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COMMON REASONS FOR CPP DISABILITY CLAIM DENIALS


A disability claim lawyer reviews documents of CPP disability claim

If you’re under the age of 65 and suffering from a disability or injury that prevents you from working, you may qualify for monthly disability benefit payments from the Canada Pension Plan (“CPP”).


CPP disability benefits may be the financial lifeline you need. Unfortunately, about 60% of initial applications for CPP disability benefits are denied.


Despite the difficulties in getting CPP disability, many people do qualify. Knowing the most common reasons for CPP disability claim denials will help you avoid mistakes and increase your claim’s chances of success.


Common reasons for CPP disability claim denials


Here are the most common reasons CPP disability claims are denied, and what you can do to avoid a denial.


1. Lack of support from your doctor.


Service Canada relies heavily on the opinions of medical professionals. Your CPP disability application will have little chance of success if your doctor won’t support it. Your doctor may refuse to support your CPP disability application because:


  • they don’t believe your disability is severe enough;

  • they think you are able to return to some type of work;

  • you refused to comply with treatment recommendations;

  • they don’t think you’ve exhausted all options (e.g., therapies, accommodations at work); or

  • your doctor is not familiar enough with your medical condition to recognize its impact on your life and your ability to work.


Whatever the reason, you should speak with an experienced disability claim lawyer before submitting your application if you don’t have your doctor’s support. There are ways to demonstrate the severity of your disability to your doctor to secure the medical support you need. Or it may be that you need to see a new doctor or specialist.


2. Insufficient medical evidence.


A CPP disability claim will be denied if supporting medical evidence is weak or altogether missing. You have the burden of proving your illness or injury using medical reports and letters from your doctor or other health professionals. Detailed forms and reports must be submitted with your application. The medical evidence you submit must contain information including your diagnosis, your prognosis, and how your condition affects your ability to do any form of work. Make sure your doctor understands the eligibility criteria for CPP disability benefits and provides an opinion on how your condition negatively impacts your employability.


3. Service Canada says your disability is not “severe” and “prolonged.”


To qualify for CPP disability benefits, your illness or injury must be both "severe" (a mental or physical disability that regularly stops you from doing any type of substantially gainful work) and "prolonged" (long-term and of indefinite duration or likely to result in death) at the time that you apply. It is extremely important that you understand and meet the eligibility criteria before you apply.


4. You haven’t tried to return to work or tried to find other work.


One of the main eligibility criteria for CPP disability benefits is that you must have a mental or physical disability that regularly stops you from doing any type of substantially gainful work. CPP doesn't consider your previous training, education and experience when deciding whether you are employable. If you are a professional or a highly skilled tradesperson, and you cannot work at that job but can work at a fast-food restaurant, then according to CPP disability, you can be gainfully employed. If you can’t get a job where you live but could get a job in another city, you will not qualify for CPP disability.


For that reason, attempts to look for work and return to the workforce are important (for example, attempting to return to your previous employment, but with accommodations; attempting to work in a new position). Failed attempts to return to a job help support your claim that you can’t work due to your disability.


5. You applied too late or haven’t contributed enough to the Canada Pension Plan.


To be eligible for CPP disability benefits, you must have made enough contributions into the Canada Pension Plan over your working life, and you must have contributed to CPP in four out of the six years immediately before you apply. If you wait too long before you apply for CPP disability, you may run afoul of the four-out-of-six-year criteria. If you have been out of the workforce for other reasons (e.g., childcare responsibilities) or working outside of Canada for a portion of your working life, this can negatively impact your application. There are ways around these stumbling blocks, including the late applicant provision, the child-rearing provision, and a social security agreement between Canada and another country you worked in. Talk to an experienced disability claim lawyer before submitting your application to ensure you meet the contribution requirements.


GET LEGAL ADVICE ON CPP DISABILITY CLAIMS FROM AN ALBERTA LAW FIRM


Calgary-based Ludwar Law Firm has over 25 years of experience representing clients with disability claims. Our clients appreciate that we take the time to explain their options, what is required to make a CPP disability claim, and what to expect during the claims process. Our legal expertise has helped win even difficult claims involving depression, chronic fatigue syndrome, and fibromyalgia. The team at our Calgary law firm will help you determine which benefits you are eligible to claim and guide you throughout the application process.

If you have already made a CPP disability claim and been denied benefits, we can help you find out why. You can appeal the denial within 90 days of being denied. Our law firm in Calgary can help you through the appeal process so you get the benefits your deserve. We welcome you to contact us today to schedule your free consultation.



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