CPP Disabiliity Decision making and practices regarding TBI claims

#1

I have a TBI with Post Concussion Syndrome going on 17 years now. I am on disability benefits through an insurer (since 2009) but was denied CPP Disability Benefits when I applied at insurer’s request and was denied. Now I am about to retire in early 2018 and as part of the application package they ask the question “Did you stop work because of a disability?” which I definitely did. I did not appeal decision as I was told with a mTBI is was pretty futile and as I was receiving benefits through the insurer it did not seem important enough to use energy to fight them. Now I am not sure I should not have appealed.
My questions are:

  1. With the increased understanding and focus globally regarding the impact of Concussion and mTBI on people, has Canada Pension reviewed and changed their decision making practices to include mTBI impacts more favourably.
  2. If I was to be accepted through CPP as disabled, would my CPP benefits be higher after retirement than someone without CPPD?
  3. Is it worth it to appeal?
#2

What reason did Service Canada give for the denial?

To qualify for a CPP disability benefit, you must have contributed to the CPP in:

four of the last six years; or
three of the last six years if you have contributed for at least 25 years.

I suspect there was a time limit that you had to appeal but I’m not sure.

  1. Yes, CPP benefits are higher for people on CPP-D first.
  2. If you can (get a laywers opinion) then it probably is worth it to appeal. Not sure if you can since so much time has elapsed.
#3

In my opinion you were misinformed about Service Canada and mTBI. They have no decision making processes against mTBI in general. The focus is always on the impairment and disability and not the medical labels or diagnosis.

Given you have been off work since 2009, I expect your CPP claim is being denied for technical reasons related to the evidence (or lack thereof) you have provided in relation to the Minimum Qualifying Period. From a technical perspective, it is hard to properly present a case where the last day of work was 5-6 years ago. Not impossible to win an appeal, but is technically difficult and evidence must be carefully put together.

If you don’t keep appealing, your insurer could still exercise its right to estimate and deduct the CPP payments, so it is important you see the appeals through to the end.

David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliabile manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.

#4

David, can an insurer retroactively estimate and deduct CPP-D?

#5

That would be against all moral values and, probably, against the law.

#6

For practical reasons, I don’t see this happening; however, it’s conceivable some insurer could try it.

David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliabile manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.

#7

Ha Ha—made my day :slight_smile:

#8

Did you ever apply.for cpp-d