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CPP Disability Denial and Appeal Overview

August 19, 2019 by dccinc

CPP Disability Denial Overview

Service Canada does not formally release the number of CPP Disability claims they process annually but it is widely agreed that Canada’s CPP Disability denial rates of about 60% are possibly the highest in the OECD (Organization for Economic Co-operation and Development).

It wasn’t until the 2016 Auditor General of Canada report on the CPP Disability (fiscal years 2014-2015) that we found the following annual statistics:

• Nearly 70,000 people applied for CPP Disability
• About 60% of initial CPP Disability applications were denied
• About 35% of those who had their CPP Disability denied appealed the Service Canada decision via the reconsideration request process
• Only 35% of those who appealed at the first level had their CPP Disability application approved
• About 40% of those who were not approved at the first stage of the appeal process, filed an appeal with the Social Security Tribunal (General Division)
• About 65% of those who went to the Social Security Tribunal were approved
• About 45% of those that took their case to the second Social Security Tribunal – Appeals Division, ended up being successful

As you can learn from the annual statistics presented above, having been denied CPP Disability benefits is NOT the end of the road. With these articles on CPP Disability Appeal Process, we want to assure you that you still stand a good chance of overturning the result of your CPP Disability case and gain access to the benefits.

If you’ve been beset by a disability you believe to be both severe and prolonged don’t hesitate to apply for the Disability tax Credit or CPP Disability Benefits program or both. Disability Credit Canada has helped many Canadians apply for CPP Disability and/or appeal CPP Disability decisions.

Below is updated information on the common reasons CPP Disability applicants are denied, the appeal process as well as a link to a step-by-step guide to help you take action in the CPP Disability appeal process.

Reasons People are Denied CPP Disability

Before starting your appeal process, it is crucial that you fully understand the reasons your CPP Disability application has failed. We strongly recommend that you read the denial letter carefully, and take notes of what the Service Canada says, in order to better prepare for your CPP Disability appeal application.

The CPP Disability denial letter will usually refer to the medical reports, doctors’ opinions and other documents that Service Canada has reviewed. In the letter, Service Canada will usually state what information it has used to arrive at its decision.

You will also find included with your denial letter an information sheet entitled: “How to Ask Canada Pension Plan (CPP) Disability to Reconsider Its Decision”. Please read it carefully as it provides you with the information required to prepare for reconsideration (appeal).

From our vast experience in helping Canadians appeal their CPP Disability decision, we have seen a few common mistakes:

1. Applicants failed to prove that their condition is severe and prolonged
2. Applicants failed to identify and obtain appropriate medical reports and employability information
3. Applicants failed to apply within the CPP Disability predetermined deadline
4. Applicants did not meet the qualifying financial contributions
5. Applicant did not fully understand the requirements and the CPP Disability application process

For extensive information on each reason of why applicants were denied CPP Disability, please refer to our article “Reasons Applicants Were Denied CPP Disability Benefits”

The CPP Disability Appeal Process – An Overview

As mentioned earlier, a CPP Disability applicant has 3 opportunities to appeal Service Canada’s decision as there are 3 levels to the CPP Disability appeal process.

We created a set of CPP-Disability-related articles that go into each appeal process in detail, here’s an overview:

1. The CPP Disability Reconsideration Request – You have 90 days to write Service Canada to let them know you want them to reconsider their decision; then collect new medical reports and other supporting documents to appeal their decision.

Learn more about the CPP Disability Reconsideration Request

2. Appeal to the Social Security Tribunal (General Division) – If you were denied at the Reconsideration stage, you may want to proceed to the Tribunal – General Division. At this stage, you also have 90 days to appeal to the decision regarding your previous submission

Learn more about the Social Security Tribunal (General Division)

3. Appeals to the Social Security Tribunal (Appeals Division) – If you were denied at the General Division Tribunal, you now have another 90 days to appeal their decision. This is the final stage of Appeals regarding to CPP Disability decision on your case.

Learn more about the Social Security Tribunal (Appeals Division)

At Disability Credit Canada, we take pride in helping disabled Canadians claim CPP Disability and Disability tax credits. Check out our other Resources

1. The Ultimate CPP Disability Guide
2. Long Term Disability Claims and Appeal 
3. Common Medical Conditions Eligible for Long Term Disability Benefits
4. CPP Disability Benefits Application Guide
5. CPP Disability Benefits Frequently Asked Questions
6. CPP Disability Request For Reconsideration Sample
7. CPP Disability Appeal Letter Sample