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Last week we discussed what has been happening recently with CPP and the state of decision letters. This week, I want to go into the next steps that you should take if you do receive a denial letter after applying to CPP Disability.

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If your CPP Disability application has been denied by Service Canada, you have the option to appeal and ask them to reconsider their decision.

WHAT IS A CPP DISABILITY RECONSIDERATION APPEAL?

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The reconsideration appeal is the first level in the CPP Disability appeal process. The reconsideration appeal is made directly with Service Canada, and it is not handled by the same medical adjudicator who made the decision to deny your application.

In Order to start the process, you first have to submit a “Request for Reconsideration” letter to Service Canada, letting them know that you will be appealing their decision. This letter must be sent within 90 days of the day you received your Service Canada denial letter.

WHAT TO SUBMIT

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As we mentioned above, you need to submit the request for reconsideration before the 90 day deadline. This can be submitted by writing a letter or submitting Service Canada’s Form

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USING THE SERVICE CANADA FORM

If you decide to submit your request through the Service Canada Form, here is a guide of the five different sections:

Section 1: Application Information

Your Contact information will be entered here

Section 2: Information about the decision

Here you will fill in the date of your application denial, and if you are sending this request in the 90 day period.

Section 3: Information you want us to consider

Check the boxes that best apply to your situation in this section. If you are still waiting on documents, there is space for you to list what you are waiting on, and when you anticipate receiving these documents.

Section 4: Reason for Reconsideration

This section is for you to give the reason(s) why you want the Medical Adjudicator to reconsider their decision.

Section 5: Declaration and Signature

Sign and date where indicated.This signature must be done in ink (not digitally)

WRITING A LETTER

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If you decide to send a letter, here is an example of a basic outline:

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-date-

Appeals and Reconsideration Division

Canada Pension Plan

Your Regional Office (Address located on denial letter)

Dear Sir/Madam:

Re: Denial of Canada Pension Plan Disability Benefits

Your Name

Your SIN

I do not agree with your decision to deny my CPP disability benefits.  I am disabled according to the legislative criteria and I wish to request a reconsideration.

Additional information to support my appeal may be forth coming and I request that your office contact me to discuss this appeal prior to making a decision to ensure that I have had the opportunity to submit all the information I can to support my reconsideration appeal.

I can be reached at: (Phone Number)

Your Name

Signature

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If you are including any documents along with your letter, indicate the documents that you are attaching in a bulleted list, giving each a name and the date obtained. Also indicate the time period that these records were covered.

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 STRATEGIES TO INCREASE YOUR CHANCES OF SUCCESS

Finally, here are some self-help strategies to increase your chances of success.  Make sure you have done the following:

• Obtained and reviewed your Canada Pension Plan disability file. You can get a copy of your file by completing the Personal Information Request form which you will find in the Downloads section of this website. You will need to send this form in to the CPP regional office who is adjudicating your claim.
• Understand why CPP Disability are denying your claim.  I have posted a lot of information on the blog about why CPP disability is usually denied - and how to understand the CPP disability language.  If you understand the reasons why CPP disability have denied your claim then you will better understand how to put together your appeal. 
• Find out what your MQP is?  Minimum Qualifying Dates are extremely important and you need to review your file to see if the medical information that has been submitted provides evidence around the time of the MQP.
• Once you have reviewed your file, it is important to decide what additional supportive documentation you may need to get and who to get it from. Make contact with your doctor and any other people you might want to get letters from.  Most doctors charge money to obtain the evidence you need to support your appeal.  It is not helpful to get a doctor to write that your disability is "severe and prolonged".
• Understand your responsibility to provide information to support your appeal. Understand how CPP disability is determined. Read through the blogs and the appeal guide on this website.
• Make sure all the information you have collected will help with your appeal. Sometimes clients get discouraged because their doctors write that they may be able to do "some light work" but keep in mind that the work has to be regular and substantially gainful.  It is a good idea to speak to your doctor about their thoughts on your capacity to work before obtaining a written report.
• Your written submission should address when you stopped working and why you think you are unable to work in any job because of your disability. It should discuss if you have tried to return to work and failed due to your medical condition, and if you looked for work, how your disability prevented you from finding a job.  The submission should outline your functional limitations.

AFTER SENDING YOUR LETTER

After receiving your appeal letter and documents, it is common for the CPP disability medial adjudicators to contact you to clarify things or ask your assistance in getting more information. This information that the adjudicator is seeking will be helpful to your claim.

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If you have any questions, concerns or need help with this process contact us! We are here to help you.

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