CPP Disability - Guide to application kit forms
Anyone who wants to apply for a CPP disability benefit, or any individual who wants to help someone apply for a CPP disability benefit must contact SDC to obtain the CPP disability application kit. Or, you can access and print a CPP disability application kit online. All forms must be completed in writing.
The application kit includes several forms. They are listed below along with a follow-up checklist:
- An Application for Disability Benefits Form
- Questionnaire for Disability Benefits Form
- The Medical Report Form
- Consent Form to disclose information/consent for medical evaluation
- The Child Rearing Dropout Provision Form
- Checklist before sending in the application kit
An Application Form for Disability Benefits
This form asks straightforward questions about the applicant. It is important to answer all questions completely, including name, date of birth, social insurance number, gender, address, and other information that identifies the applicant. The applicant will also be asked to provide information about children that he or she may have. If the children are considered "dependent", this is important as they may be eligible for a benefit. If the children are not in the custody and control of the applicant, but are with someone else, additional forms will have to be filled out. If children are between 18 and 25 years of age, and are attending school full-time, additional forms will need to be filled out. If this situation applies, contact SDC to get these forms.
Checklist for this form - make sure you:
- Checked to make sure all information to identify the applicant has been provided.
- Provided information on direct deposit if that is the payment preference.
- Provided information on any children.
- Included original birth certificates of the applicant and children (SDC will return these to you), or readable photocopies which have been certified as true copies of the original. The kit includes the list of people who can certify (sign) a photocopy.
The applicant must sign this form.
Questionnaire for Disability Benefits Form
This part of the application provides some of the information used to determine if the applicant meets the CPP definition of disability. This information, along with the Medical Report to be completed by the applicant's doctor, will be assessed to determine whether the applicant's medical condition is severe and prolonged.
It is important to provide clear and relevant detailed information. The applicant needs to provide information that describes the illnesses or impairments that prevented him or her from working, as well as engaging in other activities. This allows CPP to see the extent of the medical condition and the limitations it causes. Feel free to use additional sheets of paper to provide this information (include the applicant's social insurance number on each sheet).
Indicate the date that the applicant stopped working. It is also necessary to provide information as to why the applicant stopped working, and in particular, how the applicant's medical condition affected their employment and whether this led to the applicant not being able to work on a regular basis any more.
The applicant will also be asked to provide information on physicians seen and hospital stays over the last two years, and a list of medications and treatments.
Checklist for this form - make sure the applicant:
- Signed the questionnaire.
- Added his or her social insurance number on top of every page and any attached sheets.
- Provided all the required information clearly and completely and has not left any questions blank. If a question is not relevant to the applicant's situation, it is best to write "not applicable" or "I don't know".
The Medical Report Form
The applicant must fill out the first section of this report which identifies the applicant by name, address, date of birth, telephone and social insurance number. The physician who is most knowledgeable about the applicant's medical condition should fill out the remainder of the report. Any additional specialists' reports are welcome and can be submitted with the application. To ensure correct file matching, it is very helpful to add the applicant's social insurance number on any attached pages from a physician. SDC has distributed to General Practitioners a Physician's Guide which explains medical eligibility requirements for a CPP disability benefit. Once the applicant's physician has filled out the Medical Report, he or she can submit it directly to SDC, or return it to the applicant who can include it in the CPP application kit.
Checklist for this form - make sure the applicant:
- Has chosen the physician who best knows his or her medical condition to fill out the Medical Report.
- Attached other supporting medical reports, tests, or other documents and include the applicant's social insurance number on each page.
- Co-ordinated the submission of the Medical Report (whether to be included in the application kit or sent directly to SDC).
- Photocopied the Medical Report for the applicant's files.
Consent Form to disclose information/consent for medical evaluation
Any individual applying for a CPP disability benefit is asked to sign a release/consent form which allows SDC to access medical and non-medical information from various sources, such as: physicians; disability insurers; employers; and hospitals. If SDC asks the applicant to attend an examination by a qualified physician or consultant specialist and the physician or consultant believes diagnostic tests are necessary, this form also gives consent for these tests. The Authorization to Disclose Information / Consent for Medical Evaluation form is now available online.
The purpose of the form is to allow the gathering of information to determine whether an applicant meets CPP disability eligibility requirements, which are related to his or her ability to work on a regular basis.
An applicant has the choice not to sign the consent form and thus not authorize any further release of information or consent to a further medical evaluation. However, this means that SDC will make its final decision solely on the information presented in the applicant's file, which may be insufficient to present a convincing case.
If the applicant does sign the consent form, the Privacy Act, Access to Information Act and the Canada Pension Plan legislation will protect the information received. The applicant can request access to any personal information SDC collects.
Checklist for this form - make sure the applicant:
- Understands the purpose of the consent form.
- Signs the authorization and consent form, if in agreement.
The Child Rearing Dropout Provision Form
There are two types of eligibility requirements for a CPP disability benefit: contribution eligibility requirements - the applicant has to have made enough contributions; and requirements which prove the disability is severe and prolonged.
The provision contained in this form can help the applicant meet contribution eligibility requirements for CPP disability and/or increase the monthly amount of the CPP disability benefit if the application is approved. This provision relates to periods of time when an applicant's earnings from work were low or zero because he or she was raising children under the age of seven. This period of time can be eliminated or dropped from the applicant's contributory period. This is called the Child Rearing Dropout Provision (CRDO).
In order for SDC to "drop out" this period of time when calculating contribution eligibility requirements, the applicant must have:
- reduced or stopped work to care for children under the age of seven and
- been receiving Family Allowances, OR
- been the spouse of someone receiving Family Allowances and remained at home as the primary care giver of a child, OR
- been eligible for the Canada Child Tax Benefit, or would have been eligible had the applicant applied for the benefit and no other person was eligible for the Canada Child Tax Benefit for the same children.
The primary care giver of a child is the person who was most responsible for the day-to-day needs of the child (preparing meals, daily supervision and discipline, ensuring the child gets to school, taking the child to appointments).
To be eligible for the Canada Child Tax Benefit, an individual must have been the primary care giver of a child under seven. And the individual would have had to be living with the child and be a resident of Canada for income tax purposes.
If the applicant is not sure whether he or she meets the requirements under this form, it is recommended to apply anyway. SDC staff can determine if the applicant qualifies. The Child Rearing Dropout Provision form is now available online.
Checklist before sending in the Application Kit forms
Checklist - make sure the applicant or the friend or family member who is helping to prepare the application:
- Reads the General Information and Guide and understands it and the applicant's obligations.
- Provides the required proof of birth for the applicant and children if applicable.
- Adds the applicant's social insurance number on all pages, including any attached sheets.
- Includes all reports and documents that support the applicant's claim.
- Photocopies all information that the applicant is submitting for the applicant's own records.
- Makes note of the date that the applicant is sending/submitting the application kit.
Make sure the applicant:
- Signs and dates all of the forms.
The application kit can be mailed to our offices or the application can be submitted in person. To submit it in person, contact SDC to make an appointment. If you do submit in person, remember to bring proof of birth.