Information for health care professionals
Health care professionals may need to provide medical details for individuals applying for Canada Pension Plan (CPP) disability benefits. This essential information allows Service Canada to assess a patient's eligibility, or continued eligibility, for benefits.
What affects a patient's eligibility
A patient's eligibility is based on multiple factors, in addition to the medical diagnosis.
Service Canada considers the following when assessing eligibility:
- Type and severity of the condition
- How treatment affects the ability to work
- Prognosis
- Age, education, and work history
- Ability to regularly attend work, earnings, and work hours
- Volunteer and educational activities
You may not need to fill out a medical form
If your patient already receives disability benefits from an insurance company or government agency, they can send their latest medical report directly to Service Canada.
Make sure your patient or their provider is sending it before choosing not to complete the form yourself.
Complete the medical form
What to do if you are the health care professional completing the form:
Step 1 - Choose the form that applies to your patient:
Step 2 - Submit form:
- Submit the form promptly to the Service Canada office listed on the form. If you're unable to provide the required medical information, call us to avoid delays.
Medical information you may need to provide
Provide a clear and comprehensive medical assessment of your patient's condition and how it affects their ability to work. If your patient did not apply when they first became disabled, we may ask you for information going back several years.
Information you may need to provide when completing the medical form
- Medical conditions, impairments, functional limitations, prognosis, and treatment
- Impact on patient's ability to work now and in the future
- Planned investigations or specialist consultations
- Psychosocial impacts of disability on your patient's ability to work
- Supporting documents (for example, clinical notes, medical investigation reports, specialist reports, hospital discharge reports, etc.)
Note: you do not need to include your patient's entire medical file.
Can you submit clinical notes
If your clinical notes address all the questions in the Medical Report, you may submit them instead of completing the entire Medical Report. In this case, you are only required to complete the following 2 sections of the Medical Report:
- Section 5 - Medical conditions, impairments, functional limitations and treatment
- Section 9 - Declaration
This option is only available for patients who you are following closely and for whom you are keeping detailed clinical notes.
Follow-up requirements from health care professionals
Your medical input is important not just for the initial CPP disability application, but also during appeals, follow-up reviews, reassessments, or vocational rehabilitation.
Service Canada regularly reviews client files to confirm continued eligibility. You may be asked to:
- Provide updated medical information
- Complete a short medical report
To avoid delays in your patient's benefits, please answer all questions on any forms you receive.
Patient privacy and managing their information
The personal information of patients is administered in accordance with CPP legislation as well as the Access to Information Act and the Privacy Act, under which applicants have the right to formally request a copy of their CPP disability file, including any medical reports and supporting documents.
Appropriate exemption to the release of information may be applied if the release of medical information is considered to be against the patient's best interests (section 28 of the Privacy Act).
If sharing certain medical details could harm your patient, indicate this in your report. Service Canada will contact you directly to determine if this information can be withheld.
Billing
Mail your invoice to the Service Canada office listed on the form.
What to include:
- Patient's name, address, birth date, and SIN
- Your full name or the full name of the medical centre and one of the following:
- business number
- GST/HST number
- your SIN
Your payment will be made to you by cheque. Patients are responsible for covering any extra costs.
Reimbursement amounts for health care professionals
| Terminal Illness Medical Attestation for a Disability Benefit Under the Canada Pension Plan (ISP-2530B) | $85.00 |
|---|---|
| Medical Report for CPP disability benefit (ISP-2519) | $85.00 |
| Reassessment Medical Report (ISP-2509) | $25.00 |
| Medical Report - Recurrence of the Same Medical Problem (ISP-2525) | $25.00 |
| Scannable Impairment Evaluation (IMPAIR) | $50.00 |
| Declaration of Incapacity - Physician's Report (ISP-1800) | $65.00 |
| Narrative report | Up to $150.00 (depending on complexity and time required) |
Service Canada will pay directly for consultations or evaluations
Sometimes, Service Canada may request independent medical consultations or functional capacity evaluations.
If requested, Service Canada will cover the cost by paying the specialist or evaluation facility directly. Patients do not need to pay for these specific examinations.
T1204 tax slips for service providers
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 (CRA) as required. Refer to the CRA's website for additional information.
Contact us
If you have general questions about CPP disability benefits or specific questions about your application, contact us.