My wife’s claim for CPP disability benefits was denied and she has begun the appeal process. Her disability is chronic pain due severe arthritis in her lower back. She also has some herniated disks.
They are telling her that chronic pain is not something that they consider a disability, however, her Brother had been given a CPP disability pension years ago for fibromyalgia, which suggests to us that chronic pain is very much considered a disability.
Her doctors have tried all sorts of heavy synthetic painkillers, to no effect. She now has a medical marijuana prescription and so far, this is the best medication she has received.
Unfortunately, the marijuana – and for that matter, the synthetic drugs too – pretty much incapacitates her intellectually.
My questions are, do the drugs prescribed not indicate the level of pain the patient is experiencing – especially since they don’t work? And how can they say that severe pain is not a disability when the only option is pain management with mind-altering substances? How is one to work in any capacity when they are always high on drugs?
Who is “they”?
Their doctor?
I’m glad you don’t accept their attempt to brush you off.
Fribro probably has other symptoms besides pain.
I would think not since everyone reacts differently to a certain drug.
I would think if you go to the doctor and say the pain killers make her high (describe the exact symptoms) then you have a medical record of that.
Maybe the doctor can document what her condition is when she is undergoing treatment.
You need to prove that the treatment for pain causes x, y, z and she can’t do work “a” because of symptom “x” and work “b” because of “y” and work “c” because of “z”.
Chronic pain can be accepted by CPP-D. My husband was approved. The reason he was granted was 1. extensive history of trying multiple medications which failed-on opiods now 2. Followed by a Specialist at the pain clinic. 3. Failed attempt at rtw 4. rehab cancelled due to medical instability 5. Followed by a Psychiatrist and regular visits 1-2 times a month to a psychologist. 6. Bi-weekly treatment by physio and accupuncture 7. Included 5 years of complete medical history 8. Focused on pain, fatigue and mental health
He also has likely MS but not complete for criteria. He also has had 4 successful surgeries on his wrists.
Give them everything! Include a daily time sheet for a month showing what she does each day and rate pain and fatigue on a scale of 1-10
Thank you both very much for the responses. Her circumstances are further complicated by our location. I work nine months in a very remote location and she comes with me. There are no opportunities for Dr visits, etc. In fact, we don’t even have a phone, other than satellite phone.
She was assessed by the pain clinic and scheduled for treatment but had to cancel due to our location. Then the pain clinic refused to accommodate her during our three month break so she’s effectively unable to receive treatment because of weather restrictions on travel and scheduling conflicts with the pain clinic.
She has given our Daughter power of attorney so that she can take care of communications with Service Canada now and also has an advocate.
I will get her to start documenting her medication and rating pain too. I have instructed my Daughter to raise the issues of fibro and marijuana with the adjudicator. I guess we’ll see what they say to that.
Hi Ron, I think you have zero’ed in on the main problem here. Pain can certainly be disabling and that is widely accepted; however, receiving ongoing treatment is a requirement to be successful in having a CPP case approved. She would need to get under regular care of a doctor and attend the pain clinic for you to have any chance of success. In my experience.
David Brannen
Disability Lawyer with Resolute Legal
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Service Canada and Insurers to will see not getting treatment as a failure to mitigate. Ron does not need to quit his job to look after his wife but she is expected to try treatment-so that may mean staying with friends or relatives to try getting better.
Hi all, The issue of our location though, from our perspective, is that since we are here for nine months, this is by definition, our home and we do not maintain a residence a city where a pain clinic exists. She is a Canadian citizen and is still within Canada. She is available for treatment three months per year but the pain clinic refuses to accomodate her. The treatment that is available would only treat the herniated discs, not the arthritis. The arthritis is the major source of pain.
Lastly, if she were to stay with family in order to receive treatment, we would be apart for nine months per year, effectively making us separated.
That would be persuasive evidence that she has done anything and everything to get better. It is a lousy situation–but she needs to be under regular treatment or prove she has done everything to get better.
They will use her travelling to a remote location as a motivating reason on why she wants disability benefits–because not only is there a lack of treatment -there is also a lack of employment for her. It is lousy–she must be under continuous Doctor care for her condition. A way around it is if she has a Doctor write that her condition would not be improved by treatment.
I can certainly see your (their) point, but separating family for that long of a period seems a little overboard to prove that she wants to be pain-free.
The issue of whether or not she wants to work is more an issue for EI or welfare applicants, not a disability. They can look at her lifelong work record to see she has been an active member of the workforce for the past 40 or so years.
We are not travelling to a remote location. Because we are here for nine months out of twelve, we are resident here. We are simply unable to travel to a treatment facility during the months when they want her to. If they would have accommodated her between June and August 2017, she would have under went treatment then.
There are only 2 pain clinics that we know of and they are both on Vancouver Island, we have no family for her to stay with with-in reasonable proximity to either.
For her to rent an apartment in either of those cities would be cost prohibitive at which point it would make more sense to quit my job.
The history of her back problems goes back to the 1980’s when she first started experiencing pain. It took 3 or 4 years and many doctors to even get a proper diagnosis. Finally, in 1992 she had surgery and the pain was gone. In 2012, it started to come back and she saw a doctor who warned her that she would likely not be able to work for very much longer and that because of her age, there was no chance of surgery.
In 2016, her dr at that time told her to stop working. At the same time, I got laid off of my job so we moved south to be closer to the pain clinic. That’s when she began the process of application for cpp-d and went on medical EI. By the end of that summer, I got this job and we had to go. She didn’t come up here to avoid treatment or work. I had to find a job because my EI would have ended.
I am sure we’re not alone. This is a big country with many very remote areas. For them to suggest that someone who has worked and paid into cpp all their lives should not be able to collect on a disability because they can’t travel large distances in winter weather in Canada, or that they’re not interested in treatment because they’re unwilling to set up a home near a clinic that won’t treat them when they’re available is asinine.
Sorry, I don’t mean to start sounding like I’m getting frustrated but I guess I am. I do appreciate the feedback and advice.
The contractual wording in the insurance policies are very unforgiving. Judges will look at what is reasonable, but you have to show you have done everything possible. Ultimately though, you have to be under regular care of a doctor or it is a no go.
Well, she has just received the second official denial. Reasons given are as follows: #1. She moved to a remote location and is not receiving the recommended treatment. #2 That she has not seen a physician about her unexplained weight loss. #1. What has actually happened here is that when she was advised by her GP to stop working, we were living in Fort Saint John, in northern BC. I got laid off at that same time and so we left FSJ and went to the south coast and lived on our boat near the pain clinic and she started the process. After 8 months and still no word from CPP I took this job. We need an income and there was no one for her to stay with in Victoria and she cannot maintain the boat on her own.
Her treatment had been scheduled for October but we had to leave at the end of August. They told her to call back in January to reschedule treatment for May, when we were to return. She called, emailed, had our Daughter call several times and were consistently told that they could not schedule yet. In May, they finally scheduled her for another consultation. We both went and the Dr sat there and looked over her test results from the year before. He never suggested that new tests were needed or anything like that. Then he insisted that he could not treat her until November. THIS is the problem. There was no reason they could not have scheduled her for the treatment at that June appointment and THAT’s why she hasn’t received the treatment.
Further on the treatment, from what we can ascertain, the treatment will only treat her herniated disks, not the main problem, which is arthritis and severe calcium build up on one side of her spine. That is what she received the surgery for in 1992 and since 2012 has presented itself again.
As for the weight loss, it has nothing to do with her claim. They might as well cite the fact that she has no hearing in one ear.
They also insist that she could do light duty work on at least a part-time basis. Her last three jobs were part-time and light duty!
They also mentioned that because we are in a remote location, that there is no opportunity for employment. This is not EI or Welfare that we’re talking about, it is a disability pension. Opportunity for employment has no place in the conversation.