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CPPD (canada)
9 Replies
Fibrosukz - December 30

I applied for CPPD in august of this year before seeing a Rheumy and i have 90 days to appeal it. In the letter it stated that i was unable to return to my normal job but i could find another job. I have contacted my Rheumy for a letter of my diagnosis and when i returned home to read it, there were things that were not true, i believe there is a language barrier between us. I have tried to contact his office to speak with them and get a correct letter before i appeal.
Im wondering if anyone might have been through this and what more do i need to explain so that it does get approved???

 

toogie - January 7

Hi Fibrosukz,

I am in Calgary and think you are in Ont. I have had the same thing from my Dr. I am currently on Social Services, she filled out forms for AISH but I got turned down twice. I got a call from Service Canada about disablilty in Nov and DR had 30 days to respond with her report but hasn't done it yet. She gets another 21 days, she said she would send the report to them but couldn't answer the questions as there is no medical history because I only went to her for my feet and arms. So I am waiting for Service Canada to send me a reject letter. The Drs here don't want to deal with this because there is nothing for them.(no money) Give me an email and let me know if you have found any answers. I am glad there are other Canucks on this forum. Thanks Mary Lou

 

axxie - January 9

Hi Fibrosukz, first of all, first applicant and second appeal are denied.

Maybe the doctor did not write enough to make it convincing or he hasn't used the buzz words.

If you are applying based on just fibromyalgia, you will never be accepted, you must have a second and third issue, such as depression and a complete medical history.

May I suggest you see your primary physician and ask that person to also write a letter that would go with the first letter.

I am in Ontario and I have not yet applied, but did apply for insurance and I'm at the same point you are, I had to appeal and I had to re-write the damn letter from my doctor and present it to her. I told her that she needed to write the letter in this matter. I had help from a lawyer, can't hurt.

Usually denied, because there is not enough evidence of you being not able to work.

He must also write information, on how you can't work in the setting you are in because you can't cope with stress and that cannot work 5 days a week, because you need a couple of days to recoup because you are tired.

Talk about depression, talk about you having depression throughout your life, that you have a depleted energy that is not renewable.

 

axxie - January 9

OBTW, I'm from Ontario, don't know where you are, but I may be able to help you, with the wording of the letter, but will not post the letter on this forum.

If you are interested, let me know I can be reached on my hotmail account, my name is sandrivers put it all together and write me.

 

Myriam - January 14

Wow, I have wrote on this forum for a while! Since I have been pregnant, my fibro is not giving me issues anymore. Now the reason I am talking to you guys is, I work for Service Canada. I am not a adjucator, which is the person who takes the decision. What Axxie says is right, you need underlying issues as well. And if your doctor does not say word for word that you can not work it wont happen. You have the initial demand, then a reconsideration and then an appeal. The appeal may be the best thing that happens because you go in front of a panel: a doctor, a Service Canada agent and a person from the community. You have to debate your case and they will take a decision. Sometimes, they realize at that point that we can not work... The more you have the better. Also, in Ontario, you have access to ODSP, which is the Ontario Disability Support Program. They may be able to help.

 

Fibrosukz - January 28

Thanks axxie....I am in Ontario also. Sorry i havent gotten back sooner. :o( I have received another letter from my Rheumy stated that i have Fibro and insomnia. I will contact you soon axxie.
Myriam: ODSP is denied because of spouse's income.So that isnt an option. My doctor did state unable to work.
I have contacted a lawyer and he has given me some advice.

 

Fibrosukz - January 31

HI Toogie, i dont have your email addy but would love to keep ya posted. I am working on my appeal letter as we speak, type, whatever lol I can tell u tho is that i have other problems other then fms and my family dr has filled out all my forms for CPPD and it came back denied. Even tho my family dr stated i cant work. So, since my post i have received a letter from my Rheumy. But i also have an appt in March to a different Rheumy. Thats where im at now.

 

toogie - February 1

Hi Fibrosukz

I would be very interested if you receive any CPP benefits. You can reach me through gmail. It is marylouglab3. Hope to hear from you soon.

Mary Lou

 

axxie - February 2

About CPP - information you should know about...

The Canada Pension Plan Disability Adjudication Framework

The Adjudication Framework was developed to improve the clarity and transparency of the policy used to determine medical eligibility to the Canada Pension Plan Disability program. It consolidates the policy elements of disability adjudication into one comprehensive framework that provides Canada Pension Plan decision-makers with all of the information required to adjudicate Canada Pension Plan disability applications.

The basis of the adjudication framework resides in the Canada Pension Plan legislative definition of disability. The Adjudication Framework lays out in a simple format the relationship between the legislation and the various policy components.
The Adjudication Framework has a set of criteria against which the pertinent facts of each case is analyzed and evaluated. It is presented in a cascading order of criteria, components and factors and sub-factors.

The Canada Pension Plan criteria are "severe" and "prolonged". These criteria are broken down into the prime indicator (the medical condition) and a series of components which make up the "severe" and "prolonged" definition under paragraphs 42(2)(a) and 42(2)(b) of the Canada Pension Plan. These components are again broken down into factors and sub-factors. The factors and sub-factors represent the facts and legal principles determined over time by Pension Appeal Boards to be important to a determination of disability under the Canada Pension Plan.

The Adjudication Framework for Canada Pension Plan disability benefits consists of five components:
1.Severe Criterion for the Prime Indicator (Medical Condition) – 2. Severe Criterion for incapable Regularly of Pursuing any substantially gainful occupation – 3. Personal characteristics and socio-economic factors – 4. prolonged criterion – 5. reasonably satisfied standard of review for determining eligibility and or continuing eligibility for Canada Pension Plan Disability Benefits.

CPP Disability - Definition of 'Severe and Prolonged' "Severe" means that a person is incapable of regularly pursuing any substantially gainful occupation. Within this definition, the words mean: incapable: Not able or fit to pursue any substantially gainful occupation as a result of the disability. regularly: The capacity to work is sustainable. pursuing: To actually engage in an occupation, and does not mean being able to look for work. any: Work that a person might reasonably be expected to do regardless of whether it is his/her previous job by virtue of:
•having the necessary skills, education or training;
•having the capacity to acquire those necessary skills, education or training in the short term; and,
•having reasonable access to suitable employment, given the individual's limitations but does not mean a job has to be available.

substantially gainful occupation: Work that is productive and profitable. This is measured in part by a dollar amount that is set annually and against which a person's earnings are compared. However, earnings alone do not determine whether the regular capacity to pursue work exists. CPP also assesses elements of functional capacity, productivity and performance.

"Prolonged" means that the disability will prevent the individual from going back to work in the next 12 months, or is likely to result in death. To qualify, the applicant must meet both the "severe" and "prolonged" criteria. HRDC medical adjudicators assess the severity of the disability first. If the applicant does not meet the "severe" criteria, HRDC does not consider the question of whether the disability is prolonged.
Many people mistakenly believe that CPP eligibility decisions are granted on the basis of a specific disease or condition alone. This is not the case. Rather, the decision is based on the limitations that a disease or condition imposes on a person's ability to work and earn an income on a regular basis.

As of March 3, 2008, CPP Disability applicants with 25 or more years of contributions to the CPP now meet the contributory requirement for CPP Disability with valid contributions in three of the last six years instead of four of the last six years.
Patient has rights (doctors letters etc)

Release of information under the Canada Pension Plan legislation Your patient has the right to see and to receive a copy of all the information on his or her CPP file, including the medical report that you fill out and any supporting documents you include. Please indicate in your report if you feel it would be detrimental to your patient to be given particular information about his or her medical condition. CPP will contact you directly to determine whether the patient's condition has changed and whether this information can be withheld under section 25 of the Privacy Act, which states that "personal information can be withheld if the disclosure of information may threaten the safety of an individual."

 

iamladybug - March 14

Hi Fibrosukz

I also am in Ontario and have filed for the same CPP Disability..totally frustrating process
I have been denied again as well, this time I am going to fight tooth and nail!
I originally applied in 1997 was denied, struggled and "Sucked it up" with the pain, but no more.
I read an interesting article in the Toronto Star that 63% of all appeals are won so, here I go again.
May be considering a lawyer, if anyone has recommends in Ontario please let me know, I can't get much broker than I already am....

 

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