Social Security Tribunal of Canada

Notice of Appeal : Income Security

Large-print version of official source


Fill out and sign this form if you want to appeal a Canada Pension Plan or Old Age Security reconsideration decision from the Minister of Employment and Social Development Canada. We must receive your completed form within 90 days from the date you received your reconsideration decision.

Please attach a copy of your reconsideration decision to this form.

You must provide all the information below. The Social Security Tribunal Regulations require this.

We will share any documents you give us with any other parties to your appeal.

We publish many Tribunal decisions online so that people can understand how the Tribunal works. If we publish the decision in your appeal, we will first remove any information that reveals your identity.

We understand that parties may have privacy concerns. We try to respect those concerns. At the same time, the law requires us to be open about the Tribunal’s work. Learn more about how we balance open justice and privacy by reading our open justice and privacy statement (opens in new window).

If you have questions on how to fill out this form, call our toll-free line from Canada or the United States at 1‑877‑227‑8577 ( TTY : 1‑866‑873‑8381) or call collect from outside Canada or the United States at 1‑613‑437‑1640 ( TTY : 1‑613‑948‑8181), Monday–Friday between 7 a.m. and 7 p.m. Eastern Time.

1. Appellant information

(Include the contributor’s SIN if the appeal concerns a Death Benefit, Survivor’s Benefit, Surviving Child’s Benefit, Division of Unadjusted Pensionable Earnings, or a Disabled Contributor’s Child’s Benefit.)

2. Hearing

What kind of hearing would you prefer?
(Call from a location convenient to you such as your home or your representative’s office.)
(You will travel to a Service Canada Centre near you and participate using their videoconference system. The Tribunal member will join from a different location.)
(Connect to the videoconference from a location convenient to you such as your home or your representative’s office. The Tribunal member will join from a different location. This option requires a high-speed internet connection. We will contact you to ensure this option will work for you.)
(Your hearing will take place at a Service Canada Centre near you. The Tribunal member will be in the same room as you.)

3. Language

(The Tribunal will get an interpreter for you.)

4. Accessibility (alternate arrangements)

Please tell us if you need any alternate arrangements for your appeal (such as wheelchair access for your hearing). We want to ensure that everyone can participate in our proceedings on an equal basis.

To request accommodation for a particular need please contact us by phone, email, fax, or mail. All our contact information is at the end of this form.

Visit our website for more information on our accommodation and accessibility policy (opens in new window).

5. Reconsideration decision


6. Reason(s) for your appeal of the reconsideration decision

7. Documents to support your appeal

Include any documents that could support your appeal.

Examples of supporting documents:

  • Medical reports or medical certificates (example, doctor’s report or specialist’s report)
  • Employment documents
  • Bank statements
  • Proof of residence
I am including copies of supporting documents

8. Late appeal (if applicable)

We must receive this completed form within 90 days from the date you received your reconsideration decision. If we receive your notice of appeal after the 90 days, you must explain why it is late. The Tribunal member will then decide whether your appeal can go forward. Please note that the Tribunal can’t accept an appeal filed more than one year from the date you received your reconsideration decision.

The Tribunal member will consider:
  • Whether you have a reasonable explanation for why your appeal is late
  • What steps you took that show that you always intended to appeal
  • Whether extending the time for filing your appeal would be unfair to the other party/parties
  • Whether your appeal has a reasonable chance of success
  • Any other reason why we should allow your appeal to be filed late

9. Representative information

You don’t need a representative. If you choose to have a representative, you are responsible for any costs.

Do you have a representative?
Please indicate which category of representative you have and fill out their information below.
Representative Name
I have confirmed with my representative that they want the Tribunal to send them correspondence and documents by email.

10. Declaration and signature of appellant

I declare that, to the best of my knowledge, all the information I provided as part of my notice of appeal is true.

If you have a representative:

I authorize the Tribunal to share any information about my appeal with my representative. I understand that the Tribunal will normally communicate only with my representative and that I will personally receive information only about my hearing and the final decision.

How to submit your appeal

Fill out, sign, and send us a copy of this form and copies of any supporting documents by email, fax, or mail. Keep all your original documents.


1-855-814-4117 (toll-free in Canada and the United States)
1-613-941-5121 (long distance charges may apply)

Social Security Tribunal of Canada
PO Box 9812
Station T
Ottawa ON  K1G 6S3


Email us at or call our toll-free line from Canada or the United States at 1‑877‑227-8577 ( TTY : 1-866-873-8381).

You can also call collect from outside Canada or the United States at 1-613-437-1640 ( TTY : 1-613-948-8181).

Social Security Tribunal website (opens in new window)


  • Email is the fastest way to send us information.
  • You must tell us if your contact information changes. If we can’t reach you, we may proceed in your absence.
  • Keep all letters or documents we send you. They are numbered for easy reference and will be needed at your hearing.
  • If you change your representative, tell us right away.
  • Everything you send us must be in either English or French: Information about translation (opens in new window).
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