Canada Pension Plan (CPP) disability

Decision

[1] The appeal is dismissed.

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

Overview

[3] The Appellant was 59 years old when he applied for a CPP disability pension. He says he has physical and mental health conditions that make him unable to work. He completed Grade 10 and has no other education or training. He says he has always worked in physically demanding jobs. He says he has not been able to work since 2002.

[4] The Appellant last applied for a CPP disability pension on May 5, 2020.^{Footnote 1} The Minister of Employment and Social Development (Minister) refused his application. The Appellant appealed the Minister’s decision to the Social Security Tribunal’s General Division.

[5] The Appellant says he was badly burned in a truck fire on August 29, 1990. He was in hospital for several weeks and required surgery. He then needed therapy to build up his strength before he could return to work. He said he doesn’t remember when he returned to work. But he did go back to various jobs a few years after he was burned.

[6] The Appellant says he cannot get evidence about his injuries and conditions around 1997. One of his doctors passed away and the hospital doesn’t keep records that long. He says the truck fire caused post traumatic stress disorder (PTSD). He didn’t need or want treatment at first. He didn’t mention symptoms of PTSD to his doctor until seven or eight years ago.

[7] The Appellant hurt his knee in 2012 and needed surgery. He feels that was when he had to stop trying to work at any job. He also had a heart attack and needed cardiac surgery in 2016.

[8] The Minister says there is no evidence to support a finding of disability by December 31, 1997. The Minister said they could not obtain evidence from that time despite repeated efforts. The Appellant worked after 1997 but the Minister was unable to obtain detailed employment information.

[9] The Minister says the Appellant did not establish that he had a severe disability by December 31, 1997.

What the Appellant must prove

[10] For the Appellant to succeed, he must prove he had a disability that was severe and prolonged by December 31, 1997. This date is based on his contributions to the CPP. ^{Footnote 2}

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

[12] A disability is severe if it makes an appellant incapable regularly of pursuing any substantially gainful occupation.^{Footnote 3}

[13] This means I have to look at all of the Appellant’s medical conditions together to see what effect they have on his ability to work. If the Appellant is able to regularly do some kind of work to earn a living, then he isn’t entitled to a disability pension.

[14] A disability is prolonged if it is likely to be long continued and of indefinite duration, or is likely to result in death.^{Footnote 4}

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

[16] The Appellant has to prove he had a severe and prolonged disability by December 31, 1997. He has to prove this on a balance of probabilities. This means that he has to show that it is more likely than not he is disabled.

Matters I have to consider first

The Appellant needed extra time to prepare for the hearing

[17] The evidence on file contained very little information about the Appellant’s health by December 31, 1997. The Minister said they could not obtain medical and employment records from that time. The Appellant did not submit any evidence but claimed he had a severe disability as of 1990.

[18] I invited the parties to attend a case conference to discuss the rules that apply to the appeal and the importance of relevant evidence. The Appellant said he needed more time to try to obtain relevant evidence. The Minister’s representative did not object to a delay to allow the Appellant to try to obtain medical evidence.^{Footnote 5}

[19] On September 13, 2023, the Appellant said he had no more evidence to submit, and he was ready to proceed.

Reasons for my decision

[20] I find that the Appellant hasn’t proven he had a severe and prolonged disability by December 31, 1997.

Was the Appellant’s disability severe?

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

The Appellant’s functional limitations didn’t affect his ability to work by December 31, 1997

[22] The Appellant says he has:

• PTSD from the 1990 MVA (diagnosed and treated around 2012)^{Footnote 6}
• Knee injury (2012)^{Footnote 7}
• Back injury requiring surgery (2021)^{Footnote 8}
• Heart attack (2014)^{Footnote 9}

[23] However, I can’t focus on the Appellant’s diagnoses.^{Footnote 10} Instead, I must focus on whether he had functional limitations that got in the way of him earning a living.^{Footnote 11} When I do this, I have to look at all of the Appellant’s medical conditions (not just the main one) and think about how they affected his ability to work by December 31, 1997.^{Footnote 12}

[24] I find that the Appellant didn’t have functional limitations that affected his ability to work by December 31, 1997.

What the Appellant says about his functional limitations

[25] The Appellant says that he has medical conditions that cause functional limitations that affect his ability to work. He says he was severely burned in 1990. That incident caused him to develop symptoms of PTSD. He did not seek medical attention for those symptoms until seven or eight years ago.^{Footnote 13}

[26] After the fire the Appellant said he could work for a few years. He can’t remember all of the jobs or when they happened. He remembers that working in physically demanding jobs made all of his symptoms worse. In 2011 he started to feel that he couldn’t deal with people. He developed feelings of paranoia and began to stutter. It became very difficult for him to try to work. In 2012 he injured his knee and needed surgery. In January 2021 his back deteriorated so much he needed surgery.

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

[27] The Appellant must provide some medical evidence that supports that his functional limitations affected his ability to work by December 31, 1997.^{Footnote 14}

[28] The medical evidence doesn’t support what the Appellant says. The medical reports and the Appellant’s testimony confirm that most of the conditions that may affect the Appellant’s ability to work happened years after 1997. There is no medical evidence that shows his health conditions affected the Appellant’s ability to work by December 31, 1997. There are some notes that mention the Appellant had serious burns from a truck fire in 1990. Those notes don’t explain any functional limitations the burns may have caused.^{Footnote 15}

[29] Dr. Smith is the Appellant’s family doctor. He diagnosed the Appellant with PTSD from the truck fire in 1990. He did not explain when the Appellant developed the symptoms or when he felt the symptoms would have affected the Appellant’s ability to work. He does say the PTSD was related to the fire in 1990 and impairs the Appellant’s abilities.

[30] The Appellant did not see Dr. Smith until 2009. He said he didn’t talk to Dr. Smith about symptoms of PTSD until several years later (2012 or later). Dr. Smith’s notes confirm the Appellant was injured and has PTSD. They do not address when the PTSD affected the Appellant’s abilities. Without more information it is difficult to understand how Dr. Smith could give evidence about the Appellant’s health in 1997. He said he didn’t have access to any medical records and didn’t begin treating the Appellant until 2009. I also note that Dr. Smith said the Appellant worked until 2001 or 2002. He said he recommended the Appellant stop working in 2002. He also said the Appellant’s “current” (2016) disability was caused by his knee and low back pain.^{Footnote 16}

[31] There is evidence the burns happened in 1990 and may have resulted in symptoms of PTSD. But there is no medical evidence to show when or how symptoms of PTSD (or the burns) affected the Appellant’s ability to work. This is also consistent with the fact that the available evidence and the Appellant’s testimony show that he continued to work until at least 2002.^{Footnote 17}

[32] The medical evidence doesn’t show that the Appellant had functional limitations that affected his ability to work by December 31, 1997. As a result, he hasn’t proven he had a severe disability.

Why I didn’t consider the Appellant’s personal characteristics

[33] When I am deciding whether a disability is severe, I usually have to consider an appellant’s personal characteristics. Factors like age, education, language abilities, and past work and life experience, may affect whether an appellant can work in the real world.^{Footnote 18}

[34] I didn’t consider the Appellant’s personal characteristics. The reason is that an appellant can’t qualify for a disability pension because of personal characteristics alone. There still has to be medical evidence to support a finding of disability.^{Footnote 19}

[35] The Appellant didn’t provide evidence showing that he was disabled by December 31, 1997. Since there is no relevant medical evidence there is no reason to consider his personal characteristics.

[36] The Appellant didn’t prove he had functional limitations that affected his ability to work by December 31, 1997. This means he hasn’t proven his disability was severe by then.^{Footnote 20}

Conclusion

[37] I find that the Appellant isn’t eligible for a CPP disability pension because his disability wasn’t severe. Because I have found that his disability wasn’t severe, I didn’t have to consider whether it was prolonged.

[38] This means the appeal is dismissed.