Kristy thought she would be covered by the Canadian Pension Plan (CPP) disability insurance after battling cancer and undergoing two major surgeries.
She was denied.
Unfortunately, cases like Kristy’s happen all too often.
The Huffington Post reported, about 60% of CPP disability applications are initially denied — one of the highest rejection rates for a disability insurance program among the nations of the Organisation for Economic Co-operation and Development (OECD).
CPP Disability benefits provide financial assistance to eligible individuals who suffer from a “severe and prolonged” disability, as well as to individuals in other limited circumstances. With Kristy, her illness didn’t meet the prolonged criteria, as she was expected to return to her job eventually.
While Canadians cherish and depend on the CPP, only few fully understand it. We agonize over when to take it; we over – or underestimate how much we’ll get; and we become anxious to find out if we’ve been approved and then stressed to find out that we’ve been denied.
The CPP Disability program is a difficult system to navigate if you are not familiar with what is required to successfully appeal the denial of your application for benefits.
Claims are denied due to anything from insufficient paperwork to a lack of proper medical and employment information.
If your claim has been denied there are 3 major stages to the CPP appeal process:
Stage one: Request Reconsideration
If your application for CPP disability benefits is denied, you should receive a letter from Service Canada setting out the reasons for the denial, as well as the steps that can be taken to request a reconsideration of the decision. A request for reconsideration of the decision is the first mandatory step required in the appeals process. A new employee will review your claim, as well as any additional information you provide, and will render a new decision. You must make a written request for reconsideration within 90 days of receiving your CPP disability decision.
Stage two: Social Security Tribunal (SST) General Division
If you have requested reconsideration of your CPP disability application and are still denied, you may then appeal to the General Division of the Social Security Tribunal (SST).
Your appeal to the General Level of the SST must be in writing and must be received within 90 days of the date of your reconsideration decision. There’s a form on the SST’s website you can use to appeal, or you may write a letter explaining your appeal to the SST.
Stage three: Social Security Tribunal (SST) Appeal Division
If you have appealed to the General Division of the SST, and again been denied, then you have one last avenue left for appeal: to the Appeal Division of the SST. This last level of appeal is perhaps the most challenging since you must seek and obtain permission to appeal.
Each one of these CPP Appeal Process stages has it’s own rules and its own deadlines. It is important that you speak with a CPP disability lawyer to make sure that you comply with the deadlines and the rules of each stage of your appeal.
If you believe you are entitled to CPP disability benefits and have had your claim denied, our lawyers at Harris Law can help you obtain the benefits to which you are entitled.