Unfortunately my CPPD application was denied on the basis that I “should” be able to work in the future. I have multiple chronic illnesses, two of which have poor data on recovery, but in particular there is no strong data that patients recover to their baseline.
I don’t have additional information to send other than to write a letter reiterating what I wrote in my application that the symptoms have been worsening over the last several years and my functional limitations are marked such that completing ADLs are not possible every day.
Has anyone had success with a reconsideration request like this (without additional supporting medical info)? I mean they have what they need I think - charts from different specialists, my PCPs charts, lab work and imaging etc. my application was huge and I wonder if they just didn’t read it properly?
It’s quite common for people to focus on the wrong things in their initial application. In Canada it’s not about the diagnosis, it’s about how the disability limits your ability to work. Get a copy of David Brannen’s book on CPPD and follow his approach.
Looks like to didn’t meet the “prolonged" requirement of “severe and prolonged" to get cppd benefits.
It likely boils down to one of your doctors saying in their forms that you might be able to return to work one day or they just weren’t direct and said your prognosis is guarded and it is unknown when or if you’ll be able to return to work in the foreseeable future.
I don’t think an additional letter written by you will help. You need the doctor that fills out the medical report to write that you are not expected to return to work in the future, and to give the reasons. Like you wrote, they don’t read all the details properly; that’s why you need to make sure that the medical report clearly shows a poor prognosis to return to work.
My initial application was denied. In my request for reconsideration I included a letter from my psychologist which reinforced the statements submitted by my doctor.
All the best with your request for reconsideration.
Hi all, thanks for your responses ! I used David’s book and workbook for the application. It was extremely helpful. My application focused heavily on my functional limitations and only named the actual diagnoses where medically relevant. The reason I bring up the diseases themselves is the denial letter said I should be able to work in the future, in some capacity. There is no indication in my charts, the application or scientific data regarding the diseases that this would be accurate. And the word “indefinite” in CPPs wording also doesn’t require a known time frame, by definition (someone correct me if I’m wrong please). It seems the denial was based on lack of knowledge and/or an incomplete review of the application and supporting documentation. Which is frustrating but not totally unexpected I suppose.
From the many people I’ve spoken with who were denied CPP-D, it appears that unless a doctor clearly states that the prognosis is guarded or uncertain and that the person is unlikely to return to work in the foreseeable future, the decision makers may assume the person could eventually return to work. When that happens, the condition may be viewed as not prolonged, which can lead to a denial.
Based on my understanding, decision makers generally do not research a diagnosis themselves to determine its likely outcome. Instead, they rely heavily on what the doctor writes in the medical report. If the prognosis is not clearly described, the default assumption may be that a return to work is possible.
Because of this, many people focus heavily on listing their diagnosis when communicating with Service Canada. In practice, the more important point is often the prognosis, especially whether the condition is expected to prevent work for the foreseeable future.