Can I Appeal My CPP Disability Denial?
You can appeal a Canadian Pension Plan Disability (CPP-D) denial.
Say your initial CPP-D application was rejected, what next? Don't panic; over 50% of initial CPP-D claims are denied. There are multiple levels of appeals that can overturn a denial. This post will give a quick outline of what these levels are and what happens at each stage.
How to Qualify for CPP-D Benefits
To qualify for CPP-D benefits you must suffer from a severe and prolonged disability that stops you from doing any type of substantially gainful work. For more information on Canada Pension Disability Benefits, tests you should read this post.
What is clear is that the substantially gainful threshed is a high bar to meet for many applicants. Many applicants fail to properly communicate to the application reviewer that their disability actually rises to the level of "severe and prolonged". Many applicants who are denied must consider how to gather evidence to establish that they are sufficiently disabled to qualify for benefits.
Following a denial of a CPP-D application, it is highly recommended that you speak to a disability lawyer with experience advancing CPP-D claims. Many clients who turned to NOVA Injury Law for help have found that the knowledge and experience of the legal team was helpful to expedite their claim.
Appeal Step 1: Reconsideration
Following an initial denial (from a Service Canada adjudicator) you can apply for a reconsideration appeal with Service Canada. A large number of applicants decide not to pursue an appeal via reconsideration because it will be too difficult. Others feel defeated and choose to forgo an appeal because of their own frustration with the government or the application process.
Fighting for your disability benefits can be a complicated and trying process. Take a deep breath and appreciate that a denial is not the end of the road.
How Do I Win the Reconsideration?
We are often asked by CPP-D applicants how to improve their application. Most applicants consider ordering an updated copy of their medical file, or attempt to explain why they cannot work in their former position for various reasons. This is a mistake.
In order to win your reconsideration you must provide information that speaks directly to the test under review: a severe and prolonged inability to work in any occupation.
We are often asked to consider taking on an appeal case after a reconsideration request has failed. On review of the file, it is apparent that the applicant simply failed to appreciate the test for benefits and failed to properly consider what evidence would be needed for the reviewer to decide in their favour.
Do you have concerns about evidence to support your claim during the initial application or reconsideration? If so, you should speak to a disability lawyer immediately.
Appeal Step 2: Social Security Tribunal (SST)
In the event that the reconsideration appeal results in a denial you can appeal that decision to the Social Security Tribunal. At this level, claims can be approved immediately following a review of the file. This means that you may not need to be present at an appeal hearing in order to achieve a favourable result.
If your application proceeds to the SST and the denial is maintained, the ruling is final. Given the finality of the decision made by the SST, it is essential that applicants are making the most of this stage of the appeal. Creating a strong initial disability claim is crucial in the CPP-D appeal process.
Disability lawyers specialize in bolstering disability claims to maximize acceptance potential. For more information on creating a strong disability claim, be it a CPP-D claim or a Long-Term Disability claim, you should order a copy of The Must-Read Guide To Winning Disability Insurance Benefits. You can order your free book here.
Speak to a Disability Lawyer
Jeff Mitchell is the Principal Lawyer and Founder of NOVA injury Law. Jeff has dedicated his practice to the area of personal injury, accident, and disability benefits law. He has experience helping clients apply for Canada Pension Disability Benefits.