CPP Disability Service Standards

In October 2016, the department announced CPP disability service standards for initial and reconsideration applications as well as introduced new standards for applicants with terminal illness and grave medical conditions.

The service standard on initial application and reconsideration was 120 days.  This means a decision should be rendered by the department in a 120 day time frame.

I applaud the department's decision to ensure a timely decision, but adhering to this policy has lead to denials in situations where "service" standards have superseded the ability to make a positive decision.

I am speaking about reconsiderations.  Many of my clients request reconsiderations as their initial applications have been denied.  You only have 90 days in which to appeal the decision and then the appeal needs to be developed in order to convince the department that their decision was incorrect.  This typically means obtaining a copy of the CPP disability case file, to review its contents, to obtain additional medication information, and then to prepare reasons why the original decision to deny was incorrect.  This process takes time and often more than 120 days.  For example, it can take six weeks or more to get a copy of the CPP disability case file from the government.  Then it can take physicians time to put together information or maybe a client is waiting for a specialists' appointment.  Then it takes time to work with the client to prepare their submissions. 

When DCAC is asked to help a client, we send a letter to the department ensuring that they are aware that the client is getting assistance and asking them not to make a decision until the client has been able to adequately prepare their appeal.  We send this letter in on every file.  This letter is continually ignored.  I have taken this issue to the Management of the program but still the medical adjudicators routinely ignore this request.

Was does this mean? Let me give you a couple of examples:

Client N. He was denied by the Winnipeg office on initial application.  He requested Reconsideration which was acknowledged by the Department on December 8, 2017.  A letter was sent from DCAC to this office advising that we were working with the client to request additional medical information to support the file.  We asked for the department to contact our office before making a decision to ensure the client was ready to have the matter decided.  It is after all his appeal.  The medical adjudicator H.F. RN in Winnipeg made this decision to deny the appeal without contacting the office as asked.  The submissions and additional information had been sent from our office prior to finding out the decision had already been made.  The client was not close to the 120 day service standard "deadline"

Client D. She was denied by the Victoria office on initial application.  She requested Reconsideration which was acknowledged by the Department on November 2, 2017.  The same situation as before, the letter was sent to the region asking them to contact our office prior to making a decision in order to ensure the client was ready to have a decision made on appeal.  This time the submissions and additional information was submitted on February 15th, 2018 but a decision was made by J.P. RN in the Victoria office the day before on February 14th, 2018 without contacting our office.

What does this mean?  Well now these clients are having to appeal to the Social Security Tribunal.  This puts additional stress on the client and time that they are without benefits.  This also means that the government is funding another appeal at the tribunal when they could have waited as instructed to have a fulsome review at the time of the reconsideration.

I am fed up with the disrespect of these adjudicators who continually ignore the requests of the client to wait until they have all their information in order to make an appeal.  Do you recall the newspaper article last year which talked about CRA call centers meeting service standards by just not answering Canadian's calls?  It is really easy to meet service standards when you just make decisions without waiting for the information on appeal. Think about that.  You are requesting an appeal and then you are denied your opportunity because a medical adjudicator has to meet service standards even when they are directed by the client whose appeal it is to hold off on making a decision until they have had a chance to prepare their appeal.  Is this due process?  Is this a fair way for an adjudicator to do their job?  Half the time the client does not even know the information that has been submitted in their file - or why the decision was made the way it was made.  Knowing the case against you is part of natural justice -and yet the medical adjudicator does not respect a client's desire to ensure that they can make the case against them on appeal. 

I have raised this issue with the management of the department and it continues to go on.  Are they really meeting SERVICE STANDARDS when all this does is force their clients in to another appeal system?