CPP Disability: What qualifies as a disability?

The Canada Pension Plan considers a “person deemed disabled” as someone with a “severe and prolonged mental or physical disability.” To provide more clarity, the CPP disability legislation defines a “severe” disability as any mental or physical disability that prevents someone from performing any substantially gainful work, including part-time work. “Prolonged” means a disability that is long-term and indefinite or is likely to result in death.

According to the definition of disability, no one can be deemed disabled more than 15 months prior to the time that they made their application for CPP disability benefits. The practical implications of this provision are that the largest amount that someone could receive in arrears for CPP disability benefits, is the equivalent of 15 months of benefits from the time of application. So, for example, where an individual applied for benefits, and waited 6 months for a final decision to be made, they would be entitled to a maximum of 21 months in arrears, provided that the individual had sufficient evidence to support disability back that far. If, on the other hand, someone was disabled for 5 years, but only applied for CPP disability today, they would only be entitled to receive benefits dating back 15 months prior to the application.

Courts have interpreted the legislation in many cases. The courts say that the definition of disability must be interpreted from a real-world perspective. That is, would a real-world employer hire a person given their disability.

In Villani v. Canada (A.G.), [2001] FCA 248, the Federal Court of Appeal found that a “large and liberal” interpretation must be applied to the definition of severe disability, as well as the legislative intention to apply the severity requirement in a “real world” context. This means that factors such as “age, education level, language proficiency and past work and life experience” are all relevant considerations in the eligibility analysis.

In Inclima v. A.G. Canada, 2003 FCA 117, the court suggests that an appeal should be denied where the individual seeking CPP disability benefits has not shown that they made a sufficient effort to look for and maintain work. Further, you must show that the inability to work stems from the serious health condition.

While the definition of disability is a legislative concept, the most important thing to do is make sure you have medical evidence of your disability. A disability insurance lawyer can help ensure you build the strongest case possible.