In most cases, the applicant will complete the Disability application on their own. The medical portion of the application must be completed by a treating physician. To be eligible for these benefits the applicant must:

1. be between the ages of 18 and 65
2. have sufficient CPP contributions at the time of the onset of the disability
3. be disabled according to the CPP legislation (below)

REQUESTING A RECONSIDERATION OF THE INTIAL DECISION
A request for a reconsideration to the Human Resources Development Canada, Income Security Programs, must be made in writing within ninety days of receipt of the decision. Many applicants are capable of doing this on their own. All the information submitted to the file will be considered. Usually a decision can be made within three to six months of the request. In some cases, the ISP will write directly to the treating physician(s) and request additional medical information. If there is indication on file that the applicant has applied for or is receiving benefits from the W.S.I.B. or an insurance company, the ISP will usually request benefit information from these sources. However, even though the ISP at times may request medical information, it is made clear to the applicant that the onus is on them to prove their "disability".

APPEALING A DECISION TO A CPP REVIEW TRIBUNAL
If a reconsideration is denied, the next step would be to appeal to the Office of the Commissioner of the Canada Pension Plan Review Tribunals. Regardless of the reasons outlined in the denial letter, the appellant has the right to make an appeal and have the appeal heard by a Review Tribunal. It is possible to have the Minister’s decision reversed without having to go to a Review Tribunal hearing. The appeal must be made in writing within ninety days of receipt of the denial letter. The OCRT will notify the appellant that within three to four months the appeal will be heard by a Tribunal panel. They are also advised that they may (not mandatory) have a representative to appear at the hearing. At this point most of our client retain our services for further handling of their appeal.

The chairperson of the Review Tribunal is a lawyer. One of the members will be a qualified health care professional and the other member will be a community member. The Review Tribunal is an impartial body who will make a decision in accordance to the CPP legislation and all the information previously provided to the file and any new information that was not previously considered. Witnesses may be brought to the hearings and an interpreter will be present when one is needed.

We will be provided with a copy of the case file a couple of months prior to the hearing. In preparing for the upcoming hearing, we will obtain and gather the evidence we need from the doctors and specialists including any outstanding medical evidence to support our claim for Disability. In many cases, important and crucial documentation has not been submitted and therefore not previously considered. In reviewing the file, we often come across many discrepancies or errors made in the initial application. In appearing at a Review Tribunal, we have the opportunity to raise these issues and clarify them so that the decision makers fully understand the applicant’s situation.

With proper preparation and representation of the medical evidence other relevant information; an appeal can be resolved successfully at this level. A decision is made in writing and directed to the parties involved by registered mail usually within eight to ten weeks of the hearing.

PENSION APPEALS BOARD
When an appellant’s appeal is dismissed by the Review Tribunal, the claimant can appeal this decision to the Pension Appeals Board. The Pension Appeals Board is also independent from the Human Resources Development Canada. Members are federal or provincial court judges and are appointed by the Order-in-Council. Pension Appeals Board hearings are not automatic. The decision to hear an appeal is made by the Pension Appeals Board. This process is initiated by filing an application for leave to appeal in writing within ninety days of receiving the decision of the Review Tribunal.

The Pension Appeals Board will advise us the decision to grant or deny leave to appeal. Should leave to appeal be refused, the decision of the Review Tribunal is final. If the Board grants leave to appeal, preparations will be made to schedule a hearing. Hearings are held across Canada and are open to the public. The Minister is always represented by legal counsel and expert witnesses. Leave to appeal is granted or refused within two to six months. When leave is granted it can one year before the case is scheduled for a hearing. Each appeal is assigned an appeal number. Hearings are scheduled in order of when leave to appeal was granted.

Unlike the Review Tribunal hearings, the Pension Appeals Board hearings are not held in Toronto throughout the entire year. These hearings are held in every province for one or two weeks in major cities usually once or twice per year. During the period of time in which we are awaiting a hearing date, we must thoroughly prepare the case. This includes researching previous and relevant Pension Appeals Board decisions that we can use as supporting case law. We will obtain all medical information necessary, including consultation reports, investigation results and updates from all treating physicians. We will provide all the new information and documentation to the Pension Appeals Board as well as counsel for the Minister.

The Legal Services department is in a position to propose an “offer” to us if that department becomes satisfied with the evidence that the appellant is in fact disabled. An offer will be made directly to us at which time we will consult with the client and explain to him / her what has been allowed. If the client agrees that the offer made is within reason, we will sign and return a Consent to Judgement to that department. A situation such as this, resolves the matter without having to have a hearing.

Pension Appeals Board decisions are final and binding.