More complaints I am afraid......

Firstly I am finding that the wait times for processing CPP benefits is increasing - people are waiting for at least five months to hear a decision on their applications or reconsiderations.  I do not have to tell you about the state of most families' finances and how many rely on a double income in order to make the mortgage and whatever other obligations they have. I cannot for the life of me understand how putting individuals through the financial stress of repeated denial of disability benefits can help a person's medical condition.  Add stress, depression, frustration, marital conflict, guilt, and a whole host of other issues to the mix and you are certainly not helping a client improve.  It is so frustrating for me to see and hear first hand the toll the length of processing times and denial rates are having on good decent Canadian people who face life changing disabilities. It sickens me. And the number of calls and emails I get each week, each person expressing their despair and frustration with the system is a challenge.  My advice is to carry on - keep positive - and keep up the fight against the unfair denials - because at the end of the day - I believe that most people have legitimate claims - why else would they waste their time and cause anguish to themselves and their families for the fun of dealing with a bureacratic system. It is not logical.

I have also had my fill of bad hearings. I am not sure if Panel members feel rushed or overwhelmed with the amount of information they have to review, or whether they are burnt out with the number of appeals they are sitting on because of increased hearing numbers or because the amount of appeals are increasing - but lately I have not felt that all of the Panel members are prepared - and I also wonder if they are reading the files.  Again a caveat - many many members have done their homework and are ready - but some alas I feel are not.  I have had any excellent relationship with the Review Tribunal office but I feel this whole issue of documentation collation and page numbering (see prior rant) is not doing the panel members, the representatives, and most importantly the appellant any service at all. And this could be the problem and vibe that I am sensing in recent weeks. You would think that simple page numbering would not make a big difference but it does.

Maybe I am just frustrated with the whole system period.

I did have some good news this week. A client lets call him Roger won his appeal. He has had quite a time of it - firstly a bone head Panel member - made in my opinion a really stupid decision on the last hearing - it was postponed. He waited another 10 months in order to get the second hearing - with no resolution to the issues raised in the first hearing - but any way - he was waiting for a treatment - a treatment that has a waiting list of over two years - so what he is supposed to wait that length of time to see if this possible treatment may help his medical condition - I think not.  I must add that in the documents it stated that this proposed treatment was something that the doctors "hoped" might help - it was not like surgery or something that had a good chance of success - so in the meantime - Roger lost his house that he had paid for  over 25 years of hard work - his wife left him - and he is now housebound and mired in chronic pain and anxiety - an illustration of what happens to real good person - a person who was described by his previous employer as a "working-machine" - because of this system he found himself in - through no fault of their own. Anyway I just spoke with Roger and I am so hopeful that the feds do not appeal this decision - he has been through enough. Thank goodness the new panel saw Roger's reality and did not postpone the hearing again.  Even though I disagreed strongly with the first Review Tribunal panel if they decide they want to adjourn well good luck for an appellant. Again I find complaints are challenging for me - I know the Review Tribunal are down members and I worry about coming across a member I complained about in another matter.

Anyway that is enough for a Friday afternoon. Take care and hang in there. Allison

I am often ask what makes me decide to get involved and case manage a CPP appeal.

I get a lot of calls from people and some of them do not qualify - it is usually not due to a medical condition per se - but more so because they are hooked on technicalities - like MQP issues.

So when I get a file what do I look at - or how do I decide what makes a "good" case.

Well firstly obviously the medical information is important - trying to make sure all of the medical information is included is a big part of the leg work in case managing a file. But you know often times - the paper work does not tell the full story - so how a person presents is a big part of my decision. Sometimes I can have not so great medical - and a really compelling client whose disability journey will provide far more to the mix than the paper trail. I would like you to keep in mind that the Feds will argue that there must be OBJECTIVE medical evidence - but that is only one part of the totality of the information so keep that in mind. Sometimes I have a really great medical file and a client who is frankly not that likeable. It does have an impact. You do not want to waste your 90 appeal minutes complaining about the WCB or the government or the doctors or whatever your beef is. So keep that in mind. And sometimes, you can have a strong medical file, a candid and forthright client who is 100 percent decent, and you have a crap panel who renders a crap decision.

This happened to me and I am not going to say if it was recent or not.

This particular Panel and I am not going to say where I was for obvious reasons - were awful - and the atmosphere of the hearing was very tense. I have been around the block many many times - and whilst I am unable to predict a decision sometimes - I can certainly tell if someone had a good hearing experience. Well this hearing experience was awful. I am able to help out somewhat to try and change the mood but this time I felt very discouraged.

So what does one do in that situation? Well not much unfortunately. Once the Review Tribunal is over then a decision will be made by the Panel. And it makes my blood boil that good people are at the mercy of these intimidating and dare I say it - bitchy Panel members.

I want to make it clear though - for the most part the Review Tribunal members are very professional it is only once in a while this happens.

I do not know what the decision will be - but if people who do not have someone to help them - and have to go through a difficult hearing - that would be a tough spot for anyone to be in. And what could one do - because it is your word against theirs.

If I complain to the powers that be - then I am in an awkward position because the members are rotated - and I may just so happen to come across a member again - not a good start for another client's appeal.

Any way this particular appeal got me fired up. But I got to get back to work. Until next time.

Well firstly I would like to say that one of my goals for DCAC this year is to take the time to make regular blog entries. I get a lot of emails from people out there who find the blog entries helpful and informative and of course that is my goal, to keep you up to date on what is happening in CPP land.

The first thing I would like to talk about the changes that the Office of The Commissioner of Review Tribunals has made which have significantly impacted my work as well as other individuals who case manage CPP appeals. I also believe it has impact on the client as well which has been born out in the appeals that I have been at since the change was implicated. I am not critizing the staff at OCRT, budgets have been cut and changes to meet budget have to be made. In the past the Review Tribunal would send both the client and the case manager a copy of the hearing file that was numbered, indexed, and bound. This will no longer happen. As well, the Appellant will no longer receive copies of documents that HRSDC has sent to the Review Tribunal office - they will only be sent to the case manager or advocate. The Appellant will also not receive a copy of the any of the hearing documents - other than a letter which says when their appeal is scheduled.

Okay so for me, the person who I am helping will have no idea what is in their file before the Review Tribunal unless I copy the file and send it to them - which essentially means - while the government is saving money - the people who are helping the people, who the Feds have often in my opinion unfairly denied to begin with - are not. Do you get my drift here?

The only way the Appellant can keep on top of what is going on in their appeal or know what documents exist is if I send them a copy. So many times clients have gone through their files and have had no idea of the reports that have been written or conversations with Feds that have been taken out of context - all of this just adds another layer of complexity to the mix.

For individuals who pay disbursements the fees will become increased.

But even with all of this - what I find the most disturbing - is that the Tribunal hearings are becomming more and more challenging -without page numbering there are delays as we all shift through documents - it disrupts the flow of the hearing - and it wastes time - an appellant is typically allowed one and a half hours to explain why they meet the legislative criteria - and now I am spending time with panel members shuffling documents. My last issue is the fact that often there are documents missing - it happens to me all the time.

Grrrrrrr.

If you do not have someone to advocate for you then all the documents will still be sent to you. But just keep in mind that you have to manage these documents and sometimes I find it an overwhelming task - let alone a person has a disability - the paper trail for me is onerous.

I wonder how the cuts in the Fed's budget is going to impact the denial rates. I think it is going to be a very interesting year. It is almost a perfect storm for claims - aging populations, the economy, and I really anecdotally see the increase in denials, the increase in processing times to even hear a decision. I know I got an email last week from someone who told me she had put her application in two weeks ago and she wanted to know what the hold up was - I did laugh out loud - and this person was really ticked at the answer I gave her.

So please keep me informed of what is going on in the trenches. If you need help do not hesitate to email - it may take me a bit to get back to you though so please be patient.

Happy New Year.

I have set up the clinic to be able to conduct appointments via webcam using Skype.

I have found that this is an excellent way for people to consult with me from all over Canada.

If you are interested in talking wiith me via Skype please email me to set up a time and then send a friend request using Skype to the Disability Claims Advocacy Clinic.

Please note I will not respond to friend requests to people who have not identified themselves to me!

I was recently in the UK - I am Australian but my paternal relatives are British. I saw a poster that was made by the UK government in 1939 the year my father was born and at the onset of World War 2. I purchased this poster and I now have it hung next to me in my office.

I love this message and I think any one who is denied CPP disability should adopt it as their mantra.

I certainly do - day in day out - tell people - to keep calm and carry on - as well as tell myself to keep calm and carry on - especially when I get aggravated people call me who are so frustrated with the Feds and the denial of their benefits and they want to vent!

Have a good day,

I often receive phone calls from individuals who are applying for CPP disability at the request of their private insurance companies. The insurance companies usually require that their clients make application to CPP disability, as CPP is first payer on most disability insurance policies (also many WCB programs, Provincial disability programs, Auto insurance programs etc.) When these individuals are denied CPP, the insurance companies require that they appeal and often I get called because there is a level of fear that if the client is denied again, the insurance company will also deny them as well. Most insurance companies do not provide the resources their clients need to handle these appeals, and if I may be frank, many of the disability insurance adjudicators do not understand themselves the procedure a client has to go through when appealing the denial of CPP disability benefits.

So it is a no brainer that I get panicked calls from private insurance clients who are now facing CPP appeals and the added stress and worry that because CPP has denied them, that their insurance company may shortly do the same.

I am not trying to malign insurance companies here, as getting their clients CPP disability saves them a large amount of money over the life span of a claim, so they are entirely motivated to get their clients on CPP disability. I recently made a presentation to the disability adjudicators at a large insurance company and at the end of the presentation it was clear to me that the adjudicators now had a better appreciation and understanding of the complexity of the CPP disability program. Although the adjudicators had received "outreach services" from the Feds - I believe sorry to say - their presentations may not accurately portray what is really going on in the trenches!

As I have said previously, CPP disability benefit is viewed as the "first payer" by most private insurance plans. This means that most insurance plans take CPP disability benefits into account when calculating a claimant's entitlement to disability benefits. Most private long-term disability plans require a claimant to apply for CPP disability and to appeal a denial. Many agreements also indicate that noncompliance with these terms can result in withholding or reduction of long term disability benefits by the estimated amount of the CPP disability benefit. This is standard practice and part of standard form agreements of most private insurance policies.

If you have been denied a CPP disability benefit and you have been asked to appeal by the insurance company, then make sure you follow their recommendations. I believe most insurance companies are aware that CPP disability has a fairly measurable denial rate and so they may expect that you will denied on application. Do not be fearful of the denial from CPP disability. Next make sure you send in for your reconsideration within the 90 day appeal period and ask your adjudicator if the insurance company has some resources available that can help with your appeal. Also ask the insurance company if they can provide you with the medical information that is on your file - that way you do not have to pay for photocopying charges from your doctor's office. Most insurance companies have collected medical evidence on you in order to support your LTD claim - so as collecting CPP disability is in their best interests - I really think they should help you out by providing you with this information. If there is an issue with this I would ask for a supervisor and explain your motivation for wanting to collect this information.

Also, if there are insurance company staff who read this blog - I would like to ask them to consider having someone who works in the trenches, explain to them and their disability adjudicators the reality of managing a CPP disability appeal so they can help their clients secure the benefits that will offset their bottom lines.

Often I am asked by someone who has to appeal the denial of a CPP disability benefit who is receiving LTD private insurance what is the point to receiving CPP disability?

Although the income received from a CPP disability benefit is taxable and reduces your non-taxable long-term disability benefit, there are advantages to receiving a CPP disability pension:

· it places a freeze on your financial earnings as of the date of disability. This prevents CPP from establishing a record of zero of nil earnings to average into your future retirement or disability income calculation for the period you are disabled from working and not contributing to the CPP fund. Without this earning freeze your future entitlement to CPP benefits, including retirement benefits could be adversely affected.

· there is a federal tax credit available when a individual completes and submits the Disability Tax Credit Certificate (Form T2201) with their income tax.

· if you are in receipt of CPP disability benefits at the time of your death, CPP survivor benefits will be paid at the full level as though you have been working until the date of your death.

· CPP benefits provide a cost of living allowance every year. Any COLA increases will not be deducted from long-term disability benefits.

· if you have children they may be eligible for a children's benefit as long as you are receiving a CPP disability benefit. CPP pays benefits for children if they are:

a. under 18 years of age. These benefits are paid to the individual who has the care and custody of the children; or,

b. between the ages of 18 and 25 years old and attending school on a full-time basis. This benefit is paid directly to the child

Hello Everyone,

Yes I am still working here at the Clinic. It has been some time since I have been able to blog. Many things have happened and I have case managed a lot of files in the last six months that have been interesting to say the least!

My reason for blogging today?

Well in the mail today I received two files that were sent to me for review - and unfortunately both of these cases were rightly denied based on what are late MQPs.

A MQP or Minimum Qualifying Period date - is what I like to call THE MAGIC DATE. It is critically important to the adjudication of a CPP disability claim.

You know you have to be found "severe and prolonged" - but you also have to be found severe and prolonged at the time of the MQP.

If you have a late MQP your denial letter may say something like this -

"Unfortunately, you do not have enough earnings and contributions. However, Canada Pension Plan has a late application provision that allows us to consider if you had a disabilty that was both severe and prolonged and has been continuous since you made enough contributions to the CPP to qualify. In your case, you had made enough contributions to qualify until December of a given year"

Okay like I said this is a magic date and the decision makers have to find the applicant disabled as of that time and continuously to present - the lady whose file I reviewed this morning had an MQP of December 1997. This means she has to be found disabled from December 1997 until present. This is tough because it would require 14 years of continuous medical evidence to support this claim - sometimes this is easy to do - there may have been an accident or medical condition that has been clearly related to that time period - but most times I will say with a late MQP like that, is a challenge to establish disability.

Sometimes, there is a late MQP, and then a person tries to work after that MQP, and the feds deny because they say there is evidence of work capacity after the MQP.

This happened recently with a lady called Cindy. Cindy is very young 29 years - but she had been chronically sick with chrons since she was 19 years old - and I mean sick - surgeries, infections, abdominal pain, fatigue, malnutrition -the medical evidence was pretty conclusive - but the problem in Cindy's file was that she continued to try and work, and try to go to school, and try to do all those things that a young woman wants to do.

Cindy had earnings after her MQP - the Feds denied her because of this - they realized she was disabled now - but she was not disabled at the time of her MQP. Well her earnings were substantially gainful but she only lasted a short period of time - six months - before her chrons kicked up and she was hospitalized again - not to mention that throughout her work she repeatedly had to decline work shifts and often had to leave work because she was so sick - I really admired Cindy cause she continually tried to work and she felt so guilty because her parents were continually having to support her financially. I do not know what the results of the appeal will be but I will let you all know.

So you can see here how important the MQP is - it really is a magic date - it is like when your coverage expires like an insurance policy.

The calculation of the MQP is very complicated and there are so many different ways the Feds calculate the MQP - all different requirements and legislative tenants go into the calculation of the MQP. But I just wanted to get it out there that the MQP is critical in the adjudication of a claim.

In the files that I reviewed this morning - the applicant went through the hearings without any understanding of the MQP - bad move.

If you have a hearing or your are appealing the denial of a CPP disability benefit - then make sure you know the MQP. If you have any questions about this send me an email. One thing I will tell you - if you have an MQP say December 2006 and you have only submitted medical evidence from 2009 forward then you have not met your responsibility to establish your disability at the time of your MQP. So that means you will need to submit medical information from December 2006 in order to establish that you were disabled at this time.

Hopefully this has all made sense to you!

For those of you who want further reading on this subject - the Office of the Commissioner of Review Tribunals has a good explanation of the MQP calculation rules and the link for that is

www.ocrt-bctr.gc.ca/hwt-cmm/cpp-rpc/req-cond-eng.html#more_MQP

The lead story on the CBC National News last night was on Disabilty Tax Credit abuse and the various agencies that have enabled and facilitated these applications.

Most people who claim the disability tax credit are eligible for the benefit.

Many more people with disabilities who would be eligible for the disability tax credit get no benefit of the Disability Tax Credit because they do not have a taxable income.  The Disability Tax Credit should be a refundable benefit I know many individuals with disabilities who survive on incomes below or close to poverty levels - if they had the extra refunded benefit - like the GST or Child Tax benefit - that would be a large financial improvement in their lives. 

Disability Tax Credit eligibility also determines eligibility for other benefits such as the Child Disability Benefit, the Registered Disability Savings Plan, the Working Income Tax Disability Benefit.  It is no longer simply used as a mechanism for offsetting the additional costs of disability for those with a taxable income.

It is easier for those with mobility or sensory impairments to become eligible than those with cognitive impairments in that the evidentiary base is easier to identify and establish- many individuals with mental health, intellectual disabilities, brain injuires, learning disabilities, and episodic disabilities have a hard time qualifying.

Using doctors as the gatekeepers for this benefit is a poor use of an expensive and limited resource.  The Canada Revenue Agency should explore other means of gatekeeping this deduction.

This is the message from the disability community.

I am still getting a lot of calls from people who are being reassessed - some are grudge reports to CPP from ex spouses or crappy neighbours, but some are as a result of reported earnings.

Please, if you are trying to work - tell CPP this - it will avoid all of this hassle as well as perhaps avoid overpayments. There are allowable earnings provisions under the Canada Pension Plan and I will find information and post it on the blog - I may even contact a adjudicator in the reasessment department at CPP and see what she says people should do if they want to try to work - or they are working.

The point I am trying to get across is that the Feds will find out if you are working and you have not reported it to CPP.  There is some misconception out there that if you are on CPP you cannot work an hour - I was in Ottawa this weekend at the Council of Canadians with Disabiities meeting with representatives from the disability community from across the country and this came up - that you cannot work an hour and collect CPP - it just baffles me that there are is so much misinformation and rumour out there!

Anyhow, back to my point here - if you are working or if you want to work get in touch with me and I can give you some advice or directiion on how to proceed. If you have been reassessed the appeals are different - as I have said before the feds have to prove that you have the capacity to work - they cannot dispute their initial decision that you qualified for CPP, they can only argue that you have regained capacity - and unlike any other appeal to CPP, the onus or responsibility to establish you have regained capacity is theirs to meet. See what I mean - these appeals are not the usual run of the mill.

It is a fearful time for some people when CPP is reassessing your eligibility. Hang in there - and watch what you say and do to your ex spouses and neighbours!

I get a lot of calls at the office asking me how long it will take before CPP decides on either the application or the request for reconsideration.

I have been able to make some calls and I have found out the approximate processing times.

British Columbia Region - Initial Appliation - 25 weeks processing time - Reconsideration - 20 weeks processing time.

Manitoba and Saskatchewan - Initial Application - 20 weeks processing time - Reconsideration - 14 weeks processing time.

Alberta - Initial Application - 26 weeks processing time - Reconsideration - 16-18 weeks processing time.

Ontatio - Intial Appication - 120 days processing time - Reconsideration - 120 days processing time.

I am sorry I do not know the Atlantic Regions.

Also these time spans are averages - they fluctuate according to work loads and whether or not CPP is developing your file by collecting additional information.  Note if CPP is developing your file that is a good thing - as it is an applicant's responsibility to establish disabiity - so if the feds are looking into it is not just a straight out denial.

Finally back in the office for three straight weeks - looking forward to catching up and returning calls. Wishing it was spring already.