You have completed your application for Canada Pension Plan disability benefits, feeling pretty confident that you will be approved. After all, you cannot work and your doctors have supported your decision to apply for disability benefits.
Approximately three months later, you get the news. Your application has been denied. The Canada Pension Plan Medical Adjudicator, based on the information you provided, has determined you do not meet the legislative criteria. You may not have a clear understanding as to why they think you are not eligible for the benefits you feel entitled to. How do you get Canada Pension Plan to reconsider their decision?
To request reconsideration, you must do it in writing and you must send it to CPP within 90 days after the date you received your letter of denial. Reconsideration is the first step in the administrative review process in which you have to appeal Canada Pension Plans’ decision. The reconsideration step provides you with the opportunity to explain why you are dissatisfied with the decision. You can also add information that was not in your initial application.
A Canada Pension Plan Medical Adjudicator who did not adjudicate and deny your initial adjudication application will review your case. This review will take place at the Canada Pension Plan regional offices.Your case will be reviewed again. When a determination is made on your case, you will be notified of the decision in writing. Generally this process takes approximately three months dependent upon whether the Medical Adjudicator wishes to develop your claim by collecting additional information.Please note – it is your responsibility or onus to establish your claim under the legislation. That means it is not the responsibility of the Canada Pension Plan Medical Adjudicator to collect the information, it is up to you to provide it.
You can request Reconsideration on your own. However, you do stand the chance of a second denial. There are options available to you. Instead of asking Canada Pension Plan on your own to reconsider your case, get an expert advocate from DCAC to step in and case-manage your appeal. This is the best way to improve your chances of getting approved. They know what Canada Pension Plan is looking for. They know how to read your Canada Pension Plan file. They know how to gather information and how to present it. They know what type of “legislative technicalities” you may be hooked on. They know what to do to get you approved.