Claimant denied PRDB due to insufficient disability evidence

Citation: RD  v  [NAME] , 2026  SST  353 Social Security Tribunal of Canada General Division – Income Security Section Decision Appellant: [redacted] Respondent: [redacted] Decision under appeal: [NAME] reconsideration decision dated September 10, 2025 (issued by Service Canada) Tribunal member: [NAME] of hearing: Videoconference Hearing date: February 4, 2026 Hearing participant: Appellant Decision date: February 24, 2026 File number: GP-25-1473 On this page Decision Overview What I have to decide What the Appellant must prove Reasons for my decision Conclusion Decision [ 1 ] The appeal is dismissed. [ 2 ] The Appellant, R. D., isn’t eligible for a [NAME] ( [NAME] ) disability pension or a post-retirement disability pension (PRDB). This decision explains why I am dismissing the appeal. Overview [ 3 ] The Appellant is 65 years old. She fell in July 2020 and fractured her knee. She missed a lot of work because of it. She fell again in April 2022 and had to stop working again. She went back to work in the spring of 2023, but chronic pain in her knee (and other areas too) made it hard. She stopped working for good in October 2025. [ 4 ] The Appellant started receiving a [NAME] retirement pension in April 2019. The Appellant applied for a [NAME] disability pension on June 5, 2023. The [NAME] (Minister) refused her application for disability benefits. The Appellant appealed the Minister’s decision to the Social Security Tribunal’s General Division. [ 5 ] The Appellant says that she had a severe and prolonged disability since she injured her knee in July 2020. She had to support her family, so she had no choice but to work in extreme discomfort. Her knee injury was very severe, and she also felt chronic shoulder and back pain. Her mental health has also suffered. She pushed herself until she simply couldn’t do it anymore. [ 6 ] The Minister says the evidence doesn’t support that the Appellant was disabled under the [NAME] . First, the Appellant isn’t eligible for a disability pension because the law says she applied too long after she started receiving a retirement pension. Second, she doesn’t qualify for a PRDB. While she may have some limitations, she demonstrated the ability to continue to perform modified work on a full-time basis. Her physicians also supported her ability to perform modified work. She in fact worked past March 2024, which is when she would have had to become disabled by to qualify. What I have to decide [ 7 ] I have to decide if the Appellant is eligible for a disability pension. [ 8 ] If she isn’t eligible for a disability pension, then I have to decide if she is eligible for a PRDB. The Appellant isn’t eligible for a disability pension but may be eligible for a PRDB [ 9 ] The Appellant isn’t eligible for a disability pension. [ 10 ] A person who is getting a retirement pension can only get a disability pension if they apply within 15 months of when the retirement pension started. Footnote 1 [ 11 ] The Appellant’s retirement pension started in April 2019. To cancel it and get a disability pension instead, she had to apply no later than June 2020. She didn’t apply until June 2023. What the Appellant must prove [ 12 ] The Appellant may still be eligible for a PRDB. The PRDB is for people between ages 60 and 65 who become disabled in or after the month they started receiving their [NAME] retirement pension. Footnote 2 [ 13 ] For the Appellant to succeed, she must prove she has a disability that was severe and prolonged by March 31, 2024. This date is based on her [NAME] contributions and the fact that she can only qualify for the PRDB until the month she turned 65 years old. Footnote 3 The Appellant turned 65 years old on March 8, 2024. [ 14 ] The [NAME] defines “severe” and “prolonged.” [ 15 ] A disability is severe if it makes an appellant incapable regularly of pursuing any substantially gainful occupation. Footnote 4 [ 16 ] This means I have to look at all of the Appellant’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 Appellant is capable regularly of doing some kind of work that she could earn a living from, then she isn’t entitled to a disability pension. [ 17 ] A disability is prolonged if it is likely to be long continued and of indefinite duration, or is likely to result in death. Footnote 5 [ 18 ] 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. [ 19 ] The Appellant has to prove she has a severe and prolonged disability. She has to prove this on a balance of probabilities. This means she has to show it is more likely than not that she is disabled. Reasons for my decision [ 20 ] I find that the Appellant hasn’t proven she had a severe and prolonged disability by March 31, 2024. I reached this decision by considering the following issues: Was the Appellant’s disability severe? Was the Appellant’s disability prolonged? 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 affected her ability to work [ 22 ] The Appellant has: right knee pain secondary to patellar fracture right shoulder pain back pain anxiety / depression Footnote 6 tear in left eye Footnote 7 [ 23 ] However, I can’t focus on the Appellant’s diagnoses. Footnote 8 Instead, I must focus on whether she has functional limitations that got in the way of her earning a living. Footnote 9 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 her ability to work. Footnote 10 [ 24 ] I find that the Appellant has functional limitations that affected her ability to work. What the Appellant says about her functional limitations [ 25 ] The Appellant says that her medical conditions have resulted in functional limitations that affect her ability to work. She says she was in severe pain but forced to work in extreme discomfort because she had to support her family. She finally couldn’t take it anymore and stopped working in October 2025, shortly after she hurt her eye. [ 26 ] The Appellant worked on a [NAME] packing chicken. It was hard work – she worked long hours and was expected to do her job fast. [ 27 ] In July 2020, the Appellant stopped working after she fell and fractured her knee cap. She eventually had surgery in August 2021. She returned to work on modified duties in November 2021. She had to wear a knee brace and was able to use a chair. But she was expected to work just as hard as before her injury. [ 28 ] In April 2022, the Appellant fell again, this time hurting her right shoulder, back, hip, and her knee again. She went off work. It’s not clear when she returned, but likely around April or May 2023. Footnote 11 She had a doctor’s note that said she need modified duties for 12 weeks with 4 hours sitting and 4 hours standing. In July 2023, another doctor’s note said she needed modified duties for 6 to 8 hours a day with limited movement and preferably sitting. Footnote 12 And in October 2024, a doctor’s note confirmed for another 6 months her current modified duty requirement for 8 hours a day of sitting work. Footnote 13 [ 29 ] The Appellant says that her employer didn’t honour the doctor’s notes. Several times a week she would have to work on a [NAME] where she couldn’t fit her chair. She had to stand, which was more painful than sitting. And she was always expected to work fast. Her supervisors would time her. They didn’t care that the doctor had said modified duties. They would get mad if she complained. This made her very stressed and depressed. [ 30 ] Despite the pain and mistreatment, she pushed herself to work. She needed to get paid. She even asked for overtime, but she wasn’t allowed because of the doctor’s note that said she was restricted to modified duties. [ 31 ] Packing chicken was a physically demanding job. The Appellant’s conditions made it difficult to stand, but it hurt to sit as well. Lifting and reaching with her right arm was also painful. Working made her exhausted and increased the pain in her knee, shoulder and back. She would take Tylenol or an analgesic, which helped. She also took medication for depression/anxiety for the past 14 months, which also helped. But working was a physical and mental struggle even with the medication. [ 32 ] In August 2025, she was accidentally poked in the eye at work. She went off work for 11 days and didn’t get any help from her employer or WSIB. She had to go back to work, and they continued to push her to work hard. She finally decided she couldn’t handle working like this anymore and quit in October 2025. What the medical evidence says about the Appellant’s functional limitations [ 33 ] The Appellant must provide some medical evidence to support that her functional limitations affected her ability to work no later than March 31, 2024. Footnote 14 [ 34 ] The medical evidence supports what the Appellant says. [ 35 ] The Appellant’s family doctor, [NAME], said the following about the Appellant’s medical conditions and related functional limitations: Footnote 15 right knee pain secondary to patellar fracture symptom onset July 2020 chronic knee pain decreased strength difficulty walking and standing right shoulder pain symptom onset July 2020 right shoulder pain and tenderness decreased strength difficulty lifting and reaching with right arm [ 36 ] There is also evidence of neck, back, and hip pain after the Appellant’s fall in April 2022 in [NAME]’s chart notes. Footnote 16 [ 37 ] [NAME] didn’t recommend that the Appellant stop working. Instead, [NAME] recommended six to eight hours of modified duties with an accommodation to sit while working. Footnote 17 Modified duties while sitting for 8 hours a day was confirmed by [NAME], orthopaedic surgeon, in October 2024. Footnote 18 [ 38 ] The medical evidence supports that the Appellant’s functional limitations affected her ability to work. [ 39 ] Next, I will look at whether the Appellant was able to work in the real world with the functional limitations from her medical conditions. The Appellant could work in the real world by March 31, 2024 [ 40 ] When I am deciding whether the Appellant could work, I can’t just look at her medical conditions and how they affected what she could do. I must also consider factors such as her: age level of education language abilities past work and life experience [ 41 ] These factors help me decide whether the Appellant could work in the real world—in other words, whether it is realistic to say that she could work. Footnote 19 [ 42 ] I find that the Appellant was able to work in the real world. She was still able to work as of March 31, 2024. The Appellant’s age, education, and language abilities (English is her second language) would make it difficult for her to find other work. But the reality is that the Appellant was working full-time hours earning a substantially gainful living until October 2025, well past the date she must have become disabled by to qualify for the PRDB. [ 43 ] The evidence shows that the Appellant worked continuously from when she returned to work in April or May 2023 until she quit in October 2025. She worked on average 8 hours a day, 5 days a week. She said that she didn’t take much time off because she had to work to get paid. She even asked to work overtime. This strongly supports that she was regularly capable of work during this period. [ 44 ] The Appellant was able to earn a substantially gainful living up to March 31, 2024, and beyond. She had low earnings in 2021 ($4473) and 2022 ($11,334) because of the injuries to her knee and the associated recoveries. Footnote 20 But after she returned to work in 2023, she earned $24,773 that year. In 2024, she earned $33,670. There is no evidence about what she earned in 2025, but I have no reason to think it was at a lower rate than in the previous two years, which were both substantially gainful earnings. Footnote 21 [ 45 ] The length of time she worked and consistently earned substantially gainful wages shows that she could work in the real world. I accept that the Appellant was pushing through significant pain and discomfort to work and earn a living to support her family. She continued to work even though her employer wasn’t following her doctor’s orders about modified work. And she was able to do it for about two and a half years after she returned to work in 2023. That couldn’t have been a failed work attempt. Footnote 22 Working consistently for that long supports that she had work capacity. Conclusion [ 46 ] I find that the Appellant isn’t eligible for a [NAME] disability pension because she applied too long after she started receiving a retirement pension. The Appellant isn’t eligible for a PRDB because her disability wasn’t severe by March 31, 2024. Because I have found that her disability wasn’t severe, I didn’t have to consider whether it was prolonged. [ 47 ] This means the appeal is dismissed. Footnotes Footnote 1 See section 66.1 of the [NAME] and section 46.2(1) of the [NAME] . Return to footnote 1 referrer Footnote 2 See section 44(1)(g) of the [NAME] . The Minister agrees the Appellant made enough contributions to the [NAME] to qualify for the PRDB if she is disabled. Return to footnote 2 referrer Footnote 3 Service Canada uses an appellant’s years of [NAME] contributions to calculate their coverage period, or “minimum qualifying period” ( MQP ). The end of the coverage period is called the MQP date. See section 44(2) of the [NAME] . The Appellant’s [NAME] contributions are at GD2R-89 and 90. Return to footnote 3 referrer Footnote 4 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 a person could receive as a disability pension. Return to footnote 4 referrer Footnote 5 Section 42(2)(a) of the [NAME] gives this definition of prolonged disability. Return to footnote 5 referrer Footnote 6 There is no medical evidence of depression or anxiety, but I believe she is on medication for this (escitalopram), so I will also consider functional limitations from these conditions in my assessment of her capacity for work. Return to footnote 6 referrer Footnote 7 The Appellant said at the hearing that this injury happened in August 2025. She submitted prescriptions to support her testimony (see GD7). However, I won’t consider this condition because it was after March 31, 2024, and therefore can’t help her qualify for a PRDB. Return to footnote 7 referrer Footnote 8 [NAME]  v  Canada (Attorney General) , 2013  FCA  81. Return to footnote 8 referrer Footnote 9 [NAME]  v  Canada (Social Development) , 2008  FCA  33. Return to footnote 9 referrer Footnote 10 [NAME]  v  Canada (Attorney General) , 2011  FCA  47. Return to footnote 10 referrer Footnote 11 The Appellant said she returned to work in January 2023, but her family doctor’s chart notes suggest she was given a sick note that permitted her to be off work from February to May 2023. Then there is another note from her doctor dated April 3, 2023, stating she needs modified duties for 12 weeks (4 hours sitting, 4 hours standing). See GD2R-156 and 162. Return to footnote 11 referrer Footnote 12 See GD2R-169. Return to footnote 12 referrer Footnote 13 See GD2R-24. Return to footnote 13 referrer Footnote 14 [NAME]  v  Canada (Attorney General) , 2008  FCA  377; and Canada (Attorney General)  v  [NAME] , 2020  FC  206. Return to footnote 14 referrer Footnote 15 [NAME]’s medical report, dated July 30, 2023, at GD2R-134 to 142. Return to footnote 15 referrer Footnote 16 [NAME]’s chart notes, at GD2R-149 to 178. Return to footnote 16 referrer Footnote 17 [NAME]’s chart notes, at GD2R-162, and 169. Return to footnote 17 referrer Footnote 18 [NAME]’s note, at GD2R-24. Return to footnote 18 referrer Footnote 19 [NAME]  v  Canada (Attorney General) , 2001  FCA  248. Return to footnote 19 referrer Footnote 20 See GD2R-90. Return to footnote 20 referrer Footnote 21 Section 68.1 of the [NAME] explains what it means for a job to be “substantially gainful”, which includes a calculation for a specific amount. In 2023, it was $18,508.36. In 2024, it was $19,339.74. The Appellant earned more than those amounts in both years. Return to footnote 21 referrer Footnote 22 Sometimes evidence of a return to work doesn’t show that someone has work capacity because it is a failed work attempt: see [NAME]  v  [NAME] , 2022  SST  292. However, the Federal Court said that “two years of earnings consistent with what had been earned before cannot be a failed attempt.” [NAME]  v  Canada (Attorney General) , 2010  FC  48. Return to footnote 22 referrer