What Is Required to Appeal a Canada Pension Plan Disability Claim?

The Canada Pension Plan Disability Program Provides a Financial Benefit When a Long-Time Contributor Becomes Unable to Work Due to Disability. A Claim Must Be Submitted to Service Canada. If Denied a Reconsideration Request Is the Next Step. If Denied Again, An Appeal to the Social Security Tribunal Is Required.

Understanding the Canada Pension Plan Disability Benefit Program Including the Claim Process and Appeal Process

Claim Form Document The Canada Pension Plan Disability Benefit is a financial assistance program that may be available to persons who substantially contributed to the Canada Pension Plan (CPP), are under sixty-five (65) years of age, and are unable to work due to a disability.  After submitting a claim application and receiving claim approval, a monthly benefit is provided.  For claimants with dependent children under eighteen (18) years of age, the Canada Pension Plan Children's Benefit may also be available.

The Law

The Canada Pension Plan Disability Benefit is prescribed and governed by the Canada Pension Plan, R.S.C. 1985, c. C-8, and in particular, among other sections:


Commencement of pension

69 Subject to section 62, where payment of a disability pension is approved, the pension is payable for each month commencing with the fourth month following the month in which the applicant became disabled, except that where the applicant was, at any time during the five year period next before the month in which the applicant became disabled as a result of which the payment is approved, in receipt of a disability pension payable under this Act or under a provincial pension plan,

(a) the pension is payable for each month commencing with the month next following the month in which the applicant became disabled as a result of which the payment is approved; and

(b) the reference to “fifteen months” in paragraph 42(2)(b) shall be read as a reference to “twelve months”.

When pension ceases to be payable

70 (1) A disability pension ceases to be payable with the payment

(a) for the month in which the beneficiary ceases to be disabled;

(b) for the month immediately preceding the month in which the beneficiary commences to receive a retirement pension under this Act or under a provincial pension plan;

(c) for the month in which the beneficiary reaches sixty-five years of age; or

(d) for the month in which the beneficiary dies.

Application for retirement pension deemed to have been made

(2) Where a disability pension ceases to be payable to a person by reason of his having reached sixty-five years of age, an application under section 60 shall be deemed to have been made by and received from that person, in the month in which he reached that age, for a retirement pension to commence with the month following that month.

Effect of receiving a retirement pension

(3) A person who commences to receive a retirement pension under this Act or under a provincial pension plan is thereafter ineligible to apply or re-apply, at any time, for a disability pension under this Act, except as provided in section 66.1 or in a substantially similar provision of a provincial pension plan, as the case may be.

Commencement of benefit

70.01 Subject to section 62, if payment of a post-retirement disability benefit is approved, the benefit is payable for each month commencing with the fourth month following the month after December 2018 in which the applicant became disabled, except that if the applicant was, at any time during the five-year period next before the month in which the applicant became disabled as a result of which the payment is approved, in receipt of a disability pension payable under this Act or under a provincial pension plan or a post-retirement disability benefit,

(a) the benefit is payable for each month commencing with the month next following the month after December 2018 in which the applicant became disabled as a result of which the payment is approved; and

(b) the reference to “fifteen months” in paragraph 42(2)(b) shall be read as a reference to “twelve months”.

When benefit ceases to be payable

70.02 A post-retirement disability benefit ceases to be payable with the payment

(a) for the month in which the beneficiary ceases to be disabled;

(b) for the month in which the beneficiary reaches 65 years of age; or

(c) for the month in which the beneficiary dies.

Reinstatement of disability pension or post-retirement disability benefit

70.1 (1) Subject to this section, a person who has ceased to receive a disability pension or a post-retirement disability benefit because they have returned to work is entitled to have that pension or benefit reinstated if, within two years after the month in which they ceased to receive it, they become incapable again of working.

Request for reinstatement

(2) A request by a person for reinstatement of a disability pension or a post-retirement disability benefit shall be made to the Minister in accordance with the regulations. Subsections 60(2), (4), (5) and (8) to (12) apply to the request, with any modifications that the circumstances require.

Consideration and approval of request by Minister

(3) The Minister shall approve a request made by a person under subsection (2) if the Minister is satisfied that

(a) the person has a severe and prolonged mental or physical disability that is the same as, or is related to, the disability that entitled the person to receive the disability pension or post-retirement disability benefit that is the subject of the request;

(b) not more than two years have elapsed from the month in which the person ceased to receive the disability pension or post-retirement disability benefit to the month when they became incapable again of working; and

(c) the person had not reached 65 years of age and, if the request is for reinstatement of a disability pension, was not receiving a retirement pension in the month in which they became incapable again of working.

Reinstatement of disabled contributor’s child benefit

(4) On reinstatement of a pension or benefit under subsection (3), the Minister shall approve the reinstatement of a disabled contributor’s child benefit that had been payable to the child of the person whose pension or benefit is reinstated if the Minister is satisfied that the child meets the requirements under this Act for payment of a disabled contributor’s child benefit.

Notification of decision — disability pension or post-retirement disability benefit

(5) The Minister shall in writing inform a person who makes the request for reinstatement of a pension or benefit of the Minister’s decision whether or not to approve the request.

Notification of decision — disabled contributor’s child benefit

(6) The Minister shall in writing inform the person who has made the request for reinstatement of a pension or benefit, a child of that person or, in relation to that child, a person or agency referred to in section 75 of the Minister’s decision whether or not to approve a disabled contributor’s child benefit.

Application of provisions — reinstated pension or benefit

(7) The provisions of this Act that apply to a disability pension or a post-retirement disability benefit, as the case may be, except paragraphs 42(2)(b), 44(1)(b) and (h) and (2)(a) and subsection 44(4) and sections 69 and 70.01, apply to a pension or benefit that is reinstated under this section, with any modifications that the circumstances require.

Application of provisions — disabled contributor’s child benefit

(8) The provisions of this Act that apply to a disabled contributor’s child benefit, except paragraphs 44(1)(e) and 44(2)(a) and subsections 44(4) and 74(2), apply to a disabled contributor’s child benefit that is reinstated under this section, with such modifications as the circumstances require.

Amount of disability pension and survivor’s pension

(9) Despite subsection (7) and subject to any division of unadjusted pensionable earnings under sections 55 to 55.3, the basic monthly amount of a disability pension that is reinstated, and the monthly amount of any survivor’s pension under this Act that is payable to the person whose disability pension is reinstated, shall not be less than the amount that was payable for the month immediately preceding the month in which the pension ceased to be payable, adjusted annually in accordance with subsection 45(2).

Commencement of payments

(10) A disability pension, post-retirement disability benefit or disabled contributor’s child benefit that is reinstated pursuant to a request under this section is payable commencing with the month following the month in which the person who made the request under this section became incapable again of working.

As shown above, the Canada Pension Plan statute contains many twists and turns and can be difficult to follow; and accordingly, professional legal assistance in reviewing the applicable terms within the statute can be of significant help in understanding the benefit as well as further helpful in preparing the Application documentation and advocating for claimant rights if needed.

Qualifying Criteria

To qualify to receive the Canada Pension Plan Disability Benefit, a claimant:

  • Must be under sixty-five years of age;
  • Must meet the minimum contribution requirements;
  • Must suffer from a mental disability or a physical disability that results in the inability to do any type of substantially gainful work; and
  • Must suffer from a disability that is of a long-term nature and is of an indefinite duration or will likely result in death.

Applying For Benefits

The Canada Pension Plan Disability Benefit application document, medical report, and procedures, can be intimidating and, where the duty is upon the person claiming the benefit that must demonstrate a genuine disability, troublesome if done incorrectly or insufficiently.  Accordingly, a person submitting a claim should seriously consider getting the help of an experienced professional legal practitioner.  An experienced practitioner will know the procedure and documents and may be able to avoid shortcomings in the process that could result in denials or delays.

Application Document Medical Report

Stages of Process

There are two potential stages to CPP Disability adjudication at the Service Canada level. At the first stage, your application and supporting medical report from your physician are evaluated and assessed for the eligibility criteria under the Plan. If your application is denied, you must then request reconsideration. At this stage, you must write to Service Canada and explain why they erred in their original decision regarding your application. If your reconsideration request is denied, you must then file a Notice of Appeal with the Social Security Tribunal of Canada, where your appeal may be heard in writing, by teleconference or through an in-person hearing.

Step One

Submit application and medical report documents to Service Canada.  A response advising of approval or denial takes about four (4) months.

Step Two

If necessary, meaning that the claim was denied by Service Canada at the initial application stage, then the next step involves submitting a reconsideration request to Service Canada.

Step Three

If necessary, meaning that the claim was denied again by Service Canada, this time at the reconsideration stage, then the next step involves submitting an appeal to the General Division of the Social Security Tribunal of Canada.

Step Four

If still necessary, meaning that the claim was denied by the General Division of the Social Security Tribunal of Canada, then the next step is a subsequent appeal to the Appeal Division of the Social Security Tribunal of Canada

Step 5

If still further necessary, the next step would be an appeal to the Federal Court of Canada.  If a claim goes this far, then a lawyer, rather than a paralegal, is necessary to appeal to the Federal Court of Canada.

Summary Comment

The Canada Pension Plan Disability Benefit provides social security protection to persons who suffer a disability that impairs the ability to earn a living.  The benefit may be available to a claimant who is less than sixty-five (65) years of age, among other criteria.  Upon turning sixty-five (65) years of age, the benefit will automatically convert from the Canada Pension Plan Disability Benefit to the Canada Pension Plan Retirement Benefit.

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