CPP Disability Guide for Stroke Survivors. Eligibility, How to Apply & Denial Process
Stroke is the leading cause of adult disability in Canada and the third leading cause of death.
It is estimated that 40% of stroke survivors are left with moderate to severe impairment and about 10% are severely impaired and require long-term care.
With over 60,000 strokes happening in Canada every year, strokes’ long-term effects on the Canadian population are significant.
Even though strokes are more likely to occur in people 65 years or older, tens of thousands of Canadians under 65 years of age struggle with the effects of stroke and the impairments that follow.
In Canada, if a stroke victim is under the age of 65, has been actively paying into the Canadian Pension Program during their working years, and he/she cannot rejoin the workforce due to impairments caused by a stroke (mental OR physical), they may be eligible to receive monthly CPP Disability payments until they reach retirement age.
We created this article to highlight the CPP Disability program and what those suffering from the debilitating aftermath of a stroke need to know when applying for the benefit.
Throughout this article, we will cover:
- What is CPP Disability?
- Is a stroke considered a disability?
- How do I apply for CPP Disability?
- Common reasons CPP Disability claims are denied
In this article, we will discuss the CPP Disability program from a stroke survivor’s point of view but there is more to CPP Disability program than that. To learn more about the CPP Disability program, check out our comprehensive CPP Disability guide for an in-depth look.
Is Stroke Considered A Disability?
According to the Canadian Chronic Disease Surveillance System, the number of Canadians who survived a stroke grew by 40% in recent years and it is estimated that there are more than 400,000 Canadians living with the impairments caused by a stroke.
As the Canadian population grows and ages the number of stroke survivors is expected to rise dramatically in the coming years.
With that being said, stroke by itself is not considered a disability by Canadian government organizations such as CRA and Service Canada but long-term effects of stroke can be life-altering and, in some cases, life-limiting so only when the impairments are severe and prolonged that the CRA and Service Canada may view the person as disabled.
As seen in the chart below, the risk of having a stroke increases with age and the more severe impairments and death happen to older men and women but for the purpose of this guide we will focus on those under 65 that due to impairments caused by stroke may have stopped working.
While having a stroke is not considered a disability, the long-term impairments resulting from a stroke can be severe and debilitating. People experiencing these impairments could be affected to a disabling degree, therefore continuing in their jobs or even performing the necessary daily life tasks could be overwhelmingly challenging.
Some of the impairments that can result from a stroke are:
- Around 90% of stroke victims suffer from a wide variety of mental, physical, psychological and emotional conditions.
- Up to 80% can suffer from Hemiparesis- weakness in one-half of the body.
- Between 40%-60% develop bladder and bowel complications after their stroke.
- Around 50% of stroke victims will be left so severely impaired they’ll be unable to rejoin the workforce.
It may sound daunting, but these statistics reveal that while a stroke itself is not considered a disability under Service Canada, the disabling effects of stroke can certainly qualify a person for CPP Disability.
What Disabilities Result From A Stroke?
As previously mentioned, several disabling conditions can result from a stroke. As strokes directly affect the brain, stroke survivors may experience disabling impairments, ranging across physical, emotional, psychological, and mental spectrums.
It is important to note that strokes can have long-term effects on the mental health of survivors. Whether the impact of mental health is the direct result of brain damage due to the stroke or the stroke’s impact on their quality of life, mental and emotional ramifications of stroke are very real.
We have outlined many, but not all, of the possible complications.
What are the Physical Effects of a Stroke?
- Vision problems
- Hearing problems
- Speech problems
- Digestive and bowel issues
- Difficulty swallowing
- Difficulty gripping and holding objects
What are the Mental And Cognitive Effects of a Stroke?
- Difficulty reading, writing or concentrating
- Difficulty with organizational processing and learning new things
- Problems with judgment
- Issues with object recognition or perception of distance
- Task performance (even without a corresponding physical impairment)
- Planning and problem solving
What are the Effects a Stroke has on your Mental Health?
- Mood and personality changes
- Depression or Anxiety
- Post-Traumatic Stress Disorder (PTSD)
- Disinhibition or Poor impulse control
What is CPP Disability?
The Canadian Pension Program Disability Benefit is a taxable monthly payment allotted to individuals who:
- Have contributed to the Canada Pension Plan (CPP)
- Are under the age of 65
- Cannot work due to a severe disability.
To be eligible for CPP Disability, you must be under the age of 65 and are unable to continue in the workforce due to a disabling condition. CPP Disability provides a lump sum retroactive payment (up to 18 months to compensate you for the months passed until your application was approved) as well as a fixed monthly payment until you reach the age of 65.
It is important to note that you cannot receive the CPP Disability and your Canadian Pension allotment at the same time unless you receive benefits retroactively after you have turned 65. if you have just turned 65 and your disability started before 65, you may be able to apply for the CPP Disability and receive retroactive payments alongside your regular CPP benefit.
CPP Disability Eligibility Criteria
There is a wide range of conditions and impairments that can qualify a person for CPP Disability. The required qualifications for the CPP Disability must fall within three essential requirements: Age, CPP-contribution Requirements, and Length and Severity of conditions. The application must also provide proof of fulfillment of the criteria listed above to fully qualify for the CPP Disability. We will go through each of them below.
Age Requirements For CPP Disability
The Canadian Pension Program Disability Benefit helps people between the ages of 18 and 64 who have stopped working due to an impairment that keeps them from gainful employment. Once these individuals have turned 65, their CPP Disability turns into the standard CPP benefit.
The claimant will not receive both the CPP Disability simultaneously as regular CPP benefit payments unless they are receiving their CPP Disability payments retroactively.
CPP Contribution Requirements For CPP Disability
To qualify for CPP Disability, you must have contributed to the Canada Pension Program.
All working Canadians must pay into the CPP by law, but contributing to CPP does not automatically guarantee you will be eligible to receive the CPP Disability.
To qualify you:
- Must have been an active contributor to CPP for at least 4-6 years before your application,
- Have been an active contributor to CPP for 25 years or longer and have paid into the CPP for 3 of the previous 6 years before applying.
Proving Your Condition is Severe or Prolonged
As mentioned above, age and previous CPP contributions affect an individual’s eligibility to receive CPP Disability, but they are not the only factors.
The most important eligibility criteria for qualifying for CPP Disability are the way the impairment affects your ability to perform daily life activities.
The individual’s impairment is determined by two key factors: Severity of condition and Prolonged duration.
“Prolonged” and “Severe” mean that your condition prevents you from doing the work you were previously doing before its onset and prevents you from further gainful employment in a field outside your original job. It also means the recovery from the condition is either impossible or would take an unknown amount of time.
Service Canadas’ Definition of “Severe”: The Government of Canada defines “Severe” as meaning the individual has a mental or physical disability that regularly stops them from doing any type of substantially gainful work.
Service Canadas’ Definition of Prolonged: The Government of Canada defines “Prolonged” as meaning that the individual’s condition is long-term and of indefinite duration or is likely to result in death.
If you meet the above criteria, you could be eligible to receive the Canada Pension Program Disability Benefit. To learn more about CPP Disability eligibility, check out the “Who is Eligible for CPP Disability Benefits?” in our CPP Disability guide.
How Much Can You Receive from CPP Disability?
The Canadian Government understands that stroke victims and their families may be facing undue financial burdens due to their circumstances. Advocacy exists to help sufferers get the support they need. However, the adjudication process for applicants to CPP Disability requires proof of their disabling conditions’ severity and longevity.
Here is a quick look at what you can receive if you qualify to receive the CPP Disability:
- A one-time retroactive payment that increases the longer you have been out of work for up to 18 months. This is calculated by taking how much you receive from a monthly CPP Disability payment multiplied by the number of months you have been out of work.
- A monthly payment of up to $1,413.66 (updated 2021), or more if you have children.
For a more accurate look at how much you can receive from the CPP Disability monthly payment, check your Statement of Contributions to the CPP by using your My Service Canada Account, or contacting Service Canada by mail or phone.
How Do I Apply For CPP Disability?
Applying for CPP Disability is straightforward, although detailed. Resources like this article, and others on our site, are designed to provide tools to those navigating the application process.
Service Canada now requires two documents to process a CPP Disability Application. These are the ISP1151-CPP Disability Benefits Form and the ISP2519-Medical Reporting Form. Both are found on the Government of Canada website. Once applying, it typically takes 120 days to get a response from the Canadian Government.
- ISP1151-CPP Disability Benefits Form: Must be filled by the claimant
- ISP2519-Medical Reporting Form: Must be filled out by a personal physician or other medical practitioners.
There is an average wait time of around four months after applying for the CPP Disability Benefit. As your application is processed, a Service Canada member will call you, and you may be requested to provide additional information.
For more information on what to expect after you have applied, visit the Government of Canada Page Canada Pension Program Disability Benefit- After you’ve applied, which outlines the post-application process.
Our comprehensive guide to the Canadian Pension Program Disability Benefit includes a “How to complete your CPP Disability Benefits Application” section, which is highly beneficial and covers areas not addressed in this article. The article covers ways of calculating the amount you may be eligible to receive, comprehensive advice for completing your application, and what to do if your claim happens to be denied.
Getting Approved for CPP Disability as a Stroke Survivor
If your claim is denied, do not be discouraged. In 2016, out of the 70,000 applicants who applied for CPP Disability, 60% got rejected on their first application. While this may sound disappointing, there are ways to request reconsideration from the government.
One of the most important steps to take would be having your doctor supply sufficient evidence that explains in detail your symptoms and impairments and how they affect your ability to work. The claims made by your doctor on your CPP Disability application must be backed with medically acceptable clinical diagnostic techniques. The more your doctor elaborates on their claim that you are incapable of retaining gainful employment, the more likely a CPP Disability adjudicator will accept it.
While a medical report is crucial, it is only the beginning step in building your CPP Disability case. You will need to collect as much medical evidence as you can surrounding your impairment, all of which should highlight the severity and prolonged nature of your impairment. Medical reports are often the cause for approval, but only in cases that make it very clear that your condition is severe and prolonged.
If you have had your CPP claim denied, do not be discouraged. There may still be options available to you. We have categorized the most common reasons for denial below and provided some action items for reconsideration.
Common Reasons CPP Disability Claims are Denied
Unfortunately, it is not uncommon for a claim to be denied, even when the applicant qualifies for disability. Around 60% of all CPP Disability applications are denied due to various reasons such as insufficient information or proof that the applicant’s condition is severe enough to prevent them from retaining gainful employment.
If your application was denied and you’re seeking additional assistance through the appeal and denial process, contact Disability Credit Canada today. We will guide you through the appeal and denial process with our extensive knowledge and experience.
Here are some of the most common reasons for denial:
Denial Due To A Late Application
Many claims are denied because the claimant is applying for assistance too late.
One of the requirements for CPP- D is that the claimant must have been an active contributor to their CPP for 4 out of the last 6 years. If you have not paid into CPP for at least 4 of the previous 6 years, your claim may be denied.
It is still possible to get a provision and qualify for the benefit if this is the reason your claim has been denied. You may be able to qualify with the Late Applicant Provision, which you can find more information about by visiting our free article on Reasons CPP Disability Applications Are Denied.
Denial Due To Condition Being Deemed Neither Severe or Prolonged
Your application may be denied if your condition is not considered “Severe” or “Prolonged”. If your claim is denied for this reason, but your life and livelihood are still severely affected by the disabilities caused by your stroke, you may be able to request an appeal.
Denial Due To Lacking Information (Medical Or Otherwise)
Your application must include all the required information to confirm your condition’s severity and longevity. In most cases, you will need to provide extensive medical records to support your disability claim.
You may be able to appeal the decision on your application, call in to provide further details or resubmit at a later time with more comprehensive information.
Sometimes even qualified individuals are denied their claims simply because there is not enough information in the application to support the seriousness of their impairment.
Denial Due To Not Meeting The CPP Contribution Requirements
Your application could be denied because you have not paid into the minimum requirements for your CPP contributions.
Some extenuating circumstances may still allow you to be eligible for some CPP Disability payments. You may still qualify if you did not meet contribution requirements because:
- You were a caregiver to children.
- You were working abroad.
- You suffered an impairment so disabling or severe that you were unable to apply during
- the required period.
In these cases, you may still be eligible for CPP Disability Benefits.
How Do I Appeal A CPP Disability Decision?
As we stated above, it is not uncommon for your CPP Disability application to be denied. There are many ways to appeal the decision. If your application is rejected, you can appeal the outcome of your case.
For more information, check out our article “How To Write A CPP Disability Appeal Letter.”
Other Available Benefits
If you cannot work following a stroke or become the primary caregiver of a stroke victim, you may be eligible to receive several other benefits that provide financial assistance through your Federal and Provincial governments.
The Government of Canada offers a Benefits Finder that you can quickly locate Provincial supports in your area. You can also visit the Heart and Stroke Foundation of Canada, a free resource of Provincial and Federal support options depending on your region.
On a Federal level, you may be eligible for:
The Employment Insurance Sickness Benefit can provide short-term (15 weeks) financial assistance if you cannot work due to medical reasons. You may be able to receive up to 55% of your earnings up to a maximum of $573 a week.
The Government of Canada and the Canada Revenue Agency (CRA) have created the Disability Tax Credit to help Canadians with disabilities (and their families) have more significant financial support. The DTC is a non-refundable tax credit that the disabled person, or their family, may be eligible to receive, based on the federal taxes paid.
There are several ways a person can qualify for the disability tax credit. To find out more about eligibility requirements, visit our free information page on the Disability Tax Credit Eligibility Information and Conditions. To be eligible, you must meet specific criteria regarding the nature of your conditions. However, with these criteria met, you or a loved one caring for a disabled person should receive the DTC.
Please refer to our comprehensive article, The Disability Tax Credit Ultimate Resource Guide, for more information on the DTC.
The effects of a stroke can be devastating for Canadians and their families. If you or a loved one has suffered debilitating impairments due to a stroke, you may qualify for CPP Disability.
CPP Disability can help keep you financially stable following a stroke and help you with additional expenses related to your impairments. The benefit also provides programs aimed at helping you rehabilitate and rejoin the workforce.
If you or a loved one has experienced a stroke, don’t take on the financial burden alone. There is assistance available that can help if gainful employment is no longer an option.
At Disability Credit Canada, we have helped hundreds of Canadians with their CPP Disability Benefits application. Our extensive experience and knowledge of the CPP Disability program is second to none. Once we take on your case, we will leave no stone unturned to get your CPP Disability application approved.
We offer free assessments and work on a NO WIN – NO FEE basis, meaning we only get paid if you do and are incentivized to bring you the most out of your refund!