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CPP Disability - I am helping someone apply for or appeal their benefit
- Who is a helper?
- I want to help my family member or friend apply for a CPP disability benefit
- I want to help my family member or friend appeal a CPP disability decision
Who is a helper?
A helper or an advocate is someone who speaks or acts on behalf of others. In this case, a helper or an advocate is someone who wants to help a person with a disability apply for a CPP disability benefit or appeal a decision. You could be of assistance by simply explaining the contents of an application form or by locating specific information. You may attend an appeal hearing with the person appealing and help explain his or her case.
As a helper or advocate, you should also seek the support of others who may help you, such as family, friends, physicians, other advocates, and people with disabilities or groups representing them. They may be able to provide you with support and resources helpful to you.
I want to help my family member or friend apply for a CPP disability benefit
Checklist of eligibility requirements
Make sure that the person you are helping to apply for a CPP disability benefit meets the three basic elements of eligibility:
- meets the minimum contributions and earnings requirements;
- meets the definition of disabled under CPP legislation; and
- is under 65 years of age.
Locating specific information
You may be able to help your family member or friend locate important information such as his or her birth certificate. If the applicant was born in Canada but cannot find his or her birth certificate, you can contact the government office of the province or territory where the applicant was born for specific identification cards. These offices will be able to assist you.
If you are unable to obtain a birth or baptismal certificate, please contact Service Canada as we may be able to accept other documents.
Record Keeping
When you are helping the person fill out the application kit, make sure they keep photocopies of everything they submit. If you talk to someone from Service Canada, write down the name of the person and the date and time that you spoke to him or her. Keep all the information in one place. Always have the Social Insurance Number of the applicant when you call Service Canada.
You should also confirm if your family member or friend is receiving Employment Insurance (EI) benefits. This may affect his or her eligibility for a CPP disability benefit. For regular benefits, EI requires that the applicant be available and able to work. To be eligible for a CPP disability benefit, an applicant's disability must be severe and prolonged so that it stops him or her from doing any type of regular work. Receiving EI sickness benefits, which do not indicate ability to work, does not impact CPP disability benefits.
It is very important that your family member or friend apply as soon as possible, especially if the person's medical condition stops him or her from working on a regular basis. If the individual applying does not know his or her CPP contribution history, he or she should contact Service Canada to obtain the information, or request their Statement of Contributions. The CPP legislation does contain exceptions, or special provisions which may help applicants meet their CPP minimum contribution requirements. Contact us for more information.
How to apply
The applicant must apply in writing. You can now print the Application for Disability Benefits or contact us to obtain an application kit. As the advocate helping your family member or friend apply, please make sure that the applicant signs, and that you co-sign, the application form.
The CPP disability application kit contains forms and instructions for the applicant, including:
- application forms related to the individual and his or her dependent children;
- a questionnaire for details of the person's work history and medical condition;
- a medical report to be completed by his or her doctor. If the person has more than one doctor, choose the one who knows the most about the main medical condition;
- a consent form that Service Canada staff may need to get additional information from other parties; and,
- a Child Rearing Provision form to complete if the person stopped working, or reduced the number of hours they worked while taking care of children under the age of seven. If this provision applies, it may improve your family member or friend's eligibility or the amount of the benefit.
Use the applications checklist to ensure the application is complete.
I want to help my family member or friend appeal a CPP disability benefit decision
You can help your family member or friend appeal a CPP disability benefit decision by first understanding what an appeal is. You also need to understand the sequence of the appeal process (you cannot skip any appeal level). Information provided at any appeal level should be clear and concise. You need to ensure your family member or friend includes the correct type of information for the appeal.
An appeal is what someone does when he or she disagrees with a decision and wants the decision changed or reviewed. There are three decision review levels which must be followed in this order: reconsideration, appeal to the Office of the Commissioner of Review Tribunals (OCRT) and an appeal to the Pension Appeals Board (PAB). The first of these is an internal review of the decision - in other words, Service Canada reviews to ensure they have made the right decision. The other two levels are formal appeal levels administered by bodies separate and independent from Service Canada.
All requests to obtain a review of a previous decision must be made in writing. For each level that you decide to pursue, you must submit a written request within 90 days of receiving the denial decision from the previous level.
Type of information to provide
For any review level the person appealing must provide the following information in writing:
- his or her name, address, phone number and social insurance number;
- the facts that support his or her case;
- the reason(s) why he or she disagrees with the decision;
- the date he or she received the denial letter (or the date of the letter containing the decision being appealed);
- signature of person appealing. The advocate or representative of a person making an appeal can sign the letter on that person's behalf so long as the person appealing agrees to this in writing.
If you are acting on your family member or friend's behalf, make sure you indicate this in the letter. Include your name, address, phone number and your relationship to the person appealing.
Any information that supports your family member or friend's application should also be provided, although it can be sent at a later date. You need only request the reconsideration, or appeal to the OCRT or request to PAB within 90 days of receiving the previous decision letter.
What type of additional information should be provided?
- For a case related to medical eligibility, any new medical information that was not seen presented before. This information should relate to any limitations that this medical condition imposes on the applicant's ability to work on a regular basis.
- A personalized report of the symptoms experienced.
- For any case related to meeting the requirements for contributions, any new information which shows earnings not previously presented.
Is it better to send the information in quickly or wait to get the best information?
It depends on what additional information you have. While generally it makes sense to send in the best information, if you feel that the information you already have is enough to change the decision, you may want to send it in straight away. Be sure that you have made a request for a review of the decision within the required 90 days. Remember, you can send in additional information later.
Requesting information under the Privacy Act
To present the best evidence, you may want to obtain any information that Service Canada has on your CPP disability file at any level of appeal. You can obtain this information by contacting Service Canada to get a Personal Information Request Form. Fill it out and submit it to the Office of the Privacy Commissioner at the following address:
Office of the Privacy Commissioner of Canada
Tower "B" Place de Ville
112 Kent Street, 3rd Floor
OTTAWA, Ontario
K1A 1H3
1-800-282-1376
The Privacy Act gives you the right to see personal information that the Government of Canada holds about you. It also protects and controls how the federal government collects and handles the information. There is no charge to receive this information.
If you are dissatisfied with the results from your application to see your personal information, you can write to the Office of the Privacy Commissioner and the Commissioner will investigate your complaint.
If you are having a complaint investigated and cannot get the information you need, you can write to the appropriate appeal level where this situation occurred (either at Service Canada, OCRT or PAB) and request that a determination on your case be postponed until the complaint is resolved.
Information Service Canada prepares for the person appealing
If you are denied at the reconsideration level, and request an appeal at the next level, the Office of the Commissioner of Review Tribunals (OCRT) will send you an "Explanation of the Decision under Appeal" prepared by Service Canada. This document includes all relevant information about your case, including eligibility considerations such as medical reports and/or contribution information related to your eligibility for a benefit. You will receive this document approximately one month in advance of your Review Tribunal hearing. This will provide you with time to help prepare your case.
If your appeal was denied by the Review Tribunal, you can request an appeal to the Pension Appeals Board (PAB). If the PAB decides to hear your case, the OCRT will send PAB information related to your case currently on file and a copy of their appeal file. PAB will send this information to you before the date of your scheduled hearing. On the day of your hearing, the physician representing Service Canada will submit to you a copy of his or her curriculum vitae (personal resumé) as well as a summary of the information that Service Canada relies on to defend their case on your appeal.
