by David Brannen on June 12, 2020

Ultimate Guide to CPP Disability [+video]

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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Much of the online information is out of date.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 benefits. If you want to learn about strategy, and what it takes to win payments, check out my books, The Beginner’s Guide to CPP Disability and the CPP Disability Application Workbook.

Don’t have time to read the Guide now?

Subscribe to our email newsletter (The Insider) and we will send you a PDF copy of this Guide. Don’t worry, we only email you once per week (on Fridays) and you can unsubscribe at any time.

Table of Contents

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 are under the age of 65

We explain these criteria and how to know when the time is right to apply in our article How do you qualify for CPP disability benefits? [+ video]

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 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 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 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.

For a more in-depth read about the contribution requirement as well as these provisions, check out our article: CPP Disability Minimum Qualifying Period Explained.

What is the CPP children’s benefit?

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

In other words, the 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 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 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 that 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

Service Canada’s CPP Disability Adjudication Framework

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. Read all you need to know about checking your application status here: How to check your CPP disability application status.

If, at any point, you feel that your application has been mishandled or you have been mistreated by a Service Canada representative, you can file a complaint through the Office for Client Satisfaction. Read more about it here: How to file a complaint against Service Canada.

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].

If you’re looking for more tips for applying, check out our article Top 8 Tips for Applying for CPP Disability Benefits.

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 denial

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.

If you are looking for more information to help you understand why your claim was denied, take a look at our article: 7 Common Reasons for CPP Disability Denial (and what you can do about them).

The most common reason to appeal an approved CPP disability claim is regarding a dispute 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 of 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. y

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.

We have a blog article where we give a 7-step do-it-yourself guide for your CPP reconsideration appeal. You can check it out here: How to do a CPP Reconsideration Appeal [Guide + Sample Letter]

And finally, if you are considering doing a reconsideration appeal, check out our article on 7 Mistakes to Avoid When Doing Your Own CPP Reconsideration Appeal.

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 (2020-05) 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.

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.

If you are representing yourself at the Social Security Tribunal, we highly recommend reading our article:
CPP Tribunal Hearing: 5 Mistakes to Avoid when Representing Yourself

Federal Court of Appeal

If your claim is denied by the Social Security Tribunal (Appeal Division), then you can file an application for judicial review with the Federal Court of Appeal. You are then 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?

Late Appeal

If you have missed the deadline to submit your request for appeal, there may still be something you can do. To learn more, read our article How to request an extension of time to appeal a CPP disability denial.

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)

Request for Reconsideration of a CPP Decision ISP-1238 (2019-04-08)

Tribunal Hearing (SST-General Division)

Notice of Appeal General Division IS (2020-05) E

Tribunal Appeal (SST-Appeal Division)

Application to the Appeal Division for Leave to Appeal (2019-02)

CPP Disability Offices by Province and Territory

Service Canada has designated offices that handle CPP disability claims. While you can pick up an 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 offices below.

Following is a list of the Service Canada offices that handle 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 2020

Benefits are 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 as well. That way, you never have to worry about the cheque being lost in the mail — yes, it happens!

Service Canada pays benefits once per month on a designated date.

The upcoming payments dates are as follows:

January 29, 2020
February 26, 2020
March 27, 2020
April 28, 2020
May 27, 2020
June 26, 2020
July 29, 2020
August 27, 2020
September 28, 2020

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 benefits are 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 benefits:

Appointing a Representative

You may choose to 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).

List of all forms needed for CPP disability

Following is a list of all the forms you may need for a CPP disability claim or appeal. Please note that the government makes unannounced updates to these forms from time to time.

Service Canada Forms

Answers to CPP Disability FAQs

13 Most Common Questions

What are the CPP disability payment amounts for 2020?

For 2020, the maximum CPP disability payment is $1387.66 per month and the average payment is $1,010.26 per month. The children’s benefit is $255.03 per month per child.

These 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.

To learn more about the retroactive payment, take a look at our article CPP Disability Retroactive Benefits: Your Top 7 Questions Answered.

How long can you get CPP disability benefits?

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 payments 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 any other disability payments that you receive. Here is a review of how CPP disability and other common disability payments interact.

Employment Insurance Regular Benefits. You cannot get regular EI benefits and CPP disability payments for the same month. This is because the requirements for these benefits are at odds. To get regular EI benefits you must be ready and able to work; to get CPP disability you must be substantially unable to perform regular employment.

Workers’ Compensation. The federal government and each province have their own workers’ compensation programs and agencies. The programs have rules that allow them to reduce their payments 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 be reduced by some or the entire amount you are getting from CPP disability. If you get a CPP retroactive payment it may create an overpayment situation. If it does, 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 get approved for CPP disability benefits. The amount of the reduction is often the exact amount you receive from CPP disability. This is called a dollar-for-dollar reduction. However, not all disability insurance plans work this way; sometimes you may have less than a dollar-for-dollar reduction, or no reduction at all. If 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:

Inheritance money
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.

Some 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 benefits 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?

Yes. You can earn up to $5,800 per year (as of 2020) before you even need to report it to CPP disability. Once you are earning more than this amount, CPP disability will look at your situation to determine if you still meet the requirements for a severe and prolonged disability. Once you earn more than $16,651.92 per year (as of 2020), you are deemed to no longer meet the requirements for a severe and prolonged disability and benefits could only continue in exceptional circumstances.

Can you travel out of country and get CPP disability?

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

If you plan an extended trip out of the country, it is important that you update Service Canada with your new address and other contact information. We have seen people run into problems when they don’t get an important letter from Service Canada and benefits are suspended when they don’t respond as requested. If you didn’t notify Service Canada that you were travelling or moving, you can’t use the excuse that you didn’t receive 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.

Do I have to pay taxes on my CPP disability benefit?

The short answer is yes, your payments are taxable income. Follow this link to read more about paying taxes on CPP disability benefits.

How long should it take to fill out the application?

This varies from person to person, but it can take a few months to complete the disability application if you are waiting to receive copies of medical records from your doctors or other health professionals. The application form asks many difficult questions that you may not be able to answer off the top of your head. You should not try to complete the entire application in one sitting. It can be mentally exhausting and you’ll want to give yourself time to do it properly.

Check out our article “How long should it take to do a CPP disability application” for a more in-depth answer and an ideal timeline that you can follow.

What if my doctor is unsupportive and won’t fill out the Medical Report?

You can’t be approved for CPP disability benefits without a doctor’s support. If your doctor isn’t supportive, your first step should be to figure out why. Often, it is just that doctors are not satisfied that you have done all you can do to stay at work or to engage in treatment. So, the next step is to make sure you are following all advice for treatment and trying to stay at work. Most doctors will come around once they believe you have tried everything.

Sometimes doctors don’t understand how the CPP program defines a “severe and prolonged” disability. Doctors might not realize that your disability qualifies because they don’t think it is severe enough. In those cases you need to find a way to (tactfully) educate your doctor about the requirements for CPP disability.

You can read more about this here: What to do if your doctor won’t fill out disability Medical Report forms.

Do I need to hire a lawyer or representative? Can I represent myself?

This depends on your situation. If you’re submitting your first application, there’s a good chance you can do it on your own with success. Check out our article Applying for CPP Disability: 7 mistakes to avoid if you represent yourself for some best practices and advice.

Eligibility for Benefits

How do I know if I’m disabled enough to apply for CPP disability benefits?

You are likely to qualify for benefits if all of the following are true:

You are not currently gainfully employed;
You have a medical condition or illness that causes permanent impairment;
Your impairment or limitations will last at least 12 months and are of indefinite duration or will result in death; and
You are incapable of earning $1362 per month or more working on a part-time or full-time basis.

Do I have to be unable to do any job to qualify for benefits?

No. CPP disability does not require you to be completely unable to do any work. You just have to be incapable of regularly performing gainful employment. CPP disability considers your age, education, work experience, and transferable skills when determining if you are employable in the “real world,” as opposed to a theoretical job.

How does the CPP disability program define “disabled”?

The CPP’s definition of disability comes from the Canada Pension Plan Act, which states that your disability must be “severe and prolonged.” Severe means you are incapable of doing any gainful employment on a regular basis. Prolonged means your disability is not expected to improve, is of unknown duration, or is likely to result in death. Whether a disability meets the definition of “severe and prolonged” is a legal conclusion, not a medical determination.

What is the minimum qualifying period?

The minimum qualifying period (MQP) is the closed window of time when a person can be eligible for CPP disability benefits. In other words, to be eligible for CPP disability benefits, the onset of your disability from work happens within your minimum qualifying period. To have a minimum qualifying period you must meet the CPP contribution requirements for four years over any six year period. So, your minimum qualifying period will be the six year period when you last made contributions in four of those six years. For example, if that last time you met the minimum annual contributions to CPP disability was in 2010, 2012, 2013 and 2014, then your minimum qualifying period would end in 2016 — even though you didn’t contribute in 2015 or 2016. This is because 2016 would be the last year that you had four years of contributions over a six year period.

Is the CPP definition of disability the same as for long-term disability insurance or workers’ compensation?

No. The requirements for CPP disability are different from the requirements for long-term disability insurance or workers’ compensation. While the definitions can sometimes be similar, it is possible for you to meet the definition of disability for one program but not another. Therefore, simply being approved for benefits in one program cannot be used as “proof of disability” for the other programs.

How does the CPP administration determine if I am disabled?

No. The requirements for CPP disability are different from the requirements for long-term disability insurance or workers’ compensation. While the definitions can sometimes be similar, it is possible for you to meet the definition of disability for one program but not another. Therefore, simply being approved for benefits in one program cannot be used as “proof of disability” for the other programs.

Applying for Disability

How do I apply for CPP disability benefits?

You apply for CPP disability online through your My Service Canada Account (MSCA) or by mailing a completed paper application to the designated CPP disability processing office for your province.

What forms do I need to complete to apply for benefits?

You only have to complete one form — the Application for Canada Pension Plan Disability Benefits. Make sure you use the most current version of this form. If you have an application package that includes two forms for you to fill out, it is likely that you have an old version of the application that is no longer in use. Your application also has to include a medical form that your doctor fills out.

Are there any tips I should keep in mind when applying for disability benefits?

The most important tip we can give is to be honest with your answers and to take a critical look at your situation to determine the strengths and weaknesses of your application. Most people are not able to adequately recognize and address the application’s weaknesses without support from an experienced lawyer or representative. Ultimately, you need to show that you have done all you can do to get better and to stay in the workforce.

When should I apply for disability benefits?

There is a 4-month waiting period to apply for CPP disability benefits. This waiting period starts on the date that you first meet the definition of having a severe and prolonged disability. Even though the waiting period is 4 months, it is often better to wait up to a year to apply for benefits. You need to give sufficient time to show that your medical impairment is permanent and will not improve with medication or other treatment. Depending how far along you are with treatment for your medical conditions, your doctors may want more time to see if you will recover. If your doctor agrees that your condition will not improve for the foreseeable future, you can apply right away.

What is a late application for CPP disability benefits?

What is a late application for CPP disability benefits?

A late application means the CPP administration received your completed application outside of your minimum qualifying period. For example, if your minimum qualifying period ended on December 31, 2016, but you didn’t submit a complete application until January 2017, your application will be considered “late.”

A late application doesn’t disqualify you. You can still apply, but you will only be successful if you can prove the onset date for your disability happened during your minimum qualifying period, and that you have been continuously disabled since that time.

How long will I have to wait for a decision on my application?

It can take four to seven months for the CPP administration to process your CPP disability application. However, this counts from the time your application is considered “complete.” If you send in your application but the doctor’s report is missing, your application isn’t complete. The four to six months will only start once your doctor has sent in their report as well.

Delays in processing your application can happen for several reasons, but the most common are:

Backlogs with the medical adjudicator assigned to your claim
Adjudicator is waiting on a report or medical records form your doctor
Adjudicator is waiting on information from your employer

I was unable to work for a while, but I can work now. Can I apply for the past benefits owed from CPP disability?

No. Unlike other disability benefits programs, CPP disability does not cover situations where a person was off work for a period of time. This is referred to a closed period or a closed claim. In that situation, your disability will not be deemed “prolonged,” and you will not qualify.

Appealing a Denial

My claim for CPP disability was denied. How do I appeal?

No. Unlike other disability benefits programs, CPP disability does not cover situations where a person was off work for a period of time. This is referred to a closed period or a closed claim. In that situation, your disability will not be deemed “prolonged,” and you will not qualify.

How long do I have to appeal?

No. Unlike other disability benefits programs, CPP disability does not cover situations where a person was off work for a period of time. This is referred to a closed period or a closed claim. In that situation, your disability will not be deemed “prolonged,” and you will not qualify.

What happens if I miss the deadline to appeal?

If you miss the deadline to appeal, you will probably have to start over with a new application. It is possible to request an extension of time to appeal, but these extensions are only granted when you can show you had a good reason for missing the deadline.

Is the appeal worth the effort?

Yes, it is worth the effort. The majority of people who eventually get approved for CPP disability have to do at least one appeal. Depending on your age and medical condition it can be difficult to have your claim approved on the initial application, even if you are legitimately disabled.

Can I file a new application instead of doing an appeal?

Technically the answer is yes, but you are much better off doing the appeals rather than starting over. If you start a new application you will lose out on several months of back payments. You also risk making conflicting statements between the two applications, which can hurt your credibility. Finally, in the worst case scenario, repeated applications might make it look like you are abusing the system. That can result in automatic denials of your repeated application. Starting a new application can cause many problems and we recommend you seek advice before doing so.

Hiring a Representative

What are the types of representatives I can hire for a CPP disability claim?

There are two types of representatives in Canada: licensed representatives and unlicensed representatives. Licensed representatives include lawyers and paralegals (in Ontario only). Unlicensed representatives is a broader category that includes anyone who helps another person apply for CPP disability. This includes paralegals in all provinces other than Ontario. Licensed representatives have legal training, have malpractice insurance, and meet minimum standards of competence and ethics. There are no standards of competency or ethics for unlicensed representatives. Most unlicensed representatives don’t have malpractice insurance.

Is there any benefit to having a disability lawyer as my representative?

The benefit of working with a disability lawyer is that you can have confidence your representative will be competent to handle your disability application or appeal. If the lawyer is negligent or makes a mistake with your claim, then you are protected by their malpractice insurance.

When is the best time to hire a representative?

The earlier you hire a representative, the better. If you want to have the best possible chance of approval, you should hire a representative to help with your application. The earlier a representative is involved in your case, the easier it is for them to build a winning narrative for your application or appeal. If you represent yourself, you may say things or fill out the forms in a way that makes it harder for the representative to help win your appeal later on.

How will a representative help with my case?

A representative will interview you and review your medical records to better understand your situation and story. They will be able to identify strengths and weaknesses in your claim, and then work to emphasize the strengths and overcome the weaknesses. The representative will write to your doctor to get information needed to win your claim. They will help prepare the application and appeal submissions. Finally, the representative will represent you at your Tribunal hearing.

How much does a representative cost?

Most representatives will work on a no-win, no-fee basis. The fee charges will be a percentage of the retroactive benefits awarded to you, up to a maximum of 33.3% plus taxes.

Some representatives will require you to pay for any expenses related to your claim or appeal. Others will pay these expenses and only charge you if the case is won.

Working with your lawyer to build your case

Do I need to get medical records or reports for my lawyer?

No — most representatives will order copies of your medical records. All records provided to Service Canada must be “certified” true copies. It is easier for a lawyer to certify a true copy if the records come directly from the doctor.

What if my doctor gives me a report?

If your doctor or other health provider gives you a copy of a report, you should send that to your lawyer as soon as possible.

What if Service Canada sends me a form to be filled out by my doctor?

Once you hire a lawyer, it is critical that the lawyer control all CPP disability-related communications with doctors and other treatment providers. If Service Canada sends you a form for your doctor to fill out, give it to your lawyer and let them send it. Sometimes it is necessary for the lawyer to include a letter to the doctor clarifying the questions being asked or giving more context to the questions.

Possibly, but make sure any request like this comes from your lawyer — not from you. Getting a doctor to write a letter without directions or specific questions to answer is not a good idea. It can result in the doctor saying things that hurt your case, or it can be a waste of money if the doctor doesn’t address the key issues.

No. Don’t send anything to the Social Security Tribunal on your own. It is important that your lawyer coordinate all information to present the best possible case. All communications should go through your lawyer.

Should I phone my lawyer after every doctor’s appointment?

You should notify your lawyer’s office after any visits with doctors or other professionals. You don’t necessarily need to call; you can email this information or send a message through your lawyer’s communications systems.

When should I phone my lawyer?

You should phone your lawyer’s office whenever you have questions about your case. You should also phone to notify your lawyer of any changes to your situation. This includes attending medical appointments, address changes, or changes to your work status.

Should I try to get letters from my friends and relatives about my disability?

Possibly. Don’t do this without first speaking with your lawyer. Letters from friends and family are only effective in certain situations. They should only be used when they can support the narrative the lawyer is trying to show with your case. Random letters from friends and family are rarely effective.

What else can I do to help my case?

The best thing you can do to help your case is to cooperate with your lawyer’s office in collecting documents, signing forms, attending all recommended treatment and giving updates on your situation.

What are hearings like?

There are three ways your hearing might be held: in person, on a teleconference, or on a videoconference. Teleconference hearings are the most common. Hearings are run by a tribunal judge and last for 90 minutes. During this time, you present your case and answer any questions posed by the judge. You give a closing statement on why your case should be approved.

How long does it take for a hearing to be held and a decision to be issued?

All hearings must be booked one year from the date you file your notice of appeal to the Social Security Tribunal. So, from the date of your application it can take up to 12 – 24 months for your hearing to be scheduled if your claim is not approved along the way.

Service Canada does not usually send a representative or lawyer to the general division tribunal hearings; however, they always send a representative to the appeal division tribunal hearings. You won’t know for sure if Service Canada is sending a representative until you arrive at the hearing. You should always prepare as though they will be there.

How will I be notified about the date of my hearing?

The Social Security Tribunal sends an official letter confirming the date of your hearing. This letter is sent to both you and your lawyer. Your lawyer will also notify you when the hearing has been booked. The tribunal also calls your lawyer a week before the hearing to confirm that it is going ahead.

What happens if I get the notice of hearing before I get a letter from my lawyer telling me about the date?

Sometimes the Tribunal will forget to send letters to both you and your lawyer. If you get a letter notifying you of your hearing but haven’t heard from your lawyer, you should call your lawyer immediately. It is possible that the Tribunal forgot to send the notice letter to your lawyer and they may be unaware.

Will Service Canada bring a vocational expert to testify against me at the tribunal hearing?

No. Service Canada does not typically hire vocational experts to testify against CPP disability applicants. This is a common practice of the Social Security Disability Administration in the United States, but this practice has not been followed by Service Canada.

Will I have to send out any forms before my hearing?

Once your hearing is booked, there are no further forms to be sent out. Before your hearing is booked, you do need to send a Notice of Readiness form to tell the Tribunal you are ready to have your hearing scheduled. If you have a lawyer, they will prepare this form for you to sign and they will send it to the Tribunal.

What will my lawyer do to prepare for my hearing?

All lawyers handle this differently, but you should expect to have two or more meetings with the lawyer to prepare for the hearing. The preparation includes reviewing the important documents and information to be presented at the hearing. The lawyer will also practice the type of questions the judge will ask you at the hearing.

What can I do to help get ready for my disability hearing?

You should read the written submissions prepared by your lawyer and Service Canada. You should also review the documents contained in the hearing file. You should do whatever preparation your lawyer requests. This includes thinking of specific examples to illustrate how your disability affects you.

After benefits are approved

What do I have to do to get benefits started?

Unfortunately, there is nothing you can do to speed up the process of getting payments started. You will just need to wait for Service Canada to process your claim. Sometimes they will contact you to confirm your banking information or mailing address.

How long will it take Service Canada to pay me?

How long it takes to get paid depends on when your claim was approved. If Service Canada approves your claim before the Tribunal hearing, it can take 1-3 months for payments to start. If you won your case at the Social Security Tribunal, it can take 3-6 months for benefits to start. If you win at the Tribunal, Service Canada has up to 90 days to decide if it wants to appeal that decision; they don’t start payments while your case continues to be in appeals.

Will I get a notice from Service Canada explaining my benefits?

Yes. Once your claim is approved, you will receive a Payment Explanation Statement that shows a breakdown of your one-time retroactive payment and ongoing monthly payment amount.

How far back does the retroactive benefit go? How is it calculated?

The retroactive payment is calculated based on the date you filed your application. The retroactive payment goes back a maximum of 12 months before the date of your application up to the date your claim is approved. It can be less than 12 months if your disability onset date was less than 15 months before the date of your application. So, if your claim was approved 8 months after filing your application, then your retroactive payment would likely be 20 months of payments (12 + 8).

How is the retroactive benefit paid to me?

Service Canada pays the retroactive benefit in a one-time payment, usually deposited directly into your bank account. You can request that it be paid by cheque if that’s what you prefer.

How will CPP disability benefits be paid to me?

Service Canada can pay CPP disability benefits by direct deposit or by cheque. For the vast majority of people, we recommend choosing direct deposit.

Avoiding Termination of Payments

What is a continuing disability review?

After they approve your CPP disability claim, Service Canada can review your situation to make sure you continue to be eligible for benefits. These ongoing reviews are referred to as continuing disability reviews. Service Canada doesn’t do this in all cases. The younger you are, the more likely it is that your situation will be reviewed. Sometimes reviews will be triggered if Service Canada receives anonymous tips from people that you are faking or not really disabled.

What do I have to do for a continuing disability review?

You have to cooperate with the ongoing review. This could include filling out a questionnaire or speaking with the Service Canada medical adjudicator by phone. Service Canada will usually write to your doctor directly if they need medical records or information.

What if Service Canada decides I am no longer disabled, but my doctor says I can’t return to work?

If Service Canada decides to stop your payments, you have the right to appeal that decision. You will use the same appeals process that applied before your claim was approved.

If Service Canada stops your approved claim, we recommend you seek legal advice immediately.

Is there anything I can do to help ensure my benefits will not get cut off?

Yes. Continue to seek appropriate medical advice and keep in touch with Service Canada. Inform Service Canada of any changes to your address. Let them know if you regain the ability to work on a part-time basis. You may be able to keep your payments even if you are working part time, but if you don’t inform Service Canada they may terminate your benefits immediately pending an investigation.

Returning to Work

Will I lose my benefits if I try to return to work?

No — not if you coordinate the return to work with Service Canada. Service Canada has a special program for people receiving CPP disability who want to try to return to work. This program is very supportive of people who want to make a good faith effort to return to work. You can receive vocational counselling, tuition for courses, or assistance with your job search. They will continue your full CPP disability payments for up to two years while you try to return to gainful employment.

If my return to work fails, do I have to start over with a new application for CPP disability?

If you fail to return to work within two years of your last CPP disability payment, Service Canada will resume your claim without the usual application process. If your return to work lasted between two and five years, then you are eligible for a fast track application process. After five years, you would have to do the normal application process.

If my return to work fails, do I have to start over with a new application for CPP disability?

If you fail to return to work within two years of your last CPP disability payment, Service Canada will resume your claim without the usual application process. If your return to work lasted between two and five years, then you are eligible for a fast track application process. After five years, you would have to do the normal application process.

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About David Brannen

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.