CPP Disability Appeal: Social Security Tribunal – General Division

Learn about the CPP Disability appeal at the Social Security Tribunal - General Division
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August 19, 2019 by dcci

If your CPP Disability application reconsideration has been denied, don’t be discouraged as you can still proceed to appeal Service Canada’s decision to the Social Security Tribunal – General Division.

The following article will describe the appeal in detail. But first, please see an overview of the core steps to the CPP Disability Social Security Tribunal – General Division

  1. To start an appeal, you must first complete a Notice Of Appeal. This Notice Of Appeal must be completed and sent to the Tribunal within 90 days after Service Canada has communicated their decision of the Reconsideration to you.
  2. After receiving the Notice Of Appeal, the Tribunal will then send it to Service Canada, and request documents related to your file. Once the Tribunal has received your file from Service Canada, they will respond to you and include a Notice Of Readiness.
  3. You will now have 365 days from the date the Tribunal received the appeal to file a Notice of Readiness. It is now your time to gather relevant and extensive information to support your appeal.
  4. The Tribunal will send a Hearing Information Form two months before the 365-day period has expired. Both the appellant and Service Canada submits a Hearing Information Form.
  5. A Notice of Hearing will then be sent to all parties. The hearing is held or a decision is made based on the written record. The final decision will be sent to both parties by the written record.

Important Notes on Social Security Tribunal – General Division

Assess Your Chances Of Success

Before investing your time in preparing for the appeal, we highly recommend that you carefully assess your case. This initial self-assessment is to have a look on your previous application, in order to prepare better for the appeal. There are some situations where the Tribunal has no choice but to deny your case in compliance to the law as follow:

  • If you do not have sufficient contributions to CPP
  • If you do not have any medical evidence to show that your condition was severe enough to prevent you from working at any job on a consistent basis when you last qualified for benefits
  • If you have been receiving early retirement benefits for more than 15 months before you applied or became disabled after you started receiving early retirement benefits

Notice Of Appeal

To start an appeal, you need to complete the Tribunal’s Notice of Appeal form which is available on the Service Canada website. Most of the information required on the Appeal form is personal information, so it is important that you include the most up-to-date personal information when you send in this form.

Section 4 of Notice Of Appeal asks you to explain the reasons why you are appealing the decision. You should provide a clear explanation about why you are appealing, but it is not necessary to go into a lot of detail at this stage as you will be able to make a more substantial submission with all your new documents later.

Section 5 of the Notice Of Appeal form asks you to attach any documents you may have to support your appeal. The only document you must attach is the CPP Reconsideration Denial Letter. The Tribunal needs to see this letter before it will accept an appeal. Please make sure to complete all parts of the Notice Of Appeal, as your application will not be considered if any part is left out. The Tribunal will then send you a letter of acknowledgment regarding your submission of a completed Notice Of Appeal within 2 -3 weeks.

The Acknowledgement Letter

In the Acknowledgement Letter, the Tribunal will notify you that they will be obtaining all your CPP Files from Service Canada, including CPP Disability application, medical information, doctors’ letters, a record of earnings, CPP contributions, decision letters, and usually includes adjudication summaries. You should also receive a copy of your file from the Tribunal about a month after you receive the Tribunal’s acknowledgment letter.

Important Note:

You will have 365 days from the date that the Tribunal received your Notice Of Appeal to provide any additional information or argument in support of your appeal. It is always a good idea to wait until you review your file before gathering additional information, as you should still have 10 or 11 months to do so after you have received your file.

Your CPP Disability File and Notice Of Readiness

The Tribunal will send you another letter enclosing your CPP Disability file. Read this letter carefully as it advises you that you have up to one year from the date it received your appeal (date will be shown in the letter) to provide the Tribunal with any new information you want to be considered. Along with its letter, the Tribunal will also provide you with a Notice of Readiness Form. You will have up until the date that is shown in the letter to complete and send your Notice of Readiness.

Do not complete the Notice of Readiness unless you are sure that you have no more new information to provide or no more arguments to make in support of your appeal! It is certainly wise to wait until you have reviewed a complete copy of your CPP file. The Tribunal might not accept any new information from you after you send in your Notice of Readiness.

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Decision-making Process of The Social Security Tribunal

Security Tribunal decisions are made by a single Tribunal Member. There is no automatic right to an In-person Hearing. Decisions can be made in any of the following ways:

Summary Dismissal

If the Tribunal believes your appeal has no reasonable chance of success, it can summarily dismiss your appeal.

The Tribunal must advise appellants in writing before summarily dismissing an appeal and give the appellant a chance to provide a written response. If your argument convinces the Tribunal that your appeal has a reasonable chance, you might overturn the result of your appeal. There is an automatic right to appeal a summary dismissal decision to the Appeals Division of the Tribunal. This decision can be made at any time during the appeal process.

Decision-Based on the Written Record

A Tribunal Member could decide not to hold any type of hearing and make a decision based on the written record alone. A Tribunal Member can grant an appeal based on the written record or dismiss it.

There is no automatic right to appeal this type of decision.

The Tribunal uses this form of hearing when: the issues are not complex; there are no gaps in the information in the file or need for clarification; credibility is not a prevailing issue. There may be other factors that a Tribunal Member might consider when choosing this form of hearing.

Hearing by Written Question and Answers

If the Tribunal Member deciding your appeal needs more information, he or she can send you questions in writing, which you will answer and send back. The Tribunal may use written questions and answers if there are gaps in the evidence that require more information.

Telephone Hearing

The Tribunal could decide to hold a hearing by tele-conference. All parties will be given instructions on how to connect to the conference call. The Tribunal tends to use conference calls when there are gaps in the evidence, but there is only one person participating in the hearing and credibility is not a prevailing issue.

 Video conference

The Tribunal could also hold a hearing by video conference. You will go to a Service Canada Centre that has a video conferencing room and won’t be allowed to use your own computer. Video conferences may be used if there are gaps in the evidence and credibility is an issue, the case is complex, or there will be multiple people at the hearing.

In Person Hearings

The Tribunal could hold an in person hearing where everyone gets together in the same place.

For example, an in-person hearing may be appropriate if the issues in the appeal are unusually complex, or if someone participating in the appeal has a disability that will make it difficult to understand what is said by telephone or video conference.

Witnesses

Your oral testimony is the most important source of information for the Tribunal. You are also allowed to call witnesses who can give testimony in support of your appeal.

The Social Security Tribunal usually schedules hearings to last an hour and a half. You should only call witnesses who are genuinely helpful to your case. If possible, ask your witness to prepare a statement that you can submit before the deadline for adding new documents has passed. You can also ask a friend or family member to attend the hearing for support.

Tribunals are often in favour of witnesses who know you well (spouse, partners, close friends) and can provide evidence about how your life has changed over time because of your disability. It is not necessary to have a witness at the hearing, but it can help if there is someone who has direct knowledge of your personal history.

One of the best witnesses, from the Tribunal’s perspective, is a health professional. Most CPP Disability cases are decided based on information about the degree of the appellant’s health related limitations. Unfortunately, many health professionals are unable to take the time to attend a hearing and they may expect to be paid for their time. However, you can make arrangements with the Tribunal to have a witness provide testimony by phone. A health professional may be more willing to help with the appeal without charge if they can be connected via a phone call from their office.

Preparing Your Case For The Appeal

It is very important to carefully review and familiarize yourself with all the information in the file.

As you go through the file, look for any important missing information. In particular, read all the medical letters and reports, check the CPP contribution record, and look at Service Canada’s adjudication summary notes for the application and reconsideration decisions.

Keep the following questions in mind as you review the file:

  • Is there information in the file you were not aware of?
  • Has any important information been left out?
  • Which information supports the appeal?
  • Do the Service Canada adjudication notes give you more insight into why the application was turned down?

The answers to these questions will help you decide your next steps. Focus on identifying the things you need to do or obtain to support your case before the Tribunal.

Prepare For Your Hearing

One of the most important things you can do to prepare for a hearing is to gather new information that supports your appeal.

Current letters from doctors or specialists can help

Make sure your health professional understands that you can only access your CPP Disability benefits if you are unfit for any form of work and your condition is not likely to improve in the foreseeable future. If your qualifying date is sometime in the past, make sure your doctors are aware of this date. You must be able to provide medical evidence indicating you were disabled as of your qualifying date and continuously since that time.

If the medical information in the file is out of date, or if you have started seeing new health professionals, please be alerted and continue to ask your current health professionals and specialists to provide you with the most up-to-date records and details on your condition. It may be necessary to clarify medical information that is already in the file.

Other documents

You should consider obtaining other documents to support your argument that you are incapable of working or being retrained for alternative work. Some examples are:

  • Letters from previous employers or others who know how your disability limited your ability to work
  • Comments from employment counselors or other vocational specialists who have evaluated your capacity to work.

It is best not to send new information to the Tribunal in bits and pieces. Wait until you have all of the documents you plan to rely on and include them as attachments to a single submission. This way, you have more overall understanding and control of your documents.

Tips For Your Hearing

  • If it is a telephone hearing be sure to describe things that the Tribunal Member can’t physically see – your physical problems.

For example:

  • You can’t lift your arm
  • You have to use a cane when walking
  • You rely on other supporting equipment in daily living activities

Try your best to help the Tribunal member to visualize and understand how your condition affects you on a daily basis

  • Stay focused: explain why you think you meet the eligibility criteria for CPP Disability. The Tribunal cannot allow an appeal based on compassionate grounds or on the basis of financial need. Your job is to explain why you think the facts of your case satisfy all the eligibility requirements.
  • Be prepared to answer some difficult questions. The Tribunal may focus on the weak parts of the appeal. Be truthful and straightforward with your answer.
  • Always follow the direction given by the Tribunal.
  • Be respectful to everyone at the hearing. If you disagree with something that is said, you will usually have a chance to express your point of view.

After The Hearing

The decision will not be made on the day of the hearing. Since the hearing was recorded, the Member of the Tribunal will then review your case and listen to the information presented in the hearing.

The Tribunal will advise you to expect a written decision in about two months. It should be noted. However, some decisions can take longer.

If you were denied CPP Disability benefits when appealing with the Social Security Tribunal – General Division, you are left with one last chance to appeal and can bring your case to the next level of appeal: The Social Security Tribunal – Appeals Division.

We have written an article to discuss the Social Security Tribunal – Appeals Division process.

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

  1. The Ultimate CPP Disability Guide
  2. Long Term Disability Coverage through the Canada Pension Plan 
  3. CPP Disability Benefits Application Guide
  4. CPP Disability Benefits Frequently Asked Questions
  5. CPP Disability Denial and Appeal Overview
  6. CPP Disability Request For Reconsideration
  7. CPP Disability Request For Reconsideration Sample
  8. CPP Disability Appeal Letter Sample
  9. Top Reasons CPP Disability Applicants Are Denied

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