CPP Disability Appeal Changes and Bill C-38

With the new appeal process for CPP Disability Claims coming into effect on April 1st, 2013, it becomes even more important to properly prepare for a CPP Review if you have been denied CPP Disability Benefits.

The Previous CPP Disability Benefits Appeal Process

Under the system which was in place until March 31, 2013, when you have been denied benefits, you could apply for reconsideration of the denied decision. If that denial was upheld on reconsideration, you once again had the right to appeal to the Review Tribunal. This Review Tribunal included a three person panel of experts who would review your case in person and then issue a decision. These experts included a health professional and a lawyer.

If the decision of the Review Tribunal was not satisfactory, a further appeal could be made to the Pension Appeals Board which was overseen by  Superior Court Judges. If the request for an appeal was granted, a hearing would be scheduled.  This hearing was considered a "hearing de novo" which required that the Judges hear all of the evidence as new evidence.

The Implications of the New Bill for CPP Disability Claims

Under Bill C-38, the Federal Government's New Omnibus Bill, the changes to the appeal process for CPP Benefits claims are significant. After April1st, appeals will be heard by the new Social Security Tribunal which will consist of a General Division and an Appeal Division. As the name suggests, the Appeal Division will hear appeals from the General Division.

The changes with the new Bill become critical, as if your case is dismissed by the Social Security Tribunal, as a summary dismissal, you are denied the right to appeal to the General Division. This summary dismissal takes place without a hearing, if the SST determines that your case 'has no reasonable chance of success'.

If your case moves on to the General Division, it is heard by a single adjudicator.  Based upon the information which is currently available, it appears that this adjudicator may have no background in either the legal or medical field. This person will have access to, but is not required to use, legal and health professionals, to review your case.

Another key influence on your outcome may arise as this hearing does not need to be heard in person. The new review process allows this review to be done using a question and answer format which may take place in writing, by teleconference or in person. In many cases, a hearing in person provides the best opportunity to discuss our case and to ensure that the appropriate evidence is heard. For those coming from a distance though, the written or teleconference option removes some of the barriers to making an appeal.

If your appeal moves on to the Appeals Division, and there are limited grounds on which this may happen, the level of expertise is different than under the previous system.  Under the new system, it is no longer required that the members of the Appeal Division are Judges or former Judges.

There is no 'hearing de novo' under the new Appeals Division, and thus it will simply be a review of the previous evidence and testimony. This process overall implies a more stringent and difficult appeal process which may not necessarily benefit the applicant. Under the new system, it is even more critical that your initial submissions must be strong and that your best case be put forward accurately from the outset.  If your case is complex, it is advisable to bring on the services of a disability lawyer, who can  increase the likelihood that your request for benefits will be approved.

Getting An Expert Involved Increases Your Chances of Success

A successful end result impacts how you live the rest of your life. A disability lawyer can help you prepare for the often stressful process and walk you through what it takes to create a successful submission to the SST.

Next week we will look at what it takes to prepare for a successful submission to the Social Security Tribunal and how best make your way through the new regulations if your CPP Benefits Application is denied.