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HOW TO APPLY FOR CPP DISABILITY BENEFITS
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HOW TO APPLY FOR CPP DISABILITY BENEFITS
Will you need an advocate’s help?
This guide is not meant to take the place of an advocate or lawyer. It is a self-help tool that provides an outline of the application process. We have designed the guide so that it should be easy to follow. If you have any questions this guide does not answer, you can contact Canada Pension Plan at 1-800-277-9914. A series of information numbers are provided at the end of this manual.
CPP DISABILITY BENEFITS ELIGIBILITY
There are two eligibility criteria for CPP Disability Benefits:
1. You have made the necessary contributions to CPP during employment
2. You must meet the definition of disability as laid out in the CPP egislation.
CPP Contributions
Contributions to the Plan are based on the amount of earnings from employment and self-employment. Recent changes to the contribution requirement provisions made by the federal government make the date that your disability is deemed to begin very important.
If CPP determines that you became disabled prior to January 1, 1998, then you must have worked and contributed to CPP in either two of the three years, or five of the ten years before you became disabled.
If CPP determines that you became disabled after January 1, 1998, then you must have made contributions to the Plan in four of the last six years.
The CPP definition of disability
You must be deemed to have a “severe” and “prolonged” mental or physical disability to qualify for benefits.
CPP defines “severe” as a condition that makes “a person incapable of regularly pursuing any substantially gainful occupation.”
“Prolonged” is defined “a severe disability that is likely to be long continued and of indefinite duration.”
STEP 1:
THE APPLICATION
CPP Disability Benefit Applications can obtained by contacting your local Income Security Program office or by phoning the general number: 1-800-277-9914. The application includes a General Information Guide to assist in filling out the form. Applicants should read this guide before filling out the application.
The application package is divided into the following sections
The Application for Disability Benefits which asks for basic information about the applicant and any dependant children.Questionnaire for Disability Benefits. We will focus on this form in Step 2 of this guide.
The Authorization to Disclose Information - Consent for Medical Evaluation which allows CPP to obtain medical, employment and educational information about you.
A Medical Report completed by the doctor who is most familiar with your disability.
The Child-rearing Dropout Provision which should be completed by applicants who made low or zero contributions to CPP because they were caring for children under the age of seven.
STEP 2.
FILLING OUT THE QUESTIONNAIRE FOR DISABILITY BENEFITS
Some questions in the Questionnaire for Disability Benefits are particularly important and may influence the outcome of your application. The questions this manual reviews give the applicant the opportunity to describe the nature and extent of their disability.
The more comprehensive this information is the better. We recommend that you fill in the application and describe a day when the limitations associated with your disability are at their greatest. This way, CPP will have the best opportunity to see how your disability affects your day-to-day life and your ability to work.
The following questions on the Questionnaire need to be carefully and thoroughly answered:
Q 5 -- The date you stopped working is entered here. This is important because benefits are payable from the fourth month after the applicant is deemed to have become disabled. In this question, it is also necessary to answer why you stopped working. If disability was a factor in terminating employment, it is important to explain that here.
Q 11 and 12 -- If you indicate that you plan to return to work, or that your doctor thinks you should; it is likely that the application will be turned down. In order to qualify for disability benefits it is assumed that you will not be able to work in the foreseeable future.
Q 16 -- This question asks when the person felt they could no longer work because of their disability. The answer given here will often match with question 5 which asks for the applicant’s last day of work. If the two dates are different, it is important to explain why.
Q 18 -- This question asks the applicant to describe their “illnesses or impairments”. You need to be clear in stating the nature of your disability or disabilities.Make sure you list each medical condition and be specific.
Q 20 -- If you have other “health-related conditions or impairments”, which have not been described in question 18, they should be explained thoroughly here. Even if a person’s “primary” disability is not severe enough, according to CPP definition, other limitations or impairments may together cause a person to be unable to work.
Q 21 -- Another way to explain the extent of your disability is to describe how it has affected non-work related activities, like hobbies, sports or volunteer work, and other social activities. In this section, you should state any limitations that your disability has created in these activities.
Q 22 -- This question gives the applicant the opportunity to describe how many day-to-day activities are affected by the disability. There are a series of boxes with headings such as sitting, standing, sleeping, driving, etc. where the applicant is asked to describe limitations in these areas. (Again, this question should be filled out describing a bad day, giving the most realistic picture of your disability). For each activity try to be as detailed as possible about what you can’t do, not what you can do
Q 23- 24 - 25 -- These questions deal with the medical practitioners you have dealt with over the past years. Try to include everyone that you have seen and any hospital stays you have had.
Q 26 - 29 -- List medications and any treatments you have had. Treatments include: physiotherapy, chiropractic visits and counselling. Also list any assistive devices that you require such as canes, wheelchairs, breathing apparatus, splints, memory aids etc.
Q 30 -- We recommend that you indicate whether you would consider Vocational, Rehabilitation if you condition improves. However, if you are in your 60’s you could reasonably say no because of your age.
N.B -- Remember to sign the questionnaire and put your Social Insurance Number (SIN) on every page.
STEP 3:
THE MEDICAL REPORT
The doctor who is most knowledgeable about your disability should be asked to complete the Medical Report. Prior to the completion of the medical report, we recommend you talk to your doctor to see if he/she is in support of your application.
It is a good idea to tell your doctor how your disability affects your daily life. If you are dealing with a new doctor , he/she may not be able to provide sufficient detail to CPP. In this instance, it may be advisable to schedule a couple of visits before you ask for the Medical Report to be completed. It is worthwhile to submit any reports from specialists you have seen.
Here are a few tips in dealing with your doctor:
- Make an appointment specifically to talk about your CPP application.
- Ask the doctor whether he/she feels that your disability creates a severe barrier to employment, not only now, but in the future.
- Check with your doctor to see how long your disability is expected to last.
N.B. - Remember, in order to qualify for CPP Disability Benefits your condition must be both “ severe and prolonged” at the same time.
Who should fill out the medical report?
The General Practitioner
The advantage of obtaining information from a G.P. is that he/she is probably the doctor that knows you best. Also, if you have more than one disabling condition, the G.P. may have the best overview of how all your disabilities affect your daily living and your ability to work.
The Specialist
The advantage of getting information from a specialist is that he/she usually has more in-depth knowledge of your specific disability. Also, the opinion of a specialist may have more weight with CPP than the opinion of a general ractitioner.The specialist will usually provide information only on the condition that he/she is treating. They may not understand how your disabilities interact. Specialists generally don’t know patients their patients very well as they may see them only once or twice.
The doctor has the choice of returning the Medical Report (and the bill) to you, or submitting it directly to Income Security Programs. We suggest that you ask your doctor to return the Medical Report to you once completed. Ask if you may make a copy. You then include the Medical Report with your part of the application. If the application forms and medical form are returned at the same time it will avoid confusion and possible delay in processing your claim.
STEP 4.
OTHER SUPPORTING DOCUMENTATION
You can submit additional documentation with your application. For example, there may be medical letters and reports which provide useful information about your disability. However, such documentation should be reviewed carefully. It will not help your application if the medical reports are out of date or if a doctor indicates that you should be able to work in the near future.
Other health professionals can be asked to provide support letters. Relevant information that details how your disability affects your daily life and your ability to work can be very useful.
Family and friends can also be asked to provide letters. This kind of information is often considered of secondary importance by CPP.
STEP 5:
PUTTING YOUR APPLICATION TOGETHER
A complete application must include:
- The Application for Disability Benefits
- The Questionnaire for Disability Benefits
- The Authorization to Disclose Information / Consent for Medical Evaluation
- The Medical Report
- The Child-rearing Dropout Provision form (if relevant)
- Other supporting Documentation.
N.B. We recommend you make a photocopy of the complete application.
STEP 6.
SUBMITTING YOUR APPLICATION TO
CPP.
The General Information Guide that was included with your application, outlines the steps you need to take in order to ensure that CPP receives all the information they require.
A brief overview:
If you are mailing your application
- Enclose all the required birth records
- Put your Social Insurance Number on all pages
- Sign and date all forms
- Enclose the Medical Report from your physician.
N.B. If you are mailing your application, it is advisable to send it Registered Mail.
If you are submitting your application in person :
Phone Income Security Programs (1-800-277-9914) to make an appointment to submit application forms.
Bring proof of birth to the appointment
Ask the person you speak to how long it will take to get a reply.
ACKNOWLEDGEMENTS:
This kit is produced by Saskatchewan Voice of People with Disabilities.
The CPP Appeal Kit includes: Application Manual, Appeals Manual, Information Fact Sheets, Appeal VideoEditing and layout: - Allison Schmidt, Debra Klashinsky, Trina Chivers, Bev Prescott, Michael Huck.
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2708 Montreal Crescent, REGINA, Sask. - (306) 352-6221, Fax: (306) 352-6250 e-mail dcac@sk.sympatico.ca |
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