I recently added a post to the blog which discussed two cases that I appealed to the Pension Appeals Board. Both of which dealt with; what is a substantially gainful occupation?
There was two different scenarios - June who was on a Canada Pension Plan disability who had been cut off for working - and then Lila who was appealing because she was found capable of working doing seven hours a week job sharing with another lady who ironically is on Canada Pension Plan disabiliity. For the details on these cases please review the prior blog post.
I am happy to report, that both of these cases were successful in their appeals.
I would like to thank "Sally" at the Pension Appeals Board as the decision for June was sent within two weeks of the hearing - which is something that I have not experience before - and the favourable decision was welcomed by June and her family.
When I attended these hearings, I took with me a copy of The Adjudication Framework For Canada Pension Plan Disability Benefits: Severe Criterion for "Incapable Regularly of Pursuing any Substantially Gainful Occupation."
The point of me doing this is because I get so frustrated with the constant denial letters which quote "while you are unable to do your current job you still have the capacity to do some type of substantially gainful occupation." Or they will say - well you are working earning whatever amount (which is often well below what is considered substantially gainful) so you are not disabled according to the legislative criteria - it is just maddening.
So now these two decisions will hopefully give some reference for people who are appealing a denial decision.
The Board state: "I find it interesting the document submitted in Ms. Schmidt's submission entitled "The Adjudication Framework..." On page 11 of the document it states: The substantially gainful amount is the maximum monthly CPP retirement pension. The annual amount is equal to twelve times the maximum monthly CPP retirement pension.... An individual who is working to the maximum capacity that his or her disability permits, and whose earnings are less than the substantially gainful amount, is not productive and is not performing. This individual can be determined incapable of working at a substantially gainful level."
Lila was earnings for 2006 - 2011 never exceeded the substantially gainful earnings amount and for 2010 her earnins were about one third of the allowable amount - yet she was denied by the Feds because they said she was working. Just another example of how despite guidelines being in place - they never appear to be followed.