The Canada Pension Plan Disability Benefit (CPPD) is a federally funded long-term disability benefit program available to disabled individuals (and their dependent children) who have contributed to the plan through the course of their employment.
In addition to having made sufficient contributions to CPP, you must also demonstrate that you are suffering from a “severe and prolonged” disability. A “severe” disability is a physical and/or mental disability that prevents you from earning a living. While a “prolonged” disability means that your disability will prevent you from working for the foreseeable future.
Unlike some provincial plans, CPPD is not based on your household earnings. If you have made sufficient contributions to CPP over the years, you will need only to provide evidence of a serious and long-standing disability, to be approved for the benefit.
If you are approved for CPPD benefits, it will not reduce your future entitlement to your CPP pension. Once you reach age 65, CPPD will be automatically converted to your pension benefit.
The Why
There are several important reasons to apply for CPP Disability benefits. The most obvious, is that it provides you with a monthly income (based on your prior earnings) and while it is taxable, the benefit is subject to an annual cost of living increase.
If you are approved for CPP Disability, you will also be permitted to earn a small amount of income from employment, without any reduction to your benefit. This allows you to supplement your income, while benefiting from engaging in minimal employment, as tolerated by your illness. This can be both psychologically and financially beneficial to you.
The third reason to apply is that, if you are receiving long-term disability benefits from a group policy from your employer or from an individual policy of insurance, the may require you to apply for CPPD so that the insurer may reduce the amount they pay you, by the amount you receive from CPPD..
Finally, if you are in litigation with an insurance company, claiming payment of long-term disability benefits under a group or individual policy of insurance, it is important that you “mitigate” your damages by applying for CPPD. This means that the the insurer and the court will want to see that you are doing everything possible to improve, not only your medical condition, but also your financial situation. While being approved for CPPD may reduce the long-term disability benefit amount from the insurance company, the approval can be used as evidence of a “severe and prolonged” disability, which can be persuasive and ultimately result in a better outcome for your long-term disability lawsuit.
The When
The best time to apply is when it becomes clear to you and your doctors that it is unlikely that you will return to work, in the near future (or within the next year or more). CPPD will often pay retroactively (up to one year in the past), if the evidence it receives shows that you have not been able to work well-before you submitted your initial application. The payment of arrears, can be of significant financial assistance at a time when you are not and have not been earning an income from employment.
Similarly, it is important that you exhaust all appeal options under the CPPD program. Often individuals are denied on the basis that they have not tried all possible treatment options available or recommended by their doctors or perhaps that it is unclear to CPPD as to whether the disability is truly prolonged, as a prognosis for recovery has not been provided. The passage of time and the submission of additional medical records on appeal, may result in the reconsideration of a denial and ultimately, the award of the benefit.
If you are in litigation for long-term disability benefits, often the medical records and reports that are used to support your case, can also be submitted to CPPD, as persuasive evidence of a “severe and prolonged” disability. If you are in litigation and applying for or appealing CPPD, you should request a copy of the records and reports in your legal file and forward them the CPPD as part of your initial application or as evidence on reconsideration or appeal.
The How
The Application for Canada Pension Plan Disability Benefits is available online or at Service Canada offices. The application package includes application forms for you and your dependent children, a questionnaire about your medical condition and work history, a medical report to be completed by the doctor most familiar with your disabling condition, and a consent to allow Service Canada to obtain additional information about your disability and your employment.
The initial application is straightforward and few people require professional assistance (lawyer or paralegal) to complete and submit the forms. If the initial application is denied, the applicant can request a reconsideration of the decision. In some limited circumstances, it may be helpful to obtain legal assistance with the reconsideration . However, generally, the reconsideration consists of providing new or more specific information which can easily be submitted by your doctors, on your behalf.
If the denial of CPPD benefits is upheld after reconsideration, you have the option of appealing the decision with the Social Security Tribunal. If you find yourself scheduled for a Tribunal hearing, it may be helpful to obtain representation from a lawyer familiar with CPPD and long-term disability law. Your lawyer should be able to ease your stress by presenting your case and all the medical evidence to the tribunal on your behalf.
