The CPP Disability Benefit is a program under the Canada Pension Plan (CPP) that provides disability benefits through financial assistance to Canadians who are considered disabled and are unable to work at any job on a regular basis due to significant medical impairments.
An audit conducted by the Auditor General of Canada on CPP Disability in approvals showed that only 40% were approved after the first application out of 70,000 annual CPP Disability applicants. Since the audit in 2016, the forms and application process have been simplified by Service Canada to make it easier for applicants to receive their CPP Disability benefits. Even so, denial rates of the CPP Disability Benefit are still significantly higher compared to other countries around the world.
Having your application denied can be frustrating and discouraging, especially since the reason for denial is often not always clear. Below, our experienced disability lawyers breakdown Canada Pension Plan (CPP) Disability Benefits and Eligibility to help you better understand the benefits you are entitled to and set you up for success when applying.
Types of CPP Disability Benefits
CPP Disability Pension
The CPP Disability Pension is a taxable monthly payment available to people under the age of 65, who have contributed to the CPP and who cannot regularly work because of a disability. Those receiving the CPP Disability Pension will automatically be converted to a CPP Retirement Pension when they turn 65.
CPP Post-Retirement Disability Benefit
The CPP Post-Retirement Disability Benefit (PRDB) is a benefit for those between 60 and 65 and who have received CPP retirement payments for a minimum of 15 months before applying for the CPP Disability Benefit.
The PRDB is for CPP retirement pension beneficiaries that are found to be disabled but not eligible for a disability pension due to receiving their CPP retirement pension for more than 15 months. You cannot receive both a CPP retirement pension and a CPP disability benefit at the same time. The PRDB is only available to those receiving an early retirement pension. If you apply for CPP Disability Benefits but are not eligible because you have received the CPP retirement pension for more than 15 months, you will automatically be considered for the PRDB.
You can find the government’s CPP retirement pension calculator on this page.
CPP Children’s Benefit
If you are receiving CPP disability benefits (disability pension or post-retirement disability benefit), your dependent children may also be eligible for a children’s benefit.
The CPP Disability Children’s Benefit is a monthly benefit for dependent children, under age 18 or between 18 and 25 and attending school full-time, of someone receiving a CPP disability benefit.
Who is eligible for CPP disability benefits in Canada?
Three conditions must be met to be considered eligible for CPP disability benefits: age, contribution, and having a severe and prolonged disability.
In short, you are eligible for CPP Disability Benefits if you:
- Have a proven “severe and prolonged” disability as defined by Service Canada
- Meet specific CPP contribution requirements
- Are between the ages of 18 and 64
Disability Requirements
To qualify for CPP disability benefits, a disability must be both “severe” and “prolonged,” as defined by Service Canada, and must be proven to their medical adjudicators. Both the severe and prolonged criteria must be met simultaneously at the time of applying. The disability must also prevent you from being able to work at any job.
The terms “severe” and “prolonged” have specific and legal definitions that are essential to understand when considering if you should apply for CPP Disability Benefits. Service Canada defines the terms as:
- Severe means that you have a mental or physical disability that regularly stops you from doing any substantial gainful work.
- Prolonged means that your disability is long-term and of indefinite duration or is likely to result in death.
Since there is no standard definition of “disability” in Canda, you may not qualify for CPP Disability Benefits even if qualify for a disability benefit under other government programs or private insurers. Service Canada medical adjudicators will determine whether your disability is both severe and prolonged based on your application and supporting documentation.
There are many conditions that are often covered by the CPP Disability Benefits criteria. The following is a list of conditions that typically qualify for disability benefits.
Mental/Psychological Impairments
- Alzheimer’s Disease
- Anxiety
- Bipolar Disorder
- Dementia
- Depression
- Insomnia
- Obsessive-Compulsive Disorder (OCD)
- Post-Traumatic Stress Disorder (PTSD)
Physical Impairments
- Angina
- Arthritis
- Back Injury
- Bowel Disorder
- Cancer
- Congestive Heart Failure
- Diabetes ( Type 1, Type 2, Diabetes Insipidus (DI)
- Emphysema
- Fibromyalgia (FM)
- High Blood Pressure (Hypertension)
- Hearing Loss
- Glaucoma
- Hip Replacement
- Human Immunodeficiency Virus (HIV)
- Knee replacement
- Migraines
- Obesity
- Osteoarthritis (OA)
- Osteoporosis
- Parkinson’s Disease
- Retinopathy (diabetic, hypertensive, solar)
- Rheumatoid Arthritis
- Spinal Cord Injury (SCI)
- Walking Impairment
- Heart Disease
Contribution Requirements
To be eligible to receive CPP Disability Benefits, you must have contributed to the Canada Pension Program to a certain extent. Working Canadians must pay into the Canada Pension Plan program by law. However, paying into the CPP does not mean that you are eligible to receive CPP Disability Benefits automatically.
To be eligible to receive the CPP Disability you must have actively contributed to CPP in:
- At least 4 of the 6 years before your application
- 3 of the last 6 years if you have contributed to CPP for 25 years or more
In case you do not meet the above requirements at the time of your CPP Disability application, a late applicant provision is available.
The provision will allow Service Canada to judge your eligibility based on:
- Contributions you made before the date when you stopped working instead of the time you sent your late application.
- The fact that you were completely unable to work from that time until the present day.
Age Requirements
You must be between the ages of 18-64 to be eligible to receive CPP disability payments. The CPP Disability Benefit is meant to support those who are impaired from working during their working years. When an individual reaches 65, the payments for CPP Disability will automatically be converted into a retirement pension instead.
If you are over 60 and receiving CPP for early retirement, you cannot collect the CPP disability pension. You cannot collect both disability and retirement pensions at the same time. If you are receiving CPP retirement payments, they must be converted to CPP disability payments in under 15 months of receiving retirement payments. If you apply for CPP disability benefits but are not eligible because you have received the CPP retirement pension for more than 15 months, you will automatically be considered for the Post-Retirement Disability Benefit.
What Happens After You Apply for CPP Disability Benefits
It takes approximately 120 days for a decision to be made from the date the application and all supporting documentation are received. Once the processing of your application begins, you may be contacted by a medical adjudicator asking for additional information or request you see another doctor to re-evaluate your medical condition.
How Can a Lawyer Help with CPP Disability Claims?
Adjusting to life after an accident or illness can be extremely difficult, especially after working for a living for many years. Applying for CPP Disability Benefits can be a long and frustrating process for many who are unfamiliar with the program requirements. It shouldn’t be a burden you have to bear on your own in an already difficult time. Having a trusted team of disability lawyers in Nova Scotia handle the application process on your behalf ensures that all eligibility requirements are assessed and can increase the likeliness of a successful claim.
Letting the legal team manage your claim also allows you to focus on your health and wellbeing instead of paperwork and processing.
The specific requirements of a “severe and prolonged” disability can be challenging to prove to your government on your own. Disability lawyers know what evidence to gather and present, how to summarize medical charts, and which specific questions to ask your treatment providers and doctors to get the best results. Your lawyer’s written and oral submissions may be the driving factor you needed to have your claim approved.
Moreover, having a lawyer behind you can get your application approved the first time, instead of dealing with the complicated process of appealing a denial and having to wait for what you’re owed even longer. Your lawyer will often work with your treatment providers to ensure that they understand the technical requirements when they are filling out the forms.
If you applied and your application has been denied, consulting a legal counsel is highly recommended. Unfortunately, many of the people involved in your application, from doctors to general practice lawyers, misunderstand what it means to have a prolonged and severe disability. Our personal injury lawyers at Valent Legal are detail-oriented and can review your application, making the adjustments needed and fight for you to get through the challenging process of CPP Disability Reconsideration.
If you have been denied Canada Pension Plan (CPP) Disability Benefits or would like to have professional legal advice to help increase your chances of approval for your application, contact us today. Valent Legal is ready to help you get the disability benefits you are entitled to. Valent Legal has flexible fee arrangements including flat rates done on contingency.
