BUSINESS

CPP Disability Benefits Denied To 60% Of Applicants, Among Highest Rejection Rates In World

12/02/2014 05:52 EST | Updated 02/02/2015 05:59 EST
Martin Barraud via Getty Images
OTTAWA - One terminally ill Canadian denied Canada Pension Plan disability benefits has been "diagnosed with brain cancer and is currently undergoing chemo and radiation treatments," according to the government's woefully backlogged social security tribunal.

Another of the tribunal's so-called crisis files, obtained under the Access to Information Act, describes an applicant as having been "diagnosed with liver cancer and received a liver transplant."

Yet another has been "diagnosed with Pick's Disease, which is terminal."

They are among the ailing or injured Canadians who have applied to have their cases expedited as they endure long waits for appeals in a new system that is grappling with an ever-growing, 11,000-case backlog, mostly involving CPP disability claims.

About 60 per cent of CPP disability claimants are initially turned down — one of the highest rejection rates for a disability insurance program among the nations of the Organisation for Economic Co-operation and Development.

Claims are denied due to everything from insufficient paperwork to a lack of proper medical and employability information.

Michael Prince, a public policy professor at the University of Victoria and vocal critic of efforts to streamline the social security appeal process, said it makes no sense why so many Canadians are being turned down.

"If so few people who make an application are approved in the first instance, why aren't we dealing with it at the front end of the problem?" Prince asked in an interview.

"If you're turning so many people down, you're going to have more appeals, so why not try to figure out what you're failing to communicate to Canadians about how to properly and successfully apply for CPP disability benefits?

"Could it be because there is no desire to make it a more successful process?"

Prince notes that "deny, delay, wait for them to die" is the cynical philosophy thousands of military veterans in both Canada and the United States have ascribed to their respective veterans affairs departments as they wait months — sometimes years — for disability benefits.

But the plight facing those seeking pension disability benefits is just as dire as that confronting Canada's military veterans, many of whom have to wait months to find out if they're eligible for help, the federal auditor general has concluded.

"It's as bad, if not worse, than what's going on with the veterans," Prince said.

"Some people have been waiting for as long as five years for CPP disability benefits. They may not wear a uniform and medals, but they have no less traumatic experiences and struggles with surviving as veterans do."

The tribunal insists there's a 68 per cent success rate for appeals launched by ailing and injured Canadians who are denied disability benefits.

But data provided by the tribunal earlier this year shows that in its first year of existence, the new body held just 461 hearings on appeals from people denied CPP disability and old-age security benefits. Of those, 303 were dismissed.

That's compared to thousands of hearings held the previous year under the old regime.

The tribunal had no answer as to why so many ailing and injured Canadians are denied benefits when they first apply for them. But it pointed out that medical conditions often worsen.

"It should be noted that in CPP disability cases, which represent more than 90 per cent of the income security cases, appellants often have evolving medical conditions," Laura Revilien, a tribunal official, said in an email.

"Although appellants may not have qualified for the benefit at the time of the department’s reconsideration decision, they may file new medical evidence while their appeal is at the tribunal. This information is then shared with the department and could result in a settlement agreement between the department and the appellant."

Employment and Social Development Minister Jason Kenney was on the hot seat in the House of Commons on Tuesday over the fact that terminally ill and financially strapped Canadians have had to apply to have their cases expedited as they await their appeals.

"This is completely outrageous," said NDP MP Jinny Sims during question period. "Canadians paid for these benefits with their premiums. They shouldn't have to go begging when they need them."

Kenney said the government has appointed 22 additional part-timers to help deal with the backlog. It has also shifted 12 members from the employment insurance section of the tribunal to the overtaxed CPP and old age security portion.

Earlier this month, the government also used its latest budget bill to remove a requirement in previous legislation to cap the size of the tribunal at 74 full-time staff. It also scrubbed limits on the number of hours part-time tribunal members are allowed to work.

When it was established, the new tribunal was supposed to provide a more efficient appeal process for those denied employment insurance, CPP and old-age security benefits.

It was also supposed to save Canadian taxpayers $25 million a year by streamlining the appeals process, even as stakeholders warned that the plan to replace nearly 1,000 part-time referees with 74 full-timers could result in a 16-month backlog.

Follow Lee-Anne Goodman on Twitter @leeanne25

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