So to read this story on CPP disability denial

http://www.edmontonjournal.com/Spruce+Grove+dying+cancer+fighting+disability+benefits/10797822/story.html

 

I am posting this story on CPP disability and the denial of benefits.  I would like to extend my best wishes to Mr. McClure and his family.

This story illustrates the importance of understanding what happens when individuals apply for early retirement benefits available at at 60.

Mr. McClue was diagnosed with rectal cancer in the Fall of 2012.  He applied for CPP early retirement benefits in December 2012 and continue to work during this time period until another tumour was found on his lung in early 2013 - he stopped working on April 23, 2013.

When you take an early retirement benefit from CPP you MQP (the magic date - the date that you need to be found disabled by) becomes the month before you start taking early retirement benefits - this means in this case the MQP is November 2012.  Unfortunately, Mr. McClure was working at the time of the MQP and therefore he has been denied.

Another issue that comes up when individuals take early retirement benefits is that once you have collected these for 15 months - you are unable to switch them over to CPP disabiltiy benefits.  So many people take their early retirement to supplement their income and then in their early 60s become disabled and are then unable to switch these benefits over - I have numerous phone calls like these on a weekly basis.

I agree with Michael Prince - Mr. MrClure's case is not unusual.  Along with the excessive denial rates there is a complete lack of communication from the Feds in terms of how to make application for Canada Pension Plan.  I have written extensively on the importance of the MQP as well as what happens when someone takes an early retirement benefit.  Mr. McClure correctly states that these MQP rules are never made clear to most people when they apply for CPP disability.

My advice to Mr. McClure is to request an expidited hearing at the Social Security Tribunal - in this situation  - I feel the SST will do what they can to help this gentleman - but I do think he will continue to be denied because he is caught up on this legislative technicality with the MQP being November 2012.  Of course this would depend on his work activity after that date - was it regularly - did he have the capacity to work - etc. 

This is a really tough case to be sure - as obviously there is no doubt that Mr. McClure has a disability that is both severe and prolonged but as you know there is the third piece in the equation and that is the contributions and unfortunately the contributory rules.  The CPP letter suggesting that Mr. McClure does not have a disability that is both "severe and prolonged" is inaccurate that is for sure and I think the Feds could do a better job of helping people understand the reasons why they are being denied.  I think that there is little understanding about the rules when you take early retirment benefits.

I agree with Mr. McClure that the Feds need to be doing a better job - this system is so broken.

I wish you all the best Mr. McClure.

Kenney pledges to reduce the SST backlog

http://www.theglobeandmail.com/news/politics/kenney-pledging-to-wipe-out-social-security-tribunal-backlog-by-this-summer/article22851348/

 

This is the latest article on the Social Security Tribunal backlog.  It notes in this article that Minister Kenney pledges to reduce the backlogged cases by summer 2015.

While I certainly hope that this is the case, I find it difficult to understand how with the current resources that are available you could make your way through the approximately 11,000 appeals.  I feel there is a strong element of election year optics in play here and I will stand by my comments that leaving all of these people hanging and waiting and suffering is a national disgrace and should have been dealt with months ago. 

It is already February and there are say five months to July and I am assuming that is when summer will start.  So let's just make it six months until the end of August.  That is 180 days.  And if the backlog is 11,000 cases - then that means that the tribunal must hear around 60 cases a day.  I do not know how this would be possible given the requirements and procedures the appeal goes through before an appeal date.  As I have said in my previous posting - there is a 90 day document exchange - so that means that if Minister Kenney is going to reduce these back logs by the end of summer - all the hearings would have to be scheduled by March or April of 2015. Any way I will let enquiring minds decide whether this may be realistic or not.  

I do hope it happens because it is time that these people who have been waiting get their appeals settled.  

I hope they do well at the SST and get it done. I have concerns in that, I hope that the quality of the decisions will not suffer as a result of this frantic push to get these appeals done.

Also I fear that there will be telephone hearings and while this might be an efficient way to get an appeal heard I personally do not think this is best for the Appellant.  I just know from the hundreds of appeal hearings I have attended that it is best to see and speak to the Appellant in person.  I have also seen the statistics on the denial rates when a telephone hearing is conducted - I personally would avoid this option.  Read my previous blogs on the statistics they are noted. 

So if you are scheduled an appeal in the next little while, please get someone to help review this information.  As I have said in my prior emails it is very important that this appeal is managed well as you will have very limited appeal rights if you are not prepared for this tribunal. I worry that all the Appellants who have been desperate to get an appeal heard will end up shafted. And not because of the staff and Tribunal Members at the SST but because they will not be adequately prepared for the appeal process.  

Anyway, I wonder how things will unfold over the next little while - I know there is further investigations to see if this "pledge" that Minister Kenney is making is realistic and I wonder if Minister Kenney will end up regreting these statements.  

I will keep you posted - If you get an appeal hearing date - call or email the office and we will be happy to give you some pointers.  Allison

 

Hearings at the Social Security Tribunal

The Social Security Tribunal continue to work hard to schedule cases.  It appears from what I am experiencing. that the legacy appeals are starting to move.  I know that I am seeing hearings scheduled for cases in the 121 - 123 range.  That is great news I am sure for many people who have been waiting for so long.

The first thing that will happen is that you will get a letter from the Social Security Tribunal advising that your appeal is now with a Tribunal Member and is ready to be heard.  Approximately four to six weeks later, you will receive by express post mail (you have to sign for it) a complete copy of the documents the Social Security Tribunal has on file.

You will receive a letter with your hearing date information.  It will tell you the type of hearing that you are going to have. As I have noted before, there are several ways for the Tribunal Member to conduct a hearing, they are a personal appearance, a video teleconference,  a teleconference, written questions and answers, and a hearing on the record.  Review what type of hearing that you are going to be given.  I would think twice if you have been given a teleconference hearing.  I think it is way better for you to have an in-person hearing or a video conference.  I have outlined my reasons why I feel this way in earlier blog entries.

If you want to change the format of your hearing - then you will need to write a letter asking for this to be changed - and if you are in this boat - please contact the office and I will provide some information on how to proceed with that.

The next thing you will note is that there is a document exchange period. You will be required to submit documents by a certain date.  At this time, you should review your file to determine if it is up to date with medical information.  You would need to submit documents within this 90 day exchange period.  I have had a client who was waiting for an appointment that fell within the 90 days but prior to the 30 day deadline that she had to submit her documents - so I wrote and asked for an extension and I have found that the Tribunal Members do their best to accommodate this - they want all the information they can get in order to help understand your appeal.

During this period you may also receive a submission from the Minister which is their position as to why your appeal should be denied.  It is important to review this information - and to determine how you are going to respond to this.  If you want to do a written submission it may help the Tribunal Member understand your position.  I would however, make sure that you have this reviewed by an expert to ensure that you are submitting helpful information that fall within the government tenets (I hope I have spelled that right VC).

I would like to compliment the Tribunal Members that I have met in recent months - some new - and some I know from the old Review Tribunal.  I think the hearings have been excellent - I think the Tribunal Members have been very well prepared and have done their utmost to ensure that the Appellants have a good hearing experience.  The only complaint I have are the locations of the hearings - I think they could be a little more comfortable for the clients but really that is a minor complaint.

Do not manage this appeal alone, get someone to help you through the process - it is a big hearing - there is a lot at stake.

Testimonials from recent clients!!

I am very pleased with the service provided by Allison.  She is truly dedicated to the cause of the disabled and disadvantaged.  Prior to my disablement by multiple sclerosis, I worked in a social services office and was well versed with different processes of getting disability benefits.  I proceeded with my own claim for CPP with just the help of my doctor and a social worker.  The process was very daunting, and Service Canada was of little or no help.  My original submission was woefully inadequate and I was denied.  I applied for reconsideration and did more research.  I found that like all things government, one needs to draw a detailed roadmap for the government employee doing the work in order to have any chance of success.  Even with my experience, I was not up to the challenge; I needed someone who was.  My research led me to Allison, and she took on my claim.  Within three months of her starting work on my claim, I got a favourable decision and am now receiving from CPP the benefit of my contributions that I paid during my working years.  The roadmap that she drew was painstaking accurate and detailed.

 

For those who are considering whether to hire an advocate, I can only say this:  Don’t go it alone.  When you go it alone, you have to do all the heavy lifting; you cannot expect nor does the law state that Service Canada has to do any of it for you.  You cannot just drop a stack of medical records in the adjudicator’s lap and expect them to spend all the time needed to make sense of it in a manner that is in your favour.  This is what they are supposed to do, but it will not happen unless you also have that expertly drawn roadmap.  Allison can provide that roadmap for you.  Please remember that CPP-D is not welfare.  If you have contributed to CPP, can meet the contribution and time tests and can no longer work due to disability, you have an entitlement to a benefit.  Don’t give up, call Allison and let her help you.  I cannot thank Allison enough for her time and effort.

 

Thanks again Allison for all your time and effort.

MB

 

 

I have simple advice for people with disabilities, if you looking for help and you lucky enough to find DCAC, than you are on the right truck. Trust Allison and simply FORGET THE REST because she is definitely THE BEST. Mr. Z.Z. 

 

Thank you to both these clients.  I appreciate your words of recommendation.

Scheduling of Hearings at the Social Security Tribunal

A quick entry to update those people who are currently waiting for appeals at the Social Security Tribunal.  I am speaking to those appellants who are Legacy Appeals - they are those who were at the Review Tribunal at the time of changeover to the Social Security Tribunal.

I have over the last two weeks received dates for hearings for individuals whose appeals are numbered 122 - 123.  

So these individuals had probably applied to the Review Tribunal to have their appeal heard in around early 2012.  These hearings are also being scheduled for the May - June 2015 period. 

Still a huge back log  waiting - all of the remainder of the legacy cases - they are numbered up to 125 and all of the Appeal GP-13 and GP-14.  But progress - finally  progress.

I would also like to caution people on two things - firstly - if you have an appeal scheduled at the Social Security Tribunal please get help with this.  It is just plain foolish to try to manage this type of appeal alone.  There is too much at stake and with very limited appeal rights if you are denied - you may just be done being able to apply for CPP disability again.  Also, be careful who you choose to help you.  There are individuals out there who claim to be able to do this work - I have written in prior blogs about the questions to ask if you are looking for someone to help you.  If you like, you can call this office and ask me.  I would rather help you decide than you rely on someone who does not have the expertise.

Secondly, try not to get to this level of appeal.  If you have been denied CPP disability, get help at the initial stages of application and for sure at the reconsideration appeal.  My staff and I can help prepare and audit your CPP Disability applications.

Statistics of Reconsiderations

Yesterday I received information concerning Reconsideration appeals to Canada Pension Plan.  If you are a follower of the blog, you will have read my complaints about the stupid denials I have been receiving from certain regional offices.  I decided to request information to determine whether the trend of denials could be supported by actual figures and that is the what I received yesterday.

In 2013 -2014 fiscal year, there were 13,841 requests for reconsideration received by Employment and Skills Development Canada.  This is your first level of appeal.

Out of the 13,841 appeals received 8,564 were denied - this is a 61% denial rate.

Now that is not really surprising to me because that is what the denial rate seems to hover around.

What is surprising to me, is that in the Ontario region, they received 7,586 requests for appeals and they maintained the denial of 5,216 of them.  That is a whopping 68 percent denial rate.

So back to the stupid denials.  Many of those DCAC has received in the last several months, the Medical Adjudicator - has not waited for the additional information they were advised was being submitted in order to add more support to the appeal.  They have simply denied them without waiting, without contacting the client, without contacting anyone to ensure that the client is ready to proceed with the appeal.  And I do not have to tell you where these denials are coming from - you guessed it - CHATHAM ONTARIO.

In documents I have reviewed, it is noted that part of the Federal Government's response to reducing the horrendus 11,000 appeal back log at the Social Security Tribunal is to ensure proper adjudication at the administrative level - that is the reconsideration level.  So may I suggest to the Ministry that they check this issue out.  The client I am looking at right now there is no indication in the file that the client was even phoned to ask if there was additional information and despite a letter that had been sent to contact my office, there was no phone call to me either.  The decision to deny this benefit was made on November 28th this was despite a phone call to Service Canada to advise them that additional infomration was forthcoming and was sent on December 4th.  Is there miscommunication between the Service Canada office and the CPP Disability office?

A.L. Medical Adjudicator in Chatham office, that is just not cool - do your job - develop the file - it is not at all fair to this client who will now be stuck in the SST back log.

Some News for the New Year on the Social Security Tribunal

Happy New Year to my clients, colleagues, and friends.

I just wanted you all to read this recent article in the Globe and Mail.  Some may suggest that only 1/3 of the Social Security Tribunal members having ties to the Conservative Party means that 2/3's of the members must have ties to the other political parties - but you will note in the article it states:

"According to the analysis, there's scant evidence any tribunal member has donated to ANY OTHER PARTY other than the Conservatives."

Here is the link:

http://www.theglobeandmail.com/news/politics/one-third-of-social-security-tribunal-members-have-ties-to-conservatives/article22315771/

Why???

Do you know that under the prior system we had tribunal members and judges who were well-experienced based on years of work with the appeal system - it begs the question as to why this was changed,  The old tribunal ran under the Conservative government and those appointments seemed to be appropriate and I completely disagree with Kenney's spokeswoman who suggests that this is a "marked improvement over the former system which had no comprehensive selection process whatsoever."  Hmm????  I am sure the well-experienced Federal Court judges and previous Tribunal Members who sat on the previous Tribunals would disagree with her comments and frankly find them insulting- give me a break and nice spin- yeah "you changed it" alright.

So have a think about who is hearing your appeals?  The tribunal members that I have dealt with under the new system have been very good.  I cannot complain.  But I also find it interesting, that all of the tribunal members DCAC has had at the SST hearings, have been previous tribunal members under the old system (what few there are). 

Get help please, do not proceed alone.  In my last blog, I talked about how experience matters when dealing with CPP applications and appeals.  We have the experience here at DCAC of that I am confident. The quality and experience of the staff includes prior tribunal members, paralegals, legal consultants, and prior CPP disability employees.  I have been very blessed to have a group of people who care about the clients and who have sought me out to work with this office because they have seen first hand, how the benefit of excellent case-management, ensures that the client has the best possible information to present when they apply for CPP disability or have to appeal the decision.

If you are at the Social Security Tribunal level, you know that you are going to be in for a very long wait.  I would take this time to make sure that your case is managed, all the information is marshalled, that you have the best possible opporutnity to convince the Tribunal Member that your appeal should succeed.

The staff here at DCAC are very happy to provide a free case assessment.  It will cost you nothing to make sure that you are heading in the right direction.

 

 

Experience Counts - Choose wisely

I am now entering my 17th year of case-management work for individuals who are applying for or have been denied Canada Pension Plan disability benefits.

It was recently suggested that people like myself, were "taking advantage" of people with disabilities because we charge a fee for the services that we provide and that most people could do this work for themselves for free.

Some agencies have suggested that they know the proper terminology that needs to be used in order to get results, or that they were experienced in directing doctors on what words to use in medical reports in order to get results.  As well, that the CPP disability adjudicators need to see the "proper" words in order to be approved.

There are also some agencies who feel they have the capacity to do this work with little or no experience.

It takes a very long while of working within this system to know how to manage applications and appeals.  Before you decide or who it is you are going to get to help you with this process, please ensure that you have done your homework and determined that the service provider you engage has the necessary experience to help you.  You should ask any agency or service provider what there experience is in the system, how many appeals and applications they have completed, and how many appeals they have attended and what their success rate is.  You should ask them how they plan to approach the management of your file, and how they are going to engage your medical health practitioners.  You should ask them if they have any experience dealing with your medical condition, and if they have, how have they managed this appeal.  Ask them how many years they have been working in this system and what can they offer to help you through the process.

The government and constituency offices who suggest that service providers are taking advantage of people with disabilities well that could not be further from the truth and perhaps those haters should remember that it is their own political party that are taking advantage by not approving the applications and appeals and continuing to maintain a 60% denial rate.  If the government adjudicated these applications appropriately, why would a service to help be needed?   Best to not throw stones.

This process is very complex and it is best not to try and manage this alone.  Saying that people could do this alone - well it is true - but it is not smart. Especially now with the new appeal system and the significant delays I would caution most people to get help with this process.

I would also like to say that having doctors use the "proper terminology' is not the greatest way to manage a medical report - if a letter states that a client's disability is "severe and prolonged" I feel that this provides little help to the overall application or appeal.

Also the information on this website and posted on this blog is copyrighted.  If you would like to use this information in your literature or websites please contact my office.

I would like to wish all the followers of this blog a Merry Christmas.  It has been a challenging year but it is my hope that 2015 brings some welcome changes to the CPP disability landscape.  Take care. Allison

 

Ask for an inperson hearing at the Social Security Tribunal

http://www.winnipegfreepress.com/canada/fewer-in-person-hearings-being-heard-by-social-security-tribunal--286276871.html

It has been statistically shown that appellants are more successful in their appeals if they have an in-person hearing rather than a hearing held over the phone or by video-conference.

I think what is missing from this article, is also the level of experience of the Tribunal Member.  I know this spokesperson from the SST continues to espouse how trained and proficient the tribunal members are, but in my experience any new tribunal members lack what I call "seasoning" which is in my opinion, a detriment to the appeal process.  I hope that the new hires to the tribunal will include many more of these "seasoned" and experience members who do not require "mentorship".

As well, it is noted by Richard Beaulne spokesman for the SST - that the type to hearing held had NO BEARING on the final decision.  I can tell you right now Sir, that is a load of rubbish.  Your statistics do not support your statement. 

You say that "Members make their decisions following a complete analysis of the evidence, submissions and applicable legsilative provisions presented by the parties."  HOW CAN THE MEMBERS MAKE A COMPLETE ANALYSIS OF THE EVIDENCE WITHOUT HEARING FROM THE APPELLANT?  ARE YOU TELLING ME THAT A TELEPHONE CALL IS AN APPROPRIATE WAY TO DO THIS? The statistics your office provides seems to illustrate that there is a significantly high number of denials when a Member holds a hearing by telephone compared to the in-person hearing.  Why is that?

If you had bothered to review the previous Pension Appeals Board cases that discuss the importance of being able to receive and consider the information provided by an appellant in person - you would soon realize how ridiculous your statements are.

So listen up people......  If you are told that your hearing is to be via teleconference - then you say NO you want to have an in-person hearing - so the totality of the information concerning your appeal can be assessed by a Tribunal Member. 

If this request is denied, please contact my office and I will pass your information on to some legal professionals who are developing a challenge concerning your right to chose the type of hearing you are given and the denial of the principals of natural justice. 

I will also tell you that most of these disability cases are complex - and the contents of a CPP disability file - NEVER - contains the totality of the information.  The CPP decision makers are required to consider the TOTALITY of the information - and how do you get that without hearing from an appellant.  I am just reading a letter that was sent to CPP Disability and this is what they write "I don't understand how somebody in your office who I have never seen, spoken too or been treated by apparently has this supernatural ability to know what I am or am not capable of doing based entirely on a couple of forms consisting of questions and answers and notes.  This person has the power over my life to decide on whether I should be or shouldn't be receiving a benefit for which I have paid into all of working life."  Note that this client is now stuck in the Social Security Tribunal line up due to the denial of his disability benefits by Canada Pension Plan.

Speaking to this point, it is noted in this newspaper article that the Feds pledged to "improve and rigourously monitor departmental processes, including reconsideration to minimize the number of cases proceeding to appeal."  YEAH RIGHT.  This week has been at least five denials where the Feds did not even wait for the client to submit the additional information before they chose to deny the claim.  One denial occurred a mere 37 days after the client submitted a reconsideration - and how is that not rubber stamping?  This was despite the client advising the CPP that they had additional information to submit.

On the last statistics received by my office, it is noted that the Ontario region had a 62% denial rate.  And according to the information in previous newspaper articles this is one of the highest denial rates in the world.

MP Jinny Sims says that government cannot be "insensitive"  I would like to say that it is not insensitivity but rather abuse of people with disabilities who have paid in to the CPP for years and who continue to deny their applications without following their own adjudication guidelines.

 

 

 

 

 

 

Backlogged by Design

http://www.ctvnews.ca/politics/harper-pco-approved-15-month-hiring-process-for-social-security-tribunal-1.2152053

 

Seriously - who puts a 15 month hiring process in place for an appeal tribunal that is going to open in 6 months?  I wonder if any thought was given to the numerous Canadian people whose lives are in turmoil while they wait for an appeal by the PMO as well as the "boys in short pants" boneheads who thought that this appeal system would be more efficient, fair, and transparent.  '

Minister Kenney blames the rigourous hiring process for the delays - yet he knew that there was a huge back log coming down the pipes and did not start hiring until six months before the tribunal opened knowing that the rigourous hiring process would take 15 months.  It just stinks. 

I feel extremely bad for the Chairperson and the staff at the SST who were some how supposed to manage this screw up on behalf of the bureaucrats.  Must have been real cushy gig for the rigourously-appointed newly-hired tribunal members getting their six figure salary while Canadians with disbailities suffered?