On December 4, 2019, the Auditor General released an audit of the Ontario Disability Support Program (ODSP). ODSP is a critical program that provides monthly income supports and health benefits to low-income persons with disabilities who have no other means to pay for their basic necessities such as food and shelter.
The focus of the audit is on the increase in the number of Ontarians who rely on ODSP, which the Auditor General treats as cause for suspicion. The Auditor General’s findings are based on faulty assumptions and perpetuate the stigma that ODSP recipients are frauds and cheats. If relied upon, the report could be used to justify dangerous reforms that would undermine the well-being of tens of thousands of people with disabilities.
In reality, the Auditor General’s report reflects improvements, not problems, with the program.
Faulty Assumption #1: An increase in the number of recipients is wholly related to the manner in which the program is administered.
Reality: As a 2013 study demonstrated, Ontario is not alone in increasing government expenditures on social assistance disability income programs, which are driven by factors such as the changing nature of the labour market, an increase in precarious employment and growing levels of working poor, an aging population and cuts to other social programs that force people to rely on social assistance.
Faulty Assumption #2: An increase in the number of applications being granted means that applications are being wrongly decided.
Reality: For many years, ODSP denied a large number of ODSP applications that were ultimately granted after an appeal. Persons with disabilities and their allies worked with ODSP over the course of many years to improve the adjudication of applications. As a result, there is better training and more oversight of decision-makers. That means that decisions that are being made now are better decisions. ODSP now better serves persons with disabilities than it did in the past. An auditor is in no position to assess whether a person’s disability is substantial enough to qualify for ODSP, which should be left to people with the appropriate knowledge and training. The Auditor General seriously overstepped her role and expertise in her report by weighing in on the correctness of individual adjudication decisions, which require the application of law to medical evidence.
Faulty Assumption #3: The decrease in the number of medical reviews is a problem because it allows people who are no longer disabled to continue to receive benefits.
Reality: Medical reviews should only be ordered when there is evidence that the applicant’s condition may improve in the future. Medical reviews used to be ordered at a very high rate in situations that were not appropriate, for example for people with degenerative conditions that would not improve. Unjustified medical reviews are very costly to taxpayers, because they require multiple doctor visits, as well as medically unnecessary tests and procedures. The grant rate on medical reviews was over 80%, reflecting the fact that most people who were required to go through the process continued to qualify for ODSP. In 2016, ODSP made important improvements to the medical review process, including setting better criteria for ordering medical reviews and better screening files to identify cases where a medical review was not really necessary. The decrease in the number of medical reviews ordered means that ODSP is better serving recipients than it was before.
Faulty Assumption #4: The fact that the Social Benefits Tribunal grants 60% of ODSP appeals reflects a problem at the Tribunal and the undermining of ministry decisions.
Reality: The Auditor General’s report reflects a grave lack of understanding about the role of administrative tribunals. The Social Benefits Tribunal hears a high volume of disability appeals at which the Tribunal reviews medical evidence and hears the testimony of the applicant, placing them in a better position to assess the evidence than the original ODSP decision-maker. The high overturn rate reflects a problem at the original decision-making level, not the other way around. Rather than changing the Tribunal, the focus should be on improving first stage adjudication to ensure that applicants are not wrongly denied. The independent role of the Social Benefits Tribunal must be preserved.
Any review of ODSP should be guided by the need to ensure that it meets the needs of disabled Ontarians. Focusing on expenditures alone does not capture whether these needs are adequately met.
There is much more to be done to improve the program, as ODSP recipients have said for many years, most significantly by immediately increasing the very low benefit rate that leaves recipients in extreme and unsafe poverty.
ISAC urges the government to consult with recipients to understand the real issues with the program. In particular, we call on the provincial government to publicly declare that it will preserve the current definition of disability for access to the program and will preserve the important independent role of the Social Benefits Tribunal in ensuring that no one is wrongly denied the benefits they need for their survival.