When a person is forced to stop working because of their disability, they may struggle to make ends meet. To survive, they often apply for federally administered Canada Pension Plan Disability (CPP-D) benefits and provincially administered Ontario Disability Support Program (ODSP) benefits at the same time. When a person is approved for CPP-D benefits, they automatically qualify for ODSP benefits as a person of a “prescribed class”. This automatic approval allows them to receive essential ODSP benefits without having to also prove to ODSP administrators that they are a person with a disability.
One of the reasons for this automatic approval is because the legal test to receive CPP-D benefits is more difficult than the legal test under ODSP regarding disability severity and prognosis. The benefits programs are distinct. If an individual applies to both programs, receives an ODSP denial and appeals the decision, they may still be approved to receive CPP-D benefits.
Generally, when the individual (also known as the appellant) is approved for CPP-D while waiting for their ODSP disability appeal to be heard, the Social Benefits Tribunal will find that the issues in the appeal are resolved and no decision is needed because the appellant is a person of a prescribed class and entitled to ODSP benefits. The Tribunal will not address whether the appellant is also eligible as a person with a disability under the ODSP legal test.
The problem with the Tribunal’s approach is that when a person receives ODSP benefits solely as a CPP-D prescribed class member, their ODSP benefits depend on them also receiving CPP-D. Therefore, if they are disqualified from CPP-D for any reason (i.e. if they return to work, school, or volunteering) they can lose both their CPP-D and ODSP benefits, even if they otherwise would have met the ODSP test. If at the time of an ODSP appeal, the Tribunal determined that an appellant is not only eligible for CPP-D but also eligible for ODSP, any future disqualification from CPP-D would not result in the loss of ODSP benefits.
The Income Security Advocacy Centre (ISAC) and Chatham-Kent Legal Clinic worked together to represent a former healthcare worker receiving CPP-D benefits who desired to work sometime in the future (even in a limited or temporary capacity as her disability allowed). Unfortunately, if she tried to return to work, she may have faced the loss of both CPP-D and ODSP income support because she never received a disability adjudication under the ODSP test. Specifically, the loss of ODSP would cause her to lose access to the essential health benefits she needed to manage her serious disabilities and health-related expenses.
We challenged the Tribunal’s refusal to adjudicate our client’s disability, even though she was receiving income support as a prescribed class member. We explained the differences in the two income support schemes, raised concerns that former prescribed class members cannot receive extended health benefits or rapid reinstatement to ODSP, and discussed the likelihood that our client will lose their prescribed class status in the event that she attempted to return to work, train, or volunteer.
This case was successfully settled before the hearing occurred, but the issues raised continue to present a concern for people with disabilities who rely on ODSP and other income support programs.