The perfect resource for people looking to learn more about CPP disability.

Are you looking for reliable information about the CPP disability program?

I know how hard it is to find answers. When I first got started with CPP disability back in 2012, it was almost impossible to find good information. There is much more information now available online, but a new problem has emerged.

Much of the online information is out of date. CPP disability is constantly changing and the last thing you need is make to decisions based on incorrect information or out-dated forms.

I wrote The Ultimate Guide to CPP Disability to give you a one-stop comprehensive overview of CPP disability. My team constantly works with hundreds of people making CPP disability claims, so we keep up-to-date on the most recent changes. I am committed to keeping this article fresh, so you can be confident you have the most recent information and forms.

I also cover all the main topics about CPP disability, so you can easily scan the table of contents and sections of the Guide to find the information you need. I include links to more details articles and outside resources in case you want to dive deeper on any topic.

This Guide is not meant to teach you about strategy for winning CPP disability benefits. If you want to learn about strategy, and what it takes to win CPP disability, check out my upcoming book A Beginner's Guide to CPP Disability, which will be published in July 2019 and for sale on Amazon.ca.

ABOUT THE AUTHOR

David Brannen
Founder & Managing Lawyer, Resolute Legal
As Resolute Legal's managing lawyer, David spends his days representing people with disability claims and overseeing other disability lawyers within the firm. David is among the few lawyers in Canada who focus exclusively on disability-related claims. David is the author of A Beginner's Guide to Disability Insurance Claims in Canada and The Beginner's Guide to CPP Disability.
Ultimate Guide to CPP Online Version

 

 

Table of Contents

  1. What is CPP disability?
  2. Who qualifies for CPP disability?
  3. What is the CPP children's benefit?
  4. Is CPP Disability hard to get?
  5. What are the rules the apply to CPP disability?
  6. How to apply for CPP disability benefits
  7. How to appeal a CPP disability decision
  8. CPP Disability Offices by Province and Territory
  9. CPP Disability Payment Schedule for 2019
  10. Medical Conditions that Qualify for CPP Disability
  11. Appointing a Representative
  12. Answers to CPP Disability FAQs
  13. List of all forms needed for CPP disability
  14. Final Thoughts

What is CPP disability?

CPP disability is a federal government program that pays monthly disability income benefits to eligible people and their dependent children. To be eligible for these payments you must meet age, contribution and disability requirements.

For 2019, the average monthly payment is $1,001 and the maximum payment is $1,362. You get an extra $250 per month for each dependent child. CPP disability operates in all provinces and territories except Quebec, which has a similar program called the QPP.

Who qualifies for CPP disability?

Not everyone with a disability or illness will qualify for CPP disability. To qualify, you must meet all of the following requirements:

  • You have a severe and prolonged disability
  • You meet the minimum CPP contribution requirements
  • You under age 65

Severe and Prolonged Disability

You need to show that you have a severe and prolonged disability as defined by the CPP laws and regulations.

Severe means that you are incapable of doing gainful employment on a regular basis. Prolonged means that your disability is not expected to improve, or will be of unknown duration, or is likely to result in death.

You have to meet both the severe and prolonged criteria to qualify for CPP disability benefits.

For example, it is possible to have a severe disability caused by a fractured leg, but you are expected to recover from the injury in six months. Therefore, the injury is severe, but is not prolonged. In that case you would not qualify for CPP disability benefits.

CPP disability is not intended for situations of short-term disability, even if the disability was severe. For short-term disability you should consider applying for Employment Insurance (EI) Sickness benefits.

Contribution Requirements

To qualify for CPP disability benefit you must have contributed to the CPP program:

  • Four of the last six years
  • Three of the last six years, if you have contributed at least 25 years

If you don’t meet the above contribution requirements, you may still be able to qualify in the following situations:

You were out of the workforce to raise children

You may qualify for CPP pension credits under the Child Rearing Provision. This can allow you to qualify even though you have not worked recently because you were out of the workforce to raise a child.

You are separated or divorced

If you or your spouse contribute to the CPP program while together, then you can apply to have your CPP contributions split. They add up the credits from both spouses and then give half to each spouse. This can result in you getting credit for CPP contributions, even if you have not worked recently.

You worked in another country

The CPP disability program has agreements with similar programs in other countries. You can transfer the credits between these programs. This can allow you to have enough contributions to qualify for CPP disability, if you haven’t worked recently in Canada, but did work in another country.

Late application provision

If you didn’t meet the contribution requirements when you applied for CPP disability, then you may still qualify under the late application provision. To qualify, you must prove that your “severe and prolonged” disability started in the past, when you last met the contribution requirements, and has remained continuous to present.

Because of the legal technicalities involved, it is challenging to prove you qualify under the late application. You need to gather very specific evidence and present your case carefully. In my experience, late application cases are among the most common situations where a person can lose a winnable case. This happens because they present the wrong evidence and create the wrong narrative. If you need to appeal a late application, I recommend you get legal advice or representation.

You were physically or mentally incapable of applying

It is very difficult to qualify under this exception. You have to show that you lacked the physical or mental capacity to form the intent to apply, and did not have someone who could do it for you. Then you need to show that you applied within one year of you retaining the mental or physical capacity to apply.

Most people who try to apply under this provision will not meet these strict criterial and will need to rely on the late application provision to win benefits. 

What is the CPP children's benefit?

The CPP disability children’s benefit is paid to the dependent children of people approved for CPP disability.

In other words, the CPP children's benefit is based on the disability of the parent and not the child's disability. This is a common misunderstanding.

So, if you qualify for CPP disability, the program will also make an extra payment for each dependent child.  

All of your dependent children under age 18 qualify for the CPP Children's benefits. Children between the ages of 18-25 will only qualify if they are enrolled full time in school.

In 2019, the children’s benefit is $250 per child. If your children are under age 18, then the benefit will be paid to you or their primary caregiver. When children are over 18, the benefit will be paid directly to them.

Is CPP Disability hard to get?

Yes, CPP disability can be hard to get depending on your situation. I have both good and bad news.

Let’s start with the good news. Don’t believe everything you hear. It is not impossible to win approval of CPP disability benefits. Up to forty percent of people are approved on the first application. Many more win approval during the appeals process. Experienced advocates and disability lawyers can have approval rates  for their clients exceeding eighty-five percent.

Now for the bad news. Not all deserving people are approved. You can absolutely lose a winnable case, if you don’t handle it properly.

Disability claims are not approved based on the truth of your situation. Rather, claims are approved based on the documents you send in, and how well those documents show the truth of your situation. 

If you have an invisible medical condition — like chronic pain, fatigue, irritable bowel, depression, or anxiety — then you will have a harder time proving your disability. It is by no means impossible to win, but you need to handle your case strategically.

Want to learn more about CPP disability approval rates? Read my article: CPP Disability Approval Rates Explained [+Infographic]

What are the rules the apply to CPP disability?

The rules for the CPP disability program come from laws, regulations and published judicial decisions.

So, to understand the rules for CPP disability, you must understand how the courts have interpreted and applied the laws and regulations in other CPP disability cases. 

Below are the laws that form the baseline of the rules for CPP disability. I also include links to search engines that have the judicial decisions that have interpreted the laws.

Lawyers use both the laws and the judicial decision to understand how the rules will apply in each unique situation.

Statutes

Regulations

Policies

Case Law

How to apply for CPP disability benefits

In some ways, applying for CPP disability is not complicated. You apply by filling out and sending in two official forms to the designated Service Canada office for your province.

These forms include the Application for CPP Disability Benefits ISP-1151  (you fill out) and the Medical Report for CPP Disability Benefit ISP-2519 (your doctor fills out).

You fill out the Application and arrange for your doctor or nurse practitioner to fill out the Medical Report. You then mail the completed Application to the designated Service Canada CPP Disability office for your province.  Your doctor will do the same.

Once Service Canada gets your "complete" application (Application and Medical Report), it can take 4-6 months for them to process your claim and give a decision. In the meantime, you can check on the status of your application online at the Service Canada website.

There is no fee to apply for CPP disability, but you may need to pay your doctor to fill out the Medical Report. Service Canada will reimburse your doctor for up to $80 to prepare the application form. You would have to pay the doctor for any charges above $80.

You also need to pay to mail in the forms to Service Canada. We recommend you use Canada Post Express Mail. You cannot use email, fax or couriers.

For more detailed instructions on how to fill out the Application, see our online guide: How to Apply for CPP Disability Benefits [Practical Guide & Video]

Official Forms to Apply for CPP Disability

Following are the official forms to apply for CPP Disability. Please note that the government updates these forms regularly, so you want to make sure you have the most recent versions of the forms.

We keep an eye out for new forms and update them here as fast as possible.

Beware: There other online articles and guides to CPP disability that have not been updated and refer to older versions of the forms. Make sure you have the most recent forms.

Click on the form below to download it:

How to appeal a CPP disability decision

After you send in your application, Service Canada will make a decision to approve or deny your claim.

Whether your claim is approved or denied, you have the right to appeal any decision you view as unfavourable. It is obvious to appeal when your claim is denied.

The most common reason to appeal an approved CPP disability claim about disputes over the date of onset of disability. In some cases this is important because it can affect the amount of the retroactive CPP disability payment. This can be the difference in tens of thousands of dollars.

An appeal is a formal process to review the unfavourable decision. The appeal is handled by a new decision-maker who has the power to uphold or overturn the existing decision.

If the appeal decision is also unfavourable, then you can appeal to the next level and seek a new decision.

There are five rounds of appeal, including:

  • Reconsideration Appeal (Service Canada)
  • Tribunal Hearing (Social Security Tribunal - General Division)
  • Tribunal Appeal (Social Security Tribunal - Appeal Division)
  • Application for Judicial Review (Federal Court of Appeal)
  • Application for Judicial Review (Supreme Court of Canada)

Now let’s look at each level of appeal in more detail. 

Reconsideration Appeal

The first level of appeal is the reconsideration. You do this appeal directly with Service Canada. There is a 90-day deadline to request the reconsideration appeal. You must request this appeal using the Request for Reconsideration of a CPP decision before the 90-day deadline. You need to send in any new medical information or other documents in support of your appeal.

A new CPP medical adjudicator will review the new information, along with the existing information they have, and will make a decision. 

Social Security Tribunal (General Division)

If Service Canada denies your reconsideration appeal, you have 90-days to request an appeal with the Social Security Tribunal. You do this by filling out and sending in a Notice of Appeal General Division IS (2009-2) Form, along with any new evidence to support your appeal. 

Once you send in all new documents, the Social Security Tribunal will schedule a hearing for your case. A hearing is live meeting with the judge to review and discuss your case. It is like a court trial, but is more informal.

You attend the hearing to give verbal testimony and to answer any questions posed by the judge or hearing panel members. You can also present legal arguments for why the judge should approve your claim.

The tribunal hearing differs from the reconsideration appeal because the judge is independent from Service Canada and you are given the opportunity to give verbal testimony. 

 

Social Security Tribunal (Appeal Division)

If your claim is denied at the Social Security Tribunal (General Division), then you can request permission to appeal the decision. You have no automatic right to appeal. You have 90 days to fill out and send in an Application to the Appeal Division (Requesting Leave to Appeal)

This appeal process starts asking for permission to appeal. If you are granted permission to appeal, then you are given more time to prepare any written explanation for why you believe the general division judge or hearing panel made a mistake in denying your claim.

Service Canada will also prepare written explanations for why they believe the general division judge or panel was correct in denying your claim.  The appeal judge will then made a decision on the written documents submitted, or will hold a hearing where you are given a chance to speak and answer questions.

 

Federal Court of Appeal

If your claim is denied by the Social Security Tribunal (Appeal Division), then you can ask for permission to appeal to the Federal Court of Appeal. If you are granted permission to appeal, then you are given a deadline to send in any documents and written explanations to support your appeal. You would then attend a hearing in Federal Court where you can speak to the judge and answer questions. This is a formal court hearing.

Supreme Court of Canada

If you are denied at the Federal Court of Appeal, then you can request permission to appeal to the Supreme Court of Canada. It is extremely unlikely that you would be granted permission to appeal, but it maybe possible if your appeal deals with issues of national importance.

You request permission to appeal, but filing an application for leave to appeal with the Federal Court. You need to follow the rules of procedure for the Federal Court. You will need to file a Notice of Leave to Appeal with a supporting affidavit and brief.

To learn more about how to win your appeal, check out my article: Are You Making This Mistake With Your CPP Disability Appeal?

Forms Needed to Appeal

Following are the forms used for appeal at each level of appeal. There is one form for Service Canada and two forms for the Social Security Tribunal (SST).

When you reach the Federal Court of Appeal and Supreme Court of Canada, you no longer file a single form.

You will need to file a Notice of Motion, which includes several documents. The requirements for a Notice of Motion is set out in the Rule of the Federal Court of Appeal and the Rules of the Supreme Court of Canada.

Reconsideration Appeal (Service Canada)

Tribunal Hearing (SST-General Division)

Tribunal Appeal (SST-Appeal Division)

 

CPP Disability Offices by Province and Territory

Service Canada has designated offices that handle CPP disability claims. While you can pick up a CPP application Kit in any Service Canada office, you must mail your completed paper application to the designated processing centre for your province or territory.

The phone number for CPP disability is 1-800-277-9914. You use that number no matter what province you live in. There are no direct lines for the CPP disability offices below.

Following is a list of the Service Canada offices that handle CPP disability claims for each provinces and territories:

Newfoundland and Labrador, Service Canada, PO Box 9430 Station A, St. John’s, NL A1A 2Y5 

Nova Scotia and Prince Edward Island, Service Canada, PO Box 1687 Station Central, Halifax, NS B3J 3J4 

New Brunswick and Quebec, Service Canada, PO Box 250, Fredericton, NB E3B 4Z6 

Ontario, Service Canada, PO Box 2020 Station Main, Chatham, ON N7M 6B2

Manitoba and Saskatchewan, Service Canada, PO Box 818 Station Main, Winnipeg, MB R3C 2N4 

Alberta, Northwest Territories and Nunavut, Service Canada, PO Box 2710 Station Main, Edmonton, AB T5J 2G4

British Columbia and Yukon, Service Canada, PO box 1177 Station CSC Victoria, BC V8W 2V2

CPP Disability Payment Schedule for 2019

CPP disability is paid by cheque or direct deposit to your bank account.

Service Canada prefers you use the direct deposit option and that is what we recommend. Then you never have to worry about the cheque being lost in the mail (yes it happens!)

Service Canada pays CPP disability one per month on a designated date.

The upcoming payments dates for CPP disability are as follows:

  • June 26, 2019
  • July 29, 2019
  • August 28, 2019
  • September 26, 2019
  • October 29, 2019
  • November 27, 2019
  • December 20, 2019

Medical Conditions that Qualify for CPP Disability

Service Canada and the Social Security Tribunal view your medical condition as a prime indicator of the seriousness of your disability. This is part of the Medical Adjudication Framework for CPP Disability, which is used by Service Canada.

When assessing your medical condition, the medical adjudicator and tribunal judges will consider the following factors:

  • The nature of your condition
  • Functional limitations imposed by the condition
  • Impact of treatment
  • Medical opinions
  • Interaction with other conditions
  • Personal characteristics

Any medical condition can qualify a person for CPP disability. This is because CPP disability is paid based on the seriousness of a person’s symptoms and disability, rather than the seriousness of the medical condition in general.

Following is a partial list of medical conditions that can qualify you for CPP disability:

Appointing a Representative

You can appoint a representative to help with your CPP disability application or appeal. Both Service Canada and the Social Security Tribunal will recognize and communicate with your designated representative.

For Service Canada, you can authorize a representative in your My Service Canada Account, or by signing a Consent to Communicate Information to an Authorized Person Form (ISP 1603 CPP).

The Consent to Communicate only allows communication and does not allow the person to make changes to your account, sign documents or accept payments on your behalf.

You need to have a Power of Attorney document, and give a copy to Service Canada, to enable another person to sign documents or make changes to your account.

For the Social Security Tribunal, you can authorize another person by signing the Appointment of a Representative and Authorization to Disclose Form (SST-ATD 2018-05 E).

Please note that in all provinces and territories only a licensed lawyer or paralegal may represent another person before the courts or Tribunals.

This includes the social security tribunal.

If you plan to be represented by an unlicensed person, it is possible he or she will be barred from representing you in the hearing. Most hearing judges are lawyers and they have a duty to prevent the unauthorized practice of law.

Answers to CPP Disability FAQs

What are the CPP disability payment amounts for 2019?

For 2019, the maximum CPP disability payment is $1,362.30 per month and the average payment is $1,001.15 per month. The children’s benefit is $250.27 per month per child..

Theses CPP disability payment amounts increase each year by the rate of inflation based on the Consumer Price Index. If there is a year when there is no inflation, then the amounts stay the same.

If you are into math and want to know exactly how the CPP disability benefit is calculated, read my article: CPP Disability Payment Amounts: How to Know How Much You Get [+Video]

 

What is a CPP disability retroactive payment?

Often referred to as back pay or a lump-sum payment, the CPP retroactive benefit is a one-time payment made to people who are approved for CPP disability benefits.

The retroactive payment represents past benefits owed over a months (or years) leading up to the day your claim was approved.

The retroactive benefit includes both your disability benefits and any children benefits.

The amount of the retroactive payment varies from case to case depending on when you became disabled and how soon your claim was approved. There can be no back payment if your claim is approved quickly, or can be tens of thousands of dollars. It is common for retroactive payments to be in the range of $15,000 to $30,000.

 

How long can you get CPP disability benefits?

CPP disability benefits can be paid until you reach age 65, assuming you continue to meet the disability requirements.

Depending on the nature of your illness and disability, you may not be guaranteed to have payments go to age 65. If your symptoms improve and you can return to gainful employment, then your benefits would stop.

Service Canada has the right to review your situation at any time. You are more likely to be reviewed if your are young and your condition or symptoms could improve with time or treatment.

Your CPP disability will stop on the day you turn 65. At that point, you can transition over to CPP retirement benefits. You can make the arrangements in the months leading up to your 65th birthday so there is a smooth transition.

 

How does CPP disability affect other disability benefits or payments?

If you are approved for CPP disability benefits, you may wonder if it will affect other disability payments you are getting. Below I review the interaction of CPP disability and other common disability payments. 

Employment Insurance (EI) Sickness benefits

You cannot get EI sickness payments and CPP disability payments for the same month. If you are getting EI sickness payments when approved for CPP disability, you must notify the EI program immediately. You will need to refund the EI program for any over payments caused by a retroactive payment of CPP disability benefits. 

Workers compensation

Each province and the federal government have their own workers’ compensation programs and agencies. The programs have rules allowing them to reduce what they pay you, if you start getting CPP disability payments. The rules for how this is done are different for each program. Generally speaking, your workers' compensation payment will reduce by some or all of the amount you are getting from CPP disability. If you get a CPP retroactive payment, it may create an overpayment situation, and you will need to pay some or all of it over to the workers compensation program.

Long-term disability insurance payments

Most long-term disability insurance companies have the right to reduce what they pay you if you are approved for CPP disability benefits. The amount of the reduction is often  the exact amount you are getting from CPP disability. This is called a dollar-for-dollar reduction. However, not ally disability insurance plans work this way, so sometimes you may have less than a dollar-for-dollar reduction, or no reduction at all. It you get a retroactive payment of CPP disability benefits it can create an overpayment situation. The overpayment means that you will need to pay some or all of the CPP retroactive payment over to the insurance company.

Provincial Disability Income Support Programs

Each province and territory has a disability income support program. These programs pay disability income to people who cannot work because of a medical condition or disability. To be eligible for payments you must meet a financial means test. In other words, your family income must fall below a certain amount in order for you to qualify for benefits.

The most common provincial disability support programs are ODSP (Ontario), PWD (British Columbia) and AISH (Alberta).

Provincial disability support programs require you to apply for CPP disability if you are eligible to do so. Usually your provincial disability payment will be reduced by the exact amount you are getting from CPP disability. This is called a dollar-for-dollar reduction.

 

Is CPP disability affected by non-employment income?

CPP disability is concerned with your ability to work and earn income from employment. Other non-employment income will not affect your right to CPP disability benefits.

Common examples of non-employment include include:

  • Money from inheritance
  • cashing out RRSPs
  • Rental income
  • Dividend payments
  • Passive investment income

Income from a severance payment or package should not affect your CPP disability payments. On paper, a severance package or payment can make it appear that you worked during the time covered by the payment.

You may need to clarify with CPP disability that the income is from a severance payment or package and not for work you did during that time.

Other types of income that will not affect your CPP disability payments:

  • Compensation paid from court or human rights settlements
  • Spousal support payments
  • Winning the lottery

How does family income or assets affect CPP Disability?

Your personal assets and family income have no affect on your right to CPP disability benefits. You can be a millionaire and still qualify for CPP disability if you meet the age, contribution and disability requirements.

The lack of a “financial means test” is a key difference between CPP disability and provincial income support programs like ODSP, PWD and AISH. Provincial programs will use your family income as one of the criteria for payment of benefits. Provincial benefits are only paid if your total family income falls below a certain amount.

 

Can you work and get CPP disability?

We often asked how much a person can earn and still get CPP disability. You can work while on CPP disability and earn up to $5,500 per year before you have to report it to Service Canada.

Once you earn more than $5,500 per year, Service Canada will monitor your situation more carefully. Once you are capable of earning $16,347.60 (or more) per year, then you are deemed to be “gainfully employed,” and would no longer qualify for CPP disability benefits.

So when you are earning between $5,500 and $16,000 Service Canada will decide whether you can keep getting CPP disability payments.

Service Canada may terminate your CPP payments even if you are earning more than $5,500 per year, but less than $16,000 per year. Always be up-front and honest with Service Canada about your income. They are willing to work with you to allow you to keep CPP disability benefits while you are trying to get back into the workforce.

 

Can you travel out of country and get CPP disability?

Yes, you can travel out of country and it will not affect your right to CPP disability payments. You can even move permanently out of country and still get CPP disability payments.

If you plan an extended trip out of the country,  is important that you tell Service Canada of your new address or how you can be contacted. We have seen people run into problems when they don't get an important letter and benefits are suspended when they don't respond as requested by Service Canada.

If you didn't notify Service Canada that you were travelling or moving, then you can't use the excuse that you didn't get their letter. 

 

Does CPP disability cover medical, drugs or dental?

No, the CPP disability program does not pay for medical expenses or drugs. The CPP disability program only pays a monthly benefit to an eligible person and their dependent children. You should contact your provincial government to determine if you qualify for assistance under their programs.

Final Thoughts

Still feeling unsure about your CPP disability claim? Sometimes a quick call with us can help you move forward with confidence. Call us at 1-888-732-0470 or use the calendar below to schedule a time for our disability support team to call you.