How to Apply for CPPD Benefits
The Canada Pension Plan (“CPP”) is a social insurance program that provides a variety of benefits for those who pay into the plan if those individuals experience income disruption or loss.
The CPP requires all employed Canadians (except for those in Quebec) to contribute a portion of their annual income to the plan. Usually, CPP contributions are automatically deducted from the employee’s paycheck. While the primary CPP benefit is the traditional retirement pension, a contributor may also be eligible to receive Canada Pension Plan Disability Benefits (“CPPD”).
The Test for CPPD
CPPD benefits provide partial income replacement to eligible contributors, so long as they satisfy the two-stage test:
1. Valid Contributor: Applicants must have made CPP contributions in 4 of the last 6 years ot 3 of the last 6 years if the applicant has contributed for at least 25 years. If an individual has received CPPD for another disability, then contributions each year following the end of that benefit is sufficient. This period is known as the minimum qualifying period (“MQP”).
2. “Severe and Prolonged” Disability: According to section 42(2)(a) of the Canada Pension Plan Act, an applicant must prove that their mental or physical disability is “severe and prolonged.” In Villani v. Canada (Attorney General), the Federal Court of Appeal rejected the burdensome ‘total disability’ interpretation of this provision. Instead, the court adopted a common-sense interpretation of assessing disability in its “real-world context”:
a. Severe: Applicant must be incapable of regularly pursuing any substantially gainful occupation (This is not based solely on medical evidence, but a broader capacity to work). When performing the severity analysis, consideration must be given to “all of the circumstances” of the applicant, including (1) background factors, such as “age, education level, language proficiency, and past work and life experience” (Villani); and (2) the medical histories.
b. Prolonged: Disability must be either long-term, indefinite, or is likely to result in death. If the prognosis positive and recovery is expected within a reasonable and foreseeable timeframe, then the prolonged requirement will not be satisfied.
Once qualified, an individual is eligible to obtain CPPD benefits, of which there are two types: (A) the disability pension for those not yet receiving a retirement pension or (B) the post-retirement disability benefit for those who are not eligible for the disability pension because they have received CPP retirement benefits for more than 15 months and are under the age of 65.
To apply for CPPD benefits, you must submit an ‘Application Kit’, which includes (A) an application form (ISP1151) and (B) a medical report (ISP2519) to be completed by your doctor or nurse practitioner. CPP will pay your health care professional up to $85.00 to complete your medical report. While the application may be filled out on a computer, you cannot apply electronically. Instead, you must print a copy and mail it to the CPP along with all required documents. Helpful checklists explaining the required documentation and procedure is found within the application kit. The application process should be initiated as soon as you believe you satisfy the ‘severe and prolonged’ disability test.
According to CPP, it takes approximately 4 months to render a decision following an application. If deemed eligible, then you will begin to receive your monthly CPPD benefits the fourth month after the month you are determined to be disabled. You may also receive up to 12 months of retroactive payments from the date your application was received. If you are deemed ineligible and disagree, then you must request a reconsideration of the decision within 90 days of the initial denial. If you disagree with the reconsideration decision, the next step is to contact the Social Security Tribunal (“SST”) to appeal the denial.
If you would like to receive more information on CPPD eligibility or the application process, you can call the CPP’s toll-free number at 1-800-277-9914.