CPP disability General Division: Your reasons for appealing
If you agree with everything in Service Canada’s reconsideration decision, there’s no reason to appeal. If you disagree with the decision, even just a part of it, you can appeal to the Social Security Tribunal (SST).
You have 90 days to appeal after you receive the reconsideration decision.
If you appeal, then change your mind, you can withdraw (cancel) your appeal. If you do this, Service Canada’s reconsideration decision will remain valid.
Let’s look at common scenarios for appealing to the SST.
Generally, people want to appeal a reconsideration decision because they feel that the decision was unfair and that they’re actually eligible for benefits.
When you appeal to the General Division, you need to give details. For example, if you think you actually meet the eligibility requirements for benefits, you need to mention how you meet those requirements. Or, if you think Service Canada didn’t follow the law correctly, you need to mention how.
This is what we mean when we talk about explaining your “reasons to appeal.” You’ll also need to send us documents to support those reasons.
Here are some examples of things the SST can make a decision on:
Alex has serious health problems that prevent him from working. He applied for Canada Pension Plan (CPP) disability benefits. Service Canada decided not to pay him benefits. It said that he didn’t go to all the therapy sessions that his doctor recommended.
The law says that you should do everything possible to get better. This includes following your doctor’s recommendations.
If Alex decides to appeal, he can explain why he could not go to all the therapy sessions his doctor recommended. He can explain what he did try to do to get better.
We can decide whether Alex did all he could to get better and return to work.
Darya can’t work because of her disability, so she applied for CPP disability benefits. Service Canada decided not to pay her benefits. It agrees that she may not be able to do her usual work. But it says that she should be able to do some type of work (full-time, part-time, or seasonal) that is “substantially gainful.” This means that she could earn a living from her work.
If Darya decides to appeal, she can explain why she’s not able to do other types of work. She can show the SST all the different jobs she did try to do but wasn’t able to. This includes some jobs she didn’t tell Service Canada about.
We can decide whether Darya is able to do work and earn a living.
Here are some examples of things the SST cannot make a decision on:
David was getting CPP disability benefits for many years. On his 65th birthday, Service Canada converted his CPP disability benefits to a CPP retirement pension. He doesn’t think that’s fair because he’s still disabled and will never get better. So he wants to appeal to the SST.
The law says that when you turn 65, you can’t get CPP disability anymore. It ends, and it gets automatically replaced by a CPP retirement pension.
We can’t change the law. We don’t have the authority to tell Service Canada to continue paying David CPP disability benefits.
Abby applied for CPP disability benefits in August 2020. Service Canada approved her application and decided to pay her benefits retroactively starting in September 2019. That's the maximum retroactivity possible. Abby thinks her payments should start before that because of her personal circumstances. Her concern is that she needs the extra money.
The law says that when you apply for CPP disability benefits, you may be considered disabled 15 months before you apply. This is called your “deemed date of disability.” The law also says that you can start getting CPP disability benefits only 4 months after your deemed date of disability. So if Service Canada decides to pay you benefits retroactively, they can go back a maximum of 11 months.
We can’t make exceptions to the law. We can’t tell Service Canada to start Abby’s payments before September 2019 so she can have more money.
What happens if you don’t have a “reasonable chance of success”
If you appeal, an SST member will look at your case and the documents you send us. A member is the decision-maker in an appeal. They have to look at your situation and see what the law says about it. They can’t change the law. They have to follow what it says.
A member will consider whether your appeal has a “reasonable chance of success.” That means the member will consider whether you have an argument that could possibly succeed. If they think you do, then they will want to hear more about it in a hearing.
If the member says you don’t have a reasonable chance of success, the member may start the summary dismissal process.
What’s a summary dismissal?
When an SST member starts the summary dismissal process, it means they’ve decided that you don’t have an argument that could possibly succeed. They think your case might not have a reasonable chance of success.
Anya applied for Canada Pension Plan disability (CPPD) benefits. Service Canada decided not to pay her benefits. It says she doesn’t qualify because she hasn’t made enough CPP contributions. She paid into CPP for only 2 years when she worked in 2019 and 2020. She believes she should get CPPD benefits because there are special circumstances that prevented her from working and paying into CPP.
In Anya’s case, the law says she must have paid into CPP for at least 4 of the last 6 years to be eligible for benefits.
The SST member assigned to Anya’s appeal has noticed that the facts aren’t in dispute (both Anya and Service Canada agree that she paid into CPP for only 2 years).
So the member is thinking about summarily dismissing Anya’s appeal because she hasn’t made enough CPP contributions. Members have to follow what the law says. They can’t make exceptions. For Anya, the summary dismissal process will start.
If your appeal starts down the summary dismissal process, we’ll send you a letter. The letter will explain that your SST member thinks they may have to summarily dismiss your appeal.
You can tell us in writing why you think your appeal should not be summarily dismissed.
The member will look at what you send us.
Then the member will do 1 of 2 things:
- summarily dismiss your appeal in writing
- allow your appeal to go to the next step
If the SST member summarily dismisses your appeal, there won’t be a hearing, and we’ll close your appeal file. You’ll get the summary dismissal decision in writing. Service Canada’s reconsideration decision will remain valid.
You can appeal the member’s decision. If you want to appeal their decision, you have to appeal to the Appeal Division. The Appeal Division is the second level in the appeal process after the General Division.