Canada Pension Plan (CPP) disability

Decision

[1] The appeal is dismissed.

[2] The Claimant, G. P., isn’t eligible for a Canada Pension Plan (CPP) disability pension. This decision explains why I am dismissing the appeal.

Overview

[3] The Claimant is a 59 year-old woman who stopped working at X in 1988 or 1989. She has not worked since. She is claiming rheumatoid arthritis and fibromyalgia prevent her from working. Her MQP is 1997 with the child rearing provision applied. She was 35 years-old at the time of her MQP

[4] The Claimant applied for a CPP disability pension on June 27, 2018. The Minister of Employment and Social Development (Minister) refused her application. The Claimant appealed the Minister’s decision to the Social Security Tribunal’s General Division.

[5] The Claimant says she cannot work due to the pain of fibromyalgia and rheumatoid arthritis.

[6] The Minister says there was no significant factor limiting her ability to work at her MQP. The rheumatologist noted in 2002 that she had pain and swelling in the past two years, many years after the MQP.

What the Claimant must prove

[7] For the Claimant to succeed, she must prove she had a disability that was severe and prolonged by December 31, 1997. This date is based on her contributions to the CPP, along with credit split provision and the child rearing provision.^{Footnote 1}

[8] The Canada Pension Plan defines “severe” and “prolonged.”

[9] A disability is severe if it makes a claimant incapable regularly of pursuing any substantially gainful occupation.^{Footnote 2}

[10] This means I have to look at all of the Claimant’s medical conditions together to see what effect they have on her ability to work. I also have to look at her background (including her age, level of education, and past work and life experience). This is so I can get a realistic or “real world” picture of whether her disability is severe. If the Claimant is able to regularly do some kind of work that she could earn a living from, then she isn’t entitled to a disability pension.

[11] A disability is prolonged if it is likely to be long continued and of indefinite duration, or is likely to result in death.^{Footnote 3}

[12] This means the Claimant’s disability can’t have an expected recovery date. The disability must be expected to keep the Claimant out of the workforce for a long time.

[13] The Claimant has to prove she has a severe and prolonged disability. She has to prove this on a balance of probabilities. This means that she has to show that it is more likely than not she is disabled.

Reasons for my decision

[14] I find that the Claimant hasn’t proven she had a severe and prolonged disability by December 31, 1997.

Was the Claimant’s disability severe?

[15] The Claimant’s disability wasn’t severe. I reached this finding by considering several factors. I explain these factors below.

The Claimant’s functional limitations didn’t affect her ability to work

[16] The Claimant has rheumatoid arthritis and fibromyalgia. However, I can’t focus on the Claimant’s diagnoses.^{Footnote 4} Instead, I must focus on whether she had functional limitations that got in the way of her earning a living.^{Footnote 5} When I do this, I have to look at all of the Claimant’s medical conditions (not just the main one) and think about how they affect her ability to work.^{Footnote 6}

[17] I find that the Claimant didn’t have functional limitations.

What the Claimant says about her functional limitations

[18] The Claimant says that her medical conditions have resulted in functional limitations that affect her ability to work. She says that she cannot work due to pain.

[19] The Claimant also stated that she has been in pain since 1997, when an MRI revealed she had rheumatoid arthritis (RA). She masks the pain and lives with it because of medication.

What the medical evidence says about the Claimant’s functional limitations

[20] I believe the Claimant now feels she is unable to work. However,she must provide medical evidence that shows that her functional limitations affected her ability to work by December 31, 1997.^{Footnote 7}

[21] The medical evidence doesn’t support what the Claimant says

[22] There is very little medical evidence dated at the time of the MQP. The Claimant stated that she tried to get her medical files from BC but they had been destroyed. She also contacted her family physician from 1997, Dr. Jonathan Phillips, and he did not have any of her files.

[23] Therefore, she has not provided the MRI from 1997 that she is relying upon stating she had RA at the time.

[24] The Claimant was diagnosed in BC with RA in early 2002, according to Dr. Morris, rheumatologist in Calgary.^{Footnote 8} He also indicated that pain and swelling had been present for two years, which would be 2000, three years post-MQP. In the 2002 report, he found she had no systemic features other than fatigue and morning stiffness. Functionally she had a severe loss of internal and external shoulder rotation and could not walk on her toes and heels due to pain in her feet. She had bene using methotrexate which helped a great deal, but stopped when she moved from British Columbia six months earlier.

[25] In 2003, six years post-MQP, Dr. Morris diagnosed fibromyalgia and clinically inactive RA, and found the bulk of her pain was due to fibromyalgia. He encouraged her to begin exercises, something she did not do. He reminded her that exercise was the only way her fibromyalgia pain would get better.^{Footnote 9} The Claimant testified that the methotrexate she was taking helped with her fibromyalgia and the RA.

[26] Dr. Morris noted in 2003^{Footnote 10}, six years after her MQP, that she was unable to function in any job at that time. He indicated that she had RA and was placed on anti-rheumatic drugs which could take a few weeks to a few months to kick in, and it was common to experiment with medication. He hoped she would see improvement.

[27] Dr. Morris once again reiterated that the RA started in 2000 and the fibromyalgia onset was 2003.^{Footnote 11}

[28] Another rheumatologist, Dr. Norma Jibb, noted in 2007 that the Claimant reported she was diagnosed with RA in 1998 or 1999 in BC. She did not get treatment until moving to Calgary in August 2002, and started controlling the RA with Methotrexate and hydroxycholorquine.^{Footnote 12}

[29] In her testimony, the Claimant said she and her husband moved to Vancouver around 1991 and lived there until 2002. Dr. Phillips was her family physician. In 2000, she got pains in her hip area Dr. Philips sent her for an ultrasound and MRI and that was when they found RA. The Claimant, understandably, was not clear on her timelines. I accept this as her MQP is 24 years ago.

[30] Whether she was diagnosed with RA in 2000 or in 1997, there is no medical evidence showing she required any intervention or that the RA was a severe condition. She stated that she took Tylenol at the time, until she started Methotrexate in 2002.

[31] The medical evidence does not indicate a severe condition at the time of her MQP causing functional limitations that would prevent her from working.

Functional limitations preventing her from working

[32] The evidence, including the Claimant`s testimony, does not show she had functional limitations by reason of her health that would prevent her from working at the time of her MQP and continuously to date.

[33] The Claimant’s testimony is that she left her job at X in 1988 or 1989 because she moved with her husband from X to X, BC. The job at X was seasonal. She had worked for two years as a receptionist and filling out tax returns. In her second year, the last year she worked, she received an award for being one of the best tax return employees and receptionist.

[34] She did not leave her job due to any medical condition or functional limitations.

[35] She testified that she did not get a job in X because he husband was getting sporadic jobs and they were on assistance. She was at home looking after the children. She was also sick due to scar tissue from caesarian sections, resulting in surgery and a resolution of her condition.

[36] As well, the Claimant has testified that she did not work in Vancouver because her husband was working and her children were in school and she was looking after them.

[37] The evidence doesn’t show that the Claimant had functional limitations that affected her ability to work by December 31, 1997. As a result, she hasn’t proven she had a severe disability.

[38] When I am deciding whether a disability is severe, I usually have to consider a claimant’s personal characteristics.

[39] This allows me to realistically assess a claimant’s ability to work.^{Footnote 13}

[40] I don’t have to do that here because the Claimant’s functional limitations didn’t affect her ability to work by December 31, 1997. This means she didn’t prove her disability was severe by then.^{Footnote 14}

Conclusion

[41] I find that the Claimant isn’t eligible for a CPP disability pension because her disability isn’t severe. Because I have found that her disability isn’t severe, I didn’t have to consider whether it is prolonged.

[42] This means the appeal is dismissed.