Applying for a disability claim can be confusing, and it’s a lot to take on when you’re already struggling with your health. Throughout my time dealing with CPP disability claims, I have tried to provide the best information possible to help individuals succeed at the application stage.
As part of our Ultimate Guide to CPP Disability Benefits, what follows are my top 8 tips for applying for CPP disability benefits. I hope these will give applicants a better understanding and make the process easier.
1. Make sure you qualify
If you have begun your application already, you are probably aware of the eligibility criteria.
To be eligible to receive CPP disability benefits, you must:
- Be between the ages of 18-65
- Have made contributions to CPP for 4 out of the last 6 years,
or 3 out of the last 6 if you have over 25 years total contributions
- Have a disability that is both “severe and prolonged”
(Here, severe means that you have a mental or physical disability that regularly stops you from doing any type of substantially gainful work. Prolonged means that your disability is long-term and is either of indefinite duration or is likely to result in death.)
Before going through all the work to apply, I highly suggest you take time to confirm that you qualify for CPP disability benefits, especially based on the contribution aspect. Even if your disability meets the “severe and prolonged” definition as laid out by Service Canada, if you did not contribute enough into the plan you will not be approved. I recommend you look into this factor as soon as you begin to consider ceasing work. Of course, you can still review your eligibility if you are already off work.
The contribution criteria requires you to meet the minimum qualifying period for benefits. To qualify, you need to have worked 4 of the last 6 years before you go off on disability, or 3 of the last 5 years if you have contributed for 25 years. There are some exceptions — if you were off work and not contributing during a period due to being a primary child care provider in the household, for example.
If you don’t meet the criteria or fall under an exception, you may need to continue working and contributing until you meet the minimum qualifying period. You might have to look for alternative disability benefits providers if you won’t be able to satisfy this criteria.
2. Don’t send in your application before you’re eligible
While you may have confirmed that you qualify from the contribution standpoint, the CPP disability program requires you to be off work for 4 months before being eligible for the program. During this time, we suggest you apply for any other disability assistance you have available to you including, but not limited to, EI sickness or any private insurance claims you may have. While you wait, I suggest you begin to work on your CPP disability application and have it ready to send off when you have been off work long enough to be considered eligible.
If you need more information or advice on how to complete your CPP disability application, check out our article: How to Apply for CPP Disability Benefits [Practical Guide + Video].
3. Tell the Best story in your cover letter
Here at Resolute Legal, we believe that the best story wins. The story you tell in your cover letter can make or break your CPP disability claim, so take the right amount of time and attention to write the best possible version.
Your cover letter should be addressed to your local Service Canada office and reference both your name and social insurance number. In the first paragraph, you should state which forms you are attaching as part of your application, and then list the forms and additional documents you have attached (with page references, if possible).
The rest of the letter should give more information about your education, work history, and the impact of your disability over time. This is essentially where you should be describing your timeline of events to the adjudicator — from the initial appearance of your symptoms to where you’re at present-day. You must be sure to explain what the symptoms are and how they have evolved. Detail your diagnosed condition(s) within this section and describe how they have prevented you from working. It is important to include any reduced work or accommodations made before you ceased work. If you made attempts at any other type of work, you should include these too. These attempts might be accommodated duties inside the role that you can no longer satisfy the job requirements for; other types of positions held elsewhere; or volunteer work.
Make sure to include a section to explain how you feel the disability’s impairments have limited you in your personal life as well. This might include things like household chores, personal grooming (showering), socializing, commuting (driving), exercising, child care or any other daily activities affected.
Avoid making negative claims about suggested treatments or complaints about physicians; try not to be argumentative in general about your condition, diagnoses, or the disability claim program itself. The whole process can be frustrating, but showing your frustration will not help you get approved.
The key is to tell your own story by focusing on your actions. The letter doesn't necessarily have to be long — it just has to show that you have done everything in your ability to get better and remain at work.
4. Double-check your application
Fill in your application to the best of your ability. When you are done, ask someone who knows you and your situation well to review it to ensure there are no mistakes or information left out.
As part of this double-check, make sure you have used the most current version of the forms. Make sure to download them directly from Service Canada’s website. If you submit the wrong forms, you will have issues with delays and will likely be required to re-do your application with the correct forms.
5. Prepare additional supporting documentation
Most medical conditions vary vastly from person to person. To heighten your chances of success, you will need to gather all other medical evidence, in addition to the medical report filled in by your doctor. This includes narratives and reports from specialists or treatment providers, medication prescription histories, test records, or any other medical documents your family doctor has that detail your limitations.
Detailing your attempted treatments and the different doctors you've seen is key for approval of CPP disability benefits. It is not enough for you to just mention it in your cover letter — having the actual medical documentation to back anything you have claimed will strengthen your chance of success.
You may need to specifically request additional records during the appointment when you provide your doctor with the CPP disability medical report. Be aware you may have to pay for these extra documents. You may need to request records or narratives directly from your other providers — counsellor or therapist, occupational therapist, specialist, massage therapist, physiotherapist, etc. Some doctors offer to handle this and send them along with their report. Verify what they are sending and gather the rest yourself so you know that everything will be submitted.
6. Have your doctor complete the medical report once you’re done everything else
Provide your doctor with the CPP medical report forms for completion only once you have your application, cover letter sections and additional supporting documents ready to go.
Confirm that your doctor will send the completed medical report to Service Canada once they’re done. They usually do, as Service Canada reimburses doctors for the form to be completed, but it’s best to make sure that this is their plan. Make sure to mention in your cover letter that your medical report will follow your application, as your doctor will complete and send it to them. You do not have to wait for your doctor to complete the report before you send in your application.
It’s very important to note that your doctor cannot simply input your diagnosis and that it renders you unable to work, or just write that it is severe and prolonged. These types of brief and generalized statements will likely result in a denial; they are not sufficient enough evidence and don’t support the personal statements outlined in your cover letter.
7. Never mail by courier
Never use a courier — Purolator, Fedex, DHL, etc. — to submit your application. Service Canada receives their mail through a normal Canada Post mailbox; therefore, no one is available for direct sign-off on receipt of a package sent with a courier.
We suggest sending your application in using Canada Post Xpresspost service — this is how we personally send our packages to Service Canada. You’ll receive a tracking number and will have verified proof that your package was sent, and you’ll also know when it arrives at Service Canada’s mailbox.
8. Be patient
The most important piece of advice I can give is to have patience after you mail out your application. I know this can be incredibly difficult after the amount of work it takes to prepare your application — especially if you’ve already been off work for some time.
Service Canada has 170 days to make a decision after they receive all of your submissions and your doctor’s medical report form. You should receive a call when they have everything they need to begin assessing your claim. I suggest you mark this date in your calendar, as well as a reminder for 170 days after. If you do not hear from them by that time, then you can reach out to check on the status of your application. Calling multiple times before this period is over will not speed up the decision process — and it’s best to avoid doing this so you don’t get on the adjudicator’s bad side.
This process is overwhelming and can be quite extensive. Remember to go at your own pace and take breaks when necessary. If you start filling out your application while you are waiting to become eligible as I suggested above, you will have enough time to get everything together. Just remember to take deep breaths and ask for help when needed.
Need to apply for CPP Disability benefits? Download our CPP Disability Application Checklist to see the exact steps we take when helping someone apply for CPP Disability benefits.