What If the Canada Pension Plan (CPP) Denies My Application for Canada Pension Plan Disability (CPP-D) Benefits?

If you receive a letter denying entitlement to CPP-D benefits, you may wish to request a reconsideration. This request must be made in writing within 90 days of receiving the decision to deny benefits. It should be sent to the regional Service Canada office that issued the decision - Scarborough, Chatham or Timmins. If you are not sure which office to send your request to, call Service Canada at 1-800-277-9914 for service in English and 1-800-277-9915 for service in French. Service Canada can also be reached online at www.servicecanada.gc.ca.

If you have additional medical documentation in support of your claim, indicating that your disability is severe and prolonged, or any other evidence you think is relevant, then you should submit it with your request for a reconsideration, including your detailed reasons for believing that entitlement is in order. There is no oral hearing at this stage. Service Canada staff, not involved in making the original decision denying entitlement, will review all of the evidence in your file to determine if you meet the entitlement criteria. You will receive a written decision when the reconsideration process has been completed.

Please note that entitlement to CPP-D benefits could impact your entitlement to benefits under the Workplace Safety and Insurance Act, 1997. For more information, please contact a qualified representative.

What If My Request For Reconsideration Is Denied?

If your request for reconsideration of the decision which denied you entitlement to benefits results in another denial of entitlement, then you may appeal to the Office of the Commissioner of Review Tribunals (OCRT) at the second level. The OCRT operates independently of Service Canada. You must request an appeal in writing within 90 days of having received the reconsideration decision. Your written request for an appeal should be sent to the OCRT at the following address:

Office of the Commissioner of Review Tribunals
(CPP/OAS)
P.O. Box 8250, Station "T"
Ottawa, ON K1G 5S5

Toll Free: 1-800-363-0076
Fax: 613-995-6834
E-mail: info@ocrt-bctr.gc.ca

What Does An Appeal to the OCRT Involve?

An oral and private hearing will be scheduled before the OCRT in a community close to your home. You may provide additional evidence that you believe supports your case prior to the hearing. You will be given an opportunity to tell the OCRT panel about your condition and how it has affected your ability to work. You may wish to bring someone to the hearing to help represent you. Service Canada is usually represented at the hearing by a regional delegate.

An OCRT Client Service Officer will contact you once you request an appeal. (S)he can answer your questions about the appeal process. You may contact your Client Service Officer at the toll free number listed above.

The OCRT panel consists of three members. The Chair of the OCRT is always a lawyer, one of the three members is always a health care professional, and the third member of the panel is from the community at large. This panel will decide if you meet the eligibility criteria for CPP-D benefits.

What If the OCRT Denies My Appeal?

There is a third level of appeal that may be available to you. It is called the Pension Appeals Board (PAB). The PAB also operates independently of Service Canada. The right to appeal to the PAB is not automatic. You must first request "leave to appeal" to the PAB. This request must be made in writing within 90 days of receiving the OCRT decision. The "leave to appeal" should be sent directly to the PAB at the following address:

Pension Appeals Board
P.O. Box 8567, Station "T"
Ottawa, ON K1G 3H9

Toll-free: 1-888-640-8001
Fax: 613-995-6834
E-mail: info@pab-cap.gc.ca

Please note that Service Canada can also request "leave to appeal" an OCRT decision. This means that if the OCRT allowed your appeal for CPP-D benefits, then Service Canada has an opportunity to appeal this decision to the PAB, if they so choose. The PAB will decide whether there are grounds to hear the appeal. If the PAB refuses to hear the appeal, then the OCRT decision is final.

What Does An Appeal to the Pension Appeal Board (PAB) Involve?

Most hearings at the PAB are heard before a panel of three federal court judges, although sometimes there is only one judge who makes the final decision. A hearing will be scheduled and you may be required to travel to a nearby city to attend. The hearing will be open to the public. You will be allowed to submit additional evidence prior to the hearing and to call expert witnesses, such as a doctor, to testify at the hearing. You may wish to be represented by a lawyer or another advocate who is familiar with the process. Please note that legal counsel and appropriate expert witnesses always represent Service Canada at these hearings. You may be entitled to recover a small portion of your legal costs. Please contact the PAB for more information. The PAB will send you a written decision after the hearing, including an explanation of the reasons for their decision.

What If the PAB Denies My Appeal?

Although the PAB decision is final, it is subject to judicial review by the Federal Court of Appeal. In order to pursue a judicial review from the Federal Court of Appeal however, there must be an error in fact or law in the PAB decision. If you are considering this option, you should seek legal advice. If the PAB allows your claim and Service Canada believes there is an error in fact or law, then Service Canada can also pursue a judicial review of the decision from the Federal Court of Appeal.

OWA Fact Sheet 39 - March 2006