CPP Disability: Ultimate Guide (Application, Denial, Appeal)

If you are disabled from working and have contributed to the Canada Pension Plan (CPP), then you may be eligible for CPP Disability benefits.

The CPP Disability lawyers and specialists at Samfiru Tumarkin LLP have proven experience successfully resolving thousands of disability and insurance claim disputes. If your CPP Disability benefits are denied, we can provide valuable legal assistance and guidance through a free consultation. Our firm will review your situation, investigate the circumstances surrounding the denial, and help you get the compensation you deserve.

Continue reading below to learn more about CPP Disability claims and how you can get the help you need if your claim is denied in Canada.

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What is CPP Disability?

CPP Disability is a federal government program under the Canada Pension Plan (CPP) that provides financial assistance to individuals who cannot work due to a severe and prolonged disability.

CPP Disability is not to be confused with the Canada Disability Benefit (CDB), a new benefit that the federal government is currently developing.

What does “severe” mean?

In the context of CPP Disability, severe means that you had a medical condition which prevents you from working not only your former job, but any job if it pays you more than $18,508.36 per year and even some jobs that pay less.

What does “prolonged” mean?

Prolonged means that your medical condition is of indefinite duration, with no anticipation of improvement to allow you to return to the workforce.

Service Canada generally suggests that you can apply for CPP Disability after a one-year period. However, if you meet the remaining criteria, you are eligible to apply for benefits after four months of being off work.

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Who is eligible for CPP Disability?

To qualify for CPP Disability benefits, you must meet the following criteria:

• Age: You must be under 65 years old.
• Contributions: You need to have made sufficient contributions to CPP through your employment.
• Disability Severity: You must suffer from a severe mental or physical disability that prevents you from performing any substantial gainful work.
• Duration of Disability: Your disability must be long-term and indefinite in duration, or it must be expected to result in death.

Meeting these eligibility requirements is crucial for receiving CPP Disability benefits, providing financial support to those unable to work due to severe and prolonged disabilities.

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Can you get CPP Disability if you never worked?

No. If you haven’t paid into the CPP system through income, you can’t get CPP Disability benefits.

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How long do I need to contribute to CPP to qualify for CPP Disability?

To qualify for CPP Disability benefits, you must have made sufficient contributions to CPP during your employment. Specifically, you need to meet one of the following criteria:

• Four of the Last Six Years: You have contributed to the CPP program for at least four of the last six years.
• Long-Term Contributors: You have contributed to the CPP for at least 25 years, including at least three of the last six years.
• Continual Contribution After Cancellation: You have paid into the CPP every year since a previous CPP Disability benefit was cancelled.

These contribution requirements ensure that individuals have a sustained and recent work history with CPP contributions before qualifying for CPP Disability benefits.

Note: There are some exceptions to these rules. Contact us today to learn more.

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How to apply for CPP Disability benefits

There are key steps you need to take to apply for CPP Disability:

1. Talk to your health care providers: Obtain their medical support for your application for CPP Disability. It will be more difficult to get approved if you do not have medical support.

2. Submit application: You must complete and send your application to Service Canada. This can be done in one of two ways:

• • Online through your My Service Canada account (which will also require you to print out and mail in a consent form, as detailed here
  • Or by mail or by dropping off a completed form at a nearby Service Canada location. You must fill out an application form for either non-terminal illness or terminal illness, depending on your particular situation.

It is extremely important that you read through the questions on the form carefully. Ensure that you fill out all of the questions in as much detail as possible.

You must disclose personal information relating to your health, disability, limitations, daily routines, and more. You should create a narrative and explain why you are unable to work due to your illness or injury. Answer all questions honestly and to the best of your ability.

3. Get the Medical Report: Your primary health care provider needs to complete the appropriate Medical Report (Either a non-terminal illness report or a terminal illness medical attestation) as part of your application.

Make sure your physician completes this in a timely manner. CPP Disability can’t accept your claim for benefits without medical documentation to support your claim.

Your doctor should answer all questions and provide detailed responses. It is common for applications to be denied due to the lack of medical evidence of severe or prolonged disability. This often happens when the answers lack specific information relating to your health. An example of this would be a blank statement such as “this patient is unable to work at this time due to a medical issue.”

4. Receive a response from Service Canada: It can take up to 120 days (four months) for a decision to be made on your application. If Service Canada requires additional information or documentation to support your claim, they may call you.

In some cases, Service Canada may arrange for you to see another doctor to evaluate your medical condition.

If it has been more than 120 days since submitting your application, and you have not received a response from Service Canada, you should contact us ASAP so we can inform you of your options and next steps.

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What happens if my CPP Disability is approved?

If your claim is approved, congratulations! That is great news!

Service Canada will provide you with written notice that your application has been successful. That written document will also likely provide the breakdown calculation of your CPP Disability benefit amount and explain any next steps or obligations that you should be aware of.

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Is CPP Disability taxable?

Yes, CPP Disability is generally considered taxable income.

To help offset your taxes, you can apply for the federal Disability Tax Credit. You can speak with your accountant for more information on this program.

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How long does CPP Disability last?

The Canada Pension Plan Disability benefits last for the length of a person’s injury or until they reach age 65 (when they transition into their CPP pension).

See our resource on the expiration of CPP Disability benefits for more information.

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What happens if my CPP Disability claim is denied?

Service Canada will likely tell you why your CPP Disability claim was denied over the phone or with written notice.

If your claimed is denied, we understand just how frustrated and disheartened you are – but know that you’re not alone.

At Samfiru Tumarkin LLP, we are committed to helping you navigate a devastating CPP Disability denial. Our firm has years of experience resolving these and other disability matters in provinces like Ontario, Alberta and B.C. A free consultation with our team can put you on the path to getting the benefits you are entitled to.

You must contact us as soon as you are denied, as there is usually a 90-day deadline to appeal Service Canada’s decision.

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Can I appeal a CPP Disability claim denial?

Yes. In most cases, you have 90 days to appeal Service Canada’s decision to deny your claim for CPP Disability benefits. However, you absolutely should not appeal before speaking to a CPP Disability lawyer or specialist at Samfiru Tumarkin LLP. There is no cost to talking to our team to better understand your rights.

A free consultation with our team can provide clarity during this confusing time – and a potential solution to secure the compensation you need. We know what information should be included in your application, and how to help your doctors fill out their portions of the application.

At Samfiru Tumarkin LLP, we have been successful at every stage of our involvement, from application to appeal.

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Are CPP Disability denials common?

Unfortunately, yes. It is estimated that around 60% of all CPP Disability applications are denied by Service Canada.

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My long-term disability insurer asked me to apply for CPP Disability. What does that mean for me?

It is very common for long-term disability (LTD) insurers to ask that you apply for CPP Disability. The main reason they do so is because they are generally entitled to receive a credit for what CPP Disability pays you.

• Example: If you are earning $2,000 from LTD benefits through the insurance company, and you are approved for $1,000 from CPP Disability, your insurer will then only pay you $1,000 monthly. The other $1,000 would come from CPP Disability.

Learn more about the relationship between these two disability benefits in our CPP Disability and Long-term Disability Benefits FAQ.

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How Samfiru Tumarkin LLP can help

Our skilled team is ready to assist you at various stages of the process, ensuring that our support is available precisely when you need it.

• Application Stage: We can assist you in completing the initial CPP Disability application. This is done by working with you to obtain records, letters and reports from your doctors in support of your application.
• Reconsideration Stage: If your CPP Disability claim is denied, we can draft a request for reconsideration for you. This includes coordinating and obtaining further records, letters, and reports from your health care provider to support the application. We will then prepare the reconsideration letter for you.
• Appeal Stage: If your reconsideration request is denied, we will help in the final appeal stage. This includes filing a Notice of Appeal, coordinating and speaking directly with your doctors, compiling written submissions, preparing you for testifying at a hearing and representing you at such hearing.

If your CPP Disability claim is denied, you need to contact the experienced team at Samfiru Tumarkin LLP immediately at 1-855-821-5900 for a FREE CONSULTATION.

Our firm has helped many people, like Sandra Bullock, Julie Austin, and Florence Steele, resolve their disability disputes. We will review the facts of your situation, tell you if you have a case, and advocate on your behalf.

Get the advice you need, the compensation you deserve.

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Fees for CPP Disability claims

The fee structure at Samfiru Tumarkin LLP depends on which stage in your CPP Disability claim you retain us for.

It is important to note that our fees are only payable if we are successful in helping you get CPP Disability. If we are not successful, you do not need to pay us anything.

• Application Stage Fee: Our fee is $2,500 flat rate, plus tax and disbursements (only if we are successful in getting you CPP Disability).
• Reconsideration or Appeal Stage Fee: Our fee is 33.33% of any retroactive lump sum payment you receive, and 33.33% of monthly benefits up to 2 years, plus tax and disbursements (only if we are successful in getting you CPP Disability).