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Importance of Medical Assessments in CPP Disability Claims

An image of a medical form with a stethoscope.

CPP disability benefits can provide you with the financial support you need if you’re faced with a debilitating illness or you’ve been seriously injured in an accident. You want to put forward the strongest application possible to ensure your claim is accepted.

The medical assessment is an integral part of any CPP disability (CPP-D) application. In fact, CPP disability medical assessments can make or break your claim. Read on for information about the importance of medical assessments in successful CPP disability claims.

CPP disability benefit criteria

To qualify for CPP disability benefits, the mental or physical condition causing your impairment must meet the criteria for severity and duration. It must be severe enough that it regularly stops you from doing the work you were doing before your injury or the onset of your condition, and it must also stop you from doing any type of substantially gainful work.

Additionally, it must be a long-term condition that cannot be corrected or whose recovery timeline is indefinite or can’t be predicted. You must show that you’ve tried all medical treatments available to you.

Types of disabilities

Conditions deemed eligible for CPP disability benefits include but aren’t limited to mental and psychological impairments like Alzheimer’s disease, Huntington’s disease, depression, post-traumatic stress disorder and insomnia. The list of eligible physical impairments is longer and includes conditions like arthritis, diabetes, fibromyalgia, cancer, heart disease and mobility issues.

Strong CPP disability medical assessments are the key to successful applications

Having a diagnosed condition is not enough on its own to qualify for CPP-D benefits. The level of severity of the conditions listed above can vary widely. In other words, receiving a diagnosis does not automatically mean you are unable to work. You must prove to Service Canada how and why your medical condition stops you from working. That is why detailed CPP disability medical assessments are so important.

Some people opt to go through the CPP disability claim process on their own, only to be met with a denial based on deficiencies in their medical assessment. At our CPP disability law firm, we regularly help clients who’ve received denials to navigate the CPP disability claim appeal process. It may be possible to fix problems caused by failing to submit sufficient medical information—but it’s better to avoid the delay and stress caused by mistakes in your initial application.

What makes for strong CPP disability medical assessments?

There are several forms that must be submitted to start the CPP disability claim process, including the ISP2519 CPP Disability Medical Report Form (a.k.a. the “medical report” or medical assessment”). The medical report is completed by your doctor or other medical professional such as a specialist you have seen. Y

ou must complete the first two sections of the form, which include identifying information about yourself plus your consent for the medical professional and Service Canada to communicate regarding your condition.

The medical report submitted with your CPP-D application must include a clear and comprehensive medical assessment of your disabling condition. A strong CPP disability medical assessment will include the following details:

  • the nature and severity of your medical condition;

  • impairments and functional limitations caused by your medical condition (i.e., the specific impact of your condition on your capacity to work);

  • prognosis (the likely course of your medical condition);

  • medications you’ve taken and treatments you have received, and their effects;  

  • upcoming treatments, planned investigations, and specialist consultations;

  • supporting documents (clinical notes, medical investigation report(s), specialist's report(s), hospital discharge reports, etc.); and

  • information about your employment situation, including whether the medical professional completing the report recommends that you stop working.

We strongly recommend that you schedule an appointment with the medical professional who will be completing the medical assessment so you can discuss the level of detail needed for your CPP application.

CPP disability medical assessments can be submitted directly to Service Canada, or they can be submitted by the applicant. You may want to request that your doctor return the medical report to you once completed so you can review it and address any issues before it is submitted to Service Canada.

What does Service Canada do with CPP disability medical assessments?

Once you’ve submitted your application, a CPP medical adjudicator will review everything submitted in your application package—including the medical report—to determine whether you meet the eligibility criteria. In most cases, Service Canada will notify you of its decision about CPP disability benefits within120 days from the date it receives your complete application and the medical report form. The processing time will be longer if your application is incomplete or further medical evidence is requested.

If your CPP-D claim is denied, you can ask for a review of Service Canada’s decision. It’s strongly recommended that you reach out to a CPP disability law firm right away for advice on bringing a CPP disability claim appeal. You may still be able to win CPP-D benefits by gathering and submitting additional information and medical evidence to convince Service Canada to change its decision.

Dedicated CPP disability lawyer Alberta and Saskatchewan

CPP disability lawyer James Ludwar is here to help if you need support applying for CPP disability benefits. Mr. Ludwar can help you successfully navigate the CPP disability claim process or guide you through the CPP disability claim appeal process if you’ve been met with an unjust CPP disability claim denial.

Check out our website to learn more about how we can help you with your CPP disability claim or other disability claims. Aside from being an experienced CPP disability law firm, we also provide other legal services for matters such as long-term disability claims to clients throughout Alberta and Saskatchewan.

If you’re ready to work with a professional CPP disability law firm, we welcome you to contact us. Your first consultation with our CPP disability law firm is free and can be done at your convenience in Calgary, Edmonton, Alberta, Saskatoon, Regina, and Saskatchewan. Request your appointment today.


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