Canada Pension Plan (CPP) disability

Decision

[1] The Claimant is not entitled to a Canada Pension Plan (CPP) disability pension. The Claimant is entitled to a CPP post-retirement disability benefit as of January 2019 with a payment start date of April 2019.

Overview

[2] The Claimant started to receive a retirement benefit under the CPP in August 2016. He continued working in his normal work until December 2016 when he was involved in a horrific motor vehicle accident that almost cost him his life. He has not worked since that time. The Minister received the Claimant’s application for the disability pension on August 15, 2017. The Minister denied the application initially and on reconsideration. The Claimant appealed the reconsideration decision to the Social Security Tribunal.

[3] To qualify for a CPP disability pension, the Claimant must meet the requirements that are set out in the CPP. More specifically, the Claimant must be found disabled as defined in the CPP on or before the end of the minimum qualifying period (MQP). The calculation of the MQP is based on the Claimant’s contributions to the CPP. I find the Claimant’s MQP to be July 2016.

[4] To qualify for a CPP post retirement disability benefit the Claimant must meet the requirements that are set out in the CPP. The Claimant must have an MQP into January 2019 or later in order to be considered for this benefit. For the purpose of the post-retirement disability benefit, the Claimant’s MQP is December 2020.

Issue(s)

[5] Did the Claimant’s conditions result in the Claimant having a severe disability, meaning incapable regularly of pursuing any substantially gainful occupation by July 2016?

[6] If not, did the Claimant have a severe disability that would allow him to qualify for a post-retirement disability benefit on or after January 2019?

Analysis

[7] Disability is defined as a physical or mental disability that is severe and prolonged^{Footnote 1}. A person is considered to have a severe disability if incapable regularly of pursuing any substantially gainful occupation. A disability is prolonged if it is likely to be long continued and of indefinite duration or is likely to result in death. A person must prove on a balance of probabilities their disability meets both parts of the test, which means if the Claimant meets only one part, the Claimant does not qualify for disability benefits.

Disability benefit

[8] The Claimant is not entitled to a CPP disability benefit.

[9] The Claimant began collecting his CPP retirement pension in August 2016. A Claimant can only request the cancellation of his retirement pension in favour of a disability pension if the Claimant is `deemed` disabled the month before the retirement pension began.^{Footnote 2} A person can only be deemed disabled if they in fact were disabled within the meaning of the CPP in the month prior to commencing receipt of a retirement pension.

[10] The evidence does not support a deemed date of disability prior to when the Claimant started to receive a retirement pension.

[11] Dr. Mallet detailed that the Claimant was hit by a truck in December 2016. As a result, he suffered a traumatic brain injury. He was also noted to have suffered multiple skull fractures, vision loss, and several fractures to his body.^{Footnote 3}

[12] I asked the Claimant about his work capacity prior to being hit by the truck. The Claimant told me that he was employed as a X until December 2016. The Claimant told me up until the time he had an accident he was fully employed doing all his jobs with no accommodations. At that time, he was also mayor of X for upwards of 9 years.

[13] The Claimant`s statements are supported by the medical evidence. I find that the Claimant became disabled in December 2016. This was after he commenced receipt of the retirement pension. As such, he cannot be deemed disabled prior to the date when he started to receive the retirement pension and therefore is not entitled to cancel the retirement pension in favour of a disability benefit.

Post-retirement disability benefit

[14] The Claimant is entitled to a post-retirement disability benefit.

[15] As detailed above the Claimant was involved in a horrific motor vehicle accident in December 2016. He suffered a traumatic brain injury.

[16] In a therapy summary from December 20, 2016 Francesca Carter, OT detailed that the Claimant would likely need assistance for instrumental activities of daily living, including:

1. medication management,
2. time management (booking and keeping appointments),
3. financial management,
4. grocery shopping,
5. laundry,
6. transportation, and
7. meal preparation due to visual and cognitive deficits including memory, executive functioning, visual acuity.

[17] The Claimant now lives in an assisted living building. His medicine is provided to him both day and night. His laundry is done for him. He has his lunch and supper made for him. He told me that he has a care aide provided twice a week. He also relies on a volunteer to help him do physical activities.

[18] He told me that he gets out for daily walks but is limited from his sight. He can see shadows and edges of sidewalks. He stays away from major roads and cross walks.

[19] A post-retirement disability benefit is payable to a beneficiary of a retirement pension who has not reached 65 years of age, is disabled, and who has made contributions for not less than the minimum qualifying period.^{Footnote 4}

[20] I find that the Claimant became disabled in December 2016 when he suffered a traumatic brain injury resulting in significant functional impairments, a loss of vision, and became reliant on others for activities of daily living.

[21] As detailed above, the Claimant meets the requirement for an MQP after January 2019 and therefore can be considered for a post-retirement disability benefit.

[22] Given these facts, I find that he is entitled to a post-retirement disability benefit.

Conclusion

[23] If payment of a post-retirement disability is approved, the benefit is payable for each month commencing with the fourth month following the month after December 2018 in which the Claimant has become disabled.^{Footnote 5} As such, the Claimant`s post-retirement disability benefit shall commence April 2019.

[24] The appeal is allowed in part.