Eligibilty Requirements

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Overview:

If you have questions such as:

  • I am severely injured and cannot work anymore. What can I do?
  • I cannot work anymore due to my disability. Where can I get support?
  • I stopped working due to my medical condition. Can I get income support?

As you can see from the chart below, the application process can be completed within four months or continue for years if your application is denied. The best-case scenario would be to get your application approved at the first stage. Therefore, it is vital to understand how to prepare the application correctly from the first step.

How do I apply for CPPD?

  • You apply by filling out the Application form provided by Service Canada. Your Application is the foremost important document. In addition to your application, you need to provide supporting documents specifically related to your claim.
  • Unfortunately, only about 40% of the claims are approved at the initial application stage. This is mostly because people do not fully understand the process. For example, the majority of people do not understand the CPPD eligibility requirements, and which documents they are to submit. Even if the process is understood, mistakes can and do happen. Errors can occur by the applicant  the decision-maker.
  • In any case, your application, and the documents you submitted will be the primary evidence to argue that you are entitled to the benefit if your application is denied.
  • At Juzkiw Law, our team understands that preparing the application can be demanding and stressful, especially when you have other concerns that require your attention. We are happy to help you prepare the application package.

Am I eligible to apply?

  • The basic eligibility requirements are:
  • You are between 18 and 65 years of age
  • You have made a sufficient contribution to the Canada Pension Plan
  • You cannot work anymore due to a severe and prolonged mental and physical disability
  • You are not sure when you will be able to go back to work

What is a severe and prolonged disability?

  • The applicant must have a ‘severe and prolonged’ disability to be eligible for CPPD benefits. You have to meet both aspects of the definition. This is one of the basic conditions that will determine your eligibility. Most importantly, your application should be supported by medical evidence that you have a severe and prolonged disability.
  • A prolonged disability means that your disability is expected to be long-term and of an indefinite period. If surgery or medical treatment can mitigate or cure your condition, it will not be considered a prolonged disability.
  •  There are other disability benefit programs provided by provincial governments and insurance companies. The fact that you are qualified for those benefits does not mean that you have a prolonged disability under the definition set by CPP.
  • A severe disability means that your disability is so severe that it prevents you from pursuing any substantially gainful occupation. For example, if you miss one day of work a week due to your medical condition, you will not meet the definition of a severe disability as you can adjust your work schedule. Also, if you are able to earn more than what CCPD benefits can provide, you will be deemed as participating in a substantially gainful occupation.

What conditions qualify as a disability to be eligible for the CPPD benefits?

 I have depression /fibromyalgia/severe migraine/anxiety/panic attacks/insomnia. Can I get CPPD benefits?

  • The answer is that it depends on whether there is a strong connection between your ability to work and your medical conditions.
  •  Your application will be assessed based on a range of factors, and your medical condition is one of them. The adjudicator will consider both physical and mental disabilities and see if they are supported by medical evidence. In addition, you need to prove how your ability to work is impacted by your disability.
  • For example, even if you have a medical condition, you may not qualify for the benefits if you have the ability to work at any suitable occupation.
  • The Social Security Tribunal (“SST”) posts its decisions on its website.  The SST is a federal agency that hears appeals when CPPD benefit applications are denied. You can insert a specific symptom or condition on their website to  see how an adjudicator interpreted those documented conditions.
  • We also provide detailed instructions on how to prepare your applications and what actions you can take if your application is denied.

When do I apply for CPPD benefits? Do I have a deadline to apply for my CPPD benefits?

  • We recommend you apply to CPPD benefits as soon as you know you are unable to work permanently, and you have sufficient medical evidence to support that. This is because your eligibility period runs from the date you last made your contribution to CCP.
  • There are two important dates to remember when you determine your eligibility:

 1) The date when you became unable to work due to your disability

  • This date does not refer to when you started to have your medical condition or disability. You may have had your medical condition for several years but managed to continue working. Think of the date when the disability got severe and stopped you from continuing the work. 
  • The year when your last CPP contribution was made

2) The year when your last CPP contribution was made

  • Add two years to the year when your last CPP contribution was made: 
  • *If you made sufficient contributions for more than 25 years including the past three out of six years, you can add three years to the last year you contributed.
  • The date when your disability got severe and prolonged must happen before December 31 of the year last CPP contribution was made. You also need to apply for the benefits before this date.

I stopped working many years ago due to an injury but did not apply for the benefits. Can I still apply?

  •  If you missed the deadline, you may still be eligible for CPP benefits if you can prove that:
  • Your injury happened before the deadline expired,
  • You made sufficient contributions for the required number of years, and
  • You have been disabled up to the present
  • This is called “late application provision.” If your application is approved, you will receive 12 months of retroactive payments based on when Service Canada received your application

How do I know if I made sufficient contributions? How long do I have to contribute to CPP to receive disability benefits?

  •  To qualify for CPPD benefits, you must have made contributions to CPP and had sufficient earnings.
  • If you were contributing for less than 25 years, you should have contributed for at least four of the last six years.
  • If you were contributing for at least 25 years, you should have contributed for three out of the last six years.
  • If you are earning more than $3500.00 a year from pensionable employment, you are required to contribute part of your income to the CPP. You will be able to find this information on your pay stub where the deductions are made. Alternatively, you can also check your CPP  contributions on the Canada Service website.
  • Before you start the application, see if any of the following situations apply to you. Service Canada has established provisions that may increase your benefit amount and the qualifying period.

I stopped working or worked less to take care of my child.

  •  If you had to leave your job or work fewer hours to take care of your child, you may be eligible for child-rearing provisions. This provision is available for primary caregivers who were responsible for rearing a child under the age of 7. You must have received the Family Allowance or been eligible for the Canada Child Benefit.
  • You must pay a sufficient contribution to the CPP to be eligible for CPPD benefits. Leaving work to take care of your child means that you had little or no contribution during that period. This may result in not meeting the contribution requirement. However, Service Canada will take into consideration that you left work to care for your child and reflect that when they assess your eligibility.
  • The provision can also increase your benefit amount. The benefit amount is calculated based on how much contribution you made to the program. When you earn more, you pay more in contributions. Therefore, your income amount becomes the basis in which to determine your basic amount. Instead of including the income from the months that you had lower earnings, Service Canada will calculate the average earnings in the 5 years prior to the birth or adoption of your child.
  • To apply for this provision, make sure you fill out section B3 of the Application form. You will find more instructions on Annex A in the Application form.

I lived and worked abroad and in Canada. I am not sure if I meet the requirements.

  • To be eligible for CPPD benefits, you have to contribute a sufficient amount to the CPP for a certain period. Meeting this requirement can be tricky if you were paying into a different country’s pension program.
  • Service Canada may consider the contributions you made in a different country if there is a social security agreement between that country and Canada. In this case, the period you paid your contributions in another country may be included when assessing your eligibility. You need to determine  if you can transfer those pension credits from another country to Canada.
  • If this situation applies to you, please make sure you fill out B2 in the Application Form.

I am divorced/separated. And my former spouse/partner had higher earnings.

  • As we talked about earlier, the benefit amount is calculated based on how much contribution you made. The amount of the contribution is calculated based on your earnings. If your former spouse or partner was making a higher income, the credits can be added and divided equally between the two of you. It is called the “credit split provision.” This can be a significant benefit for an individual who did not have income during the relationship. It may allow the individual to qualify for a CPPD benefit or increase the benefit amount.
  •  Please note that the provision will also consider whether you were married or in a common-law relationship, the period you physically lived together, and when your relationship ended
  •  Section B1 of the Application form allows you to provide the necessary information to apply for the provision.
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