Appeal Dismissed: Claimant Not Eligible for Disability Benefits After Regaining Substantially Gainful Work Capacity

Citation: [NAME]  v  [NAME] , 2026  [NAME]  163 Social Security Tribunal of Canada General Division – Income Security Section Decision Appellant: [redacted] Respondent: [redacted] Decision under appeal: [NAME] reconsideration decision dated June 2, 2025 (issued by Service Canada) Tribunal member: [NAME] of hearing: In writing Decision date: February 20, 2026 File number: GP-25-1406 On this page Decision Background What I have to decide Reasons for my decision Other matters Conclusion Decision [ 1 ] The Appellant’s appeal is dismissed. I am also varying the decision of the [NAME] (Minister). [ 2 ] The Appellant, M. B., stopped being disabled as of September 2014. This is earlier than April 2015, when the Minister found that she stopped being disabled. She was only eligible for a [NAME] ( [NAME] ) [NAME] when she was disabled. The [NAME] payments that she got when she wasn’t disabled are considered an overpayment (debt) that is owed to the Minister. [ 3 ] This decision explains why I am dismissing the appeal. Background [ 4 ] On January 18, 1994, the Appellant applied for a [NAME]. Footnote 1 [ 5 ] On March 23, 1994, the Minister approved her application. Her [NAME] was payable effective December 1993. Footnote 2 [ 6 ] On December 2, 2010, the Minister told her that it was stopping her [NAME] payments as of the end of November 2010 because she had returned to work. Footnote 3 [ 7 ] On April 13, 2011, the Minister reinstated her [NAME] payments as of February 2011. In other words, she continued to receive a [NAME] except for December 2010 and January 2011. Footnote 4 [ 8 ] The Minister stopped her [NAME] payments again at the end of May 2021 while it investigated whether she was still entitled to a [NAME]. [ 9 ] On August 12, 2021, the Minister told her that it was officially stopping her [NAME] payments as of the end of April 2015 because she had returned to work and started earning a substantially gainful income. The Minister allowed her to receive payments up until the end of April 2015. The Minister calls this a “work trial.” The Minister had already paid her from May 2015 through May 2021, so the Minister told her that she had to repay those payments. This is called an “overpayment.” Her overpayment was calculated as $60,567.17. Footnote 5 [ 10 ] On November 15, 2021, the Appellant asked the Minister to reconsider its decision. Footnote 6 [ 11 ] On September 21, 2022, the Minister told her that it had received her request for reconsideration. Footnote 7 [ 12 ] On June 2, 2025, the Minister told her that it had considered her request for reconsideration, but it wasn’t changing its decision. She still owed an overpayment and her benefits could not be reinstated. Footnote 8 [ 13 ] On September 3, 2025, the Appellant appealed the Minister’s decision to the Social Security Tribunal’s General Division. Footnote 9 [ 14 ] The Appellant says: her last General Division hearing was in April 2015 she had to wait over a decade (from April 2015 to June 2025) for the Minister to make a decision about her entitlement to a [NAME] the General Division’s decision should be set aside because the delay in making it was unreasonable and prejudicial to her; decisions should be issued within 30 days for 80% of appeals she is in financial need [ 15 ] I explained to the Appellant that her current appeal is with the General Division. Footnote 10 The Tribunal and the Minister are separate and independent of each other. She hasn’t had a hearing with the General Division before. [ 16 ] I also explained that she had to wait for a reconsideration decision from the Minister from November 2021 until June 2025, not from April 2015 until June 2025. This is still a long time to wait. But the [NAME] doesn’t set out a time limit for the Minister to make these sorts of decisions. I clarified that the General Division aims to issue final decisions within 30 days of the hearing, 80% of the time. Footnote 11 This service standard applies to the General Division, not the Minister. [ 17 ] Lastly, I explained that neither the Minister nor the Tribunal can make a decision about eligibility for a [NAME] based on financial need. We must follow the law. [ 18 ] Because the Appellant chose a hearing in writing, I sent her a letter explaining what her appeal was about. Footnote 12 I will summarize this next. What I have to decide [ 19 ] I have to decide whether the Appellant stopped being disabled. If she stopped being disabled, then I also have to decide when. [ 20 ] According to the law, an appellant stops being disabled when one of two things happens: Their disability stops being severe. Their disability stops being prolonged. [ 21 ] The [NAME] defines “severe” and “prolonged.” [ 22 ] A disability is severe if it makes you incapable regularly of pursuing any substantially gainful occupation. Footnote 13 [ 23 ] A disability is prolonged if it is likely to be long continued and of indefinite duration, or is likely to result in death. Footnote 14 [ 24 ] When the Minister stops paying you a [NAME], the Minister must prove that you stopped being disabled. The Minister must prove this on a balance of probabilities. This means the Minister must show that it is more likely than not the Appellant stopped being disabled. Footnote 15 [ 25 ] I can only consider whether the Appellant stopped being disabled after April 13, 2011. This is because the Minister reviewed the Appellant’s case and decided that she was disabled as of that date. Footnote 16 [ 26 ] To decide whether the Appellant stopped being disabled, I have to look at the Minister’s evidence supporting its decision that the Appellant can work. If the Appellant is capable regularly of doing some kind of work that she could earn a living from, then she isn’t entitled to a [NAME]. [ 27 ] If I decide that the Appellant stopped being disabled, then she isn’t eligible for a [NAME] anymore. The Minister may also require her to pay back any payments she got when she wasn’t disabled. Reasons for my decision [ 28 ] I find that the Appellant stopped being disabled as of September 2014. This is when her disability stopped being severe. Was the Appellant’s disability severe? [ 29 ] The Appellant’s disability stopped being severe as of September 2014. I reached this finding by considering several factors. I explain these factors below. The Appellant’s functional limitations affected her ability to work [ 30 ] The Appellant says she has: Footnote 17 rheumatoid arthritis anxiety depression insomnia high blood pressure high cholesterol [ 31 ] She had a right wrist fusion in 2016 and a left wrist fusion in 2020. [ 32 ] But I can’t focus on the Appellant’s diagnoses. Footnote 18 Instead, I must focus on whether she has functional limitations that got in the way of her earning a living. Footnote 19 When I do this, I must look at all of her medical conditions (not just the main one) and think about how they affected her ability to work. Footnote 20 [ 33 ] I find that the Appellant still had functional limitations that affected her ability to work as of the hearing date. Footnote 21 For example, she is fatigued and her immune system is compromised because of the medication she has to take for rheumatoid arthritis. Footnote 22 The Minister agrees that the Appellant has functional limitations. My findings about the Appellant’s ability to work [ 34 ] I find that the Appellant could work in the real world as of September 2014 despite her functional limitations. That is when her disability stopped being severe. [ 35 ] In September 2014, the Appellant started working as a lead agent at a [COMPANY] for a [COMPANY]. She worked full-time in order to qualify for employee benefits—she needed benefits to help pay for her medication, which cost $5,000 to $8,000 every eight weeks. Footnote 23 [ 36 ] Her health continued to decline and, in 2019, she decreased her hours to 32 hours per week. In 2021, she started working a pattern of two days on followed by one day off, also because of her declining health. I understand that she currently works eight hours per day, three to four days per week. She earns $16 per hour. Footnote 24 [ 37 ] At one point, she worked from home because of the Covid-19 pandemic. She could not get vaccinated because of her compromised immune system. It is unclear if she still works from home. Footnote 25 [ 38 ] The Appellant’s income from work was substantially gainful. The table below shows her income from 2014 to 2020 compared to the substantially gainful amount for each year. Footnote 26 Appellant’s Income Substantially Gainful Income 2014 $5,566.00 $14,836.20 2015 $28,597.00 $15,157.08 2016 $27,833.00 $15,489.72 2017 $31,215.00 $15,763.92 2018 $37,104.00 $16,029.96 2019 $33,614.00 $16,347.57 2020 $23,046.00 $16,651.98 [ 39 ] The Appellant’s income in 2014 appears to be below the substantially gainful income threshold. But that is only because she started working in September of that year. On a monthly basis, she actually earned above the threshold ($1,391.50 per month compared to a substantially gainful income of $1,236.35 per month). That is one reason why I find that she stopped being disabled in September 2014, not in April 2015 like the Minister found. (The other reason is that I can’t grant the Appellant a paid work trial, like the Minister did. I will discuss this more later.) [ 40 ] The Appellant was regularly capable of working. Although she decreased the number of hours that she worked in 2019, she still worked full-time. She now works a schedule of two days on, one day off. But it isn’t her schedule that needs to be regular—it is her capacity. She says working is a daily struggle, but there is no evidence that she is an unreliable employee. Given how long she has worked for the same employer, I find that she is able to work as scheduled on a sufficiently predictable basis. The Appellant doesn’t work for [NAME] [ 41 ] If you work for [NAME], you can still be considered disabled even if you make a substantially gainful income. [NAME] is one that accommodates an employee beyond what is required in the competitive marketplace. Footnote 27 [ 42 ] The Appellant doesn’t work for [NAME]. Her employer allowed her to cut back on her hours, change her schedule, and work from home. But she still did (and does) productive work. Again, considering how long she has been employed by the same employer, I find that her employer is satisfied with her performance. There is no evidence that her employer expects significantly less from her than it does from other employees. There is no evidence that her employer has experienced hardship from allowing her to cut back on her hours, change her schedule or work from home. I don’t have to consider the Appellant’s personal factors [ 43 ] When I am deciding whether the Appellant can work, I generally have to consider factors like her: age level of education language abilities work and life experience [ 44 ] These factors help me decide whether the Appellant can work in the real world—in other words, whether it is realistic to say that she can work. Footnote 28 [ 45 ] I don’t have to consider the Appellant’s personal factors in this case because the Appellant has already shown that she can work in the real world. I can’t grant the Appellant a paid work trial [ 46 ] The Minister allowed the Appellant to receive a [NAME] for several months after she resumed working. The Minister calls this a paid work trial. [ 47 ] I can’t grant the Appellant a paid work trial. The Minister’s decision to grant the Appellant a paid work trial appears to be based on its own policy, not on the law. By definition, the Appellant was no longer disabled once she regained the regular capacity to earn a substantially gainful income from work. She regained that capacity in September 2014—not several months later. The law says she wasn’t eligible for a [NAME] once she stopped being disabled. Footnote 29 [ 48 ] So, even if I agree with the Minister’s policy, I can’t follow it, because it goes against the law. [ 49 ] That said, I am not sure how necessary the Minister’s policy is. There is no evidence before me about the rationale behind the Minister’s policy. One of the possible reasons behind it might be to avoid discouraging [NAME] recipients from trying to return to work. Footnote 30 [ 50 ] However, if the Appellant had tried returning to work and was ultimately unsuccessful in doing so, her efforts to return to work would not have shown that she stopped being disabled. She would still be eligible for a [NAME]. She would not have suffered any loss of benefits for trying to return to work. [ 51 ] In the Appellant’s situation, her return to work was successful. The income that she earned from work is more than what she got from a [NAME] over the same period. So, having to repay those benefits should not set her back financially. [ 52 ] I realize that the Appellant probably didn’t set aside her income starting in September 2014 just in case she had to pay back some benefits. That might be why section 70.1 of the [NAME] says [NAME] recipients must inform the Minister without delay if they return to work. I note that the Minister made the Appellant aware of this obligation in its April 13, 2011, letter: “You must tell us if you return to work full time, part time or for a trial period.” Footnote 31 The Appellant didn’t do that. Footnote 32 [ 53 ] Had the Appellant notified the Minister as soon as she returned to work, the Minister could have temporarily suspended her payments to see if her return to work was successful. Or the Minister could have continued paying her benefits but alerted her to the possibility of having to repay them later. This could have avoided or lessened the impact of the overpayment that the Appellant now faces, without discouraging her from trying to work. [ 54 ] Finally, I note that section 66(3)(c) of the [NAME] lets the Minister forgive all or part of an overpayment if it is satisfied that having to repay it would cause undue hardship to the Appellant. The Tribunal does not have the power to forgive an overpayment. If the Appellant wants to apply for debt forgiveness, she must ask the Minister (that is, Service Canada). Other matters [ 55 ] I refused a late document from the Minister (GD6). The Minister didn’t explain the relevance of this document or why it could not be sent earlier. Footnote 33 [ 56 ] The Appellant says she has to work because she can’t live on a [NAME]. She needs benefits to pay for her medication. But this doesn’t change the fact that she is regularly capable of doing substantially gainful work. [ 57 ] Once I find that an appellant has stopped being disabled, I can’t decide whether they have become disabled again. If the Appellant believes that she became disabled again since September 2014, she can reapply for a [NAME]. The Minister (that is, Service Canada) will decide the application. Conclusion [ 58 ] The Minister has proven that the Appellant stopped being disabled and is no longer entitled to a [NAME]. [ 59 ] This means the appeal is dismissed. Footnotes Footnote 1 See GD2-31. Return to footnote 1 referrer Footnote 2 See GD2-38. Return to footnote 2 referrer Footnote 3 See GD2-27. Return to footnote 3 referrer Footnote 4 See GD2-24. Return to footnote 4 referrer Footnote 5 See GD2-12. Return to footnote 5 referrer Footnote 6 See GD2-18. Return to footnote 6 referrer Footnote 7 See GD2-8. Return to footnote 7 referrer Footnote 8 See GD2-6. Return to footnote 8 referrer Footnote 9 See GD1. Return to footnote 9 referrer Footnote 10 See my letter dated September 24, 2025 (GD3). Return to footnote 10 referrer Footnote 11 See https://www.[NAME]-tss.gc.ca/en/your-appeal/social-security-tribunal-service-standards. Return to footnote 11 referrer Footnote 12 See GD3. Return to footnote 12 referrer Footnote 13 Section 42(2)(a) of the [NAME] gives this definition of severe disability. Section 68.1 of the [NAME] says a job is “substantially gainful” if it pays a salary or wages equal to or greater than the maximum annual amount you could receive as a [NAME]. Return to footnote 13 referrer Footnote 14 Section 42(2)(a) of the [NAME] gives this definition of prolonged disability. Return to footnote 14 referrer Footnote 15 [NAME]  v  Canada (Attorney General) , 2014  FCA  187. Return to footnote 15 referrer Footnote 16 [NAME]  v  Canada (Attorney General) , 2009  FCA  158; and [NAME]  v  Minister ([NAME]) , 2022  [NAME]  182. The record of the Minister’s decision is at GD2-24. Return to footnote 16 referrer Footnote 17 See GD2-152 to 167. Return to footnote 17 referrer Footnote 18 [NAME]  v  Canada (Attorney General) , 2013  FCA  81. Return to footnote 18 referrer Footnote 19 [NAME]  v  Canada (Social Development) , 2008  FCA  33. Return to footnote 19 referrer Footnote 20 [NAME]  v  Canada (Attorney General) , 2011  FCA  47. Return to footnote 20 referrer Footnote 21 Since this hearing proceeded in writing, the hearing date is considered the last day that the parties could file documents. That was February 12, 2026. Return to footnote 21 referrer Footnote 22 See GD2-151. Return to footnote 22 referrer Footnote 23 See GD2-152 to 167. Return to footnote 23 referrer Footnote 24 See GD2-152 to 167. Return to footnote 24 referrer Footnote 25 See GD2-152 to 167. Return to footnote 25 referrer Footnote 26 See GD2-168 and section 68.1 of the [NAME] . Return to footnote 26 referrer Footnote 27 [NAME]  v  Canada (Attorney General) , 2014  FCA  187; and Canada (Attorney General)  v  [NAME] , 2023  FCA  204. Return to footnote 27 referrer Footnote 28 [NAME]  v  Canada (Attorney General) , 2001  FCA  248. Return to footnote 28 referrer Footnote 29 Section 70(1) of the [NAME] says a [NAME] ceases to be payable with the payment for the month in which you cease to be disabled. Return to footnote 29 referrer Footnote 30 The Tribunal has recognized this policy rationale in decisions like [NAME]  v  Minister ([NAME]) , 2024  [NAME]  819 at footnote 26. Return to footnote 30 referrer Footnote 31 See GD2-24. Return to footnote 31 referrer Footnote 32 See GD2-9. Return to footnote 32 referrer Footnote 33 Section 42(2) of the Social Security Tribunal Rules of Procedure sets out what factors I have to consider when deciding whether to accept late documents. Return to footnote 33 referrer