division must give  notice in writing to the Appellant and allow the Appellant a reasonable period of time to make submissions. 

I would like to say that there have been many cases that I thought would have no chance of success based on initial review of the documentation - however, upon meeting the client and discussuing the situation, it becomes very apparent that there is a lot of information missing or what is on paper does not present the totality of the situation.  Also, how is an appellant supposed to understand the legislative tenants in terms of making written submissions, how is someone who is not particularly knowledgable about the "rules of the game" supposed to put forth a adequate argument on submission?


The proposed regulations identify email as an acceptable communication method for the Social Security Tribunal. Electronic communication would be encouraged for the filing of an appeal and relevant documentation, as well as a way for SST to respond and to issue decisions. 

The Social Security Tribunal or a party to the appeal would be able to request that parties participate in three new approaches to settling an appeal: (1) pre-hearings, (2) conferences, or (3) dispute resolution processes.  The latter two may be requested at any time during the appeals process. 

The proprosed SST regulations would provide that hearings may be conducted a variety of ways, including through written questions and answers, by video or teleconferencing, or in person.  How a hearing is conducted would be decided by Members.

I think that the Appellant should decide how they want the appeal to be heard - after all - it is their appeal and their pension benefits that are being decided upon.  I am still working my way through these regulations - how disability is defined under the Canada Pension Plan is not going to change.  So you will still have to be found disabled based on the same criteria as before.  Do not leave these applications and appeals to chance in the hopes the the appeal will be developed - you need to present the case in its totality right off the bat - and with experienced representation and case-management your chances of success will be increased. 

 

 

The Importance of a Review Tribunal Hearing

Yesterday I attended a Review Tribunal hearing - my client let's call her Helen had applied for CPP Disability twice and had been denied by then a total of four times.

Her insurance company contacted me and asked if I could case-manage her appeal as based on their Independent Medical Examinations she had been found totally and permanently disabled and they could not understand why she had been denied CPP disability.

This hearing was her first face to face appeal. The hearing went very well - Helen was a credible client with very supportive medical information. I think she had a great hearing and a good Review Tribunal panel who were very prepared and professional.

So this is the thing - if she had been denied by CPP disability four times already ON A PAPER REVIEW and she has medical information that has for the past 10 years supported the fact that she is totally disabled - how is a paper review at the new CPP Social Security Tribunal going to be any different than the previous denials the Feds had made on paper?

There is no substitute for a in-person hearing. How a person presents in person is completely different to how a file reads on paper, and if you have been denied twice already on paper - what difference is a third in paper review going to make?

Okay, there is still no word on the new system - what it is going to look like what the policy and procedures are going to be. I do not think they even have an address for where the office is going to be located - and the Feds beilieve that this will all be in place by April 1, 2013.

An article in The Hill Times - Jessica Bruno September 2012 quotes that numerous sources have wondered how the new SST is going to handle the workload and that there could be a 16 month back log on hearing cases - when 74 people try to replace thousands the only thing one can conclude is that access to the system will be completely compromised for Canadians.

After 15 years in the trenches I believe that there is some sort of "ratio or quota" in terms of the CPP denial rate. Although it can never be established - sometimes when I see the denials I wonder what on earth the CPP adjudicators are reading - so I have to wonder.

If there are only going to be 34 members in the new Social Security Tribunal working on 4000-5000 cases a year - and the current 250 or so Review Tribunal members only hear 8 cases a sitting - and there are approximately 8 hearings a week in maybe 70 locations across the country - and they currently work on reviewing the cases, plus sitting on the hearings, plus writing the decisions taking at least 70 hours - how is it that these 34 new full time members are going to handle the current case load - not to mention the continual denials that the CPP Disability are pumping out on a daily basis???

This is an impossible suggestion.

I have heard through the grapevine that the Feds were not happy that their denials were being overturned by the higher arm's length levels of appeals - which I estimate perhaps overturned half of the CPP Denials. Okay the reasons I believe this happened are the case should not have been denied in the first place and two, an in person hearing and the appropriate application of the legislative tenants by professional Panel members who did their work on the file and three, an expert case-manager who put together the appeal, led to a successful result for a person who is disabled and cannot work.

The independent system also avoided the decision making process done by a government who in my opinion simply wants to save money and not to honour the tenants of the CPP Disability legislation - the Feds have indicated that they are going to save $25 million on administration costs - but how much are they going to save ripping people off from getting their benefits? One has to wonder right? That old nasty feeling concerning the quota or ratio of denials is going happen because the new Panel members are simply not going to have the time to handle the number of appeals - the math does not lie.

I believe I can say with confidence that the exisitng case load is not going to be handled by a limited number of Panel Members that the bureaucrats have identified will be working full time for the Social Security Tribunal hearing CPP Disability appeals.

Canadians are entitlted to a fair independent hearing especially when it is dealing with a pension that might be in place for many years. Under this new system I believe it is unlikely this will happen.

Some More Information

http://openparliament.ca/committees/finance/41-1/60/sue-foster-1/#%2Fcommittees%2Ffinance%2F41-1%2F60%2F?page=13

Here is a link to some further discussion in Parliament about the new Social Security Tribunal.

There is confirmation in this discussion by HRSDC that the appeals that are currently in the existing system will stay under the existing system and that new appeals received after April 1, 2013 will be heard by the new Social Security Tribunal. At least that is what I read. I will cut and paste this for those who do not wish to review the whole evidence piece.

The Chair:

"I just want to clarify a couple of things. I very much like the idea in terms of combining. You mentioned April 1, 2013. That's when the new tribunal will be up and operating, correct? I think probably the only concern one would have on this is the transition period between them coming together. Can you just address that?

Exactly how are you going to do the transition to ensure that it is seamless, so that for people who have something currently in the process when that switchover happens, it will be seamless for them?

11 a.m.

Director General, Policy, Quality and Appeals Directorate, Department of Human Resources and Skills Development

Sue Foster

They'll phase out. So new appeals coming into the systems effective April 1, 2013, will go into the social security tribunal system, whereas those already in the system will continue in the existing system.

The new tribunal will open its doors in April 2013, as I mentioned. The existing tribunals will continue to hear and consider cases that are in their system at that time to ensure that it's seamless for clients

The Chair

So they'll finish them.

Okay. That's the clarification I wanted.