Cppd delays sending confirmation of benefits letter after medical review

Hello

Last year I received a call from Service Canada. It was a Nurse Adjudicator from Service Canada, and she stated that I had been selected for a medical review of my file.

The specific words that she said was that I had been receiving benefits for some time now, and that she needs to have up to date information from my treating doctor.

It took some time for my doctor process the request from Service Canada, however in late February Service Canada received up to date information from my doctor, including a note from my doctor supporting my disability.

The note described my condition, my symptoms, and the impact of my condition to my work capacity. It listed the attempts at mitigation, such as unsuccessful past treatments. It explained in detail why I cannot be gainfully employed, and also stated that my condition is permanent.

However, I still have not received a letter from the medical adjudicator stating that my benefits would continue, despite her having told me over the phone that my benefits would continue.

This is a log of the latest interactions with the Nurse Adjudicator and Service Canada staff:

  • March 6th 2025: called the Nurse Adjudicator to inquire about the results of her review. She told me she received way too much information from my doctor, about 500 pages. (My doctor says that is unlikely, since she has personally vetted all the paperwork sent to Service Canada.)

  • March 7th: called the Nurse Adjudicator and told her in that in order to help her navigate her way through the 500 pages, I went straight to my doctor and got the right documentation, which I then proceeded to upload. She told me she would call me within a week but she never called me.

  • March 25th: seeing how I had not yet received the promised phone call from the adjudicator, I called Service Canada helpline to inquire a about my status. They told me that the “processing agent had received documents from the adjudicator” and that the Processing Agent was unsure of what to do next and had asked his superior for advice what to do next. The Service Canada call agent told me that he put a note in my file, (sort of like a flag), that would cause the Service Canada persons responsible for my file to respond within a short timeframe.

  • April 17th: was called by the Nurse Adjudicator who told me that she was sorry to have delayed to call me and that I was going to be keeping my benefits. She told me that she did not have the time to write the official letter that I was expecting, because she has not been allocated that time from her supervisors, and that I would be receiving that letter in the future.

To conclude, one month later, I still have not received any communication/ letter from the Nurse Adjudicator, and I feel frustrated that Service Canada is delaying to issue the official letter that they are supposed to send me.

What are my options? (The Nurse Adjudicator was very nice and professional in dealing with me, but I do not want to bother her.)

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Honestly as long as your payments continue, I would consider this matter successfully concluded. If you did not do so at the time, write yourself a note with the date on it with your recollection of the conversation and who it was with.

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I agree with Caro, I don’t think any follow up is needed. Just keep records and I doubt you will ever hear from them again. I thank you for sharing your experience because I knew these reviews happened but haven’t heard the details like this before.


David Brannen

Disability Lawyer with Resolute Legal

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How long until they call and does it happen to everyone at some point? Weird how insurance companies require annual updates when a condition is severe and permanent but Service Canada doesn’t.

The financial incentives are different. It doesn’t make sense to spend a ton of money on medical reviews if few pensioners who are ‘severe and prolonged’ ever improve enough to work. Maximum CPPD is pretty low compared to what private LTD may be paying out.

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It doesn’t happen to everyone. It is really hit or miss with Service Canada doing a review. I think they focus on younger people who had medical conditions that could improve over time with treatment.

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