How Hard is It to Get CPP Disability?

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Most Canadians know that the government provides CPP disability benefits, but most don’t know how hard it is to get a CPP disability. Many think it is almost impossible to get it, while others believe just the diagnosis of a debilitating disease is enough.

This article provides more information on CPP disability and its eligibility criteria and dispels common misconceptions. So, read on and learn more.

What is the CPP Disability Benefit?

The Canadian Pension Program or CPP is one of the multiple social programs managed by the government of Canada. It is a mandatory pension plan designed to ensure every Canadian worker has financial returns when it is time to retire.

Most Canadian workers contribute to the CPP, which is usually deducted from their wages. This money is kept until they reach age 65 and is then available to them in monthly pension payments.

The CPP Disability Benefit is a CPP program handled by Service Canada. It provides financial assistance to previous contributors to the CPP by providing a taxable monthly payment. It is meant to assist people with severe disabilities that prevent them from returning to the workforce.

This payment is provided to people forced to leave their jobs before retirement due to their condition. It is paid until the age of 65 and is then replaced by the usual CCP payments.

Who is Eligible for CPP Disability?

You must meet some requirements before applying for CPP disability in Canada. However, if you were denied disability for some reason, an appeals system is in place so you can try again.

You have three main requirements for eligibility: Age, contribution, and a serious and long-term disability.

In short, you need to at least:

  • Be a contributor to the CPP
  • Be between the ages of 18 to 65
  • Have a long-term disability or medical condition that has rendered you unable to work.

Contribution requirements

Just contributing once while working in Canada does not make you eligible for CPP disability. You must fall into the following categories to be eligible:

  • You must have been actively contributing to CPP at least four of the last six years before your application
  • If you have been an active contributor to the CPP, the earlier requirement is lowered to three of the past six years.

Certain provisions are available if you don’t fall under the above categories during application. These include:

  • The contributions you made before the day you stopped working instead of your application date
  • The fact that you were completely unable to work from that time to the present day

Age requirements

The second requirement is that you must be between 18 to 65 to be eligible for CPP benefits. The CPP disability benefit is meant to help individuals with disabilities during the time they would have been working.

However, after you reach the age of 65, your CPP disabilities will cease and be replaced by your retirement payments.

Disability requirements

The impairment is the most important criterion for eligibility in the CPP Disability Benefits program. Your disability must fall under the below requirements:

  • Your condition is preventing you from doing the work that you were doing before your disability began
  • It is preventing you from other gainful employment in another field
  • Recovery from your condition is impossible, or it may take a timeframe that cannot be determined.

Check Also: How to Apply for Short Term Disability?

What Impairments are Covered by CPP Disability?

Although CPP Disability Benefits cover many illnesses and medical conditions, it doesn’t mean that just a diagnosis of the ailment will make you automatically eligible.

Service Canada bases their eligibility criteria on how the medical condition affects your daily life and your ability to return to your job or look for another.

Below is a list of the most common disabilities that will qualify you for CPP Disability Benefits but remember that each case is different, and this list doesn’t contain every ailment that can leave you unable to work.

If your ailment is not on the list, as long as you can prove the effect your condition has on your ability to work, you can gain eligibility.

Mental Impairments

  • Alzheimer’s
  • Borderline Personality Disorder
  • Anxiety
  • Bipolar disorder
  • Depression
  • Dementia
  • Huntington’s
  • Obsessive Compulsive Disorder
  • Insomnia
  • Panic Disorder
  • Post-Traumatic Stress Disorder

Physical Impairments

  • Angina
  • Back Injury
  • Arthritis
  • Bowel Disorder
  • Cancer
  • Congestive Heart Failure
  • Diabetes (Type 1, Type 2, DI)
  • Elimination (Bowel, Bladder impairment)
  • Fibromyalgia
  • Emphysema
  • Hypertension
  • Glaucoma
  • Hip Replacement
  • HIV
  • Incontinence
  • Knee Replacement
  • Macular Degeneration
  • Obesity
  • Hearing Loss
  • Osteoarthritis
  • Osteoporosis
  • Parkinson’s
  • Retinopathy
  • Rheumatoid Arthritis
  • Spinal Cord Injury
  • Transient Ischemic Attack
  • Ulcerative Colitis
  • Walking impairment

How to Apply for CPP Disability Benefits?

Below are a few steps your can follow to apply for CPP Disability Benefits in Canada:

Get Support from your Doctor

The first thing you need to do before applying for disability benefits is to speak to your doctor about your intentions. You cannot gain disability benefits without their support.

Prepare your application

Fill out the relevant forms either on paper or online. This is a very important step, so you must fill it out carefully by taking all the time you need. Next, submit online or via mail to Service Canada.

Get your doctor to complete the medical report

You must send your doctor a physical copy of the medical report form. It is a good idea to book an appointment with them to complete the form so you can ensure it is done in a timely fashion. The doctor will fill out the form and mail it to Service Canada.

Talk to your medical adjudicator

After submission, a Service Canada medical adjudicator will give you a call. This person is a registered nurse and has the power to approve or deny your claim. So, it is a good idea to be ready to answer all further questions they may have. They may require more information from your doctor or employer, so you must cooperate with them.

Wait for the decision

Finally, you must be patient and wait as it can take between four and seven months. Don’t worry; this is mostly due to backlogs and not your application. You can check the status of your application online.

How Hard is It to Get CPP Disability?

Although CPP Disability Benefits are available for all eligible, it is still quite difficult. Benefits are prioritized according to the severity of the condition, and it may be that at the time you applied, your circumstances were deemed not severe enough.

An audit by the auditor general of Canada on CPP Disability approval rates found that out of the 70,000 applicants in 2016, only about 40% were approved after the first application.

However, you should not be discouraged. There have been recent simplifications in the application process, and you also can appeal your case and try again.

Still, Canada’s CPP Disability Benefits denial rates are higher when compared to similar countries.

Reasons why you could be denied CCP disability could include:

  • Your impairment is not currently recognized as eligible
  • A lack of provided information in the application that proves eligibility
  • A lack of knowledge on certain provisions that may make you eligible

What is the Amount of My CPP Disability Benefit?

The amounts that a person may be eligible to receive from their CPP Disability Benefit differ depending on their particular situation. This is so because the amount of their benefit is determined by how much they individually contributed to the CPP while they work in Canada. As a general rule, someone who has contributed to the CPP for 20 years is usually qualified for a higher CPP Disability benefit than someone who has only contributed for a few years.

Your monthly CPP disability payments are determined by Service Canada based on two factors:

  • Your monthly retirement benefit (this is your post-65 pension)
  • The fixed amount (the Canadian Government prescribes this amount annually)

They use the following methodology to determine your CPP Disability Benefit monthly payment:

(Retirement Benefit x 0.75) + flat amount

You can use your My Service Canada Account, send a letter to Service Canada via mail or phone or request an estimate of your retirement benefit amount and your most recent Statement of Contributions to the CPP if you want to know how much you might receive each month from your CPP Disability Benefit.

Conclusion

Although it is harder to get disability benefits in Canada compared to the rest of the world, it is not impossible. If you can make a proper application, preferably with the help of a lawyer, then you may have a good chance of gaining disability benefits.

Remember that even if you get denied once, it does not mean you cannot apply again. You should try multiple times to get approval; if everything is done correctly, you may get it.

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