Canada Pension Plan (CPP) disability

Decision

[1] Leave (permission) to appeal is refused because the appeal does not have a reasonable chance of success. The appeal will not be going ahead.

Overview

[2] The Applicant, L. A. (Claimant), is appealing the General Division decision. The General Division found that the Claimant did not have a severe and prolonged disability by the end of his minimum qualifying period on December 31, 2011. Therefore, it concluded that he was not entitled to a Canada Pension Plan disability pension.

[3] The Claimant argues that the General Division based its decision on an important error of fact. The Social Security Tribunal asked him for details.^{Footnote 1} The Claimant did not respond or give any specifics. He did not say what factual error the General Division might have made.

[4] I have to decide whether the appeal has a reasonable chance of success.^{Footnote 2} Having a reasonable chance of success is the same thing as having an arguable case.^{Footnote 3}

[5] I am not satisfied that there is an arguable case that the General Division based its decision on an important error of fact.

Issue

[6] Is there an arguable case that the General Division based its decision on an important error of fact?

Analysis

[7] The Appeal Division must be satisfied that the appeal has a reasonable chance of success before it gives the claimant permission to go ahead with their appeal. A reasonable chance of success exists if there is a certain type of error.^{Footnote 4} These errors are about whether the General Division:

1. (a) Failed to make sure that the process was fair;
2. (b) Failed to decide an issue that it should have decided, or decided an issue that it should not have decided;
3. (c) Made an error of law; or
4. (d) Based its decision on an important factual error. (The error has to be perverse, capricious or without regard for the evidence before it.)

[8] Once an applicant gets permission from the Appeal Division, they move to the actual appeal. There, the Appeal Division decides whether the General Division made an error and, if so, decides how to fix that error.

Is there an arguable case that the General Division based its decision on an important error of fact?

[9] The Claimant argues that the General Division based its decision on an important error of fact, but he does not say what that error was.

[10] The General Division made the following findings that were relevant to its conclusions:

• Based on his contributions to the Canada Pension Plan, the Claimant’s minimum qualifying period ended on December 31, 2011;^{Footnote 5}
• The Claimant was off work from 2010 to 2013 because of hepatitis C. He tried to go back to work, but was let go. He became severely depressed and was unable to return to work until 2014.^{Footnote 6} His long-term disability insurer stopped paying him disability benefits in September 2014 because his doctors had stated that he was able to return to work.
• The Claimant started his own renovating business. His record of Canada Pension Plan contributions shows that he did not have any employment earnings in 2014. The record also shows that he had approximately $17,000 in earnings in 2015, and just under $12,500 in 2016.^{Footnote 7}
• The Claimant was involved in a motor vehicle accident in June 2016. He sustained a traumatic brain injury from the accident;
• When the Claimant applied for a Canada Pension Plan disability pension, he stated that he had been unable to work because of injuries from the accident. He stated that he last worked as a self-employed renovator before the accident happened.^{Footnote 8}
• In the February 2019 Canada Pension Plan medical report, the Claimant’s family physician stated that the Claimant’s medical conditions were a traumatic brain injury and dental fractures. Both of these conditions started in June 2016.^{Footnote 9}
• In May 2017, the Claimant told a clinical psychologist that his health was good in the year before the motor vehicle accident.^{Footnote 10}
• The Claimant worked full-time in a physically demanding job after his minimum qualifying period ended in December 2011.

[11] The General Division accepted that the Claimant was severely disabled at the end of December 2011 and that he became severely disabled again after his motor vehicle accident in June 2016.

[12] However, the General Division found that the Claimant had returned to work by 2014. As a result, the General Division determined that the Claimant was regularly capable of pursuing a substantially gainful occupation between 2014, when he returned to work, and June 2016, when he was involved in a motor vehicle accident.

[13] Because it found that the Claimant was able to regularly pursue a substantially gainful occupation after the minimum qualifying period, the General Division concluded that the Claimant did not meet the test for a severe disability under the Canada Pension Plan.

[14] The General Division’s findings are consistent with the evidence that was before it. The records indicate the Claimant regularly worked between 2014 and June 2016. There is no medical evidence in the General Division hearing file that could suggest the Claimant had an ongoing severe and prolonged disability between 2014 and June 2016.

[15] There were few pre-accident accidents. Pre-accident dental records did not disclose any functional issues.^{Footnote 11} Clinical records of his family doctor date back to October 22, 2013, but were unremarkable. They show that the Claimant saw his doctor for dermatological issues in 2013. He had a colonoscopy in 2014. There were no medical records documenting any visits to the family doctor in 2015. Most of the records relate to the Claimant’s 2016 accident.

[16] The General Division referred to a clinical psychologist’s report. The Claimant had reported that his health was good in the year before his accident. The Claimant also told a dental surgeon and an orthopaedic surgeon that he had been in good health before the accident.^{Footnote 12} When seen for a functional capacity evaluation, the Claimant reported that he did not have any functional impairments at the time of the accident.^{Footnote 13}

[17] In an occupational therapy in-home assessment, the Claimant described himself as a healthy individual before the accident. He reportedly stated that he was, “probably in the best shape of [his] life before the accident. In [his] mind, [he] was very physically fit and very capable.”^{Footnote 14}

[18] In a mental/behavioural evaluation dated September 11, 2018, the Claimant reported that he experienced some aches and pains before the accident, related to his physically demanding work. He denied any major functional limitations at work or at home. He stated that he worked 30 to 60 hours per work doing residential renovations.^{Footnote 15} He confirmed that he was working full-time before the accident.^{Footnote 16}

[19] In another evaluation on September 12, 2018, the Claimant denied having any mental health, cognitive, or physical issues at the time of the accident. He reported that he was in excellent health prior to the accident.^{Footnote 17} In the same report, he did not report any difficulties with work before the accident.^{Footnote 18}

[20] The General Division did not misconstrue or mischaracterize the evidence. The General Division also did not base its decision on any findings of fact that it made in a perverse or capricious manner or without regard for the material before it. The Claimant does not have an arguable case that the General Division based its decision on an important factual error.

Conclusion

[21] As the Claimant does not have an arguable case, this means the Claimant will not be moving ahead to the next stage of the appeal. This ends his appeal at the Appeal Division.