Government of Canada Response to Accessibility for All

Detailed responses to the recommendations

• Recommendation 5
• Recommendation 6
• Recommendation 7

Recommendation 5:

The Subcommittee recommends that the medical report form accompanying an application for Canada Pension Plan disability benefits be amended to include at least one question allowing the applicant's physician to give an opinion on his patient's ability to hold a job.

Response:

The role of the client's physician is to diagnose, treat, and report on medical findings. They are not, and Social Development Canada does not expect them to be, experts in the eligibility criteria for CPPD, which involve considerations that transcend medical factors. However, while there is not an explicit question soliciting the physician's opinion on the applicant's ability to hold a job, the current application does seek physician input on the capacity to work. In addition to providing medical evidence, physicians are asked to comment on their patients' functional limitations. This provides CPPD adjudicators with a more complete understanding of the applicant's overall situation and provides valuable input on the applicant's ability to work.

There was a period when physicians were asked explicit questions about their patients' ability to work at their own job or any job, but these questions were removed in 1989 at the request of the medical profession. Physicians were concerned that such questions could negatively affect the patient-physician relationship, since physicians could feel pressured to make a supportive assessment. The courts have also noted the risk of physicians moving into an advocacy role, rather than remaining neutral by providing objective medical evidence.

Social Development Canada will explore what additional information could be provided by family physicians that would assist CPPD adjudicators to determine an applicant's work capacity. Since no medical professionals appeared as witnesses before the Subcommittee on this matter, and since the medical profession stated its view on this subject in the past, this review will need to include consultations with the Canadian Medical Association and other medical professionals to determine whether such questions may negatively affect the patient-physician relationship.

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Recommendation 6:

The Subcommittee recommends that the Department of Social Development compile statistical data, on an ongoing basis, on the reasons for rejecting Canada Pension Plan disability benefit applications, as well as on rejected applicants' socio-economic circumstances.

Response:

The Government agrees that it is important to collect more data on its clients, including those who are denied. In the past, CPPD has focused its data collection and research efforts on beneficiaries. In recent years, data collection on all applicants has improved, including those whose applications are denied.

The Government concurs with the recommendation to compile and publish data on reasons for denial. It will need to consider the best mechanism and frequency but there are limits on collecting and retaining additional data on denied applicants' socio-economic circumstances.

Like other administrative programs, CPPD can only collect the information needed to make a decision on an application. Information on applicants' economic circumstances is not required to make a CPPD benefit decision and is not collected, regardless of how useful it could be for research purposes. Furthermore, denied applicants who do not exercise appeal rights cease to be CPPD clients, leaving the Minister with no authority to collect additional data on those cases.

Social Development Canada is prepared to explore ways to track outcomes for denied clients, as per the Committee's recommendation, although it must be noted that tracking the outcomes of denied applicants raises serious privacy issues. Any feasible option in this regard would require prior approval of the Privacy Commissioner or the explicit written consent of the individuals concerned.

Discussions are underway with the provinces and territories regarding the possibility of research on applicant outcomes. Any research proposal would require approval of the federal Privacy Commissioner, and likely from provincial and territorial Privacy Commissioners as well. The outcome of this research could assist with possible improvements to policy or to the application process.

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Recommendation 7:

The Subcommittee recommends that the Minister of Transport immediately order an independent study of the comparative advantages of the regulatory and voluntary approaches to improving accessibility for persons with disabilities to modes of transportation under federal jurisdiction. The parameters of this study should be determined by the Minister of Transport's Advisory Committee on Accessible Transportation, and presented to the Subcommittee on the Status of Persons with Disabilities. It should take into account the experiences of other countries. With an irreproachable methodology, the study would serve as a basis for discussion in which the viewpoints of government, advocacy groups for the rights of persons with disabilities and the Canadian transportation industry could all be voiced, in order to arrive at a long-term solution by no later than 2007.

Response:

In 2003, Transport Canada released a comprehensive policy document entitled, Straight Ahead - A Vision for Transportation in Canada. It announced that the department "…will evaluate the impact of existing legislative provisions and codes of practice and determine whether other measures are needed to improve access to the federally regulated transportation system."

Transport Canada has already taken steps to develop a methodology to study the comparative advantages of the regulatory and voluntary approaches to improving accessibility for people with disabilities in all modes of transportation under federal jurisdiction. The Advisory Committee on Accessible Transportation was informed of the department's work to date, including policy evaluation work on the success of the United States regulatory model.

The Advisory Committee on Accessible Transportation is currently undergoing modernization and the first meeting of the new committee is planned for late 2005. At that meeting, Transport Canada will table for consultation a draft methodology to evaluate the success of the Canadian legislation, regulations and voluntary codes of practice as compared to the success of the United States legislation and regulations in achieving accessibility. Transport Canada will seek feedback from consumers and the transportation industry membership of the committee to finalize a methodology that will provide a rigourous evaluation and balanced assessment of the relative effectiveness of the policy approaches used in Canada and the U.S.

The department is also working with the European Conference of Ministers of Transport (ECMT) to develop a common methodology to quantify the relative successes of the various policy frameworks for accessible transportation in place across Europe and in Canada. European countries are not yet in a position to provide an evaluation of their success in this area. This methodology would allow Transport Canada and its ECMT counterparts to measure and compare the extent to which improvements in accessibility under various policy frameworks have succeeded in enabling seniors and people with disabilities to extend their personal mobility. Initial interest has been expressed, and details will be discussed in early 2006.

It must be noted that, while Canadian regulations have been in place for many years, the success of the voluntary codes cannot be evaluated adequately until they have been allowed to work for a reasonable period of time. The earliest Code of Practice was launched in 1997 and the latest in 2004. The timetable for the completion of the study of the Canada versus United States models will be determined once the methodology, which must consider such factors, has been finalized. Transport Canada can present the methodology to the Subcommittee in the spring of 2006, along with the planned timetable for completion.

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