“Self-Diagnosis” Not a Basis for Claiming CPP Disability Benefits

A recent case called Cvetkovski v. Canada (Attorney General), involved a 50-year-old man who had applied unsuccessfully for Canada Pension Plan (CPP) benefits. He had a long history of psychological disorders which made it difficult to relate to others, and left him with low energy or motivation to do his job.

To try to cope with his various mental afflictions, including Post-Traumatic Stress Disorder (PTSD) and mood issues, he had received treatment from multiple specialists. But despite having fled the war in his native Yugoslavia at the age of 25, and despite having obtained a degree in computer networking and tech support, he had only spotty short-term employment throughout most of his career in Canada.

Still, the claimant’s CPP benefits application was rejected for failure to establish that he was “disabled” within the meaning of section 42(2)(a) of the Canada Pension Plan Act. Two subsequent appeals by the claimant were also dismissed.

The problem with the claimant’s application was that he had an acknowledged disability, but was adjudged to have made insufficient efforts to cope with it.   Admittedly, he was currently unable to work, but this was because he had unilaterally discontinued his treatment, and had stopped taking his prescribed medication of his own accord.

Under the CPP legislation, a person is considered “disabled” only if he or she is determined to have a “severe and prolonged mental or physical disability”, with the “severe” criterion being manifested by an incapacity to pursue any “substantially gainful” occupation.

In this claimant’s case, he could not establish a lack of capacity for substantially gainful employment because he was unable to put forward either: 1) a valid explanation for ceasing his prescribed treatment; or 2) some medical evidence to show that there was no other course of treatment that might help him.

As the reviewing court put it:

All of his doctors have recognised that the Applicant suffers from depression and PTSD and needs help. None of them has said that “there is no hope of returning to the workforce in the future.” The Applicant cannot expect to secure CPP disability benefits based upon self-diagnosis.

In the end, the claimant’s appeal of his rejected application for CPP benefits was dismissed.

If you have questions about your eligibility for CPP disability benefits, call Van Dyke Law Office for a free consultation.