CPP Disability Request For Reconsideration

Learn about the first level of CPP Disability Appeal - Request For Reconsideration
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August 19, 2019 by dcci

CPP Disability Request For Reconsideration – Overview

The Reconsideration request is the first step in the CPP Disability Appeal process.

You have 90 days from the day you received the letter telling you that your CPP Disability application has been denied to write to Service Canada and let them know you want them to reconsider their decision.

In this article we will provide you with step by step, detailed information about the CPP Disability reconsideration process but there are several important points you must consider first:

  1. The person reviewing your reconsideration request is not the same person who turned down your application; which means you have a great opportunity to prepare your case thoroughly with new and relevant information about your condition.
  2. During the reconsideration process, you can provide new information that you think will help your case. This can include letters from your doctor and other health professionals that address the reasons why your application was turned down. You can also include letters from family or friends who are familiar with your medical condition, although these will not carry the same weight as those from medical professionals. Service Canada may also seek additional medical information or ask you to see another doctor.
  3. The CPP Disability reconsideration request review can take several months and Service Canada can take few more months to make a final decision.
  4. If your reconsideration request is successful, and your denial is overturned, you should receive a lump-sum payment, as well as monthly CPP Disability benefits.

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A Step-by-step Guide to CPP Disability Request for Reconsideration

Step 1: Send a Request For Reconsideration letter to Service Canada

The first step in the CPP Disability reconsideration request process is to write to Service Canada within the CPP Disability appeal time frame, which is 90 days from the day you received your CPP Disability denial letter.

In your letter, you only need to say that you are requesting a reconsideration of your CPP Disability denial decision.

At this stage, it is not necessary to have your case ready. You can say in your letter that you will be submitting additional information later.

We have a “Request for Reconsideration” sample ready for you to download.

Once you have your letter of reconsideration, you will want to send it to one of the following Service Canada offices in Canada.

Step 2: Requesting Your Documents from Service Canada

Once you have informed Service Canada that you would like a reconsideration, you need to ask for your files. To do that, you need to send in an “Info Source: Personal Information Request form”. You can download this form online here

Fill out the Info Source form and mail it to Service Canada. They require an original signature and will not accept a fax or a photocopy. You can return it to your nearest Service Canada office.

The Info Source form allows you to get a copy of your complete file. It will take about 5-6 weeks to receive the file. When your file arrives, it will include:

  • Your CPP Disability application form
  • Your doctor’s medical report
  • The disability summary sheet which will tell you why Service Canada denied your claim

Step 3: Reviewing Your CPP Disability Documents

Before taking actions in any step of the appeal process, we strongly recommend that you review the previous document that you sent to Service Canada as well as the Disability Summary Sheet.

The Disability Summary Sheet indicates review of your application. Read the section called “Rationale” as this section contains the adjudicator’s reasons for the denial of your claim. Appeals must be based on the reasons for rejection for relevancy and higher chance of getting approved.

When you have finished reviewing the summary sheet, it is time to look at the rest of your file.

  1. Have you described in detail how your disability prevented you from performing the duties of your last job?
  2. Have you detailed all the limitations your disability has on you?

Read the Medical Report that was completed by your doctor and review these questions

  1. Is it accurate? Does your doctor appear to be supportive?
  2. How has your disability been presented?
  3. What has been said about your prognosis?
  4. Did your doctor discuss how your disability has limited your ability to work?
  5. If you have more than one health condition, has your doctor included information about all of them?

Also, check to see if other relevant medical information is included.

  1. Is there any contradictory in your medical information?
  2. Has any doctor said or implied that you are able to work or that your condition will improve?

By answering these questions, you will figure out which are needs more work. These notes will be useful as you work through the appeal process.

Step 4: Gathering Medical Letters

We can’t stress enough how important it is to obtain strong and relevant medical evidence to support your case. This appeal process is a great opportunity to overturn the Service Canada’s previous decision. We are also aware that doctors do not have a lot of time to write letters, and will often charge a fee to do so, so it is crucial that we make the best of their time. Service Canada will only pay for medical letters that they request, and not for letters you request.

Therefore, if your doctor agrees to provide a letter, it is crucial that the letter contain the right kind of information. Specifically, it is extremely important that your doctor clearly and thoroughly address the deficiencies in your original application, as identified in Service Canada’s denial letter.

Which doctor(s) should you ask for a support letter?

  • The General Practitioner or Family Doctor (GP)

The advantage of information from your family doctor is that he/she probably knows you better than a specialist. Also, if you have more than one condition, your GP may have the best understanding of how your combination of disabilities affects your daily life and your ability to work. The disadvantage is that Service Canada will sometimes reject the opinion of a GP if there has been a different opinion expressed by a specialist.

  • The Specialist

It is important to have up-to-date information from a specialist (e.g., neurologist, psychiatrist or physiotherapist) who is involved in your case. The opinion of a specialist is often given greater weight than your family doctor’s opinion because they are considered to have more in-depth knowledge. The problem is that a specialist may not know you very well if you have only had a couple of visits. The specialist may also only be able to comment on one of many conditions. For example, a psychiatrist is unlikely to have information regarding a physical condition. One option is to request support letters from all your doctors. Another option is to ask your GP to write a letter explaining how your multiple conditions combine to prevent you from pursuing gainful employment on a regular basis. If you ask your GP for a letter, it is helpful if the GP can review any reports from your specialists, and mention in the letter that he or she has done so.

It is highly recommended that you talk to your doctor(s) before they write a letter. Find out whether they can provide the information outlined above and whether they support your application for CPP Disability. Find out how much it will cost and how long it will take them to write a letter for you.

Step 5: Gathering other Supporting Documentation and Your Own Letter

In addition to letters from your doctors, you may also provide Service Canada with letters from other health professionals who have been involved in your treatment and care.

For example, you can request letters from physiotherapists, psychiatrists, nurses, psychologists and special care worker, to name a few. The aforementioned medical professionals can provide relevant additional information on your condition and their input will benefit you in your appeal process.

Step 6: Compiling Your Information for Reconsideration

The information you send in to support your reconsideration request should focus on the facts of your disability, and should show that you fulfill the criteria of disability, as defined by the Canada Pension Plan.

As described above, you may want to send in the following:

  • A Request for Reconsideration, saying that you wish to appeal the decision
  • A letter that explains, in your own words, how your condition affects you on a daily basis and limits your ability to work
  • Letters from your doctor that indicate and provide the medical reasons to prove that your condition is severe and prolonged
  • Letters from other health professionals to further describe the full extent of your disability
  • Letters from past employers, or vocational rehabilitation personnel
  • Documentation about other disability benefits you may be receiving (have you been approved for DTC or ODSP etc.)
  • Letters from friends and family.

Important: Before the package is sent in, make a copy of all the documentation for your records. It is also a good idea to send the documentation via registered mail. Make a note of when you mail the package, and send it to one of these following Service Canada offices.

What happens next?

Once all of the Reconsideration Request documents are submitted to Service Canada it will take a few months before they come to a decision.

If Your Reconsideration Request is Successful

Congratulations! You can expect to receive a retroactive payment that is back-dated to the time that your disability was recognized by CPP. Usually, the payment comes in a form of a cheque. You are also entitled to receive a monthly CPP Disability cheque. This amount will depend on the contributions you have made to the Canada Pension Plan.

Learn more about the CPP Disability payment amount you should expect.

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If Your Reconsideration Request is Not Successful

As discussed in previous articles, the Reconsideration Request is only the first opportunity to appeal Service Canada’s decision and should you believe your impairment is worthy of receiving the CPP Disability you should consider the next step in the appeal process: The Social Security Tribunal – General Division.

To learn more about your next step please refer to our detailed guide about the Social Security Tribunal – General Division

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

  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 Appeal to Social Security Tribunal – General Division
  7. CPP Disability Appeal to Social Security Tribunal – Appeal Division
  8. CPP Disability Appeal Letter Sample
  9. Top Reasons CPP Disability Applicants Are Denied

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