Canada Pension Plan (CPP) disability

Decision

[1] The Claimant, A. M. is not eligible for a Canada Pension Plan (CPP) disability pension. This decision explains why I am dismissing the appeal.

Overview

[2] A. M. is a 53-year old former mechanical assembler. He worked in that role from 1998 to 2008. He stopped because of complications from scoliosis, a back condition that resulted in chronic pain. A. M. first applied for a CPP disability benefit in 2009 and was denied a benefit. He applied again on July 31, 2018 at the request of his long-term disability insurer. The Minister of Employment and Social Development Canada (the Minister) refused his application because it determined A. M. did not follow recommended treatment of having a nerve block injection. The Claimant appealed to the General Division of the Social Security Tribunal.

What the Claimant must prove

[3] For the Claimant to succeed, he must prove that he has a disability that was severe and prolonged by December 31, 2009. This date is based on his contributions to the CPP.^{Footnote 1}

[4] A disability is severe if it makes a person incapable regularly of pursuing any substantially gainful occupation. It is prolonged if it is likely to be long continued and of indefinite duration, or is likely to result in death.^{Footnote 2}

The reasons for my decision

[5] I find that the Claimant did not prove that he has a severe and prolonged disability by December 31, 2019. I reached this decision by considering the following issues.

The Claimant has not made reasonable efforts to follow recommended treatment

[6] The Claimant has not followed medical advice.^{Footnote 3}

[7] The Claimant was referred for nerve block injections but refused to proceed with this medical treatment.

[8] I find the Claimant’s refusal of the treatment unreasonable. The Claimant submitted a significant number of chart notes and consultation reports from physicians that have treated him. Nowhere in these documents is there any indication of the Claimant having discussed any concerns with the risks of nerve block injection.

[9] I asked the Claimant about this at the hearing.

[10] The Claimant told me that he did not want to take a risk of something going wrong with nerve blocks. I asked the Claimant how he could be concerned if he had not discussed the issue with either his family physician or the specialist that would have administered the nerve block.

[11] The Claimant told me that instead of speaking with his family physician or seeing the specialist and discussing potential risks and side-effects, he relied upon friends who told him not to proceed with the nerve block procedure. This was not a reasonable approach to take.

[12] The Claimant had easy access to his family physician and could have brought this subject up over any of the numerous visits for which he attended for health care treatment. His reliance on friends is not reasonable in these circumstances. These friends are not health care professionals and are in no position to provide the Claimant with such advice. Following such advice is not reasonable in circumstances where the Claimant`s health and capacity to return to work are at issue.

[13] The treatment would have affected the Claimant’s disability.^{Footnote 4} Dr. Chan set out that the exact cause of the Claimant`s complaints was unclear but given the persistent symptoms a nerve block of the lumbar spine was recommended to assist with resolving symptoms.^{Footnote 5} Dr. Chan went on to say if the nerve block worked, surgical consideration could then be given. If the Claimant had participated in the nerve block it would have at the very least assisted with the diagnosis of his condition and at best provided symptom resolve.

[14] It is clear this treatment would have made a difference.

[15] In the normal course the personal characteristics of an individual must be considered, this is sometimes referred to as a real world context.^{Footnote 6} I have considered such factors, as the Claimant’s age, level of education language proficiency, and past work and life experience. Ultimately, without having engaged in very reasonably medical treatment that would have been beneficial to the Claimant I cannot find the Claimant to be disabled within the meaning of the CPP.

The claimant’s disability was not severe

[16] The Claimant’s disability was not severe by December 31, 2009. This means that I do not need to decide whether the Claimant’s disability was prolonged.

Conclusion

[17] I am dismissing this appeal.