So you need to apply for CPP disability benefits but you’re unsure if you should work with a representative or just do it on your own.
Contrary to what you may hear, there are no “automatic” approvals for CPP disability benefits. While someone may get approved with little effort and no representation, others with seemingly the same situation will get denied.
The key to being approved is submitting a thorough application that presents a compelling story — and, sometimes, working with someone on your application is the best way to get your story together.
There are two types of representatives: licensed and unlicensed. Licensed representatives include lawyers (all provinces) and paralegals (Ontario only). Unlicensed representatives is a broader category that includes all other people who represent people in CPP disability claims and applications — businesses, advocacy groups, and more.
Working with the right representative can increase your chance of being approved at the initial application. Not all representatives have the same level of skill or competence, so you need to choose wisely.
If you have decided to apply on your own, however, you will benefit from knowing these 7 common mistakes people make when they’re not represented by a competent lawyer or other representative.
Check out our Ultimate Guide to CPP Disability Benefits for more invaluable tips, tricks, and information.
Mistake #1: Applying for CPP disability benefits while you’re still working full time
Generally speaking, you won’t be approved for CPP disability benefits if you’re still working full-time. There are some rare exceptions to this, but 99.9% applications will be denied if the applicant still works full time.
You may be struggling at work and want to avoid a gap in income, but unfortunately you can’t be approved if you are still capable of working — even if it is a major struggle for you.
There’s also a mandatory 4-month waiting period to qualify for CPP disability benefits. This means you must be continuously disabled for a minimum of four months before you even qualify to apply for CPP disability. During this four month period, you may be eligible to receive Employment Insurance sickness benefits to help with your finances.
When reviewing an application for CPP disability, one of the first things the CPP administration considers is whether you are capable of doing substantially gainful work on a regular basis. If you’re working and earning more than $1,362 per week, they will always assume you’re capable of substantially gainful work.
The threshold for “substantially gainful” employment is when a person has the ability to earn $1,362 or more per month (in 2019). This can be earned from full-time or part-time work.
So if you’re earning more than $1,362 per month and continue to be employed on a full-time basis, then you should not apply for CPP disability right now. You are better off to wait and apply once you have to stop work completely, or until you have to reduce your hours to the point where you’re earning less than ~$1,300 per month. If you are continuing to work in any capacity you should consult with a disability lawyer before doing your application.
Mistake #2: Not applying while you’re doing part-time or subsidized work
You can’t be approved for CPP disability if you are able to do substantially gainful work on a regular basis; however, not all work is considered substantially gainful. Also, you may be able to do substantially gainful work sporadically but not on a “regular” basis.
You should apply for CPP disability benefits if you’re only capable of working part-time and earning less than $1,362 per month.
Also, there are some types of work that CPP disability doesn’t view as “real work.” This can include:
- Employment in a sheltered workplace
- Work that requires constant supervision
- Work that is only possible because of a benevolent employer
We once won a case for a woman who was employed full time for 20 weeks per year earning more than $1,362 per month.
We were able to prove that she was being employed by a friend who felt bad for her and didn’t require her to do any actual work beyond showing up at the workplace when she could and helping out here and there. We proved to the Tribunal Judge that she only had this job because of a benevolent employer and no “real world” business would have hired her.
Mistake #3: Applying for CPP disability when you are collecting regular EI benefits
When you apply for CPP disability benefits, you must certify that you are incapable of doing substantially gainful work on a regular basis.
When you apply for regular employment insurance benefits, you have to certify that you are “ready and able to work.”
These two statements are in complete contradiction with each other. If you’re applying for both, you’re lying on one of the two applications.
CPP disability will not accept the excuse that you didn’t have any choice by applying for regular EI benefits because you needed the money to survive. It is fraud to certify that you are ready and able to work if you are, in fact, not able. If you apply for EI regular benefits, then you must not apply for CPP disability benefits.
Before applying for CPP disability benefits, you will need to make attempts to work — preferably while you are still receiving EI regular benefits. By attempts to work, I mean you actually have to get a job and show up for work. It’s not enough for you to have applied and not received a job offer; the CPP administration will say the only reason you aren’t working is because you weren’t offered a job. You have to show that you have tried doing actual work and were unsuccessful.
Mistake #4: Failing to prepare a thorough application
At the very minimum, an application for CPP disability requires you to fill out application forms; however, in most cases you will need to give more information to give yourself the best chance of approval. If you give minimal or incomplete information, your claim is more likely to get denied or delayed.
In many cases, it may be impossible for you to do the best possible job unless you work with an experienced disability lawyer. This might be tough to hear, but most people lack the self-awareness to prepare the application in a way that will be convincing to the decision-maker.
Even worse, in my experience, is that the more confident a person is in their abilities to represent themselves, the worse they are likely to do because of overconfidence and the same lack of self-awareness. This is a well-known phenomena in all types of legal advocacy — not just disability claims.
You may have heard the following expression:
“A lawyer who represents himself has a fool for a client”
People who believe they know what they’re doing are more likely to use complex or advanced advocacy strategies without really knowing what they’re doing. Lawyers who try to represent themselves in legal cases often fall victim to this. This is why judges will issue warnings to lawyers who try to represent themselves or close family members. I have had to take over for lawyers who attempted to do their own disability claims and lawsuits; these were some of the biggest messes I’ve ever had to clean up.
Mistake #5: Overstating your job duties or education
Some people are embarrassed by their lack of formal education or abilities to read and write. This can result in a tendency for some people to overstate their education, experience, and abilities.
When you complete the disability application forms, it’s critical that you’re honest about your level of education, experience, and abilities. If you overstate your abilities, the CPP administration may conclude that you’re capable of doing other types of work that you are, in fact, not capable or qualified to do.
If you try to correct things later on, it will result in a loss of credibility as you will have already certified that the information you gave was correct.
Mistake #6: Not understanding the Minimum Qualifying Period and late application rules
Not understanding your minimum qualifying period and whether your claim falls under the “late application provision” is a very common mistake that will usually result in a denial.
Not everyone who has to stop working is eligible for CPP disability benefits. To be eligible, you must have paid enough into the Canada Pension Plan and have your disability start in the window of time covered by your contributions.
You may have to deal with the late application provision if any of the following applies to you:
- You didn’t work 4 of the 6 years
- You stopped working because of disability over two years ago, but are just now applying for benefits
- You were on and off of work and changed jobs frequently
- Some or all of your income was paid “under the table”
The danger with not understanding your minimum qualifying period is that you may present a narrative that results in a denial of disability benefits. Once you present a certain narrative about your disability, it’s very hard to change it without losing credibility. We can fix the narrative, but often the judge will need to take you on your word. If you’ve changed parts of your story, they may believe you are making things up and trust you less.
Doctors and others may not understand your minimum qualifying period and can say things about your disability, believing they are helping you. In fact, they might create evidence that you do not qualify for CPP disability by wrongly establishing that your disability became severe after the end of your minimum qualifying period.
If you want to read more about the minimum qualifying period, check out our article:
CPP Disability Minimum Qualifying Period Explained
It’s critical that you present the right narrative from the start. If there’s any possibility that you’re applying for disability benefits outside of your minimum qualifying period, then it’s essential that you speak with a disability law firm.
Mistake #7: Basing your claim on undiagnosed or self-diagnosed medical conditions
While a diagnosis is not technically required for an approval of disability benefits, it’s certainly harder to be approved without a diagnosis from a doctor.
While you’ll want to list all of the medical conditions that affect your disability, be careful not to list things that aren’t supported by your doctors. The decision-makers will only consider a diagnosis or condition when there is medically accepted evidence to support the condition. You can’t rely on information printed from the internet.
It’s critical that you do not apply for CPP disability if you are in strong disagreement with your physician about your diagnosis and treatment plan. Consult a disability lawyer first as this type of situation needs to be handled very carefully.
I’ve reviewed seven of the most common mistakes that people make when representing themselves in an application for CPP disability benefits. Read these over carefully if you plan to represent yourself. If your situation involves a potential late application, part-time work, or any disagreement with your doctors, then you should speak with a disability law firm before sending in your application.