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The Appeal Process for Denied CPP Disability Claims


A lawyer shakes hands with a client after the court hearing.

You sent in your CPP disability claim application. You waited. Then you got the terrible news: CPP disability claim denied. If you don’t agree with Service Canada’s decision and want to know what to do next, you came to the right place. Today’s article will explain the process for a CPP disability claim appeal and provide tips for CPP disability claim appeal success.

 

The CPP disability claim process

 

Almost 60% of initial CPP disability benefit applications are denied. Most CPP disability claims are denied not because the applicant isn’t disabled, but because of the way the application was presented. Denials due to mistakes in the application, insufficient medical evidence, or errors on the part of the decision-maker, for example, can be fixed by appealing the initial decision.


There are four levels of appeal in the CPP disability claim appeal process:

  1. Ask Service Canada to reconsider its decision.

  2. Appeal to the General Division of the Social Security Tribunal (“SST”).

  3. Appeal to the Appeal Division of the SST.

  4. Apply to the Federal Court or the Federal Court of Appeal for a review of the decision.

Let’s have a look at each level of appeal in more detail.

 

1. Reconsideration

If Service Canada denies your claim for CPP disability benefits, your first step is a request to Service Canada to reconsider its decision. You do this by submitting the correct form along with new documents and information to explain why Service Canada should reverse its initial decision.

 

The reasons for denial (as set out in the initial decision letter from Service Canada) is crucial to what documents and information you should submit. A CPP disability claim lawyer can help you determine exactly what you need to submit and help you put forward strong submissions to convince a medical adjudicator at Service Canada to change the decision.

Service Canada will review your reconsideration request and the reasons why you disagree with the denial, then send you its reconsideration decision. 

 

TIP FOR SUCCESS: Be mindful of the deadline for requesting a reconsideration. You must request this internal review in writing within 90 days of when you received the letter from Service Canada informing you of its initial decision denying your application.

 

2. Appeal to the Social Security Tribunal – General Division


If you do not agree with the reconsideration decision, you can appeal to the Social Security Tribunal (“SST”).  You must have a reconsideration decision before you can appeal to the SST. 

The SST is an independent administrative tribunal that makes decisions on social security appeals, including CPP disability denials. The SST is separate from Service Canada and has the power to make a different decision. The General Division is the first level in the SST’s CPP disability claim appeal process.

 

You only have 90 days from the date of the reconsideration decision to bring an appeal to the SST – General Division. To start the appeal process, you fill out and submit the Notice of Appeal – Income Security – General Division form. It’s extremely important to ensure your appeal paperwork contains a detailed explanation of the reason(s) for your appeal of the reconsideration decision. You will also need to submit any documents to support your appeal (e.g., medical reports, employment documents).

 

In most cases, you will have 8 months to submit your supporting documents and arguments to the SST. Employment and Social Development Canada (“ESDC”) will then have time to submit its supporting documents and arguments (usually 3 months). You will be provided with ESDC’s materials, and you will have 1 month to reply to what it sent. The SST – General Division will send you a Notice of Hearing. After your hearing, the SST usually sends its decision in writing within 30 days.

 

TIP FOR CPP DISABILITY CLAIM APPEAL SUCCESS: It’s possible to represent yourself, but you increase your chances of success when you hire a skilled CPP disability claim lawyer to assist you with preparing your appeal paperwork and to argue your case at the appeal hearing. 

 

3. Appeal to the Social Security Tribunal – Appeal Division


If you disagree with the decision of the SST – General Division, you can appeal to the Appeal Division (the second level of appeal at the SST). You have 90 days from the date of the SST – General Division decision to apply to the Appeal Division. You must use the Application to the Appeal Division – Income Security form to start your appeal.

 

Appealing to the SST – Appeal Division is a two-step process. First, you must ask for permission to appeal from an Appeal Division member (known as “getting leave to appeal”). If you are granted permission to appeal, you and the ESDC will each typically have 75 days to submit your supporting documents and arguments, and then each have an additional 30 days to respond to what the other has submitted. The SST – Appeal Division will send you a Notice of Hearing. After a hearing, you’ll usually get the final decision within 60 days.

TIP FOR CPP DISABILITY CLAIM APPEAL SUCCESS: The Appeal Division can only grant permission for specific reasons. Make sure you understand your reasons for appealing. To get leave to appeal, you must explain what the General Division got wrong or provide new evidence the General Division didn’t have.

 

4. Judicial review by the Federal Court


You may have the option of a final appeal to the Federal Court if you don’t agree with the decision of the SST – Appeal Division. You must apply for “judicial review” within 30 days of the SST – Appeal Division’s decision. The cover letter that comes with your SST – Appeal Division decision will tell you which court to apply to (the Federal Court or the Federal Court of Appeal).


TIP FOR CPP DISABILITY CLAIM APPEAL SUCCESS: you may be able to ask for judicial review if your application for permission to appeal is denied by the SST – Appeal Division.

 

CPP disability claim appeal lawyer in Alberta and Saskatchewan

 

CPP disability claim denied? Don’t despair, and don’t give up. At Ludwar Law Firm, our dedicated team will give your case the personal care and attention you need. Our CPP disability claim law firm can help you navigate the CPP disability claim process so you get the benefits you deserve. From our offices in Calgary, we work with clients in Alberta and Saskatchewan. Contact us today to arrange for your free initial consultation.

 

 

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