Appealing Your CPP Disability Benefit Denial
Too often we have seen clients suffering from real disabilities apply for CPP disability benefits, and be denied benefits that they are entitled to. If you are denied CPP disability benefits, you may have recourse to have your matter reconsidered or successfully appealed.
The best way to appeal your denial is to speak with an experienced lawyer right away. This will help you to build a strong appeal that proves you deserve CPP disability benefits and get your benefits faster. The following is a quick guide on the multi-level appeals process for CPP Disability Benefits.
Step 1 – Request Reconsideration
If your application for CPP disability benefits is denied, you should receive a letter from Service Canada setting out the reasons for the denial, as well as the steps that can be taken to request a reconsideration of the decision. A request for reconsideration of the decision is the first mandatory step required in the appeals process.
A request for reconsideration will prompt a fresh review of your application by someone not involved in the initial denial of your application. When you request reconsideration, you are also able to forward any new information or documentation that supports your application. This new information will also be considered in the fresh review. It is a good idea to seek further medical information or documentation in support of your application to be submitted at this level of appeal.
A request for reconsideration must be made in writing, by way of a letter. It is important to note that a written request for reconsideration is required to be made within 90 days from the time you are first notified of the initial denial. We recommend that requests for reconsideration be sent via registered mail, or an alternative method that includes a tracking option, so that you have proof of your submission should your letter be lost in transit.
Step 2 – Social Security Tribunal (SST) General Division
If you have requested reconsideration of your CPP disability application and are still denied, you may then appeal to the General Division of the Social Security Tribunal (SST).
The SST is an independent administrative tribunal that will look at your file and make a determination as to whether you qualify for CPP disability benefits. The SST will decide on the manner in which it wishes to hear your appeal and can include hearings conducted in writing, by telephone conference, video conference, or in person.
At this stage of appeal and before your hearing date, you may again submit any new information or documentation in support of your appeal. If you have already been denied twice based on a determination of your medical condition, we strongly suggest that you seek further medical opinions and documentation to support your appeal at this stage, since it is the last level of appeal for which you do not need to obtain “leave” (permission) to appeal.
To appeal to the General Division of the SST you may either submit a written letter or complete and submit a “Notice of Appeal” form. Again, it is important to note that you have only 90 days from the date you receive the reconsideration decision in order to submit your appeal to the General Division of the SST; otherwise, you risk being barred from the appeal.
In addition to your appeal letter or Notice of Appeal Form, you must attach and submit within the 90-day timeframe
- (i) a copy of the reconsideration decision being appealed;
- (ii) any applicable authorization forms; and
- (iii) any further documents supporting your appeal.
We recommend that the complete package again be sent via registered mail or an alternative method that includes a tracking option so that you have proof of your submission should it be lost in transit.
Step 3 – Social Security Tribunal (SST) Appeal Division
If you have appealed to the General Division of the SST, and again been denied, then you may have one last avenue left for appeal: to the Appeal Division of the SST. This last level of appeal is perhaps the most challenging since you do not have the option of appealing as of right—rather, you must seek and obtain “leave” to appeal, which is the legal term for obtaining permission.
Leave to appeal to the Appeal Division of the SST are limited to the following three grounds:
- i) The General Division of the SST failed to observe the principle of natural justice or otherwise acted beyond or refused to exercise its jurisdiction;
- ii) The General Division of the SST erred in law in making its decision, whether or not the error appears on the face of the record; or
- iii) The General Division of the SST based its decision on an erroneous finding of fact that it made in a perverse manner or without regard for the material before it.
If you meet one of the three grounds for leave to appeal to the Appeal Division of the SST, then you may commence the appeal process in writing by way of letter, or through the SST’s Application Requesting Leave to Appeal to the Social Security Tribunal Appeal Division.
Once again, you only have 90 days in order to submit your appeal letter or application form for appeal, along with a copy of the General Division’s decision being appealed, and any applicable authorization forms. Our recommendation of submitting the package by way of registered mail or a similar method is equally applicable here for the same record-keeping purposes.
Get Help
The appeals process for CPP disability benefits can be a long, confusing, and difficult process. The information set out here is only meant to provide a brief summary of the three levels of appeal, though there is also judicial review available for decisions from the Appeal Division of the SST. If you are dealing with a denial of CPP disability benefits and are unsure of your options or have questions regarding the appeals process, call us for a free consultation.
For more information, visit our disability section. If you have any questions, book a free consultation or call 1-855-446-7765 for immediate assistance.
