Canada Pension Plan disability benefit toolkit

From: Employment and Social Development Canada

Official title: Canada Pension Plan disability benefit toolkit - Your complete guide

1.0 Canada Pension Plan disability benefits

In this section:

What are the Canada Pension Plan disability benefits

The Canada Pension Plan (CPP) disability pension and the post-retirement disability benefit are taxable monthly payments that are available to people who:

  • made valid contributions to the CPP, and
  • are regularly not able to work because of a disability

CPP disability benefits do not provide short-term disability coverage or coverage for medications or medical treatments.

The CPP post-retirement disability benefit is intended for people who are:

  • under age 65 who are receiving the CPP retirement pension and who are disabled, but did not apply for a disability pension within 15 months of their first retirement pension payment, or those who become disabled after receiving the first payment.

Eligibility

To be eligible for CPP disability benefits, you must:

  1. be under the age of 65
  2. have a severe and prolonged mental or physical medical condition, according to the definition in the CPP legislation, and
  3. meet the minimum contributory requirements

1. Be under the age of 65

You can receive CPP disability benefits only until you are 65.

2. Have a severe and prolonged mental or physical medical condition(s), according to the definition in the CPP legislation

To receive these benefits, you must have a severe and prolonged mental or physical medical condition according to the definition in the CPP legislation. Your condition must be both severe and prolonged when you apply.

What does the CPP mean by severe

A person is considered to have a severe disability if he or she is regularly incapable of pursuing any substantially gainful occupation.

Being regularly incapable means that you are usually or always incapable. A Service Canada medical adjudicator will determine whether you meet this requirement.

Substantially gainful is any profession or work a person might do to earn a living. If the total annual amount of earnings from this work is more than 12 times the maximum monthly CPP disability pension amount, the work is considered to be substantially gainful.

What does CPP mean by prolonged

Your disability is long-term and of indefinite duration or is likely to result in death.

Being eligible for a disability benefits from other government programs or from private insurers does not automatically mean you are eligible for CPP disability benefit.

3. Meet the minimum contributory requirements

To meet the minimum contributory requirements, you must:

  • have made valid contributions to the CPP in 4 of the last 6 years, or
  • have contributed for at least 25 years, including 3 of the last 6 years, or
  • meet the requirements for the late applicant provision
How CPP contributions work

The Canada Pension Plan operates everywhere in Canada, except in Quebec, where the Quebec Pension Plan (QPP) applies.

You automatically contribute to the CPP, based on what you earn above $3,500 to a maximum annual amount (this annual amount is called pensionable earnings). The maximum amount is set each January, based on the average wage in Canada.

You do not contribute:

  • while you receive CPP disability benefits
  • during periods when you have no earnings, or
  • when your annual earnings are $3,500 or less
Your contributory period

Your contributory period starts when you reach age 18. Your contributory period ends when you start receiving your CPP retirement pension, turn 70, or die (whichever happens first).

Service Canada uses the contributory period to:

Service Canada looks at:

  • how long you contribute, and
  • how much you contribute to the CPP

The more you earn and contribute to the CPP, the higher your payment will be.

Note

With very few exceptions, everyone over the age of 18 who works in Canada outside of Quebec and earns more than the Disability Basic Exemption ($5,700 per year in 2019) makes a valid contribution toward CPP disability benefits.

Post-retirement disability benefit

The new CPP post-retirement disability benefit is intended for people receiving the CPP retirement pension who are:

  • under the age of 65, and
  • became disabled after starting their retirement pension, or did not apply for CPP disability benefits within 15 months of starting their retirement pension

If this is your situation, you may be eligible to a CPP post-retirement disability benefit in addition to your retirement pension. The post-retirement disability benefit amount is equal to the flat-rate portion of the disability benefit and will increase in January every year with the cost of living. In 2019 it is $496.36.

Eligibility requirements are the same as for the CPP disability pension. Children of someone receiving this benefit may be eligible for the disabled contributor’s child’s benefit.

The post-retirement disability benefit ends:

  • the month the beneficiary turns 65
  • the month the beneficiary is no longer deemed to be disabled, or
  • the month of death

CPP disability benefits eligibility map

Scenario 1

  • Are you under the age of 65? (if your answer is no)
Eligibility result

It does not appear that you meet the requirements to receive CPP disability benefits. If you are unsure about some of your answers, please fill out and submit the CPP disability benefits application (ISP1151) or use the Benefits Finder to learn more about other benefits.

Scenario 2

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is no)
Eligibility result

It does not appear that you meet the requirements to receive CPP disability benefits. If you are unsure about some of your answers, please fill out and submit the CPP disability benefits application (ISP1151) or use the Benefits Finder to learn more about other benefits.

Scenario 3

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is yes)
  • Have you contributed to the CPP for 25 years or more? (if your answer is yes)
  • In the 6 years before you became disabled, did you contribute to the CPP for at least 3 years? (if your answer is yes)
Eligibility result

You may qualify for a CPP disability pension or a post-retirement disability benefit. Complete and submit the CPP disability benefit application (ISP1151).

Scenario 4

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is yes)
  • Have you contributed to the CPP for 25 years or more? (if your answer is yes)
  • In the 6 years before you became disabled, did you contribute to the CPP for at least 3 years? (if your answer is yes)
Eligibility result

You may qualify for a CPP disability pension or a post-retirement disability benefit. Complete and submit the CPP disability benefit application (ISP1151).

Scenario 5

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is yes)
  • Have you contributed to the CPP for 25 years or more? (if your answer is yes)
  • In the 6 years before you became disabled, did you contribute to the CPP for at least 3 years? (if your answer is no)
  • Were you the primary caregiver of a child under the age of 7? (if your answer is yes)
  • Did you contribute to the CPP in the years before the child was born? (if your answer is yes)

You may qualify for a CPP disability pension or a post-retirement disability benefit. Complete and submit the CPP disability benefit application (ISP1151).

Scenario 6

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is no)
Eligibility result

It does not appear that you meet the requirements to receive CPP disability benefits. If you are unsure about some of your answers, please fill out and submit the CPP disability benefits application (ISP1151) or use the Benefits Finder to learn more about other benefits.

Scenario 7

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is yes)
  • Have you contributed to the CPP for 25 years or more? (if your answer is no)
  • In the 6 years before you became disabled, did you contribute to the CPP for at least 4 years? (if your answer is yes)
Eligibility result

You may qualify for a CPP disability pension or a post-retirement disability benefit. Complete and submit the CPP disability benefit application (ISP1151).

Scenario 8

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is yes)
  • Have you contributed to the CPP for 25 years or more? (if your answer is no)
  • In the 6 years before you became disabled, did you contribute to the CPP for at least 4 years? (if your answer is no)
  • Were you the primary caregiver of a child under the age of 7? (if your answer is yes)
  • Did you contribute to the CPP in the years before the child was born? (if your answer is no)
  • Did you contribute to a social security program in another country? (if your answer is no)
  • Did you become separated or divorced from a spouse or common-law partner? (if your answer is yes)
Eligibility result

You may qualify for a CPP disability pension or a post-retirement disability benefit. Complete and submit the CPP disability benefit application (ISP1151).

Scenario 9

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is yes)
  • Have you contributed to the CPP for 25 years or more? (if your answer is no)
  • In the 6 years before you became disabled, did you contribute to the CPP for at least 4 years? (if your answer is no)
  • Were you the primary caregiver of a child under the age of 7 during this period? (if your answer is yes)
  • Did you contribute to the CPP in the years before the child was born? (if your answer is no)
  • Did you contribute to a social security program in another country during this period? (if your answer is no)
  • Did you become separated or divorced from a spouse or common-law partner during this time? (if your answer is no)
Eligibility result

It does not appear that you meet the requirements to receive CPP disability benefits. If you are unsure about some of your answers, please fill out and submit the CPP disability benefits application (ISP1151) or use the Benefits Finder to learn more about other benefits.

Scenario 10

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is yes)
  • Have you contributed to the CPP for 25 years or more? (if your answer is no)
  • In the 6 years before you became disabled, did you contribute to the CPP for at least 4 years? (if your answer is no)
  • Were you the primary caregiver of a child under the age of 7? (if your answer is no)
  • Did you contribute to a social security program in another country? (if your answer is yes)
  • By adding those contributions, will you have a total of 4 years of contributions (or a total of 3 years if you contributed for more than 25 years)? (if your answer is yes)
Eligibility result

You may qualify for CPP disability pension or a post-retirement disability benefit. Complete and submit the CPP disability benefit application (ISP1151).

Scenario 11

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is yes)
  • Have you contributed to the CPP for 25 years or more? (if your answer is no)
  • In the 6 years before you became disabled, did you contribute to the CPP for at least 4 years? (if your answer is no)
  • Were you the primary caregiver of a child under the age of 7? (if your answer is no)
  • Did you contribute to a social security program in another country? (if your answer is yes)
  • By adding those contributions, will you have a total of 4 years of contributions (or a total of 3 years if you contributed for more than 25 years)? (if your answer is no)
  • Did you become separated or divorced from a spouse or common-law partner? (if your answer is yes)
Eligibility result

You may qualify for CPP disability pension or a post-retirement disability benefit. Complete and submit the CPP disability benefit application (ISP1151).

Scenario 12

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is yes)
  • Have you contributed to the CPP for 25 years or more? (if your answer is yes)
  • In the 6 years before you became disabled, did you contribute to the CPP for at least 3 years? (if your answer is yes)
Eligibility result

You may qualify for CPP disability pension or a post-retirement disability benefit. Complete and submit the CPP disability benefit application (ISP1151).

Scenario 13

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is yes)
  • Have you contributed to the CPP for 25 years or more? (if your answer is yes)
  • In the 6 years before you became disabled, did you contribute to the CPP for at least 3 years? (if your answer is yes)
Eligibility result

You may qualify for CPP disability pension or a post-retirement disability benefit. Complete and submit the CPP disability benefit application (ISP1151).

Scenario 14

  • Are you under the age of 65? (if your answer is yes)
  • Do you have a severe disability that regularly prevents you from working? (if your answer is yes)
  • Is it a prolonged disability? (if your answer is yes)
  • Have you contributed to the CPP for 25 years or more? (if your answer is yes)
  • In the 6 years before you became disabled, did you contribute to the CPP for at least 3 years? (if your answer is no)
  • Were you the primary caregiver of a child under the age of 7? (if your answer is yes)
  • Did you contribute to the CPP in the years before the child was born? (if your answer is yes)
Eligibility result

You may qualify for CPP disability pension or a post-retirement disability benefit. Complete and submit the CPP disability benefit application (ISP1151).

Things to consider before applying

  • Applying for CPP disability benefits will not reduce the amount of CPP retirement pension you receive at age 65
  • While receiving CPP disability benefits, you do not make contributions to the plan

If you are a Quebec resident

The CPP operates everywhere in Canada except in Quebec. When you work in Quebec you contribute to the Quebec Pension Plan (QPP) instead of to the CPP.

You must apply for QPP disability benefits if:

  • you worked only in Quebec, or
  • you currently live in Quebec and have contributed to both the CPP and QPP, or
  • you have worked in Quebec, currently live outside Canada and your last province of residence was Quebec

If you have a terminal illness

For the purposes of CPP, a terminal illness is a disease state that cannot be cured or adequately treated and is reasonably expected to result in death within 6 months. There is a different application form to complete: the Terminal Illness Application for a Disability Benefit under the Canada Pension Plan (ISP2530A).

Service Canada’s goal is to make a decision for applicants with a terminal illness within 5 business days of receiving a complete terminal illness application. If employment or medical information is missing, the decision may take longer.

If you have a grave medical condition

Service Canada has a list of 32 severe and rapidly progressive medical conditions that cause severe functional limitations and may result in death. If you have one of these conditions, you are very likely to be eligible for the CPP disability benefit.

Our goal is to make a decision for applicants with grave medical conditions within a month. When you apply for CPP disability benefits with the Application for Canada Pension Plan Disability Benefits (ISP1151) and Medical Report for a Canada Pension Plan Disability Benefit (ISP2519), Service Canada will determine whether you have one of these conditions based on the information in the application.

The list of conditions can be found in Annex A of the Medical Report for a Canada Pension Plan Disability Benefit (ISP2519).

Service Canada’s Service Standards

Our goal is to make a decision within these timeframes:

CPP disability benefits application:

Within 120 days of receiving a complete application.

Grave medical condition(s):

Within 30 days of receiving a complete application.

Terminal Illness:

Within 5 business days of receiving a complete application.

Reconsideration:

You can request a reconsideration within 90 days following a decision. Service Canada will inform you of the decision. Service Canada will inform you of the decision within 120 days of receiving your request and all information.

To apply for CPP disability benefits, complete the Application kit for Canada Pension Plan Disability benefits (ISP1151). Include as much detail as possible in your application to avoid any delays. See Section 3.0 Applying for additional information.

If you have a terminal illness, complete the Terminal Illness Application Kit for a Disability Benefit under the Canada Pension Plan (ISP2530A).

For reconsideration, you may write us a letter or complete the Request for Reconsideration of a Canada Pension Plan Disability Decision (ISP1145). You will find further information on requesting a reconsideration in Section 4.0.

Provisions

One or more of the following provisions could help you qualify for CPP disability benefits or increase the amount you receive.

Child-rearing provision

If you stopped working or worked less to care for a child under the age of 7, the child-rearing provision may help you qualify for CPP disability benefits or increase your benefit amount. The child-rearing provision allows you to not count a period of low earnings or no earnings when you were raising your child.

The child-rearing provision may apply to you if:

  • you did not work or had low earnings because you were the primary caregiver of your child under the age of 7, and
  • you have received Family Allowance payments or been eligible for the Canada child tax benefit or Canada child benefit (even if you did not receive the benefit)

The CPP considers the primary caregiver to be the person who is most responsible for the daily needs of the child (or children) until the age of 7. Some examples of the responsibilities of the primary caregiver are:

  • supervising the child
  • preparing meals
  • going to school meetings and events; and
  • attending the child’s medical appointments

Note

Only one parent can qualify for any child-rearing provision periods.

Late applicant provision

The late applicant provision may help you qualify for CPP disability benefits if you did not apply when you first became disabled.

You may be eligible if:

  • you had the required amount of CPP contributions and the required number of years of CPP contributions on the date you first became disabled (as defined by the CPP legislation), and
  • you have been continuously disabled (as defined by the CPP legislation) from that date up to the present

You do not have to apply separately for this provision. It will automatically be considered when you apply for CPP disability benefits.

Incapacity provision

The incapacity provision supports you if you were previously:

  • physically or mentally incapable of forming or expressing the intent to claim CPP disability benefits, and
  • incapable of asking someone else to apply on your behalf

This provision may allow Service Canada to go further back in time to pay retroactive benefits.

There is a time limit after you regain the capacity to apply.

Contact Service Canada by phone or in-person to have the Declaration of Incapacity – Physician’s Report sent to you.

Credit splitting upon separation, divorce or end of a common-law relationship

The CPP contributions you and your former spouse or former common-law partner made during the time you lived together may be equally divided after a divorce, separation, or the end of your common-law relationship.

International social security agreements and the Canada Pension Plan

If you have lived or worked in Canada and in another country, and you do not meet the contributory requirements for CPP disability benefits, one of Canada’s international social security agreements may help you qualify.

2.0 Child’s benefit

In this section

Disabled contributor's child's benefit

The Canada Pension Plan provides a monthly benefit for dependent children of someone receiving CPP disability benefits.

Eligibility

The dependent child must be:

  • under age 18 or between 18 and 25 years old and attending school or university full-time; and
  • the biological child of the contributor
  • a child who was adopted legally or “in fact” by the contributor before the age of 21, or
  • a child who was legally or “in fact” in the custody and control of the contributor before the age of 21

See section 7.0 for examples of eligibility.

Note

  • Once a child turns 25, they are no longer eligible for the benefit.
  • The parent or guardian must be receiving CPP disability benefits.

How to apply for a child’s benefit

Apply in one of the following ways:

  1. if the dependent child is under 18 and in the custody and control of the applicant: When the parent or guardian of a dependent child completes the application for CPP disability benefits, they will be asked questions about the children in their custody and control. Service Canada will consider the application to be for their dependent children if any relevant information is provided. There is no additional step to apply for the child’s benefit
  2. if the dependent child is under 18 years old and not in the custody and control of the applicant, the custodial parent or guardian should complete and submit:
  3. if the dependent child is between the ages of 18 and 25 and is attending school or university full-time, the dependent child should complete and submit:

Note

Call Service Canada at 1-800-277-9914 to notify us when schooling or re-training is complete.

3.0 Applying

In this section

When to apply

You should apply for CPP disability benefits as soon as you develop a severe and prolonged (see section 6.0 for definition) or terminal mental or physical medical condition that regularly prevents you from working.

You must apply for CPP disability benefits in writing. Send Service Canada your completed application forms as soon as possible. The date your application is received could affect when your benefits starts. It takes Service Canada about 4 months to determine your eligibility and to start payments.

For information on income assistance while waiting for your CPP disability benefits application to be processed, see Section 7.0 on Employment Insurance sickness benefits.

How to apply

  • Answer every question with as much detail as possible to help Service Canada understand your situation and make a faster decision.
  • For information on how to submit supporting documents with your application, consult Annex B of the Application for Canada Pension Plan Disability Benefits (ISP1151).
  • If you are not able to complete the application, you can authorize someone else to do it for you. See section 3.0 for more information.

Required forms

Print, fill out and sign the Application for Canada Pension Plan Disability Benefits (ISP1151) and mail it to Service Canada.

Complete sections 1 and 2 of the Medical Report for a Canada Pension Plan Disability Benefit (ISP2519). Sign and mail the report to Service Canada with your application. Your doctor or nurse practitioner must fill in sections 3 to 9 and submit them separately.

If you have a terminal illness, print out the Terminal Illness Application kit for a Disability Benefit under the Canada Pension Plan (ISP2530A and ISP2530B).

Note

If you are receiving a disability benefit from an insurance company or a provincial/territorial agency, you can ask them to send Service Canada your most recent medical report(s) instead of sending the Medical Report form (ISP2519).

Canada Pension Plan disability benefits application checklist

Use the following checklist after completing the Application for Canada Pension Plan Disability Benefits (ISP1151) and the Medical Report for a Canada Pension Plan Disability Benefit (ISP2519).

  • Have you written your Social Insurance Number in the box at the top of each sheet you have added? [yes, no]
  • Have you provided your date of birth on page 1? [yes, no]
  • Have you read and signed section H on page 17 (consent for Service Canada to obtain personal information)? [yes, no]
  • Have you read and signed section I on page 18 (declaration and signature)? [yes, no]

If you are currently receiving a disability benefit from an insurance company or a provincial/territorial agency:

  • Have you asked them to send your most recent medical report(s) to Service Canada? [yes, no]

If you are not currently receiving a disability benefit from an insurance company or a provincial/territorial agency:

  • Have you completed Sections 1 and 2 of the Medical Report? [yes, no]
  • The Medical Report must be signed within 12 months of presenting an application.
  • Have you asked your doctor or nurse practitioner to complete sections 3 to 9 of the Medical Report and mail it to Service Canada? [yes, no]
  • Have you removed the information and instructions pages from the application at the front and back? [yes, no]

Service Canada will pay your doctor or nurse practitioner (up to a certain amount) for completing your medical report (see amounts below).

They are responsible for sending Service Canada a bill. If they charge more than Service Canada’s maximum amount, you are responsible for paying the extra cost.

Service Canada will pay up to the following amounts

Form title Amount
Initial Medical Report for a Canada Pension Plan Disability Benefit (ISP2519) $85
Terminal Illness Medical Attestation for a Disability Benefit Under the Canada Pension Plan (ISP2530B) $85
Reinstatement of CPP Disability Benefits, Physician Confirmation Form $20
If Service Canada asks for other information, including a narrative, and depending on the complexity and the time required for completion. $150

Note

To get the Reinstatement of CPP Disability Benefits Physician Confirmation Form, contact Service Canada.

Assistance completing the application

Authorizing someone else to help you

Do you want to authorize someone to communicate with Service Canada for you? Print the Consent to Communicate Information to an Authorized Person (ISP1603), complete it, and mail it to Service Canada.

Note

The person you authorize will not be able to apply for benefits on your behalf, change your payment address, or make changes related to withholding of federal income tax. However, they can get help from Service Canada to clarify eligibility and find out which forms are required.

Incapability

If a CPP applicant is unable to manage their own affairs due to a severe mental impairment, there are 2 options:

To do this:

Download the agreement and certificate forms.

4.0 After you apply

In this section:

How long will it take

Service Canada will notify you of our decision about 120 days from the date we receive your complete application and any necessary documents.

Service Canada will send you a letter to tell you that your application has been received. A Service Canada representative will also call you to:

  • explain how your application will be processed
  • let you know the type of information we need from you, and
  • answer any questions

If 120 days have passed and you have not heard from us, and want to know the status of your application, please contact us.

When will I receive my benefit

Your disability benefit usually begins in the 120 days after Service Canada determines that you have a severe and prolonged mental or physical medical condition, as defined by the CPP. For example, if Service Canada determines that you were disabled in July, then you will start receiving your benefit payment in November.

You may receive up to 12 months of retroactive payments from the date your application was received.

How much can I receive

The amount you can receive on a monthly basis will depend on the benefits you are approved for.

The disability pension is a flat-rate ($496.36 in 2019), plus an amount based on how much and for how long you contributed to the Canada Pension Plan. The maximum disability benefit for 2019 is $1,362.30.

The post-retirement disability benefit is the same flat rate ($496.36 in 2019). It does not matter how much or for how long you contributed to the Canada Pension Plan.

When you turn 65

  • If you have been receiving the disability pension, it stops and the full retirement pension begins, and
  • If you have been receiving the post-retirement disability benefit, it stops. You may continue to receive a retirement pension.

Receiving disability income from another source

If you are receiving disability income from other sources, such as a private insurance company or a provincial or territorial social assistance program, you may still be eligible for CPP disability benefits, but the other sources may reduce their payments.

Contact your insurance company or social assistance program for details about your case.

Receiving more than one Canada Pension Plan benefit

If you are eligible for both a CPP survivor’s pension and a CPP disability pension, they will be combined into a single monthly payment. If you are eligible for the CPP post-retirement disability benefit, it will be paid as a separate monthly payment.

If you are receiving a combined retirement and survivor pension, and are then granted a post-retirement disability benefit, you will receive the higher amount of the survivor or post-retirement disability benefit flat rate.

Request for reconsideration

If you disagree with Service Canada’s decision on your application for CPP disability benefits, you can ask for a reconsideration within 90 days of receiving a decision letter.

What is a reconsideration

A reconsideration is a review of your application by a Service Canada staff member who was not involved in making the original decision. They will also review any new information that you provide or others provide for you. Service Canada staff may also seek more medical information about your case.

How do I request a reconsideration

You must submit a written request for reconsideration. You may write us a letter or complete the Request for Reconsideration of a Canada Pension Plan Disability Decision (ISP1145). Include:

  • your name, address, telephone number, and Social Insurance Number
  • a detailed explanation of why you want a reconsideration
  • any new information that could affect the decision, and
  • your signature and the date

Mail the request to Service Canada at the return address provided on the application form.

Reconsideration takes about 120 days. Service Canada will inform you by mail of the decision and the reasons for the decision.

Complete and send your request to Service Canada right away, even if you are waiting on additional information that you would like to provide us for reconsideration.

Complete Section 3: Information you want us to consider and select “I want Service Canada to review the decision using information already submitted and new information that I will be providing as soon as I receive it.

Complete the table with information about the document or appointment, indicate whether the document is enclosed or the date you estimate you will send it to us.

Note

Service Canada will start reviewing your request for reconsideration once we receive all the information.

If you disagree with the reconsideration decision

If you disagree with the reconsideration decision, the next step is to appeal to the Social Security Tribunal. To do this, complete the Canada Pension Plan Notice of Appeal – Income Security – General Division form.

For more information, contact the Social Security Tribunal:

  • by email: info.sst-tss@canada.gc.ca
  • by phone from 7:00 a.m. to 7:00 p.m. Eastern Time: Monday to Friday: 1-877-227-8577 (toll-free in Canada and the USA)
  • 613-437-1640 (from outside Canada and the USA, call collect)
  • TTY: 1-866-873-8381

Extension request

If you have already applied for CPP disability benefits but you have an upcoming medical appointment that might affect your eligibility, you can ask Service Canada to delay deciding whether you are eligible. You can ask for an extension the first time you apply or when you request a reconsideration. To request an extension, contact Service Canada.

When do the benefits stop

CPP disability benefits are not necessarily permanent. They are long-term benefits that are intended to partially replace your employment income for as long as your disability regularly prevents you from working.

CPP disability benefits will stop:

  • when you are no longer disabled according to the CPP legislation
  • when you turn 65, or
  • when you die (To avoid overpayment, it is important that someone notify Service Canada about your death)

When CPP disability benefits stop, any related disabled contributor’s child’s benefits also stop.

If you are receiving CPP disability benefits when you turn 65, your disability benefit will automatically be converted to a CPP retirement pension the month after your 65th birthday. You will not need to apply. Your retirement pension will be less than your CPP disability pension.

You may be eligible for the Old Age Security (OAS) program and its benefits which include: the Old Age Security pension, Guaranteed Income Supplement, Allowance and the Allowance for the Survivor.

5.0 Important information

In this section

Returning to work

Doing volunteer work or going to school while receiving CPP disability benefits

Your CPP disability benefits will not be affected if you do volunteer work or go to school.

Note

If you successfully complete a school, university, trade, technical training or rehabilitation program, you must notify Service Canada by calling 1-800-277-9914.

Doing paid work while receiving CPP disability benefits

You can work and earn up to a certain amount without telling Service Canada. For 2019, this amount is $5,700 (before taxes) and may change in future years. This is not a cut-off point for benefits, but an opportunity for you and CPP disability benefit staff to discuss whether additional assistance could help you return to work on a regular basis, if your condition permits.

If you earn more than this, you must call Service Canada at 1-800-277-9914.

If you delay contacting Service Canada when you start working and earning over the allowed amount, you might have to pay back some of the money you received.

Disability reoccurs within 2 years

If you stop receiving CPP disability benefits because you reported your return to work, but your disability reoccurs less than 2 years later, the CPP offers you an automatic reinstatement. You have up to one year from the month you stopped working because of your disability to inform Service Canada that you would like your benefits reinstated.

This means that if you are unable to continue working because of the same disability or a related disability, you can ask to have your benefits start again without having to re-apply. Your disability benefits can be quickly reinstated if:

  • your benefit stopped less than 2 years ago because you returned to work
  • you cannot continue working because the same or a related disability has reoccurred
  • you are under the age of 65, and
  • you are not receiving the CPP retirement pension*

There is no limit to how many times you may ask for your benefits to be reinstated.

If your children are still eligible, their disabled contributor’s child’s benefit will also be reinstated.

*Some restrictions apply to reinstate the CPP post-retirement disability benefit. Contact Service Canada for details.

Disability reoccurs within 5 years

If you stop receiving CPP disability benefits because you return to work, but your disability reoccurs in more than 2 years but less than 5 years, you may be eligible for a fast-track reapplication.

Requirements:

  • the date you stopped work must be within one year of the date of reapplication and within 5 years of the date that benefits stopped because you returned to work
  • you cannot continue working because the same or a related disability has reoccurred, and
  • you must have made valid contributions in every year since the benefit stopped

If your children are still eligible, their disabled contributor’s child’s benefit will also be reinstated.

Vocational Rehabilitation Program for recipients of Canada Pension Plan disability benefits

The Disability Vocational Rehabilitation Program is a voluntary program that helps CPP disability benefits recipients return to work. If you are receiving CPP disability benefits, you may be eligible for employment counseling, financial support for training, and job-search services.

New technologies, medical treatments and skills training are making it possible for some people with severe conditions to re-enter the workforce.

While you participate in the program, you continue to receive your regular CPP disability benefits, including while you search for a job.

To participate in this program, contact Service Canada.

Tax considerations

Canada Pension Plan disability benefits are taxable. Service Canada will deduct income tax from your benefit each month if you submit the Request for Voluntary Federal Income Tax Deductions form (ISP3520CPP).

Note

Service Canada will deduct income tax only if you submit a request.

Disability Tax Credit

You may also be eligible for the Disability Tax Credit administered by the Canada Revenue Agency, which could reduce the amount of income tax you may have to pay.

To apply, you must:

  • complete Part A of the Disability Tax Credit Certificate (T2201)
  • ask a medical practitioner to complete Part B and certify that you have a severe and prolonged impairment and describe the effects of this impairment, and
  • once the Disability Tax Credit Certificate (T2201) is complete, send the form to the Disability Tax Credit Union at Canada Revenue Agency. Mail the form to the address indicated on the last page of the Certificate

Note

Service Canada’s definition of disability is different from the definition used by the Canada Revenue Agency.

In case of death

What if I die before starting to receive CPP disability benefits?

If you signed a Canada Pension Plan Disability Benefits Application (ISP1151) and Service Canada receives it before your death, we will continue to process your application. If it is approved, any money payable up to the date of death will be sent to your estate.

If you signed your application for a disability benefit and Service Canada receives it after you die, your application must be denied.

In either case, your estate may be eligible to receive the CPP death benefit. Your survivors may be eligible for the CPP survivor’s pension and surviving child’s benefit.

Reassessment of eligibility

Service Canada reassesses cases from time to time to ensure that only eligible people receive disability benefits.

If your case is being reassessed, you may be asked to provide Service Canada with details about your current medical situation or other information.

Once all the necessary information has been collected, Service Canada will make a decision to continue or stop disability benefits. We will send you a letter to inform you of the decision.

Overpayments

If you receive payments to which you are not entitled, you will have to pay them back.

6.0 Glossary and resources

In this section

Glossary of terms

Note

In case of conflict between the interpretation of terminology in this toolkit and the terminology of the Canada Pension Plan and Regulations, the terminology of the Plan and Regulations prevail.

Allowable earnings

The maximum amount that a CPP disability beneficiary can earn in a calendar year without notifying Service Canada. In 2019, the amount is $5,700.

Automatic reinstatement

If a person cannot continue working because their disability reoccurs within a 2-year period, their CPP disability benefits can be reinstated automatically. Service Canada will mail the necessary forms to you when your benefits stop.

Beneficiary

Someone who is receiving Canada Pension Plan benefits.

Canada Pension Plan (CPP)

A mandatory public insurance plan that provides contributors and their families with partial replacement of earnings in the case of retirement, disability or death.

Canada Pension Plan death benefit

A one-time, lump-sum payment to the estate on behalf of a deceased CPP contributor.

Canada Pension Plan disability pension

A taxable monthly payment that is available to people who have contributed to the CPP and who are regularly not able to work because of a severe and prolonged mental or physical medical condition.

Canada Pension Plan retirement pension

A taxable monthly payment that is available to eligible contributors. You can apply for, and receive a full CPP retirement pension at age 65, or receive a reduced pension as early as age 60, or an increased pension as late as age 70.

Canada Pension Plan survivor’s pension

A taxable monthly payment that is available to the person who, at the time of death, is the legal spouse or common-law partner of the deceased contributor.

Child-rearing provision

If you stopped work or worked less because you were the primary caregiver of your children under the age of 7, the child-rearing provision allows this period not to be counted when calculating your CPP contributions and benefits amount. This increases your CPP disability benefit payment. It may also help you have enough years of contributions to be eligible for CPP disability benefits.

Custody and control

Includes formal and informal custody and control arrangements, including sole custody, shared custody and joint custody.

Dependent child

A biological or adopted child of a CPP disability beneficiary or a child in the beneficiary’s care and custody. The child must be under the age of 18 or between 18 to 25 and attending school full-time.

Disabled

Someone is considered to be disabled for CPP disability purposes if they are determined under the CPP legislation to have a severe and prolonged mental or physical medical condition that regularly prevents them from working at any substantially gainful occupation.

Disability Basic Exemption

The Disability Basic Exemption is $5,700. You must earn more than this amount in 2019 to count it as a “contributory” year for CPP disability eligibility purposes.

Disabled contributor’s child’s benefit

A monthly benefit for a dependent child of someone receiving CPP disability benefits.

Incapable of making an application

Mentally or physically incapable of forming or expressing an intention to make an application.

Incapacity provision

A provision that allows someone to apply retroactively for CPP disability benefits if they were previously physically or mentally incapable of forming or expressing the intent to apply.

Old Age Security pension

A taxable monthly pension available to people aged 65 and older who meet the eligibility requirements, whether they are still working or have never worked.

Post-retirement disability benefit

A new monthly benefit for CPP retirement pension recipients under the age of 65 who have made sufficient contributions to the CPP and are regularly incapable of working because of a severe and prolonged mental or physical medical condition.

Power of attorney (POA)

A document giving someone the legal authority to act on your behalf to manage your legal and financial affairs.

Prolonged

A disability is considered prolonged only if the CPP determines that it is likely to be long-term and of indefinite duration or is likely to result in death.

Quebec Pension Plan

A mandatory public insurance plan for workers in Quebec aged 18 and over whose annual employment income is over $3,500.

Reconsideration

The first level of recourse for CPP applicants who disagree with a decision. It is a review carried out by a Service Canada staff member who was not involved in the initial decision. You must request a reconsideration in writing within 3 months of receiving the decision letter.

Severe

A disability is considered severe only if the CPP determines that it usually or always prevents you from doing any substantially gainful work.

Social security agreement

An agreement between Canada and another country that coordinates the pension programs of both countries for people who have lived or worked in both countries.

Social Security Tribunal

An administrative tribunal that makes decisions on appeals related to the Canada Pension Plan, Old Age Security and Employment Insurance programs. It operates independently from Service Canada.

Substantially gainful occupation

Any profession or work a person might do to earn a living. If the total annual amount of earnings from this work is more than 12 times the maximum monthly CPP disability pension amount, the work is considered to be substantially gainful.

Links to other resources

Benefits Finder
You may be eligible for benefits other than CPP disability benefits. Use the Benefits Finder to find other Government of Canada, provincial, or territorial benefits.
Canada Revenue Agency
A Government of Canada agency that administers taxes, benefits and related programs.
Child disability benefit
A tax-free benefit for families who care for a child under age 18 who is eligible for the disability tax credit due to a severe and prolonged impairment in physical or mental functions.
Disability Award
A tax-free payment for Canadian Armed Forces members or veterans who have an injury or illness resulting from military service.
Registered Disability Savings Plan (RDSP)
A Government of Canada program that helps parents and others save for the long-term financial security of a person who is eligible for the Disability Tax Credit.
Registered Disability Savings Grant and Bond
If you have a Registered Disability Savings Plan, you can apply for a Canada Disability Savings Grant and/or Bond.
Education funding for people with disabilities
Grants and student loans to assist people with disabilities and their families.
Employment Insurance sickness benefit
A Government of Canada program that offers temporary financial assistance to unemployed workers who are unable to work because of sickness, injury, or quarantine.
Federal Excise Gasoline Tax refund program
If you have a permanent mobility impairment and cannot safely use public transportation, you can ask for a refund of part of the federal excise tax on gasoline you buy.
Quebec Pension Plan disability benefits
Apply for Quebec Pension Plan (QPP) disability benefits instead of CPP if you worked only in Quebec, you currently live in Quebec and have contributed to both the CPP and QPP, or you have worked in Quebec, currently live outside Canada and your last province of residence was Quebec.
Tax credits and deductions for persons with disabilities
Tax credits and deductions are available for people with disabilities, their supporting family members, and their caregivers.

7.0 Other benefits

In this section

Employment Insurance sickness benefits

If you cannot work because of sickness, injury or quarantine, but you would otherwise be available to work, you could be eligible to receive up to 15 weeks of EI sickness benefits.

You must meet the eligibility criteria and provide a medical certificate signed by your doctor or an approved medical practitioner.

Canada Benefits Finder

Use the Canada Benefits Finder to see if you may be eligible for other federal, provincial or territorial benefits.

Foreign benefits

If you live or have lived or worked in another country, you may also be eligible for benefits from that country.

Canada’s social security agreements with other countries may help you qualify. Each agreement is different so you will need to contact Service Canada to find out more about your situation. If you have lived or worked in a country that does not have an agreement with Canada, contact that country directly to find out if you are eligible for a benefit.

CPP disability benefits examples

1. Contributions in 4 of the last 6 years

Who

Zan is 32 years old and stopped working this month because of a severe and prolonged medical condition (according to CPP legislation).

Scenario

Zan applies for the CPP disability pension. His salary was $45,000 per year. He contributed to the CPP in 4 of the last 6 years.

Outcome

Zan is eligible and starts receiving the CPP disability pension.

2. 25 years of contributions with contributions in 3 of the last 6 years

Who

Jamie started working and contributing to the CPP at age 18.

Scenario

After working for 22 years, at age 40 Jamie decided to return to school to change careers. At age 45 Jamie went back to work. He contributed to the CPP for 3 years before having to stop work due to a terminal illness. Jamie has contributed to the CPP for at least 25 years, with contributions in 3 of the last 6 years.

Outcome

Jamie is eligible for the CPP disability pension.

3. Late applicant provision

Who

Wayan had to stop working several years ago because of a severe and prolonged medical condition (according to CPP legislation). He did not apply for CPP disability benefits until recently.

Scenario

In the 6 years before becoming disabled, Wayan contributed to the CPP for 4 years. His annual earnings were more than the Disability Basic Exemption of $5,700.

Outcome

Wayan is eligible for CPP disability benefits based on the late applicant provision. He will receive retroactive payments going back 11 months from the date Service Canada received his application.

4. Credit splitting

Who

Rishi and Roni were married for many years and now have separated. Rishi never worked because of a disability, while Roni worked and contributed to the CPP. Rishi had not been receiving CPP disability benefits because he had no CPP contributions.

Scenario

Rishi contacts Service Canada to apply for a division of pension credits. The CPP contributions Roni made while they lived together are combined, then divided equally between them.

Outcome

Rishi now has valid contributions to be considered for CPP disability benefits.

5. International social security agreements

Who

Paz contributed to the social security system of Peru for many years before immigrating to Canada. Paz began working in Canada upon his arrival, but within 2 years, he had to stop work because of a severe and prolonged medical condition.

Scenario

Paz does not have enough contributions to CPP to be considered for CPP disability benefits. However, since March 2017, Canada has an international social security agreement with Peru.

Outcome

Paz can be considered for CPP disability benefits. By combining his years of contributions to the Peruvian social security system with those to the Canada Pension Plan, Paz will meet the requirement for contributions in 4 of the last 6 years. The amount that Paz receives will be based only on his CPP contributions. Paz should consider applying for a disability pension from Peru as well.

6. Child-rearing provision

Who

Chris recently stopped working because of a severe and prolonged medical condition.

Scenario

He had previously been out of the workforce to look after his daughter since she was born 6 years ago. During that time, Chris received the child tax benefit/Canada child benefit.

Before his daughter was born, Chris had worked half-days for 4 years.

Outcome

Chris does not have enough CPP contributions in the last 6 years to qualify for CPP disability benefits. However, the child-rearing provision allows Chris to exclude the last 6 years.

Chris is eligible for CPP disability benefits because he has 4 years of contributions in the 6 years before he stayed home to raise his daughter.

7. Applying for the post-retirement disability benefit

Who

Carl began to receive his retirement pension at age 60 after 40 years of work. He had a disabling event occur at age 62.

Scenario

Since Carl has been receiving his retirement pension for more than 15 months, he is not able to cancel his retirement pension to receive a disability pension. Since Carl has contributions to the CPP in 3 of the last 6 years prior to the disabling event, he may receive the post-retirement disability benefit.

Outcome

If the post-retirement disability benefit is approved, Service Canada will send him a monthly amount equal to the flat-rate portion of the disability pension as a top-up to his retirement pension.

Disabled contributor’s child’s benefit examples

1. Child under 18 years of age who is in the care and custody of the disabled contributor

Who

Lane is the legal guardian of Lee, aged 11.

Scenario

Lane recently applied for and was granted a CPP disability benefits. On the application, Lane stated that Lee was in his custody and control.

Outcome

Lane will receive the disabled contributor child’s benefit on Lee’s behalf.

2. Child under 18 years of age who is not in the care and custody of the disabled contributor

Who

Morgan and Marley are separated and have a daughter together. Morgan recently applied for and was granted CPP disability benefits.

Scenario

On the application, Morgan stated that Madison, age 10, was in the custody and control of Marley, Madison’s other parent. Morgan gave consent to Service Canada to contact and tell Marley that Madison is entitled to the disabled contributor’s child’s benefit.

Outcome

Because there is continuing contact between Morgan and Madison, Morgan must complete the Application for Benefits for under Age 18 Children of Disabled Contributor (ISP1152) to receive the benefit on Madison’s behalf.

3. Transition from under 18 years of age to over 18 years of age - Disabled contributor’s child’s benefit

Who

Sushila has a parent who is receiving CPP disability benefits. Sushila just turned 18 years old and is still in school.

Scenario

This fall, Sushila will be attending university full time. Each year that Sushila attends, she will have to complete the Declaration of Attendance at School or University (ISP1401).

Outcome

The disabled contributor’s child’s benefit will be paid directly to Sushila.

4. New applicant for disabled contributor’s child benefit - Over 18 years of age

Who

Nicki is 20 years old and attends college full time. One of Nicki’s parents has just been diagnosed with a serious illness and is applying for CPP disability benefits.

Scenario

Since Nicki is over 18, he must complete the Application for Child’s Benefit (ISP1400) and the Declaration of Attendance at School or University (ISP1401).

Outcome

If Nicki’s parent is granted a CPP disability benefit, the disabled contributor’s child’s benefit will be paid directly to Nicki.

8.0 Contact us

Visit the nearest provincial or territorial Service Canada office or contact Service Canada by phone from Canada or the United States, toll-free at 1-800-277-9914 or TTY: 1-800-255-4786.

Office hours: 8:30 am to 4:30 pm Eastern Time, Monday to Friday.

To access information on your specific file visit My Service Canada Account.

For more information, and to connect with Service Canada on social media:

Visit us on Twitter

Watch our videos on YouTube

9.0 Guide for health care professionals

In this section

Overview

As a health care professional, you play a key role in our process. You may be asked to provide medical information about a patient of yours who has submitted an application for CPP disability benefits. The medical information that you provide will enable Service Canada to assess your patient’s eligibility or continued eligibility.

We may also seek information from specialists or obtain a second opinion from an independent medical examiner.

CPP disability benefits provide partial earnings replacement in the form of monthly payments to Canada Pension Plan contributors who have made the required contributions and are deemed regularly unable to work at any substantially gainful occupation due to a severe and prolonged physical or mental disability.

CPP disability benefits:

  • do not provide additional payments for prescription drugs, medical supplies, assistive devices or other health-related services
  • are not intended for short-term disability coverage, and
  • automatically convert to a CPP retirement pension at age 65

A separate monthly benefit is paid to a CPP disability beneficiary’s children who are under the age of 18, or 18 to 25 and attending school full-time, or to a retirement pension beneficiary who is receiving a post-retirement disability benefit.

Working with your patient

The medical information you submit about your patient’s capacity to work in any substantially gainful job is essential, not only for the initial application, but also during appeals, reassessments or vocational rehabilitation.

Note

Substantially gainful work or occupation is considered to be any profession or work a person might do to earn a living. If the total annual amount of earnings from this work is more than 12 times the maximum monthly CPP disability pension amount, the work is considered to be substantially gainful.

Service Canada needs enough information to be satisfied that your patient meets the eligibility requirements for CPP disability benefits.

What we need from you is a clear and comprehensive assessment of your patient’s medical condition, together with information about any limitations on their capacity to function.

You can help your patient by submitting the medical report promptly.

Note

We cannot make a decision to grant a disability benefit until we receive your report.

Patient eligibility

To be eligible for CPP disability benefits, the applicant must:

  • have a physical or mental impairment that is both severe and prolonged
  • be under the age of 65; and
  • meet the CPP contribution requirements

Eligibility is determined on the basis of other factors in addition to the medical diagnosis. Our medical adjudicators consider the individual’s circumstances, including:

  • the nature and severity of their medical condition
  • the impact of the medical condition and treatment on their capacity to work
  • their prognosis
  • their personal characteristics such as age, education, language proficiency and work experience, and
  • their work performance and productivity

Medical adjudicators do not consider the availability of suitable employment in the applicant’s region when determining eligibility for CPP disability benefits.

For more information on eligibility criteria, see section 1.0.

Summary of CPP disability adjudication guidance

Nature of the medical condition

A disability must be a physical or mental medical condition that is both severe and prolonged:

  • your patient’s disability is defined as being severe if they have a mental or physical disability that regularly stops them from doing any type of work
  • your patient’s disability is defined as being prolonged if it is likely to be long-term and of indefinite duration, or is likely to result in death
  • the progressive nature of the medical condition needs to be apparent.
  • demonstrating whether a patient’s medical condition is cyclic, slowly progressive, rapidly progressive or recurrent will help the medical adjudicator determine whether a disability is severe and prolonged

Functional limitations

When a medical adjudicator evaluates a patient’s functional limitations, they are looking at limitations affecting work capacity.

The adjudicator will also review your patient’s work history for absences due to the related illness.

Your patient’s medical condition is always the prime indicator of whether they are regularly incapable of pursuing and maintaining a substantially gainful occupation.

Impact of treatments

The medical adjudicator must determine how your patient’s ongoing treatments are likely to affect their medical condition and ability to work in the short-term and/or in the future.

The medical adjudicator will take into consideration whether or not a patient has made use of medication or other treatment.

  • It is critical to report the efficacy of the medication or treatment that your patient is taking/undergoing.
  • Using the information to determine your patient’s prognosis will help the medical adjudicator make a decision.

The medical adjudicator may request a copy of clinical notes for longitudinal evidence on exam findings, recommended treatments or responses, etc.

Statements and/or opinions expressed by medical practitioners

Medical statements that you or other health professionals make in reports form part of the medical evidence in a determination of disability. The medical statements must be evaluated in terms of what is consistent and logical in relation to all the evidence in a case and the way CPP determines a severe and prolonged disability.

In the “Additional Information” section of the Medical Report for a Canada Pension Plan Disability Benefit (ISP2519), you can make statements and express opinions about the medical condition you observe.

If your patient has a condition for which traditional objective tests are not available, CPP may request evidence from a wide variety of sources.

  • The opinions you provide will be considered along with other sources to obtain a holistic view of the individual.
  • Correlating medical documentation must be on file to support all statements/opinions expressed.

Existence of multiple medical conditions

If your patient has 2 or more medical conditions, a medical adjudicator will determine if it is a case where one medical condition might not indicate incapability to perform any work, but 2 or more medical conditions together would indicate such incapability.

It is therefore important that you provide all supporting evidence in relation to multiple medical conditions.

Evidence includes but is not limited to: a copy of investigative reports pertaining to the condition(s), consultation reports and hospitalization records.

Personal characteristics

The medical adjudicator will consider your patient’s personal characteristics as part of a comprehensive approach to a case. The medical adjudicator will determine when, where and if personal characteristics, in combination with the medical condition and work capacity evidence, support the determination of a severe and prolonged disability.

The personal characteristics to be considered are:

  • age
  • education
  • work experience, and
  • language proficiency

Personal characteristics are to be evaluated:

  • on a case-by-case basis, and
  • always in combination with a medical condition

Application forms

The Application Kit for CPP Disability Benefits (ISP1151) is available online or by contacting Service Canada. Service Canada’s contact information can be found in section 8.0.

The kit includes:

Note

The medical report must be signed within 12 months of presenting an application.

You must complete the medical report on behalf of your patient.

The medical information you provide is critical to our assessment of an application.

Note

If you diagnose your patient with a terminal illness, you are responsible for completing Section E of the Terminal Illness Application for a Disability Benefit under the Canada Pension Plan (ISP2530A). The application will be processed within 5 business days for the terminally ill and within 30 business days for the gravely ill.

Type of medical information needed

The following information related to an applicant’s medical history is required for the medical report:

  • the medical diagnosis of the physical or mental illness affecting the client’s ability to work
  • the findings upon which the diagnosis was made
  • the resulting physical or mental functional limitations or restrictions
  • the date of onset of the limitations or restrictions
  • the prognosis of the medical condition
  • the impacts of treatment, and
  • whether the applicant’s medical condition is episodic, continuous, resolving, or unknown

We do not need your patient’s entire medical file. Provide only the information relevant to the main physical or mental conditions that affect your patient’s capacity to work, including supporting documents such as:

  • consultants’ reports
  • diagnostic test results
  • investigative reports, and/or
  • hospital notes

If your patient is regularly capable of working, they are unlikely to be eligible for CPP disability benefits.

If your clinical notes address all the questions in the medical report, you may send those notes instead of completing the entire medical report (which will have been sent to you to fill out). However, you must complete the prognosis section of the report and sign the form.

We ask that you address the impairment(s) and associated functional limitations (physical, cognitive, emotional/behavioural) of the medical condition on your patient’s capacity to work.

Please provide supporting documents for your comments as this will greatly assist us in making a decision.

In the case of a late application, we may ask you for information going back a number of years in order to determine when the application met the contributory requirements. With the appropriate information, we can treat an application as though it had been submitted at an earlier date, when the applicant met the contributory requirements.

We must determine whether your patient can be considered to have been medically eligible from that date, continuously, to the present time.

Contact Service Canada if you are not able to provide the medical information requested. This will help prevent delays in determining your patient’s eligibility.

We may be able to get information from your patient or from other sources, or we may decide to send your patient for an independent medical consultation.

Our medical adjudicators are responsible for making decisions on applications for CPP disability benefits using the Canada Pension Plan Adjudication Framework, and may request additional information.

Medical information for continuing eligibility

You are very important in helping us determine whether your patient should continue to receive a disability benefit, or whether they might be eligible for the CPP Disability Vocational Rehabilitation Program.

We periodically review a beneficiary’s case to ensure continuing eligibility, and we may ask you for up-to-date medical information on your patient’s condition. If so, you may be asked to complete a short medical report.

Our periodic reviews give us an opportunity to make contact with clients and identify what services would suit them best. If your patient’s case is being reviewed, your patient will also be asked to provide medical and non-medical information.

Because everyone’s medical condition is unique, each case is looked at individually. Once all the necessary information has been collected, a decision to continue or stop disability benefits is made.

Note

To avoid delays for your patient, please answer all the questions on any forms you are asked to fill out and send it back to Service Canada as soon as possible.

Other information

While medical information is of primary importance, the CPP disability program takes a holistic approach to decision-making.

For example, some factors considered are:

  • age
  • education
  • language proficiency
  • transferable work skills, and/or
  • experience

Note

Local socio-economic conditions are not considered.

Applicants and beneficiaries who are deemed ineligible for benefits may request a reconsideration of the initial decision to deny or discontinue a benefit. An applicant who is denied a benefit or a beneficiary whose benefit is discontinued may appeal to the Social Security Tribunal.

Billing

You must mail your invoice to the Service Canada office address indicated on the application form.

You will be paid by cheque and payment will be mailed to the address you provide on the invoice.

Your invoice must include:

  • your patient’s name
  • your patient’s address, and date of birth or Social Insurance Number, and
  • your business number, GST/HST number or Social Insurance Number

Service Canada will pay up to the following amounts

Form title Amount
Initial Medical Report for a Canada Pension Plan Disability Benefit (ISP2519) $85
Terminal Illness Medical Attestation for a Disability Benefit Under the Canada Pension Plan (ISP2530B) $85
Reinstatement of CPP Disability Benefits, Physician Confirmation Form $20
If Service Canada ask for other information, including a narrative, and depending on the complexity and the time required for completion. $150

Your patient is responsible for covering any extra costs. Fees outlined in this section are set in consultation with the Canadian Medical Association and are subject to change.

Note

The Reinstatement of CPP Disability Benefits Physician Confirmation Form must be obtained by contacting Service Canada.

Employment and Social Development Canada (ESDC) no longer provides copies of T1204 tax slips to service providers. However, ESDC will continue to submit all T1204 information to the Canada Revenue Agency as required. Refer to the Canada Revenue Agency for information for recipients.

Privacy

The personal information of patients is administered pursuant to the Canada Pension Plan legislation as well as the Access to Information Act and the Privacy Act, under which applicants and beneficiaries have the right to formally request a copy of their CPP disability file, including the medical reports and supporting documents.

Appropriate exemption to the release of information may be applied if release of medical information is considered to be contrary to the best interest of the individual (section 28 of the Privacy Act).

If you believe it would be detrimental to your patient to be given particular information about their medical condition, indicate this in your report. We will contact you directly to determine whether this information can be withheld.

Report a problem or mistake on this page
Please select all that apply:

Thank you for your help!

You will not receive a reply. For enquiries, contact us.

Date modified: