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?

S

 

 

 

 

 

An

 

H

 


 


 

Social Security Tribunal - When will you get an appeal?

I have had several emails this week asking me what will happen after the 365 days expire on March 31, 2014 for the legacy appeal cases that came over to the new Social Security Tribunal from the old Review Tribunal.

Many people have asked me when they can expect that their appeals will be heard.

On March 10, 2014 I emailed the Chair of the Social Security Tribunal to ask what the strategy would be in terms of what the Social Security Tribunal will be in terms of managing this large volume of appeals - to date I have not got a response but as soon as I do I will post this information on the blog.

What I do know is that I have sent in many appeals with Notice of Readiness signed and I have not got any response from the Minister in terms of their position.  The expiry is coming up so am I to assume that they are not going to add their position?

I also know that I have sent in appeals in September 2013 and I have not had any indication when an appeal will be held.

So the short answer to when you will get an appeal - well who knows and I am hoping once I hear back from Madam Chair at the Social Security Tribunal that we will be able to have some answers.

If you are not prepared and have not submitted all of your appeal information you will need to request an Extension of time to submit the Notice of Readiness to the Social Security Tribunal.  You will need to provide reasons why you are requesting an extension.  I have been able to request extensions on files in which I have asked for additional medical and I have yet received this from the doctor.  Frankly I  think this whole Notice of Readiness process is flawed because disability is fluid and Appellants who have forward MQPS should be able to continue to submit information, also I do not feel that anyone should be prevented from providing information which will help support their appeal. 

I have noticed that the Minister's Explanation of Decision are pretty much identical in most cases - except for the name change - but basically they argue the same points everytime - you would think that they would be more creative with denials - but perhaps they have no other way but to follow the denial script.  When I have some time after this deadline expires, I will write about the Explanation and how to address these points.

Any questions please call or email, and as soon as I hear what the strategy is for the SST hearing these appeals I will advise.

 

CPP Disability - Requesting a 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.

CPP Disability Backlogs

There is a long line up of people waiting to attend a hearing  for Canada Pension Plan disability benefits.

As the wait grows longer more and more people are enduring financial hardship as they wait to receive CPP disability benefits through a program they funded while they were working.

At the time of the changeover to the Social Security Tribunal approximately 7000 appeals were waiting to be heard, typically there is around 3000 cases per year added to the appeal process as Canada Pension Plan have a 62% denial rate. Wait times have significantly increased causing hardship.

If your application is denied and you have to appeal your Canada Pension Plan disability claim, it is very important that you get help from a professional.

The implementation of the Social Security Tribunal was touted to save the goverment around $24,000,000.  This reduction in staffing in terms of tribunal panel members along with a centralized 1-877 Information Line have led to increased wait times to have basic enquiries answered.

 

Help When Filing a CPP Disability Appeal

We recommend the following steps when planning to file a appeal for CPP Disability benefits.

1.  Get Help

Those who have applied to CPP for disability benefits without a representative should get help with the reconsideration appeal.  If you are at the Social Security Tribunal level - it is imperative that you find someone to help you.  I have clearly outlined the reasons why a represenative is clearly beneficial in my prior blog entries.

2.  Don't Give Up

When people apply for CPP disability  and are denied benefits, they may decide to give up on their application.  It is very important to pursue a disability appeal - 62% of people who apply for CPP disability are denied - the denial rate appears to be systemic.  It is important to pursue a disability appeal because delaying or missing important deadlines can cause problems with you appeal.

3.  Provide the necessary documentation and details

It can take CPP disability  many years to review a CPP disability claim through the appeal process which reminds you to submit good documentation.  Continue to see your doctor and make sure you submit new medical evidence and testing as it arises.  It is important to correct any errors, explain changes to your medical condition, and provide more detail to CPP disability which is another reason why you should have a case-manager to help you with your appeal.'

I believe it is more critical than before for new CPP disability applicants to get expert assisatnce and help when applying for their benefit and to use a case-manager like those here at the Disability Claims Advocacy Clinic.  The expertise and attention to detail we are able to provide could help you receive your disability benefits as early as your initial application, which may mean avoiding the disability appeal process altogether.

 

 

Social Security Tribunal

I was very grateful to receive communication from the Social Security Tribunal who have reached out to acknowledge and reassure me that they understand the concerns and are striving to resolve them as efficiently as possible.

I understand and can certainly appreciate that this is a transition year and the SST will have challenges and kinks to iron out.

I understand that there are good people staffing the office and that they really want to ensure that the process is going to work well.

I think we all have no other choice but to patient.

Please ensure if you are in this new appeal system that you use this time to get your case prepared to avoid any further delays.

I know this is a very difficult time for many of you who are waiting - I am bringing your concerns forward and will continue to advise on this blog as I hear more information.

 

 

Another Client

Her name in Shirley.

She is in tears on the phone right now and told me that she has had a mental breakdown.

Her documents were sent in December 2013 to the Social Security Tribunal.

She cannot cope with the stress her disabiliy is getting worse.

She applied for her CPPD three years ago.

I just do not know what else I can do.

 

 

CPP Social Security Tribunal

A client who I shall call Shelley was denied at the old Review Tribunal level.

Documents were submitted to the Appeal Division of the Social Security Tribunal requesting Leave to Appeal by courier on September 5th, 2013.

To date, I have not received any consideration on this matter.  This is the answer I got from the Social Security Tribunal:

No decision on leave to appeal at this time.

This client phones me repeatedly, at least once a week asking what is going on with her case.  She has no money for treatments, she is using her line of credit to pay for her medication. I requested information and al I am told is that there is "no decision on leave to appeal at this time"  It is now five months since I have submitted these documents.

 

Another lady, let's call her Delia, she was successful at the Review Tribunal and was granted benefits, but within the 90 day appeal period, the Minister appealed the favourable decision and requested Leave to Appeal.  Her hearing was heard at the Review Tribunal in March 2013 the same month as Shelley.

Despite documents being submitted by the Minister requesting the appeal, she still has not had a decision.  It has been almost a year since she had her Review Tribunal hearing.  This is the response I got back to my request for information via email just moments ago:

Hello,

There has not been a decision made on the request for Leave to Appeal yet.

We will inform you when the decision has been made.

Regards,

Social Security Tribunal

 

 

The gentleman I spoke of in my last blog his documents were submitted October 2013 and there has been no decsion by the department or Notice of Readiness submitted - so he just sits in limbo.  This is what I was told:

We are waiting on the Notice of Readiness from the Minister.  It appears as though the last mail we received from you was on October 23, 2013.

 

There is a ground swell of support coming through this office and I am very appreciative of all the calls and emails and the sharing of individual stories - from the people who are tyring to cope with this new 'efficient' system,  the disability community,  the various MPs officers of all stripes across the country, from the ex-panel members who have reached out, and the judges of the Pension Appeals Board, to the staff who are forced to work in the trenches (I know they are good people) to the opposing side of the fence, I thank you very much and to the 500 people who read this blog a week I am working my very best to shed light.

Yesterday I had a phone call from a fellow advocate who advised that one of his clients passed while waiting for a hearing - he appealed to the old Review Tribunal in May 2012 and died while waiting. I am so sorry to hear that but the advocate continues on for this man's estate - he was 62 years old - the information regarding his terminal condition was sent in to the Tribunal but it just sat there - there was no decision, no Minister's explanation why this man was denied.  I was sad all night about this - it is so appalling.  I thank you advocate for calling me.

This government is disgraceful in my opinion;  from the senate scandals, to the way they have treated the vets, to what they are doing to people with disabilities, to cut backs to national disability organizations - I just do not get it.  Let's all think about this today on budget day when the Feds tout their good work at balancing budgets - if only the majority knew what was happening to these good people of Canada stuck in this appeal system.

 

An Update to my last blog on the Social Security Tribunal

On February 3rd, 6th, and 7th I sent emails requesting information on the status of the file that I spoke about in my last blog. 

Today I sent another two emails including to the Director of the SST.

Let's see if I get a response today.

This is unaccceptable.  This is unacceptable.  This is unacceptable.  How many times do I have to say it?

Also, my request for the Policy and Procedure documents have again been ignored.

Why? Why have any request to understand and be informed of how the new Social Security Tribunal operates have been ignored.

So much for transperancy and the efficient operations of this government as touted in the Chairman's welcome message.

This man who I am requesting information on, had to apply for consumer protection of his debts because he has been waiting since he appealed the denial of his benefits to the Review Tribunal in March 2012 and his application for CPP Disability was April 2011.

I am appalled at the destitution these people are forced to endure.

Make the information available Social Security Tribunal so that these people can move on with their lives.

 

 

 

Social Security Tribunal - Please address these delays

I am speaking with a client who has been forced in to Consumer Protection with the bankruptcy process because he has been waiting since April 2011 for CPP disability benefits.  He has been denied twice and has been waiting to be heard at the old Review Tribunal and now at the Social Security Tribunal.

That is a three year wait so far.

I had sent over all the documents - the case has been ready to proceed and yet I have not had even an acknowledgment that the documents collected on his file and sent to the Social Security Tribunal were received.

I sent these documents in early fall.

This is unacceptable and what the heck is going on there?  This is not an isolated incident - I have a list of 20 files that I have sent documents over that have not been acknowledged nor have they been responded to.   I have sent in numerous documents and nothing has been responded to - who is running this place?

It is not just me that is frustrated - I hear the department is as well.  All these documents that the SST want to control, yet they are missed and not sent, not acknowledged, and just not part of files. Read my last blog, that necessitated an email to The Chairperson before I knew what was going on in this file. 

At the time that I emailed The Chairperson of the SST, I also requested documents including policy and procedure manuals,  because from my view point,  the SST seem to be making up process as they go along - I requested these from The Chairperson of the SST and as yet I have had no follow up on these.  Another tilt to the playing field especially with these Members seem to "have discretion" over everything.  This particular case, I was advised that the Member "has discretion" to accept or not accept documents - when clearly as far as I see this is not indicated any where in any rule or regulation - which is why I request a copy of the rules the SST were following.  I would also like to know - how an appeal board - could possibly veto documents that might support a client's appeal - what right do they have to do so - is that justice - is that fair - is that giving a client due process? 

They have stated that this is a "transition year" - so what? Do all these people who are now requesting consumer protection for their debts get to excuse the delayed payment on their debts because it is a transition year at the SST?  What a load of rubbish.

Please if you have been denied and you are either waiting for an appeal to be heard at the SST, or if you are at the Reconsideration stage - get help because quite frankly you do not want to be at the end of consumer protection proceedings.

This government sucks.

 

Social Security Tribunal

I have had new information sent to the Social Security Tribunal now for months and have not had any response on these files.

Clients are calling me asking why we have not had any news.

One client's documents were submitted in early September 2013 and NOT A WORD has been heard - not even an acknowledgment that the information was received.

Obviously I am very frustrated and it is starting to show here on these blog entries.  I trust people to give me correct information especially when I am dealing with a new process that no one was really given information on.  I had one brief webinar from the Social Security Tribunal on the new processes but that is it.  I do not know how regular people who do not have my level of experience are able to manage this system.  I have been caught relying on information that was clearly incorrect that was given to me from the Department. I feel like a fool.

I have had some nice responses back from my recent entries from other indviduals who are also having troubles so at least I know I am not alone.