Canada Pension Plan Disability Benefit – After you’ve applied
6. After you’ve applied
It takes approximately four months for a decision to be made from the date we receive your application and all the necessary documents. See how disability benefit applications are assessed.
A member of our staff will call you to explain how your application will be processed, the type of information we need from you, and answer any questions you may have.
As we process your application, a member of our staff will call you. Our medical adjudicators may also ask for additional information or ask you to see another doctor who will evaluate your medical condition. When seeking more information, we have very little control over how quickly we receive it.
If more than four months have passed and you have not heard from us and would like to know the status of your application, contact Canada Pension Plan.
Note: Paying back your retirement pension
If your disability benefit is approved, you must pay back the retirement pension payments you received. Normally, we recover the retirement pension payments from your first disability payment.
What if I die before my application is received?
If you sign your application for a disability benefit and Service Canada receives it after you die, your application will be denied.
Your estate and survivors may be eligible to receive CPP benefits after your death.
How applications for disability benefits are assessed
When you submit an application for disability benefits, we must first determine whether you have made sufficient contributions to the Canada Pension Plan (CPP) over the course of your working life.
If you have enough contributions, your file is then passed on to our medical adjudicators for a medical assessment.
Our medical adjudicators
Our medical adjudicators are trained nurses with extensive knowledge of CPP legislation, regulations, policies and procedures. They receive ongoing training on up-and-coming medical developments to ensure that they understand the complexities of new medical conditions. Medical adjudicators use the CPP Adjudication Framework to make a decision on your CPP disability application. They are also supported by a group of CPP physicians and specialists who provide advice on complex medical issues.
Your medical assessment
To be eligible for CPP disability benefits, you must have a severe and prolonged medical condition. What is important is how the medical condition and its treatment affect your ability to work at any job on a regular basis. Your condition must be expected to last at least one year or be likely to result in death.
CPP disability benefits are not approved on the basis of a medical diagnosis alone or on the basis of which disability or disease you have.
When determining eligibility, our medical adjudicators consider several factors together, including:
- the nature and severity of your medical condition
- the impact of the medical condition and treatment on your capacity to work
- the prognosis
- personal characteristics such as age, education and work history
- your work performance, productivity and how much you are earning.
Under CPP legislation, the medical adjudicators do not consider the availability of suitable employment in your region when they determine on your eligibility.
What can I do if I do not agree with a Canada Pension Plan Disability decision?
If you were told you are not eligible for a CPP disability benefit, you may request a reconsideration of the decision.
What is a reconsideration?
A reconsideration is a new review of your application by the Department. Service Canada staff who were not involved in making the original decision will review your application, as well as any new information supplied by you, or by others on your behalf. Service Canada staff may also seek more medical information on your case. They may ask you to see another doctor. If this happens, CPP will pay for the doctor's visit and your travel to the doctor if that is necessary.
How do I request a reconsideration?
You must make your request for reconsideration in writing within 90 days after you are notified in writing of the decision.
Prepare your written request for reconsideration and include:
- your name, address, telephone number, and Social Insurance Number;
- a detailed explanation of why you want a reconsideration; and
- any new information that could affect the decision.
Sign and date your written request and submit it by mail to the return address on the decision letter.
Reconsideration can take several months to complete, depending on the case. Service Canada will re-examine your application and will send the reasons for their decision to you by mail.
If you disagree with the reconsideration decision
If you disagree with the reconsideration decision, the next step is to contact the Social Security Tribunal to appeal.
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