My CPP Disability Application Was Denied–What Next? (Part 1)

In our last post, we gave a basic overview of the CPP Disability benefit, which is a critical financial support for people living with severe illness or disability.

But what should you do if your application is denied? In this post, we’ll go over what happens when you want to appeal a CPP Disability denial.

Understanding the CPP Disability appeals process

If Service Canada denies your initial application for CPP Disability benefits, there are three levels of appeal:

  1. First, you can request that Service Canada reconsider their decision.
  2. If you disagree with Service Canada’s reconsideration decision, you can appeal to the Social Security Tribunal (SST) General Division.
  3. If you disagree with the SST’s decision, you can appeal it to the SST’s Appeal Division. This is the last level of possible appeal.

How many people succeed on appeal?

Service Canada doesn’t publish yearly statistics, but in 2016, the Auditor General of Canada published a report that looked at the CPP disability system.

The report found that for their very first application, 57% of people were denied. Of the people who asked for a reconsideration, 35% were successful.

Having your application denied is discouraging and many people simply give up after one rejection. But it’s worth it to keep pursuing further appeals, because the report found that at the tribunal level, 67% of denials were overturned (either by the Tribunal or by the department before the Tribunal’s decision). The report notes that “many appellants could have been approved at the initial or reconsideration stages”.

What are some common reasons that CPP Disability applications are rejected?

As outlined in the previous section, many applications are initially denied and then later approved, so sometimes there isn’t really a good reason for it being denied in the first place. That said, there are certainly some frequent issues that can lead to a denial:

  • Your application form wasn’t filled out correctly (missing information or medical documents)
  • Your healthcare provider doesn’t support your application–or you don’t have a diagnosis to support the criteria of a “mental or physical disability that regularly stops you from doing any type of substantially gainful work”
  • You’re not following the treatments your doctor has recommended
  • You haven’t tried to find modified or lighter work that might be possible with your disability

In our next post, we’ll talk about how to request a reconsideration, and share some helpful tips on managing this process.

Fighting a CPP Disability benefit denial takes a lot of energy and effort–two things you likely don’t have if you’re seriously sick or disabled. A disability insurance lawyer can relieve some of this burden from your shoulders, and help you build a strong case for having your CPP Disability benefits approved.

We understand, and we’re here to help, so please contact us if you need assistance.